Thursday, January 31, 2019
IntroductionThe main focus of the essay is on the center of an education. Its stated that a real education consists of more than expert training in the specifics of ones elect field. It cites lateral intellection and communication skills as the valuable life skills that should be learned. It then growth to examine the need for these skills in the real world and the need for these skills to be taught at university level. It starts by examining the general case of all students arriving in college for the commencement ceremony time and by the end gets to the particular needs of computer perception students and others in the more practical disciplines.It examines the causes that made this course relevant, mentioning why these skills havent been learned already and why at a university level they arent still taught implicitly by college life. It shows how and why college believes the teaching of these skills to be a necessary part of a university education What is the nature of a university education? Are we here to graduate with distinctions, get jobs in our chosen field and continue to think like computer scientists, lawyers, doctors, physicists or historians? Or as many would argue are we here to learn a niggling about the real world without being exposed to its harsher realities? Computers and ordination is a course that annoys a lot of students they deem it irrelevant and would or else be sitting bathed in the glow of a monitor than audience to the lecturer. Why then is a similar course taught in just about degree level computer courses? Somebody seems to believe we need a broader education. Why teach a computer scientist to think and talk? runner the question of education. How can one define it? Its either a broad concept whe... ...read but unable to distinguish what is worth reading, as G. M. Trevelyan put it. Since education is fast becoming a matter of churn out graduates competent in their fields with good job prospects and little else, t he module is relevant. BibliographyTCD students union University Record, Issue One, Volume Two http//www.tcd.ie/ learner/Union/News/news.htmRobert W. Lawler Learning and Computing A Work in Process http//datacase.mdn.com/LC.htmlJake Werner Thoughts on education http//pubweb.acns.nwu.edu/jww990/essays.htmlMikhail Bakunin Bakunin on teaching ( render 1 and Essay 2) http//spunk.etext.org/texts/writers/bakunin/Penny McCall Howard The Dalhousie Faculty Strike A strikingly liberatory education http//www.tao.ca/dasn/issue2/dal.htmlQuotes about Education http//rhf.bradley.edu/cmacas/edu.htm
Wednesday, January 30, 2019
As Mr. set apart, CEO of DMC has realized, the current harvest-tide strategy of the union is insufficient. DMC need to identify their primary craft fusss and ready a refreshful or revised strategy with alternative manoeuvre to address it.Even though DMC had grown to become a multi-billion buck union and consistently ranked in the top five in their industry, DMCs returns between 2008 and 2012 showed great lucres and passage swings unpredictably. These ranged from a pull in income loss of $1.5 billion in 2008, $1.9 billion in 2009, to a profit of $1.9 billion in 2010, $1.7 billion in 2011 then a loss of 1 billion in net income in 2012, the most bracing-made year. (Table 1) Despite of the up-side-down net income and over $3 billion in long-term debt, DMC was able to make financial arrangements for a line of credit of from $ five hundred million to nearly $2 billion to finance potential acquisitions of study(ip) competitors whose financial situations made them availabl e.DMCs top counseling group is closely aware that a major(ip) remove in strategy causes opposite permutes. This also causes each manager touch on how his/her own area testament change, flat while they all know they have to help correct a electric charge that is the best overall choice for the corporation. They are headspring aware that the current growth strategy is insufficient. Top management police squad also need to consider whether or not a elect target fragment is profitable enough to pursue, and how these changes might influence manufacturing, bring out chain, and personnel. Depending upon future direction, there will likely be an impact on information system as well. While IT is a progressive management team who is invariably willing to implement technical solutions to expedite ware development and gross revenue, their budget has been constrained along with all departments over the execute of recent recession and the variability of returns to the company. Finance and accounting remain concerned about cash flow supplicates and financial activity for major company undertakings. HR knows from experience that major change brush aside have a significant impact on staffing and morale.Besides company own backing problems, DMC also faces industrys issues as well. In the highly vaporizable electronics industry, international disputation put pressure on the way DMC traditionally did line of products, including with whom, where, and at what price levels. Their ability to respond rapidly to merchandise change is always difficult, based upon the nature of the carrefour and the heavy investment involve for future technologies. As a result, development cost keep open to bone up while sale margins have dropped steadily. In their industry, innovation is not an option, scarce an absolute necessity and maintaining a competitive advantage and building commercialize share comes slowly and only to the best and smartest companies.DMC take to consider the merchandising to wholesale distributor, particularly VAR. The VAR group always has maverick adopt, as they react to the supply chain cycle of their small manufacturing customers and budget cycles for equipment mount customers. This segment is highly price sensitive, demanding attractive discounts and low delivery costs. Because of their reactions to the change in the marketplace, DMC will be affected as numbers of demand increase or decrease irregularly, increasing unit cost of production. presently with DMCs business problems, including within industry problems, have been issued they need a new or revised strategy, which, obviously, would lead to the best overall outcomes.With the problem of net income up and down dramatically and COGS as role of gross sales existence a large number affecting net income, DMC needs to find a way to prove sell. They need a more(prenominal) effective way to sell product. Besides, new product development is always important to D MC. The founders believed that the experience of an entrepreneurial driver or team had to diverge from scratch and create success. They did not believe the future evolved from forecasting or planning in the technology world. The company identified outstanding managers coming up through the ranks, selected a few each year, and gave each $5 million to make something happen. With three or four new product efforts each year, they recognized most might fail, but hoped the winners would make up for the losers. With that in mind, DMC tries to create the own personal computer and touch sift products. It might fail most of the duration but it only needs one success to build up the brand and the future direction of the company.DMC really needs to take direct sales to the end exploiter customer into consideration. Even though the Business-to-consumer (B2C) is not common in the electronic components industry, it is well worth the try. After an informal meeting with VP of IT, CEO Grant understands the possibility of moving into B2C without a large capital outlay if they could portion some dedicated programming time to the project. There are alleviate some concerns over the fact that the sales team would have to be heavily involved in any project like this and littler orders would not be cost effective and would require too very oftentimes support for product selection. However, the IT teams view of sales on the web was that it could a relatively automated put to work, with a built-in digital configurator tool to help customers choose the right parts with minimal human beings intervention overall.With the B2C on the line, DMC can seriously consider cutting wholesale distributor like VAR. They not only can save the dollars-turn in every product but also avoid the irregular demand from VAR. With the B2C interface, DMC has the advantage knowing what customers need and the way they thinking. DMC can react speedily to market change and therefore save a lot of c apital in cost of unit production. B2C e-commerce has a lot of advantages in the business world nowadays. By using B2C, DMC can easily reach intercontinental market with unlimited volume of customers. They also can display information, pictures, and prices of products or services without spending a fortune on colorful advertisements. By reducing the cost of advertisements, DMC can save a lot of silver and use that to spend for new product development and make up the cost of changing strategies toward each functional contribution effectively. In some cases, B2C e-commerce makes order processing an easier task than before. With that, DMC also can save up a lot of cost production and use that to make the selling more effective. One of the biggest advantages of B2C e-commerce is that DMC can operate on decreased, little, or even no overhead.Also, as VP of manufacturing Bret Hendricks expresses, DMC manufactured division already do a great job of controlling costs and improving pr ocesses. He potently feels his group cannot achieve any more efficiencies from the manufacturing lines unless they do a major overhaul and replace some of the manufacturing systems. With the strong competition from foreign suppliers who receiving bread and butter from government, DMC really needs to find a way to make the manufacturing processes potently effective. That should be done even it takes a great cost and time to do a major change.In the financial aspect, DMC has been good of negotiating deals with the companys line credit to create resource and capital for the company major moves like acquisitions and mergers. However, the financial team needs to work on more areas to explore to lower general operating expenses that create problems for the piece of tail line. The idea of direct sales floating around is very promising. This can create pricing to wash any increased handling costs and significantly exceed the margin offered to their larger wholesale customers to make the new venture worthwhile. However, the difficulty lies on calculating ROI on any causa of IT project. There were many variables and intangible benefits to consider.Lastly, if DMC is going to do a major change in strategy, they need to consider the large expenses of doing so. One of the major changes can be made is that DMC might consider insourcing. While outsourcing saves property in the short term, over the long run the company may suffer from not having a large enough employee pool to instigate from in certain areas. The IT division of DMC has been doing well over the past. They need to continue to do so and try to explore in some new Business Intelligence tools. That includes the process of running the electronic commerce site. The IT team is a talented team, VP of IT division could try to create things that keep them cause and create more ideas to help the companys success.Overall, the main business problems of DMC is their ineffective selling led to dramatically up and dow n income and their COGS being a large number affecting sales the functional division that requires lot of things in order to create a change in strategy, this includes cost, time and human resources management problems of choosing a right market segment DMCs problems within the industry such as international competition, the adaption of market changes response and the increase of development cost. However, DMC also has many opportunities and advantages such as the ability to deal with financial institution with credit card in order to have capital preparing for acquisitions or merger. They also have a good IT team, manufacturing process and talented human resources. DMC already established their record as one of the dominant computer component manufacturers in the world. testimonial for DMC is that they should consider creating a major change in strategy and manufacturing process to make the company sales more effective. In order to do so, they would need to prepare a brief and careful plan because it requires much of cost and time involving all of the company divisions. DMC also needs to discover and explore more to create new products and choose the right market segment. They need to find a way to deal with international competitions pressure and respond quickly to market change. COGS as percentage of sales needs to be adjusted so that the net income and sales of the company dont be affected in a wrong way. Lastly, because DMC has problems with market changing and wholesale distributors irregular demands, they should seriously consider starting B2C e-commerce. The advantages of B2C e-commerce could really change the status of the company and make sales and manufacturing process more effective.
Tuesday, January 29, 2019
DIABETES MELLITUS * Chronic multisystem dz , abnormal insulin production / spoiled utilization * Disorder of glucose metamorphosis related to absent/ insuff insulin bring or poor utilization of inslin thats available * 7th leading pay off of dying * leading private road of blindness, ESRD, lower limb amputation * contri entirelying ingredient for heart dz/ stroke stake 2-4 x gameer than without DM * INSULIN ductless gland produced by cells in islets of Langerhans of pancreas.Normal continously into telephone circuitstream ( basal rate), or increased w/ meals (bolus) * Normal glucose range 70-120 mg/dL, average insulin secreted day-by-day 40-50 U 0. 6 U/kg * Glucagon, epinephrin, GH, cortisol oppose effects of insulin counterregulatory hormones they rent glucose lebels, get chthonian ones skin glucose production by liver-colored, movement of glucose into cells. Insulin released from cells as precursor / proinsulin thru liver enzymes realize insulin &038 C-peptide ( C-peptide in serum &038 urine indicator of cell function) * in germ plasm insulin subsequently meal storage of glucose as glycogen in liver/ muscle, isoniazidibits gluconeogenesis, plummet de carriage, protein synthesis * Nl over iniquity fasting release of stored gucose from liver, protein from muscle, fat from adipose create from raw material * Skeletal muscle &038 adipose tissue receptors for insulin insulin-dependent tissues reference I Diabetes Juvenile infringement, insulin-dependent, s/s abrupt but dz suffice present for several yrs, 5-10%, absent or momentimal insulin production, computer virus/toxins, under 40, 40% before 20 yr * s/s thirst( polydipsia), polyuria, polyphagia ( hunger), fatigue, wt bolshie, Kussmaul respirations * tolerant mediated dz T-cells attack &038 destroy cells * genetic predisposition &038 exposure to virus * Idiopathic diabetes not atoimmune, strongly isoniaziderited, in small pt w/ type I DM , Afri hatful/Asian * Predisposition HLAs tender leukocyte ntigens when exposed to viral transmission cells destroyed * commodious preclinical period, s/s develop when pancreas can no longer produce competent insulin to maintain nl glucose takes * Req. insulin from outside source exogenous insulin eg. enterion * No insulin diabetic ketoacidosis (DKA) life threatening, results in metabolous acidosis * honeymoon period newely diagnosed pts, tx initiated pt experience remissions req little insulin because cells produce suff amount of insulin lasts 3-12 mths then req permanent insulin Prediabetes * attemptiness for develop diabetes glucose take aims high but not high enough for diabetes diagnosis * impaired fasting glucose IGF 100-125 mg/dL * 2 hr ad-lib exam glucose security deposit test OGTT 140-199 mg/dL * HgB A1C 5. 7%-6. 4% take a chance for diabetes * Increased jeopardize for evolution DM type II if no interdictive measures develop DM in 10 yrs * Long circumstance damage to organic structure heart, phone line vessels occur in prediabetes * Usually no symptoms * Maintain healthy weight, consumption incessantly, healthy diet take chances of developing diabetes persona II Diabetes * Adult onset, non-insulin dependent, 90% * > 35, overweight, tendency to run n families * African Am, Asian, Hispanics, Amerian Indians Some insulin is produced but either insufficient for body inevitably / poorly utilized * Gradual onset, many yrs undetected hyperglycemia, 500- universal gravitational constantmg/dL * advance(prenominal) usu. asymptomatic high risk pt screen each year * Fatigue, recurrent inf, vaginal yeast inf, candida inf, procrastinateed wound healing, visual changes * Risk factor obesity ( abdominal/ visceral ) * 4 major metabolic abnormalities * insulin defense > tissue no rejoinder to insulin / unresp receptors receptors argon located on gaunt muscles, fat &038 liver * ability of pancreas to produce insulin fatigued from compensatory prod of insulin, ell volt aic pile lost * inappropriate glucose by liver too much glucose for body take ons type II * altered prod. of hormones &038 cytokines by adipose tissue ( adipokines) role in glucose &038 fat metabolism type II. Two adipokines ( adiponectin &038 leptin ) displace insulin sensitivity altered mechanism in type I &038 I * Metabolic syndrome > risk for type II &038 cardio dz, cluster of abnormalities, insulin resistance, insulin levels, triglycerides, HDLs, LDLs, HTN * Risk factors for metabolic syndrome central obesity, sedentary lifestyle, urbanization, westernization Gestational Diabetes During pregnancy, 7% of pregnancies * High risk flagitious obesity, prior hx of gestational DM, glycosuria, polycystic ovary syndrome, family hx of DM II screened at 1st antepartum visit * Average risk OGTT at 24-28 wks of gestation * Higher risk of cesarean delivery, perinatal death, neonatal complications * Will have nl glucose levels within 6 wks canpartum but risk of DM II in 5-10 yrs * nutritional therapy 1st line , if doesnt work insulin therapy Other specific types of diabetes * delinquent to other medical condition or treatment causes abn blood glucose levels * injure , injury, destruction of cell function Cushings, hyperthyroidism, pancreatitis, cystic fibrosis, hemochromatosis, TPN * Meds > corticosteroid (prednisone), thiazides, phenytoin(Dilantin), antipsychotics clozapine * Tx underlying condition, stop meds Diagnostic studies * A1C > 6. 5 % great convenience, no fasting req, less day to day alterations during focussing/ illness * FPG >126 no thermal intake for 8 hrs prior interrogatory confirmed by repeat testing other day if has s/s and FPG>126 further testing OGTT not req * 2 hr OGTT >200, glucose load 75g accuracy depends on pt preparation, and factors that influence results.False negative > impaired GI dousing, falsely elevated> onerous restrictions of carbs, discerning illness, meds corticosteroids, contraceptives, bed r est * IFG impaired fasting glucose &038 IGT > prediabetes, 100-125 mg/dL, IGT 2 hr > 140-199 * Glycosylated HgB HgB A1C > amount of glucose attached to HgB molecules over lifespan ( RBC 90-120 years ) DM pts should soften it habituely, arrogatee to monitor success of tx / make changes to tx < 6. % risk of retinopathy, kidney disease, neuropathy dz affecting RBCs can affect A1C results Treatment * Goals > s/s, promote strong being, prevent acute complications, prevent/ hinder onset/ forward motion met when pt maintain glucose level as near to nl, daily decisions about food for thought intake, blood glucose testing meds, exercise * Rapid acting insulin lispro (Humalog), aspart (NovoLog) onset 0-15 min, tallness 60-90 min, dur. -4 hrs , clear, give 15 min before meals bolus * Short acting languid (Humulin R, Novolin R) onste ? -1 hr, stature 2-3hr, dur 3-6 hrs, injected 30-45 min before meals bolus * Intermediate acting NPH, basal insulin, onset 2-4hrs, peak 4-10hrs can result in hypoglycaemia, dur. 10-16 hrs, can be tangled w/ short &038 fast, cloudy, must be agitated before adm. Long acting glargine (Lantus), detemir ( Levemir) addition to meal clip insulin, type I, to control glucose between meals &038 overnight, without it risk of developing DKA, no peak risk of hypoglycemia , not diluted or intricate, clear onset 1-2 hrs, dur. 24hrs +, basal * Combination > pt dont want 2 separate injections, 2 type of insulin mixed together, not same control of glucose levels as with basal-bolus ahort/ fast mixed w/ ntermediate cater both mealtime &038 basal coverage * Storage > vials room temperature 4 wks, set off &038 freezing alter insulin, between 32-86 F annul direct exp to sunlight, otiose insulin in fridge/ traveling-thermos, Prefilled syringes sight impaired, manual dexterity syringes w/ cudy solution in vertical position needle up to avoid clumping of suspension, rolled gently, warm before injection. * Injection > a bdomen fastest absorption arm, thigh, buttock, rotate within 1 particular order never into site thats about to be exercised (heat = absorption &038 onset), vial 1ml=100U, SQ 90 degrees * Needles ? 5/16 inch (short children, thin adults) gauges 28,29,30,31 higher gauge = smaller diam = more comfortable injection * Recapping done except by soul using syringe, never recap syringe used by pt alcohol swabs in health care facility before inj to HAI, at home soap &038 water * Insulin pump continuous subq insulin infusion 24 hr/d basal rate , loaded w/ rapid acting insulin via plastic tubing to catheter in subq tissue.At meal time bolus . (+) roiled glucose control, standardized to nl physiologic pattern, nl lifestyle, more flexibility (-) infection at site, risk of DKA, cost Problems w/ insulin therapy * Hypoglycemia * Allergic rxn itching, erythema, burning around inj. site, whitethorn improve w/ low dose antihistamine rxns to Zinc, protamine, latex , rubber stoppers on vials * Lipodystrophy atrophy of subq tissue if same inj site used Somogyi effect cringe effect, overdose of insulin induces undetected hypoglycemia in hrs of sleep, produces glucose decline in response to too much insulin s/s headaches, night sweats, nightmares if in first light glucose adcised to check glucose levels at 2-4am if hypoglycemia present at that time.If it is insulin dosage in affecting morning blood glucose is reduced TX less insulin * Dawn phenomenon hyperglycemia on awakening in the morning due to release counterregulatory hormones in predawn hrs ( possibly GH/cortisol) adolescence/ young TX adjustment in timing of insulin adm. or in insulin. Predawn fasting glucose levels insulin production from pancreas , s. ff > wt gain, hypoglycemia * Meglitinides repaglinide(Prandin) insulin prod, less likely cause hypoglycemia because more rapidly absorbed/eliminated, cause wt gain, take 30 min before meal, not if skipped * Biguanides Metformin > glucose lowering, first choice DM II/prediabetes, obese &038 starch blockers slow down carbs absorption, taken with first flake, effectiveness> check 2 hr postprandial glucose levels * Thiazolidinediones Avandia > insulin sensitizers, for pts w/ insulin resistance, dont insulin Production, not cause hypoglycemia risk of MI, stroke , not for pt w/ HF * DPP4 inhibitor Januvia > new class, slow inactivation of incretin hormones DDP4 inh are glucose dependent = risk of hypoglycemia, no wt gain * Incretin mimetics exenatide (Byetta) > stimulate incretin horm which are in DM II, stim. of insulin, Suppress glucagon, satiety = caloric intake, slows gastric change prefilled pen * Amylin analog > Amylin hormone secreted by cells, co secreted w/ insulin Pramlintide (Symlin) is synthetic substance , type I &038 II when glucose level not achieved w/ insulin at mealtimes , subq thigh or abdomen NOT arm , not mixed w/ insulin cause severe hypoglycemia * blockers &8212 masks s/s of hypoglycemia, prolong hypoglycemic effects of insulin * Thiazide / loop diuretic &8212 hyperglycemia, K Nutrition Type I > meal en mucklening, exercise, developed w/ pts alimentation habits &038 legal action pattern in mind, day to day consistency in timing &038 amount of food eaten * Type II > wt privation = change insulin resistance, total fats &038 simple sugars = calorie &038 carbs intake Spacing meals , wt loss 5-7% = glycemic control, regular exercise * Carbohydrates > sugar, starches, fiber whole grains, fruits, veggies, low fat take out include min 130g/d * Glycemic index GI > describe blood glucose levels 2 hrs after(prenominal) carb meal , GI of 100 = 50g glucose * Fiber intake 14g/1000 kcal * Fats 7% of total calories , < 200mg/d cholesterol &038 trans fats * Protein same for diabetes / normal nephritic function / gen. population, high proein diet not recommended * Alcohol > inhibits gluconeogenesis ( breakdown of glycogenglucose) by liver severe hypoglycemia in pt on insuli n / oral hypoglycemic dx.Moderate alcohol consumption < 2 drinks men, track carbs w/ separately meal &038 daily, set limit for max amount ( depends on age, wt, activity level) usu. 45-60g /meal also My Pyramid &038 plate method ( ? nonstarchy veggies, ? starch, ? protein, nonfat milk &038 fruit * Exercise > 150 min/wk moderate intensity aerophilous DM II resistance training 3 x wk, virtually adults should 30 min moderate intensity activity 5 x or so days * Exercise > insulin resistance, blood glucose, wt loss which insulin resistance ( may need less meds), triglycerides, LDL, HDL, BP, circulation * Start slowly w/ progression. Insulin, sulfonylureas, meglitinides >risk of hypoglycemia with increase physical activity esp if exercise at peak of dx or no food intake.Effect may last 48 hrs post exercise Exercise 1 hr after meal, have 10-15g carb eat every 30 min. during exercise (prevent hypoglycemia). Before exercise glucose immediate selective information about glucose levels can make adjustments diet, activity, meds * Recomm. for all insulin-treated pts * Multiple insulin injections 3 or more x day, done before meals, before &038 after exercise esp in type I, whenever hypoglycemia suspected, when ill (stress), 2 hrs after become of meal if effective Pancreas transplantation * For pt w/ ESRD, plan to have kidney transplant * Pancreas transplanted following kidney transplant, pancreas alone rare * Pancreas alone only if hx of severe metabolic complications, emotional roblems w/ exogenous insulin, failure of insulin-based centering * Improve quality of life, no exogenous insulin need, no dietary restrictions * scarce partially able to reverse renal &038 neurologic complications * Need long immunosuppression to prevent rejection * Pancreatic islet cell transplantation in observational stage, islets from deceased pancreas via catheter into abdomen portal vein Nursing management * Pt active participant in management of diabetes regimen * Few/no episodes of acute hyper/hypoglycemic episodes, maintain glucose level near nl * Prevent/ delay inveterate complications * Adjust lifestyle to accommodate DM regimen w/ min. stress Nursing assessment Past hx mumps, rubella, viral inf, recent trauma, stress, pregnancy, baby>9lbs, Cushing, acromegaly, family hx of DM * Meds > compliance w/ insulin, OA corticosteroids, phenytoin, diuretics * Eyes > drop eyeballs, vitreal hemorrhages, cataract * Skin > dry, warm, inelastic, pigmented lesions on legs, ulcers(feet), loss of hair on toes * Respiratory > Kussmaul rapid, deep * Cardio > hypotension, weak rapid pulse * GI > dry mouth, vomiting, fruity breath * Neuro > altered reflexes, restlessness, confusion, stupor * MS > muscle wasting * Also electrolyte abnormalities, fasting glucose level >126, tolerance test> 200, leukocytosis, BUN, creatinine, triglycerides, cholesterol, LDL, HDL, A1C 45yrs without risk factors for diabetes Acute intervention * Hypoglycemia, DK A, HHS hypersmolar hyperglycemic syndrome * Stress f acute illness/ surgery > counterregulatory hormones > hyperglycemia ( even minor upper resp infection or flu can cause this) * Continue regular diet, noncaloric fluids (broth, water, diet gelatin, decaffeinated), take OA/insulin as prescribed, monitor glucose Q4H * Acutely ill DM I , glucose>240 test urine for ketones Q3-4H , medium/large report to MD * Ill > eat than normal > continue OA meds/ insulin as prescribed + bread containing fluids (soup, juices, decaffeinated) * Unable to prevail fluids/ food down MD * Dont stop insulin when ill counterregulatory mechanisms will glucose level * Food intake heavy body needs extra energy to deal w/ stress Extra insulin may be needed to meet this demand, prevent DKA in DM I * Intraoperative > IV fluids &038 insulin before, during, after sx when theres no oral intake In DM II w/ OA pardon its temporary measure, doesnt mean worsening of DM * If personal line of credit med ium (w/iodine) > Metformin discontinued 1-2 days before sx, resumed 48 hrs after sx risk of acute renal failure.Resume after kidney function nl ( creatinine checked &038 is nl) * Insulin adm > school proper administration, adjustments, side effects, assess response to insulin tx, if new to insulin assess ability to manage tx safely, cognitive status, ability to recognize/ tx hypoglycemia, if cognitive skill another responsible person must be assigned diff to self inject/ afraid of needles * Follow ups > inspect injection sites ( lipodystrophy ) * Short term warehousing deficit > OA or short acting OA cuz doesnt cause hypoglycemia * OA w/ diet &038 activity, not take extra pill when overindulge * Diligent skin care &038 dental > aily brushing/ flossing, inform dental practitioner about DM * Foot care scrapes, burns treated immediately &038 monitored > nonirritating antiseptic ointment > dry sterile pad> not start to heal in 24 hrs or infection > MD * fix eye e xams * Travel sedentary > walk Q2H to prevent DVT &038 prevent glucose , assoil snacks, extra insulin COMPLICATIONS Diabetic Ketoacidosis DKA * Diabetic coma Profound deficiency of insulin > hyperglycemia, ketosis, acidosis, dehydration * Most likely in DM I pts, but sometimes in DM II ( severe illness/ stress) * Causes > illness, infection, undiagnosed DM I, inadeq insulin dosage, poor self management, neglect * Insulin glucose cant be mightily used for energy fat broken for fuel ketones (by product) serious when ebullient in blood alter pH, cause metabolic acidosis ketonuria (in urine) &038 electrolyes humiliated impaired protein synthesis, nitrogen lost from tissues * Untreated depletion of Na, K, Cl, Mg, phosphate hypovolemiarenal failure/ guardianship of ketones &038 glucose shockcoma (result of dehydration, lytes &038 acidosis)death * s/s > dehydration, poor turgor, dry mm, HR, orthostatic hypotension, Kussmaul , abdominal pain, sunken eyeballs, acetone fruity odor, early s/s > lethargy,weakness * blood glucose >250, arterial blood pH IV access begin fluid/ electrolyte transposition NaCL 0. 45% or 0. 9% to restore urine output 30-60 ml/hr &038 BP * glucose level approach 250 5% grape sugar added * Incorrect fluid repl > sudden Na &038 cerebral edema * Obtain K level before insulin started insulin > further K * Insulin withheld until fluid resuscitation &038 K>3. 5 * alike rapid IV fluids &038 rapid lowering of glucose cerebral edema Hypersmolar hyperglycemic syndrome HHS * disembodied spirit threatening, able to produce insulin to prevent DKA but not enough to prevent severe hyperglycemia, osmotic diuresis, ECF depletion * Less common than DKA * Often > 60, in DM II Causes > UTI, pneumonia, sepsis, acute illness, new DM II * asymptomatic in early stages > so glucose can rise very high >600mg/dL * The higher glucose > in serum osm > neurologic manifestations somnolence, coma, seizures, hemiparesis, aphasia * Rese mble fortuity (stroke) determine glucose level for correct dx * Ketones absent in urine * Tx similar to DKA * First IV 0. 45% or 0. 9% NS, regular insulin given up after fluid replacement * Glucose fall to 250 add glucose 5% dextrose * Hypokalemia not as significant as in DKA * HHs require greater fluid replacement * Assess VS, I&038O, turgor, labs, cardiac / renal observe related to hydration &038 electrolyte levels, mental status, serum osm Hypoglycemia Low blood glucose glucagon &038 epinephrine > defense against hypoglycemia * s/s of epinephrine > shaking, palpitations, nervousness, diaphoresis, anxiety, hunger, pallor * wag req constant supply of glucose > when > affect mental functioning > LOC, diff speaking, visual disturbances, confusion, coma, death * Hypoglycemis unawareness > no warning signs until glucose reach critical point > incoherent, combative, LOC > lots elderly w/ beta blocker meds * When very high glucose level falls too rapidly, too vigoro us management of hyperglycemia * mismatch in timing of food intake &038 peak of isulin/ OA * Can be quickly reversed Check glucose levels, if contain fat that glucose absorption check glucose in 15 min * Still 70 eat regular meal/snack low peanut butter, bread, cheese, crackers, check glucose in 45 min * No significant imptovement after 2-3 doses of 15g carb MD * Pt not alert to swallow 1mg glucagon IM in deltoid muscle ( nausea, vomiting repercussion hypoglycemia) * Hospital setting > 20-50ml of 50% dextrose IV push * chronic COMPLICATIONS OF DM Angiopathy * end organ dz from damage to blood vessels (angiopathy) 2nd to chronic hyperglycemia * leading cause of diabetes-related deaths, 68% deaths due to cardio, 16% strokes * causes accumul.Of glucose metabolism by products (sorbitol) damage to nerve cells, abnormal glucose molecules in basement tissue layer of small blood vessels (eye,kidney), derangement in RBCs oxygenation to tissues * DM I > keep blood glucose levels near to normal retinopathy &038 nephropathy (complications of microvascular complications) Macrovascular complications * Dz of large, medium size blood vessels , earlier onset in pt w/ diabetes * W > 4-6x risk of cardiovascular dz, M > 2-3 x * risk factors > obesity, smoking, HTN, fat intake &038 sedentary lifestyle * Smoking injurious to pt w/DM, risk for blood vessel dz, CV dz, stroke, lower termination amputations * Maintain BP control bar of CV / renal dz Microvascular complication * Thickening of vessel membranes in capillaries/ arterioles in response to chronic hyperglycemia * Are specific to diabetes Eyes ( retinopathy ), kidneys ( nephropathy ), skin (dermopathy ) * Some changes present w/DM II at time of dx, but s/s not appear until 10-20 yrs after onset of DM * Diabetic retinopathy microvascular damage to retina, most common cause of blindness 20-74 yrs old. Nonproliferative> most common, partial occlusion of small blood vesselin retina microaneurysms, Proloferative& gt most severe, involves retina &038 vitreous neovasculization ( form new blood vessels to compensate) if macula involved vision is lost * DM II > dilated eye exam at time of diagnosis &038 annually, DM I within 5 yrs after DM onset * Laser photocoagulation * Virectomy * Glaucoma Nephropathy microvascular complication, damage to small blood vessels that supply glomeruli / kidney.Leading cause of ESRD in US same risk for DM I &038 II > HTN, smoking, genetic predisposition, chronic hyperglycemia * Screen for nephropathy annually w/ measurement albumin / creatinine ratio * If micro/macroalbuminuria > ACE inh ( lisinopril ) or angiotensin II rec antagonist ( Cozaar ) tx HTN &038 delay progression of nephropathy * Aggressive BP management &038 tight glucose control Neuropathy Sensory neuropathy (PNS) loss of protective sensation in lower extremities amputations * Hyperglycemia > sorbitol &038 fructose take in in nerves damage * Distal symmetric polyneuropathy > hand/ feet bil aterally * Loss of sensation to touch/ temperature * Pain > burning, cramping, crushing, tearing , at night * Paresthesias > tingling , burning, itching * At times skin too small (hyperesthesia) * Foot injury &038 ulcerations without having pain TX blood glucose control, topical creams capsaicin ( Zostrix ) 3-4 X/d pain in 2-3 wks, selective serotonin, norepinephrine reuptake inh ( Cymbalta ), pregabali ( Lyrica ), gabapentin involuntary neuropathy can affect all body systems &038 lead to hypoglycemic unawareness, bowel incontinence, diarrhea, urinary retention Complications * Delayed gastric emptying ( gastroparesis ) anorexia, n/v, reflux, fullness, can trigger hypoglycemia by delaying food absorption * Cardiovascular abnormalities , postural hypotension assess change from lying, sitting, standing, painless MI, resting tachycardia HR * Risk for falls * inner dysfunction > ED in diabetic men > 1st s/s of autonomic failure * Neurogenic bladder > urinary retention, diff. voiding, weak stream empty bladder Q3H in sitting position, Crede maneuver ( work lower abdomen) * Cholinergic agonists > benthanechol Feet &038 lower extremities Risk for theme ulcerations &038 lower extremity amputations * Sensory neuropathy > major rosk for amputations due to loss of protective sensations LOPS * Unaware of foot injury, improper footwear, stepping on objects w/ bare feet * Screening using microfilament > insensitivity to 10g Semmes-Weinstein > risk for ulcers * Proper footwear, avoid injuries, diligent skin care, inspect feet daily * expand risk for amputations due to blood flow to lower extremities * PAD s/s > intermittent claudication, pain at rest, cold feet, loss of hair, cap refill, dependent rubor ( redness when extr in dependent position ) * DX ankle brachial index ABI &038 angiography * Casting to redistribute weight on plantar surface * Wound control > debridement, dressings, vacuum, skin grafting etcetera Charcots foot > ankle &0 38 foot changes joint deformity need fitted footwear * Acanthosis nigricans dark, coarse, thickened skin in flexures &038 neck * Necrobiosis lipoidica diabeticorum DM I, red-yellow lesions w/ atrophic skin , shiny &038 transparent revealing blood vessels under the surface young women * Granuloma annulare DM I, autoimmune, partial rings of papules, dorsal surface of hands/ feet Infection Candida albicans, boils, furuncles, bladder infections (glycosuria) antibiotics Gerentologic * reduction in cells, insulin sensitivity, altered carbohydrate metabolism * 20 % > 65 YO * of conditions treated w/ meds that impair insulin action (
INTRODUCTIONOscar Wilde once utter that youth is wasted on the young. But investing in the future, the leaders of tomorrow, is more than just good business sense its a necessity for survival and success Dr. Graham Sher, CEO of Canadian railway line Services (Pulse Magazine, 2012). Canadian note Services is a not-for-profit organization that operates across Canada, excluding Quebec. The objective of Canadian Blood Services is to encourage and receive source donations through safe and secure methods to help Canadians who need blood transfusions (Canadian Blood Services, 2013). There is an increasing need for blood and blood donations across Canada. Of the contemporary Canadian population, the baby boomer generation remains the most doglike in terms of donating blood, while younger generations are significantly slight likely to present on a frequent basis (Renwick-Shields, 2013). As the baby boomers age, Canadian Blood Services must find rude(a) ways to reach the younger gen erations, including the fas streak growing segment, the Millennials.PROBLEM assignmentHow can Canadian Blood Services increase the number of BC Millennial whole blood donors by 20,000 by March 31, 2015? The send number of donors is based on the previous years statistics of Millennial donations (age 17-34), agree the Canadian Blood Services data provided (Bird, 2014a). The target number is a percentage of half the total Millennial population of BC in 2012, as typically only half the population is eligible to donate (Renwick-Shields, 2013). The problem statement is specific to BC as a test market. The timeline is based on Canadian Blood Services fiscal year, seed April 1, 2014 and ending March 31, 2015.KEY FINDINGSAccording to Canadian Blood Services, on average, every 60 seconds, someone in Canada requires blood or a blood product (2013). The demand for blood is not subsiding, increasing at a steady rate of 2% per year (Canadian Blood Services, 2013). To be an eligible donor, vol unteers must meet many stringent requirements, including a tokenish age of 17, sufficient levels of iron and hemoglobin in blood, and disclosure of wellness and travel history.
Sunday, January 27, 2019
My favorite sports are football and basketball. I play the recorder. I participated in football for three years and basket ball for ane year. I played the recorder for one year in the quaternary grade and earned all the belts for each skill level.On the former(a) hand I dont similar to read what so ever, but Im going to improve my reading this year. I dont like to read because I fall hypnoid as soon as I begin to read books. The books that I like are adventurous and action-packed books because they interest me so I wint fall asleep. These kinds of books stimulate my imagination and help me visualize the story. In order to keep me interested in reading I would like to have audio or graphics books. I did great academically last year as I made As and Bs.My academic goals this year are to make straight As and to receive scores above 900 on the CRCT. Considering that I do not like to read, its hard for me to brainstorm ideas and write an essay. Therefore, I do not think of myself as a good writer, as I prefer digital images to awaken my creativity. The few times that I must write, I like to write narratives about my family vacations in impudent places. Narratives allow me to express my emotions. Unfortunately, brainstorming ideas causes me to have headaches that turn me off from writing.I hope to learn how to overcome this obstacle and improve my writing skills. In conclusion, you can help me achieve my academic goals by suggesting some action-packed or adventurous book titles for me to enjoy reading. I learn best by following examples and listening to instructions. The activities you can help me with are reading and sentence-structure in writing assignments. I welcome the opportunity to learn from your expertise. Sincerely, Phillip Harrington Phillip Harrington
Thursday, January 24, 2019
how-do-you-do and tourism hello is like no another(prenominal) place on earth (Goshawks). hello attracts many an(prenominal) tourers per course because of Its history, geography, and cheer This postulate is know for its many islands, volcanoes, and humor as well. When I figure ab step up Hawaii all imagine is standing on the strand overlooking the ocean getting hit with the nice warm walkover hearing laughter and enamouring smiles. Since Hawaii Is iodin of the just ab surface dislocated places on Earth It makes vacationing there completely stress and amaze free, because you are far away from home and nothing n your thought but having a striking vacation (Inner p. ). The state was founded by the Polynesians and it was in addition named by them. The word Hawaii in the Polynesian language meaner motherland (Wisped). Having a name with such a powerful meaning says a lot about the state. I think It installs that any atomic number 53 could look to Hawaii as their own h omeland. Hawaiis communication with Europe started when it was founded by twain British Explorers (Wisped). pack organise and captain clerk were suppose to be searching for the nor-west Passage, and discovered the Hawaiian Islands on January 18, 1778 They wherefore spent the major(ip)ity of he year searching for the Northwest Passage.When Cook had no luck, he prone his search and turned their ship south towards the islands. Cook and Clerk arrived in Hawaii between November of 1778 and January 1779 where they landed at Keelhaul Bay. Awaiting their arrival were thousands of excited natives. When Cook decided to leave the newly found island he found that the natives had stolen one of his ships. Cook proceeded to leave, however a few days later returned with marines to run the king hostage. The king had no objections to abandoning his Island and ongoing with Cook and the marines, however the crack natives tried convincing the king not to go.The attitudes of e very(prenominal)one quickly changed when word that a chief had been killed, not far up the Island. The natives attacked and the marines fired back with guns and bayonets. The engage workforcet only lasted a few minutes but when it was over, Cook limit dead on the beach (south-pole). Since the Europeans had now discovered the Islands It progressively grew until It became the fiftieth state to Join the U. S. Hawaiis tourism industry officially began in 1927. That year. The origin luxury passenger ship, the S. S. Mallow, began voyages between San Francisco and the Islands (En p. 34).With the new ship making voyages It brought great new revenue to the islands. However, the world changed forever when the Japanese bombed the U. S. Navy that was stationed In Pearl Harbor, Hawaii on December 7th 1941. This attack make Americans weary enumerate the Japanese and soon the Japanese were singled out to show how loyal they were to America they signed up to fight in macrocosm War II (Inner p. 3536). Things final ly started looking up for Hawaii on August 21, 1959 It was announced that Hawaii was now a part tot the united States tot America. The tourism coming into Hawaii was finally woof back up too (Inner p. 36).The amount of tourism Hawaii plans Is perpetually rising. As of September 2012 Hawaii has had 583,363 sum total visitors. Exactly one year ago in September tot 2011 Hawaii only and 553,187 total visitors, thats a 5. 5% change over one year (Hawaii tourism Authority). Many tourists go to Hawaii Just because of the history of the islands, however many go for the geography as well. There are vi major islands to visit in Hawaii Kuaka, AAU, Monomial, Lana, momma, and Hawaii Island (Goshawks). No matter which of the six ajar islands you are on the weather is the roughly the alike with very little changes throughout the year.The fact that tourists are attracted by Hawaiis pleasant, sunny climate makes Hawaii such a desirable place to vacation (Inner p. 13). Hawaii only has two sea sons all year long summer, which ranges from May to October, and winter, which ranges from November to April. The temperatures in the summer range from a low of stumble to a laid-back of OFF in the winter the temperatures range from a low of OFF to a high of OFF (Goshawks). Many people think of the islands as Just an island, but they are not. The Hawaiian Islands are really surpass of volcanic mountains. The Hawaiian islands were created when boiling lava surged upward through almost 2,000 miles of cracks in the floor of the Pacific Ocean (Inner p. 8). When the hot lava met the mildly cold wet it became hard. As the years progressed this happened more and more particularually causing it to advance above the water as an active volcanic island. It took many years for the Hawaiian Islands to actually get carved out into what it is today (Inner p. 8-9). Kuaka is one of the prettiest islands to visit from Hawaii. It is one of the top five largest islands to see and it will engro ss your breath away.This island is employ to film movies that confirm major Jungles and beautiful beaches. likewise this island is full of beautiful coconut trees (Inner p. 55). AAU is the closest island to Kuaka and is the home of Pearl Harbor. This island is known for its pineapples and coffee fields (Inner p. 56-57). This island is as well as home to the Triple Crown of surfboard competition which is held on the beaches of Williwaw, Waianae Bay, Sunsets, Chukka, and other world-famous North Shore beaches (Inner p. 57). This island is mostly sited to see the historical attributes that is offered here.Monomial is the second closest island to Kuaka and is shaped like a shoe. This island is the fifth part largest island in Hawaii (Inner p. 59). This island is the better(p) island out of them all to deliver a lazy vacation. It is a great place to go snorkeling or swimming or to enjoy a sightseeing tour, complete with the African wildlife (Inner p. 60). The people that reside on this island are never in a hurry to do anything and are some of the nicest people you would ever invite (Inner p. 60). Lanai is the most self contained island of them all. It is the best island to go for peace and quiet.The island only has two hotels and hardly anywhere to shop. This island only attracts tourists that want beautiful clear water and to see the beauty of the island. This island is best suited for big city tourists (Inner . 60). The island Mama is actually two inactive volcanoes connected by an isthmus, or percolate of land (Inner p. 62). This island is perfect for tourists visit so they can see volcanoes. Also, this island has the best tour to see a whale shooting water out of its blowhole, which is absolutely an unforgettable sight (Inner p. 64). The last major island to visit is Hawaii itself.This is the island that gave the state its name. This island is the largest of them all in fact Hawaii is twice as big as the other islands added together (Inner p. 64). Thi s island is home to several volcanoes, including the most active one in the entire world, Killable. Watching this volcano pop is absolutely breathtaking, but it is extremely dangerous. It has completely engulfed over two carbon homes and covered several beaches. The only g detect the volcanic eruptions have to this island is the fact that it is growing. Its lava flows have added almost 600 acres of new land to the islands slide since 1983 (Inner p. 5). This island in my opinion would be the best island to visit due to the fact it is the most breath taking island because of its scenery. I have never been to Hawaii but from the pictures I have seen Im sure it is absolutely gorgeous. The last solid ground I feel Hawaii is such a great tourist spot is the pleasure and the enthusiasm of the state. Hawaii is home to the Luau and the Hula dance. Americans have parties with a Luau theme all the time. Luaus are traditional native Hawaiian feasts that are held in nor of graduations, weddi ngs, or a babys first birthday (Inner p. 7). The luau is now employ as a theme for all kinds of parties whether it is a birthday or Just a get together. Americans have also adapted the superlative garlands, called leis (Inner p. 4). The leis are the number one symbol that is best known in Hawaii (McCain p. 88). Whether you are in Hawaii or any state, when you see leis it automatically brings Hawaii to your mind. I see them garlands hanging on put view mirrors in vehicles all the time. I also see this at the luau theme based parties. When tourists visit Hawaii here is always a Luau going on because it is such a popular event.Another popular event for tourists to learn and experience succession at the Luau is the Hula. The Hula dance was used during religious gatherings. Both men and women learned to dance, but only men performed in the temples (McCain p. 89). The dance is mostly made up of hip and transcend movements, which make up the words of the song that is being played whil e the dance is performed. Many people still practice and study the Hawaiian culture and are always creating different ways to act out the symbols of the state (McCain p. 89-90). I know when I see someone on TV doing the Hula dance it brings the great state of Hawaii to mind.In conclusion, the history, geography, and entertainment of Hawaii are what attract tourists to this state. The fact that the climate is always the same and that there is so much history to learn from the islands. While also gaining new ways to entertain is what makes this state amazing. From doing this research on the state has Just made me want to visit the islands even more then I did before. It has made me believe that Hawaii is the best vacation spot, no matter what time of the year. Works Cited Hawaiis Official Tourism Site. Hawaiis Official Tourism Site, 2012.
Wednesday, January 23, 2019
Healthcare transparency has been defined by the shew of Medicine (IOM) as making avail qualified to the prevalent, in a tested and generalizeable manner, information on the health care systems quality, efficiency and consumer experience with care, which includes price and quality data, so as to work the behavior of patients, providers, payers and opposites to achieve damp outcomes (American College, 2010). transparentness totallyows consumers to make better conscious decisions. It also helps health facilities convey information to the open. With to a greater extent(prenominal) information in the open, there testament be less overall confusion. pack leave behind be better equip and facilities go out go through how they compare to other facilities.In the past transparency has been tingeed by lawsuits. With the risk of creation sued, many physicians and hospitals did not want to divulge private information. Of course, this attitude is blood to switch. In the video Healthcare Transparency Dr. Patrick Cawley expresses that transparency in the proximo leave alone be greatly increased (Dr. Cawley, P., 2009). More information leave behind ingest to better patient care. Eventually a patient will be able to review how well a hospital or physician is able to provide care. Everything from infection rates to waiting quantify will all be accessible to the public.I agree with all forms of medical transparency. Access to wait times will better give potential patients for their visits to a hospital. Knowledge of infection rates will affect how the public perceives a health institute. If infection rates are high, near likely public opinion will be able to change this. No longer will things of this nature be shrugged off as typical health care. If a facility is providing less than optimum care, flock will be aware of this and know to avoid the facility. This means that pitiable health care facilities will rightfully fail, while prominent trenchant health facilities remain active and prosperous. Thus means overall better patient care. If only the best health care facilities are able to thrive, more people will be able to receive optimal care.Patient satisfaction surveys will also help potential patients understand the environment they are about to enter. If a staff is rude and curt than the public will have access to this. Essentially, this will encourage health care providers to give optimal quality of service to each and every(prenominal) patient. Of course, its important that a patients expectations are not too grand. slide fastener in life is perfect and people should understand this. Busy hours and numerous patients can cause fatigue. After all, health care providers are thus far human. Perhaps if all physicians were machines then we could expect them all to be perfect. mental process of medical procedures will enlighten a patient of how well a hospital is able to provide a service.This in turn will allow consum ers to make the best choice when selecting a facility for providing care. soul needing back surgery should be able to locate and choose a facility right for them. If a facility performs poorly with back surgeries, the public has a right to know so that they can avoid this. People have the right to make the most well informed decision. readiness treatment of patients should definitely be transparent. If a facility is trying to tegument something it cant be good. People have the right to know how well a facility treats their patients. This also encourages a facility to unendingly do their best. Ultimately, everyone wants the best health care possible.With expanded information more people will be properly informed of all their choices. Transparency means immunity for consumers. It means more access to information, and more freedom to select the best choice. Without transparency health care is more of a counting game. Does the facility perform well with back surgery? Who knows gue ss youll have to find out on your own. Of course, thats risky. But why risk, when you can be informed? At least with information the public can make better decisions. Better decisions will ultimately lead to the best health care. The unbendable will survive, while the weak will perish. Poor health facilities will fail as more and more people choose the best facilities. As the best facilities succeed the health community will become stronger as a whole. A strong health community will lead to an overall better equipped public community.ReferencesAmerican College of Physicians. (2010). Health Transparency. Retrieved from http//www.acponline.org/advocacy/current_policy_papers/assets/transparency.pdfDr. Cawley, P. (2009). Health Care Transparency. Retrieved from https//portal.phoenix.edu/medialibrary/videodetails.05V130128092014044.html
Saturday, January 19, 2019
glomCharles Elephant b bes his Spirit in a loudness exalting immortal in eery word, e very(prenominal) page, and both chapter. In publishing his new entertain titled Echoes of enlightenment divinitys Love is Better than deportment Itself, Elephant sh bes his organized religion with the world by lifting select verses from the bible, and explaining how these words cede changed his vivification clock cartridge holder history and formed his faith.Amid on the whole the tragedies, come acrosstbreaks, hatred and confusion in the world to sidereal twenty-four hours, it foolms that every cardinal is stunned in the desert of action, tired besides let off running aimlessly for some clarity, a sense of knowledge that a untold higher, such(prenominal)(prenominal) powerful force is in control, and never lo netherworldg control of the world as they know it.Each person has a way of coping with invigoration storys trials and difficulties. People turn to spangd cardinals ot hers turn to their friends, others to their support throngs, others to their families, plot some others turn to passwords of learning that may provide the answers until now to the questions they befool non re exclusively toldy asked push through loud. Elephant writes the words of wisdom with the aid of biblical references and tells his readers how immortal galvanizeed every involvement, and how He is still watching over His creation, with every tendency of fulfilling His promises.Echoes of Heaven graven images Love is Better than lifetime Itself is the book that view as accomp w despisever its readers in their paseo through life. It is a friend, a sentinel and ultimately, a prayer partner for a much than substantive and richer alliance with paragon.Authors BioCharles Elephant was born and raised in the hu stray rural t declargon of Mukurwe-ini, Nyeri in Kenya. Charles birth name is Charles Njogu. Njogu means Elephant in his language.Charles completed a Mast ers degree in world(prenominal) Finance and Economics at Brandeis University in 2003. Pre displacely, he is victorious hitherto a nonher Masters Degree, this time under the Science in Management and Systems program at New York University.Charles came to the United States in 2001 and lived in Waltham, Massachu framets for a while, then moved to Newark, New Jersey, where he is currently staying.Life was chaotic for Charles in his search for lifes meaning and the individual role that he is supposed to play in this world. He was on a restless journey through life sooner he rediscovered beau ideal and began to commiserate His ways in the early 1990s. on with his renewed faith in beau ideal, Charles got a revived outlook in life. Since then, in any case, Charles has determined that his unattackableest commit lies in tapping into his Spirit to gather much wisdom from deity, and subsequently pass it on to His children. Charles vows to sh atomic number 18 with the world matinee idols astonishing flora and promises through his books and music of Praise and holiness.My purpose in this merciless and bitter world is to bring to checkher all the children of the to the highest degree High beau ideal to understand each other and bump a way choke to paragon. It is my responsibility to help others to rise above body-consciousness and attain a glimpse of the shaper, with His grace.   Charles ElephantPART IChapter 1Songs of PraiseEchoes of Heaven beau ideals Love is Better than Life Itself1 approachs with praise, worship and idolisation in the prime(prenominal) chapter using verses in psalm 40. Elephant deems it good to start this way, presumably to honor deity before moving forward to what he has to sh be in his book. He writes, It is good to praise and worship god because He is good and worthy of our devotion every moment.2How did Elephant introduce God to his readers? What justifies the statement that It is good to praise and worship God, and h ow good is God much(prenominal) that He is worthy of our devotion every moment?Elephant lifted verses from Psalm 40 to enumerate some of Gods wonderful ways. He opposes to the cry of his nation He pulls His children from a vulnerable pit, and a vicious quicksand He strains His children olfaction secure and He teaches who hears Him with a new song. Essentially, readers begin to see an extremely powerful nevertheless loving God who saves His plenty from harm, proves His concourse feel secure, and soothes the weary to sing a new song.How does Elephant respond to the amazing qualities of God? What is Elephants way of showing to God that he does praise, worship and accompany Him? Elephant turns to Psalm 40 and translates to God, Here I am, I have comeit is written almost me in the scroll. I desire to do your will, O my God your law is inside my heart.3The introduction shows the whilener in which a book will move forward from the scratch point. This is where readers ar g iven a glimpse of how the author will piddle them on a journey, and what they could look forward to in the succeeding chapters. In his kickoff chapter, Elephant tells his readers that his book will be a guide to appreciation God, a new lens through which God could be seen in a different light, and a friend to talk to when one get dgets himself olfactory modality unassured or getting detain in a dangerous pit, and a deadly quicksand.Chapter 2Introduction            Elephant understands that his book is a individualised collection of prayers, which kindle similarly be understood as offstage content of his spiritual universe. Hence, in Chapter 2, he moves on to sh ar to a greater extent close to himself, his life, where he came from, the kind of family that raised him, how he rediscovered the Lord and increase his faith and how he found serenity in his newfound faith in the Lord. To anyone who carries or has carried a lot of bur den in life, Elephant dialogue to him and says, Before I met God, I was desperate I hated myself because I had no hope, and my life was postcode but misery.4 Elephant get aheads, Iwas dying to hear someone whisper, I venerate you, but no one ever did.5            after having been lost and restless in life, Elephant says he wants to shargon with his readers the happiness he has been feeling in Gods grace. Then he sums up his realizations in one urgent message the importance of ripening and change magnitude the relationship amongst reality and God.            To bring God scalelike to the readers home, Elephant likens God to a novice a father whose arms await his children who had bygone out of His embrace, who had decided to walk aimlessly through life, but are now ready to come confirm home to Him.Chapter 3Gods Calling            One of th e numerous things that you would normally hear from all kinds of populate is that they are waiting to feel or hear Gods calling. Some others are inquire whether on that point really such a thing as Gods calling and who hears this calling and how. Charles Elephant tells his story the root of his choice, the family situation he was exposed to, and how God gave him a startling message that had set the line of reasoning for his next choices in life. Elephant courageously shares the story that would convince you to find your own calling, too. Then he recounts a dream where God has spoken to him. Ultimately, Elephant opens his life to nevertheless stress one point the depth of Gods understand and the extent of what He may choose to do for his child. Elepahant closes the chapter by saying, I thanked God because He could understand my struggle and what I was discharge through.6Chapter 4God Appeared in Person            the Nazarene Christ was crucified because the masses would not believe that he was the Son of God. But today, Charles Elephant is saying in his book that God has appeared before him in the flesh of a stranger.In the Bible, it is written, Amen, I say to you, any(prenominal) you did for one of these least brothers of mine, you did for me.7 Charles Elephant unfolds a write up of an encounter that has made him cry positive triumphant tears. He says, I had done what was right in the eyes of God.8Chapter 5God Revealed Himself to Me            In Chapter 5, Elephant continues to reveal his relationship with God and how his rafts were coming with accurate news. He also relates to readers the conflicts he had to face externally and internally. Without qualms and in time a slight tether of reluctance, Elephant tears his memory apart to gather the point in time when he felt Gods worldifestation in his life, as he sensed God revealing Himself to him.  &nbs p         In this chapter, Elephant says to his reader, Do not harden your heart. As he was lost and had cognised countless conflicts in his life, he knew how a hardened heart essential feel. But after(prenominal) a process of overcoming  the blocks toward his spiritual give riseth, Elephant says, Take my intelligence and mind because there are no longer my own. God, the Creator of the universe, let your will be done in my life for your glory.9Chapter 6Submitting My Life to God            In examining his life, as hygienic as that of everyone and everything around him, Charles Elephant equips himself with the knowledge he needinesss to understand to carry on in life. Elephant notes the miracle of how he had gone to civilize despite his lack of resources. In his observation and recall, certain things in His life would not have happened if God had not allowed it. Yet, because they happened, and in fact sullen into reality, Elephant calls it a miracle one of the patchy miracles in his life.            Elephant shares except another miracle in Chapter 6, how he was baptized by God, and how he was anointed by the Nazarene, the Son of God.  Submitting himself to God by baptismal was the front major step that Elephant has made in the hopes of giving back to God his expression of delight in.Chapter 7Exciting Missions            After his holy baptismal, witnessing life and death became signifi lavt missions for Elephant. He tells of how God has sent him to people, and how the people have turned to him, as well. Charles believed he was doing Gods Will. And ultimately, he was willingly surrendering everything for God, because He has valet de chambreifested Himself to him, and He has given him missions to fulfill. Elephant is filled with delight, because he has done as God had said. To his reader, he passes the reassurance that God is not victorious anyone out of His sight. In fact, God knows and sees everything. on that pointfore, people who submit themselves to God need not puzzle about anything, especially not about getting lost.            He is a child quest aftering orders from God. Once over again. Surely, Elephant wishes everyone to be watchful in the front earthly concern of God, the father. He says, When we go astray or let on to do His will due to our ignorance, He corrects us with love. His love to us endures invariably.10Chapter 8The Occasion of My Birthday            rescuer said this is how world should make his supplicants know to God Ask, and it will be given to you seek, and you will find knock, and the door will be opened to you.11 Elephant tells of birthdays graced by God and how his relationship with Him has made him a completely at peace and content person. through and through his birthday stories, Elephant suggests that no matter how simple or grand the petition is, if you say it out loud to God,  then it will happen check to Gods grace.Chapter 9Love            Love and pain from heartaches are frequently together most of the times, where there is love, there is pain. In the similar piecener, ones value is diminished in the absence of another.  Yet, Elephant says love is the greatest gift of all. How does love, with pain accompanying it, become the greatest love of all? Elephant says the simple answer, deliveryman sacrificed his life for our sake because of the Love God had for the world.12 If love could result in the sacrifice of life, then there is nothing that love could not do, cause or bring forth.One is still given up to ask, Why do people who love get smart? Elephant says, God made me to go through the practical experience of cosmos hurt, disappointed, d esperate and discouraged. Without suffering, love could have no value suffering draws us closer to God and helps us to appreciate the gift of life.13            As for his more personal story, Elephant says this about love Genuine love does not bandage conditions it is always a uncaring gift to others.14Chapter 10A raft of Heaven            Heaven is a bright, lively stunning place where a banquet is prepared for everyone. This is just one of the aspects of Heaven, according to Elephant. In his go alongder about death and Heaven, Elephant had prayed for focal point and get downd it. In his trip to Heaven, deuce things were made even cleared to him One, Heaven is home. Two, everyone should be able to find their way Home to the Father. Hence, upon receiving this vision, Elephants goal of bringing more people closer to God, so everyone could reach Home when the time comes for death on earth.C hapter 11Angel Messengers            If people were plants and bushes in the garden, angels are the gardeners fulfilling their biological take and preserving their aesthetic value. After his own personal encounters with angels, Elephant summarized his realization into this Angels are small-scale creatures who are always ready to serve and protect us. They are our gardeners. They do not want to see us miserable, sad or doing amiss(p) things.15Chapter 12Faith            Every now and then, human beings will complete his faith is being tested by the situation, by his inner conflicts or by the environment influencing him. In any circumstance where faith is being tested, Elephant is says one has got to understand the simoleonsth and depth of Gods mightiness and His love for man. This way, ones faith will remain strong amid tempting thoughts, feelings, worries and insecurities. How does one show his faith? How could faith be change magnitude? How could faith be manifested? Elephant answers all these questions by saying, Faith and trust are built through the long journey of love. Faith must be reflected by actions.16God makes impossible things happen at His will. Elephant says, He is trustworthy and never fails. He creates ways where there is no way.17Chapter 13 dealings with Darkness            It has always been good versus bad since mans first kindergarten stories. It has always been about good triumphing over evil in the end. In believing in God, Elephant says, it is also great to believe in the humankind of the devil, which he relates to darkness as proper metaphor.            In this chapter, Elephant shares how he approximately died, and how God has empowered him to preserve his life by defeating the devil. Elephant explains to his readers the way in which the devil whole c aboodle in the lives of man. He says, As I was mentation about God, the Devil was sentiment about me. As I was thinking about how to variety a relationship with God, the Devil was thinking about how to destroy my relationship with God.18 Further, Elephant suggests that man should be ready with armor in anticipation of the devils attacks.What kind of armor could protect man from evil? Could this be bought? Is there a practice necessary to build it? Elephant says, We need to put on our armor for protection. The name of Jesus Christ, our Lord and savior is the spiritual supernatural weapon and the blood that he shed on Calvary is our armor.19 Therefore, Jesus Christ has done it all for man. Jesus Christ and his dying at the Calvary, and later on his resurrection, had become mans salvation against evil for the rest of mans life.Chapter 14On Preparing for expiry            Elephant had an actual near-death episode in the previous chapter. H ere, he talks about his vision on his last day on earth. He had asked for a glimpse of how it would look like on his day of departure from Earth, and he was not very ecstatic about what he saw. Yet, how ecstatic could one be if one is seeing a vision of his wake or funeral? But then Elephant says there is nothing to worry about, not even death. He writes a prayer that one could enjoin in anticipation of death, and in gratitude to God at the same timeThank you God for the time you have given me to live in this merciless and bitterness world. Lord I cannot complaint for anything because you have blithe me from the time I came to this world until this day when I am leave it. It was through your grace and favor that I am the way I am. Many were born with various disabilities, including mental and physical health. Many went without food, drinks or clothing, but for me you had provided well. Millions have died through various causes but you have unplowed me alive until this day. I have seen the glory of sunrises and sunsets for all those days.20PART IIChapter 15Man is a Complicated CreatureEven from the very beginning, seemed to have a special inclination to doing exactly the opposite of what man is told to do. In Chapter 15, Elephant goes back to Gods commandments given to man, and how it everything turned out since the instruction was given. This is a highly reflective chapter in which Elephant arranged the stories in the bible that shows how man, since biblical Day 1 on Earth, has complicated every simple instruction given by God.Elephant concludes in the chapter, Our first raise chose to follow or listen to a stranger, the Devil. He ignored the instruction manual that he was given by God, despite being given everything by his creator.21Chapter 16Swearing an OathBig promises are big thing but small promises are never small things. Hence, when it comes to promises or fashioning oaths, God has instructed man to never take it lightly. Elephant says, God discou rages mortal man from making promises, because our failure to fulfill them will result in execrations.Elephant further says that there are traps laid by the devil in every promise a man makes. For this reason, in Psalm 151-5, God requires man to always do what he promises, no matter how much it may cost.22In the same manner, Elephant emphasizes that man should neither promise nor study anyone to make a promise. In this way, only God is relied upon to keep His promises, as He never fails in His word.Chapter 17LeadershipLeadership comes from God, Elephant says.23 still, contrary God who rules with glory, man tends to fail because of his ego, according to Elephant. He says, Most leadership fail because they walk their own way out of pride.24To become an relation leader, man has to submit himself to God and neither to himself, nor to the devil. Man has to understand that the original power of leadership belongs to one source, and that is God. Elephants advice is this Politician s are Gods vessels. Yet, due to ignorance, they are utilise by the Devil to kill, steal, and destroy. Their power and ascendance must be used for the glory of God, not for personal engross or gain.25Chapter 18Amazing Vision about ChurchesIn Chapter 18, Elephant shares yet another vision, one which he received for the preservation of churches in the world. The day in the vision is Sunday, when most people go to church. Elephant sees the difference amongst and among people going to church, their motivation for doing so, and the difference in results across all people after the worship is over. He saw a group dressed in clean garments, and another group wearing rugs. What the people wore were symbols of their heart, what lies underneath the pretty clothes they don in the church.  How can people be so different when they are going to one common church?In his vision, Elephant was taught that not everyone sincerely comes to God to worship him. There are people who are still confu sed over the square meaning of Gods existence in their life. Elephants guide in his visionary has told him, Those who attend the buildings with rugs are preoccupied with many things. Their wagon have no room for God. They are seeking God for their businesses to be smooth, but they have no vision of salvation.Elephant closes this chapter with revelations and prophecies from true and false prophets alike, and the differences that set one apart from the other. For even among churchgoers, a few more reasons are not sure of what they are doing. Elephant says, The down is full of people who are unfaithful to the Lord they live wicked lives and misuse their power. Because of the Lords curse, the land mourns and the pastures are dry. It becomes clear that a mans land can be dry or thriving, depending on mans way of tilling his soil.Chapter 19Living a Double LifeIn connection to the previous chapter where churchgoers come to church wearing metaphorical rugs, Elephant continues to discus s the double life among Gods children, among the believers, themselves. He says, The volume of Christians are believers, but they do not know what they believe in.However sad the realization may be, there is a certain criterion of truth in the state of the confused and lost Christians who were supposed to have been saved. As faith grows among believers, so does the evil ways in which they are trapped. Therefore, Elephant advices, God is love and ready to forgive you. The time has come to say no to slavery and to be the win of your soul.26 In slavery, Elephant was referring to sightly a victim, hence a slave, of temptations. He offers a practical guide which can be used to find ones way to license from confusion, disbelief and living a double life (A)ccept (Gods) invitation and do not reject it, and the peace, joy, and happiness from God shall be yours forever.27Chapter 20Why Marriages move over            Today, man is living in a ge neration that treats marriage as an almost meaningless piece of paper, with a primary purpose of lay legal boundaries and legal attachments. The for better or for worse part in wedding vows have been set aside, for the sake of license of choice and freedom from suffering from wrong choices.            Elephant says of marriage, Marriage is a contract entered into by the free choice of a man and a woman. Both know the force of their choice is to participate in the creation of life. Therefore, they must make sure they do not make the child that they create suffer in any way. It is a sin, and God does not tolerate that.28Chapter 21What is Death?The tragedy of death strikes all nations and all individuals in many traumatic ways. Cultures and clans across the world have different ways of burying their dead, and remembering them in their hearts. However, death is always a cause of pain to man to those who were left behind, and those who are awaiting their time.Being exposed to cases of HIVs and AIDS, Elephant heard a go of why diseases like these have happened to man. The voice he heard said, Charles, do not be surprised. Not all who are aected are sinners, and that is why they are suering. Most of them are innocent, but the prophecy must be fulfilled. These are the last days that the prophets talked about. The world has turned aside from God.Elephant was curious about the dead, and in this chapter he reveals more of his visions that led him to grow further in his faith in God, even in the presence of death.Chapter 22What is a Soul?            Soul is the energy that God places within a human body so it would receive life.29 Elephant says the soul should master the mind in harmony, and the mind should not master the soul. He further speaks of preachers who minister differently among people.When the preachers are preaching, some minister to the soul and others to the mind. Ministering to the soul results in the abyeance of sins Other preachers entertain the flesh (mind) by telling people what they want to hear. Those are preachers that are either ingrained by the Devil or have personal interests.30If mind is separated from the soul, and the soul should master the mind, it becomes clear that the mind is of the body, and the soul is of God. What does it take to have a water-loving mind, then? Worldly matters, perhaps. What does it take to have a healthy soul? Elephant says its a relationship and common communication with God.Chapter 23Who is right Christians or Muslims?            In a very concise but meaningful manner, Elephant explains the reality among Christians and Muslims, and how there should be no debate as to who is right between the two groups.            It has already been discussed in the book that man is complicated by nature. Ergo, it is not surpri sing to see religions clashing even when they are not supposed to, considering that they are worshipping one God, and resisting one enemy, the devil. Ergo, it works for the glory of God that people in spite of all the differences, are worshipping one and the same God, albeit in many varying ways.Chapter 24The secrete of the Da Vinci Code            The whole world talked of a fictional book by a them emerging author who wrote about the purported symbols in the works of the great legendary artist, Leonardo Da Vinci. Massive talks and debates were held, all for one fictional book. Yet, Elephant shares with the readers why all these debates took place. He says, Religion, belief, and faith are parts of our lives, and they give us an identity. When they are challenged, we tend to feel insecure and baneened.31 The threat mostly comes from knowing that other groups are saying that what used to be real for most is false all along. This is a thre at in that the stability of old beliefs are shaken, and a line is no longer drawn between fiction and facts.However, Elephant says, the threat should not noise anyone, and there should have been no threat at all if man has a competent understanding of what he believes in. The problem starts when ones faith is weak and therefore the Spirit is not heard. We should not walk blindly, because ignorance is as bad as any other sin.. It is our responsibility to follow Gods guidance, Elephant says.32 This guidance, when received, will draw the glaring line between fact and fiction, and kill the threat away, and will subsequently set matters unbowed between fact and fiction. The thing that matters most, therefore, is faith, unshakeable faith in God that seeks guidance all the time.Chapter 25Kenyan Road of Democracy            Kenya is precious to Elephant because first and foremost, it is his country.           He also mentions about the amazing relationship between Christians and Muslims in Kenya, together with the other religions. Hence, in Elephants country, they were one.All the turmoil that Kenya has gone through, sits deep inside each one of everyone in Kenya, such that even the political situation in Kenya has become a part of Elephants vision. Elephant says, During the elections, I did not go to vote because I knew the outcome already.33 Elephant shares how the amazing change of government in Kenya was hinted in his visions, and what he had to do to see it through.Chapter 26pope John Pauls Revelation            pope John Paul II was instrumental to Elephants continuously increasing faith. Elephant shares with the readers the testimonies of his visions concerning Pope John Paul II, and how his death has instilled him, spiritually and emotionally, and ultimately, holistically.            Elephant shares, I had a lot of confusion in my head about my life and mission until the death of Pope John Paul.34 Even after the Popes death, Elephant has witnessed a vision, which affirmed the reality of death for him, as well as the awesome glory that awaits those who have been righteous and faithful to God.            In conclusion to this chapter, Elephant says, It is true that when we die, an angel of God comes for us in a bright light to take those who are righteous to paradise laurels be to God.35PART IIIChapter 27Who is the Devil?            In this tertiary and final part of the book, Elephant tells the story of how the Devil became one, and how man is being trapped by this devils purpose over and over again. As for Elephant, he reckons that knowledge of the devil and its ways are necessary in the continuous journey of a believer in God.          &nbs p In Elephants summarized story of the devils existence, he stresses that the devil is all about pride, power and possession. So, the Devil deceives mankind to sin, so that he can remain in power and have authority and power throughout the ages.36Chapter 28Who is Jesus?            Jesus is the overall musing of  Gods love for man. As it is said in the Bible in John 316, For God so love the world that He gave His only create Son, that whoever shall believe in Him, will not perish, but will receive eternal life. As such, Jesus was the very representation of Gods immense love for His people.            Elephant recounts Jesus life on Earth, emphasizing on Jesus important teachings on love, kindness and prayer among others. Knowing Jesus is similar to knowing that God loves his creation.Chapter 29Who is God?            Elephant turns to the Bible and his own personal experience and visions in sharing with his readers the reality he knows of God. He says, Gods purpose from the beginning was for man to rule the world. God did not create man to die but to live forever37            In knowing God and His high supremacy, Elephant turns to the Bible to recount the first three commandments in Exodus 203-7, which is the ultimate verbal manifestation of GodI am the Lord your God who brought you out of Egypt, where you were slaves. Worship no other god but me. Do not make for yourselves images of anything in heaven or on earth or in the water under the earth. Do not bow down to any idol or worship it, because I am the Lord your God and tolerate no rivals. I bring punishment on those who hate me and on their descendants down to the third and fourth generation. But I show my love to thousands of generations of those who love me and obey my laws.Chapter 30Curses       & nbsp    Curses in this raw age are nothing more than witchcraft manifestation of manipulation and remedies. But in the Bible, curses existed because God has decided to unleash His anger. God, too, gets hurt and gets angry. In fact, He was so disappointed and hurt with what happened to Adam and Eve in the Bible, that He express them. This is the story of this chapter how God was badly hurt, how He has cursed the world and how he redeemed it again by Jesus Christ.            Elephant says, The curse started from one point where God was standing and spread all over the world. The blood that came from Jesus limbs dripped onto the ground, breaking the curses right from the Calvary where the cross was planted to the ground.38Chapter 31Gods Anger            In building a relationship with God, it is important to understand what makes Him happy and what makes Him angry. Even before man is b orn, he is loved. But mans complicated course of actions is inclined towards displeasing God, resulting in His anger. Therefore, if man would know what angers God and keeps that in mind, his life and his relationship with God would lie strong in faith and he will not feel abandoned or cursed by God.            Elephant says, God has taught me about the Bible through reading and repeating in my dreams or visions the events that took place from Genesis to Revelation whenever I desired to experience the same.  In his desire to experience God fully, he submits himself for visions, desiring to understand God and His ways. Elephant states how he has shared laughing moments with God, and how important it is to never leave Gods care.Chapter 32The Grace of God            Elephant starts this chapter by reminding his reader of one biblical fact all man are sinners. Yet, despite the sin and the abominab le ways of man, Gods grace shines through, so much that His Son came down to die for the salvation of man.            Even before Jesus came, Gods grace was already apparent in the former(a) studyament. Elephant says, God is love and He is merciful. He delivered the Israelites from the handsof their oppressors because He loved their forefathers. There was no price to pay after deliverance. Truly, there is no higher and holier grace than that.Chapter 33What is Forgiven?In his desire to further understand God, Elephant has prayed for an understanding of sin, and how sin would be recalled on the last day. How much is too much when it comes to sin? How could mans unforgiving ways affect the judgment that would fall upon him on the last day? To answer these questions, Elephant leaves one strong statement for his reader The wicked will have to suffer, but those who trust in the Lord are protected by his constant love. It is worth noting that throughout the book, Elephant is consistently never judgmental, and he keeps inviting his reader to repent and trust in God to experience Gods amazing love.Psalms 51, a prayer for forgiveness is an integral part of this chapter, where man is encourage to put his trust in God and know that for whatever sin, if man comes with sincerity and bow before God, then Gods grace will forgive, and ultimately, save him.Chapter 34Do Not Test God            While Christianity is under attack, man is continuously tempted to ask God for signs that He is real, that He exists, that He is powerful, and that He is, indeed God. But Elephant says in this chapter, man is not supposed to test God.            In Deuteronomy 616, it is said, Do not put the Lord your God to the test. Be sure that you obey all the laws that He has given you. Do what the Lord says is right and good, and all will be well with you.  &n bsp         In maintaining a relationship with God, Elephant says this is what is importantTherefore, it is not a question of what to receive but what to give back to God not what God is going to do but what God has done for us and what we are going to do for Him not what we can expect from God but what God expects from us.39Chapter 35Where Does God suffer?Believers and followers of God will know where he lives for it is written in the Bible, that Jesus has risen to prepare rooms for Gods children who will find Heaven after a life on Earth. In John 141-3, Jesus said, Let not your heart be troubled ye believe on God, believe also on me. In my Fathers house there are many abodes were it not so, I had told you for I go to prepare you a place and if I go and shall prepare you a place, I am coming again and shall receive you to myself, that where I am ye also may be.Therefore God lives in a acres with many rooms, and this, man is destined to see. Elephan t concludes, Jesus came to bring salvation to all mankind so that we could inherit the Kingdom of God by showing us the right way to follow.40Chapter 36Prayers            Chapter 36 is full of prayers for the believers to form a relationship with God and fortify this relationship to experience Gods grace and love.            In this chapter, Elephant discusses the cardinal Steps to prepare the Bread at the Holy Communion. The seven stairs are as follows First, prepare the ingredients while gathering the believers and ask forgiveness from one another second, ask God to bless the mixture of boodle to turn it into the Body of Christ third, pray for the utensils, too, and ask God for the blazing flame of the Holy Spirit fourth, pray for God to enrich the bread with spiritual gifts that it may be taken into the body of man fifth, give thanks to God sixth, bless the communion and pray for those who are taking it and finally, pray for forgiveness and thanksgiving before taking in the communion.Chapter 37Day of the LordIn the final chapter of his book, Elephant calls unto his readers to nourish a deeper and more meaningful relationship with Christ, to become followers and believers acting as Gods hands on Earth, for Gods glory, and for earning the right to get to the Kingdom of God on the last day.Through his experience, visions and dreams, Elephant wishes nothing more for his reader than to enjoy Gods love by rediscovering Him, and becoming closer to Him everyday.Finally, Elephant shares his knowledge of rewards that await the believers on the day of Christs  return on Earth. He wishes to enjoy this glorious second coming, with as many believers as possible.
Friday, January 18, 2019
Assignment 3 Management and Organisational Behaviour fain for Dr Retha Wiesner Faculty of furrow &type A Law University of S exposehern Queensland Toowoomba, Queensland by scholarly person name W. Amal Peiris Student number U1031128 MGT5000 INTRODUCTION Qantas faced the crisis in 2011. and it has commenced in 1990 when it was deregulated the judicature by means of privatization. Culture of Qantas remained un tiltd and it ope rambled as a government disposal. Since Qantas was a government owned organization its woo house was non competitive comp atomic number 18d to other Airlines.Qantas responded with low- comprise Jetstar and just like virginal Airways, the latter also moved into international flight lines to provide an alternating(a) to passengers. Since then Qantas set out on a modernization path whilst adapting to the global environment. However its cost tail end continue to climb. Three married couples went on a flog and it go forthed in 80,000 passengers creat ion stirred, more than 600 flights canistercelled and seven-spot aircraft demonstrateed. The impact has been matte up at both domestically and internationally. On 29 November 2011, Qantas chief executive Alan Joyce do the decision to ground the airlines entire communicate.This action stranded 68,000 passengers around the world and locked out Qantas employees in response to the protracted industrial strife. Since parties render failed to resolve the dispute at heart 21 geezerhood, went done a binding arbitration. As consequences to the Qantas crisis the main challenges be to rebuilding of trust, restoring tidy working relationships and rescuing Qantas reputation with its staff, customers, the government and other s causeholders. searing DISCUSSION ON THE POWER ISSUES EVIDENT FROM THE casing world-beater could be define as, the ability to mobilize resources (human and machine) to get things d wiz. * a resource, not an act. It is an ability, a efficacy, a likely and it does not scram to be utilize. * or sothing which is positive in terms of its output. * conception of bureau which cope withs it as the means whereby rough-cut objectives are chance ond. * a resource which can be expanded and shared to the shared benefit of all parties. Power over refers to the ability of one fellowship to impose its will on another. Power is an essential distributerial resource. It is demo by the ability to get someone else to do what you want you to do.However, if government agency holders manipulate and impose such spot on someone else to achieve individual objectives rather than common objective, a power issue is arose. Bases of Power Bases of Power refer to what power-holders control that allows them to manipulate the behavior of others. These are sit power, including ? Reward power power tightd on the distribution of rewards that others overhear as valuable. ? Coercive power power that is based on fear. ? true power and orchis authority the power a person receives as a outcome of his or her position in the formal pecking order of an organization, including process and information power.Personal power including ? Expert power influence wielded as a solvent of expertise, special skill, or knowledge. ? Referent power acknowledgment with a person who has desirable resources or personal traits, the power of being likable. As the chief executive officer of Qantas, Alan Joyce possesses the veritable power and formal authority. In the accustomed movement its limpid that Alan Joyce has utilise his power base in several circumstances, those baffle been critically analyzed bellow The fleet groundingchief operating officer denote the immediateand unprecedented grounding of all Australian domestic and international Qantas flights as a result of the proposed lock-out of the airlines staff in response to continued industrial action against the company. This resulted grounding of 108 planes at 22 airports, domestical ly and internationally. besides it was estimated to cost $20 million a day. This can been seen as a action taken by the CEO based on the his let power and formal authority, which resulted in addition to the revenue loss a loss of goodwill too.However, one can beseech that he made this decision with the best interest of the Qantas and but not anything against the unions. In his row he state that All Im concerned close is Qantas. This was not anti-union, this was pro-Qantas Ill book whatever tough decisions are infallible in order to picture the survival of this great company Actions to gloomyplay cost As further explained in later part of this analysis, collectable to the deregulation of airline industry, steering headed by Alan Joyce had to make following decisions to be competitive in terms of cost. Qantas trenchant to operate with low-cost Jetstar flights. Jetstar capacity is rattling control too. * Qantas announced a restructure which will see 1,000 short letters slashed as part of a new tenseness on Asia which would answer the circumspection to cut cost and be more competitive. However, in the lead making these decisions circumspection did not consult the parties who were going to be impacted. found on the legitimate power and formal authority management use a top-down surface in terms of these changes. From the side of the employees, they could argue that this improvement was not the right forward motion to change.From the other side one can argue that these decisions anyway had to be taken to the survival of Qantas, thence he had done these in good faith. CRITICAL DISCUSSION ON THE CONFLICT ISSUES EVIDENT FROM THE CASE AND HOW THE RESPECTIVE PARTIES HAVE DEALT WITH THE CONFLICT. The crisis which faced Qantas during 2011 is said to have commenced due to the following changes made by the management in Qantas As a result of airline industry started going through a deregulation by the Australian government, by end of 1995, Qantas an tecedently being a government owned organization became a state-supported company which is listed in Australian Stock Exchange.However, as a result previously being a government owned organization, Qantas existing cost base wasnt competitive compared to other global airlines. Hence, management had to take following initiatives. * Qantas decided to operate with low-cost Jetstar flights. Jetstar capacity is very limited too. * Qantas announced a restructure which will see 1,000 jobs slashed as part of a new emphasis on Asia which would help the management to cut cost and be more competitive. As a result of these changes following conflict issues were arose amid management and its employees.Parties deviation Issues Action Engineers Engineers mat vulnerable for fear their work would be sent overseas and they treasured only limited outsourcing. * They went on strike over pay and conditions. * posterior moved to arbitration, describing it as the appropriate outcome for the appropri ate time. Baggage and ply Staff Their Concern was for job security and outsourcing rather than pay. * They went on strike over pay and conditions Long-haul Pilots To ensure Qantas flights are operated by pilots paid at Qantas rates, not the lower Jetstar rates. The only action Qantas pilots had been taking was inflight announcements round the industrial dispute, as well as the donning of red ties that carry the message Qantas flight, Qantas pilots However, unclouded Work Australia FWA industrial umpire managed to bring the disputing parties to the negotiation table. FWA gave 21 days to disputing parties to resolve the dispute. But, within this period parties failed to reach a solution. Hence, FWA brought the dispute between Qantas and three unions to a close through binding arbitration.On the other hand, Unions argued that Qantas has failed to scupper good faith in the negotiations and reaction from Alana Joyce was totally out of attribute to the issues. CRITICALLY DISCUSS T HE LEADERSHIP STYLE OF QANTAS CEO, ALAN JOYCE AS EVIDENT FROM THE CASE AND THE CHANGE MANAGEMENT STRATEGIES THAT HE HAS USED IN DEALING WITH THE STRIKE. leading port Its obvious from the research made on the Crisis leading that leading play a central role in crisis through virtuoso making and the viable mental models. In this regard in depth knowledge on the crisis is very much crucial to a leader.In a crisis business office leaders actions are always depends on the leading style of that particular leader. A leader always makes decisions to cope with the crisis and to change the context in which it occurs in line with his/her leading style. However, these actions may not always steady and directed towards the presumption crisis situation. In the disposed(p) Qantas case, when the industrial dispute occurred, Alan Joyce as the CEO of Qantas decided to grounding of all Australian domestic and international Qantas flights as a result of the proposed lock-out of the airlines staff.Further, he decided to reimburse accommodation costs for those left stranded by the fleet grounding, and refund those who were expected to fly with the airline. Afterward, he expressed his opinion on his actions saying that All Im concerned about is Qantas. This was not anti-union, this was pro-Qantas Ill make whatever tough decisions are needed in order to ensure the survival of this great company Hence, in this situation one could argue that the leadership style of Qantas CEO is authoritarian or Autocratic where workers have low bargaining power.In late 1940s, based on the research made by the University of Michigan it was derived cardinal basic forms of leadership behaviors employee-centered and production-centered. In the employee-centered environment its expected that leaders are tender to the employees feelings and emphasizes more on interpersonal relations. In the production-centered environment its expected that leaders are more concerned with spelling out the task requirements and emphasizes more on the technical aspects of the job.When considering the above decision and description made by the CEO on the industrial dispute, its evident that CEO is authoritarian or Autocratic and relied more on the production-centered behavior. castrate management strategies Typically, change initiatives are met by some oppositeness. In general, resistance is managed best if its recognized early in the change process. This generally can be done through education, converse, participation and facilitation. In the given case its evident that management of Qantas had used Top-down approach to change.In this approach CEO believed that one-way communication backed by the formal authority of their position is enough to implement the change. However, its evident from the case that this approach is not effective. Victims argued that Qantas has failed to flourish good faith in the negotiations and this one-way communication of change process made number of issues in Qantas. E. g. The engineers, felt vulnerable for fear their work would be sent overseas. The pilots union wants to ensure Qantas flights are operated by pilots paid at Qantas rates, not the lower Jetstar rates.The direct Workers Union, which represents baggage handlers and catering staff, wants to restrict work being sent away(p) Qantas. As a CEO, who plays major role in top management, Alan Joyce does not have a monopoly on expertise, information and inputs. In such situation, bipartite communication would have given addition perspective to the change management process. Hence, in general it can be cogitate that leadership style and change management strategies used by the Alan Joyce are ineffective. THE SURVIVAL OF QANTAS may BE AT STAKE IF THE ISSUES ARENT RESOLVED IN THE FUTURE.IN YOU VIEW, IS A CULTURE CHANGE REQUIRED IN QANTAS? JUSTIFY YOUR ANSWER BY CRITICALLY DISCUSSING THE CURRENT CULTURE OF QANTAS AND EVALUATING WHETHER A CULTURE CHANGE IS NECESSARY. Although the Qantas and Australian Airlines were merged and Qantas was privatized, As a result of previously being a government owned organization the companys cost base wasnt competitive compared to other global airlines. The finale of Qantas including organizational structure, strategies, and cost base remained unchanged with the changes in Ownership.With the privatization, Qantas could have changed their culture including strategies, and cost base to be in competitive within the airline industry. Autocratic leadership was applied where workers have low bargaining power and there were no straitlaced processes for performance evaluation, health and safety and benefits (Compensation) of employees. Leadership style should be arranged to enhance problem solving, effective decision taking, where performance evaluation, health and safety and benefits (Compensation) of employees is considered.They have failed in dealing with disputes with employees where dispute has had a darksome effect on custo mers, suppliers and other third parties. Due to lack of communication Qantas failed to provide adequate notice of anticipated interruptions to normal operations. Also Qantas has failed to display good faith in the negotiations. Therefore it is important to implement proper policies for resolving conflicts. Dividend has not been paid to the shareholders company since early 2009 and according to CEO there wont be any growth in the short term.Companys cost base is not supportive for make profits and further adding to the pressure on Qantas is the severe competition from arrant(a) Australia in the domestic market. In a summary, changing culture of Qantas is very important to achieve objectives of rebuilding of trust, restoring good working relationships and rescuing Qantas reputation with its staff, customers, the government and other stakeholders. Existing cultural web Qantas Myths & Stories * Lack of job security * Poor Management employee relation Symbolic Aspects * Top manage ment remote from workers * One way communication theoryPower structures * CEO call the shot * competitive union * Complaint work force Organization * Top down Mgt hierarchy * Still follow Bureaucratic style * Strong union Control systems * Lack of open honest two way communications & Info sharing The Paradigm * Focus product not people * Atmosphere of mistrust * Structure, order & stability Rites & Routines * High Safety RECCOMENDATIONS Power As the CEO of Qantas, Alan Joyce possesses the legitimate power and formal authority. In the given case its evident that Alan Joyce has used his power base in several circumstances. E. g. He announced to ground all Australian domestic and international Qantas flights as a result of the proposed lock-out of the airlines staff in response to continued industrial action against the company. * As a result of the deregulation of airline industry, management headed by Alan Joyce took some decisions to be competitive in terms of cost. Thes e decisions resulted rate reductions and voluntary rate redundancies. However, affecting parties were not consulted earlier making these decisions. Earlier part of this analysis, it was concluded that a power issue is evident from these actions.Alan Joyce could have used his legitimate power and formal authority more acceptable way as his decisions created conflicts between Qantas and unions. This could have been done by way of * Using the power to mobilize resources to get things done efficiently and effectively. * Using the power and authorities to achieve common goals of all parties. * Creating friendliness use of flattery, creation of goodwill, playacting humble, and being friendly prior to making a decision. * Coalition acquiring the support of other people in the organization to back up the decision. Bargaining use of negotiation through the exchange of benefits or favours. * self-assertiveness use of a direct and forceful approach such as demanding compliance with requ ests, repeating reminders, ordering individuals to do what is asked, and pointing out that rules require compliance. Conflict management Its evident from the case that the CEO was unable to manage the conflict situation properly. Three unions were not happy about the approach used by the management. As conflict in an organization can be dangerous, CEO could have given more attention to the impertinent issues.All conflicting situations cannot be considered to have negative impacts. There are two sides to a conflict. i. e. constructive side and destructive side. CEO could have set constructive side of the conflict. It could have offered the management to identify otherwise leave out problems and opportunities. Further, it could have helped Qantas to become more innovative in the given issue. Hence, CEO could have understand the issue that causes the disagreement to be in a better position to manage the conflict and use the conflict to the organizations advantage.This could have bee n done by * Listening carefully to unions to embarrass misunderstanding. * Clearing the air with regular meetings that give unions a chance to question their grievances. * Offering as much information as possible about the changes to minimize confusion. * Developing conflict management strategies. Leadership CEOs actions against the industrial dispute brought number of conflicts on to the surface. This is mainly because unions were in the opinion that Qantas has failed to display good faith in the negotiations and CEO was totally out of proportion to the issue.However, leaders should play a central role in crisis through sense making and the viable mental models. In this regard CEO could have used an approach like case-based knowledge as it likely to fit out a leader with the best basis for problem-solving under crisis conditions. Case-based knowledge appears just about applicable in crisis leadership as case-based knowledge is known to be integral to planning and it provides in formation that is relevant to generating viable responses to the crisis situation.Even though it is unrealistic to predict a crisis, as a leader CEO could have taken precautionary actions to prepare for such crisis. These may include * Cataloguing likely crisis situations * Devising policies for their prevention * Formulating strategies and tactics for potential crisis * Identifying who will be almost affected by the crisis * Devising effective communication channels to those affected to limit the damage the organizations reputation. Associated change management strategiesIn the given case its evident that management of Qantas had used Top-down approach to change. In this approach CEO believed that one-way communication backed by the formal authority of their position is enough to implement the change. However, its evident from the case that this approach is not effective. Instead CEO could have used an approach like shared power and planned change. To minimize the likeliness of resistance one of the best approaches to change is, put strong emphasis on involving all parties affected by the change. Following steps could have been followed by the CEO. Education and communication educate the unions about the change before its implemented and help them to understand the logic of the change. * Participation and involvement Allowing unions to help design and implement the change and allowing them to contribute ideas and advice. * Facilitation and support Actively take care to the complaints and problems of the different categories of staff and providing training in the new ways, helping to castigate performance pressures. * Negotiation and argument Offering incentives to actual or potential resistors. Manipulation Using covert attempts to influence others. E. g. buying off leaders. * evident or implicit coercion At last resort, using force to get people to accept change. Organizational culture * Organizational culture should be change to in accordance w ith structure to achieve its common goals. * Build strategies in accordance with structure, culture, and HR policy. * Implement proper procedures for resolving industry disputes. * Start by changing peoples behavior. * shape proper plan for voluntary redundancies. deputise in the cultural communications that is, those things that communicate culture, and try to get people to adopt the new beliefs and values. * Intervene in the hiring and socialization of members. Hire people who would fit in with the craved culture, and teach them the rules, norms and expectations of the organization. * Remove any deviants from the organization. LIST OF REFERENCES University of Southern Queensland, Faculty of Business and Law, 2012, MGT5000 Managing organizational behaviour, Study book, University of Southern Queensland, Australia, pp. 20-141. Wood, Zeffane, Fromholtz, Wiesner, Creed, A2010, Organisational Behaviour core concepts and applications, 2nd Australian edn, , John Wiley Sons Australia L td, Milton, Qld, Australia. ABC (2011) What is the Qantas dispute all about? http//au. finance. yahoo. com/news/What-Qantas-dispute-abc-2933944078. hypertext markup language? x=0 ABC Updated October 31 Val Gostencnik and John Tuck (2011) six-spot lessons from Qantas, http//www. corrs. com. au/THINKING/INSIGHTS/SIX-LESSONS-FROM-QANTAS/ http//en. wikipedia. org/wiki/2011_Qantas_industrial_disputes viewed on 31 May 2012.