Discuss the cellular basis of diastolic dysfunction Essay

Discuss the cellular basis of diastolic dysfunction - Essay Example This phase comprises of the systole. As soon as the systole begins, the mitral and tricuspid valves shut close tightly in order to prevent any backflow of blood into the atria. At the same time, the pulmonary and the aortic valves are pushed open, leading to a flow of blood from right ventricle to lungs and from the left ventricle to the whole body, after getting oxygenated from the lungs. In the patients with diastolic dysfunction, the ventricles fail to relax normally during this phase of cardiac cycle. This leads to an increase in the pressure inside the ventricles when the blood returns from the second heart beat. This pressure is thus transferred to the lungs vasculature as well, leading to the pulmonary congestion as well as to the blood vessels, returning back to the heart, leading to the systemic congestion. The primary abnormality in left diastolic dysfunction is the left ventricular relaxation. This results in a high diastolic pressure along with the poor filling of the ventricles. As a compensatory mechanism, the left atrial pressure increases in order to increase the diastolic filling. This increase in the left atrial pressure continues, until it exceeds the hydrostatic and oncotic pressures in the pulmonary capillaries and eventually leading to pulmonary edema. These patients generally show the symptoms of exertion when there is a reduction in the ventricular filling time, during the times of increased cardiac activity. The circulating catecholamines further worsen the whole scenario. [5] According to Michael R. Zile, MD, Charles Ezra Daniel, Professor of Medicine, Division of Cardiology, Medical University of South Carolina; the difference between the systolic heart failure and the diastolic heart failure lies in the amount of ejection fraction during the two conditions. In systolic heart failure, there is heart failure, but with a decreased ejection fraction, while in

Twelve Angry Men Intros Essay Example for Free

Twelve Angry Men Intros Essay Set in the summer of 1957, Reginald Roses play, Twelve Angry Men, highlights the importance of speaking out for what is right. Rose demonstrates through characterisation that prejudice and preconceptions can conceal the truth. From the inception, Rose presents a biased jury who is convinced of the boys guilt based on preconceived notions. However it is through Juror 8, that Rose advocates that justice and fairness can prevail over prejudice if just one virtuous person is willing to speak out. Juror 8 is depicted as the epitome of a fair and conscientious juror who is prepared to stand alone in order to ensure a fair verdict is delivered. Although the other jurors initially lacked equity, they discover their inner voice through Juror 8 and are able to deliver a legitimate verdict. Twelve Angry Men demonstrates the weakness of the jury system. Do you agree? Reginald Roses play,Twelve Angry Men, highlights not only the fragility of the jury system, but also its strength. Rose presents to the audience that it is more by luck than legal support that the accused was acquitted, therefore implying that the jury system is flawed. Initially Rose presents a biased jury who is convinced of the boys guilt based on preconceived notions. This emphasises a major flaw of the jury system, being that prejudice can obscure the truth. In addition, the jurors votes are also influenced heavily by their own personal backgrounds. This is evident in Juror 3 and 10 especially. However it is through Juror 8s virtuous motives of finding a reasonable doubt that ensured a just verdict was delivered. Juror 8 was the only person able to look past personal prejudices from the beginning, and through perseverance was able to guide other fellow jurors to deliberate honestly and thoughtfully. Thus, Rose shows the audience that the jury system is capable of securing justice.

Risks Related To Change Management In Shell Business Essay

Risks Related To Change Management In Shell Business Essay In the very beginning it is already mentioned in the finding of this report about the factors which cause resistance to change. The two major reasons apparently identified for resistance to change are the fear of losing the job status and job security. The mentality of an individual varies accordingly and there are multiple factors which influence the human thinking. Attitude towards change is a similar example of this and not everyone take it positively. Fear of losing here refers to the risk of carrying out the change process unsuccessfully. The moral of the individuals could go low if the results of the change are unsuccessful and the individuals are mainly scared of failure so they dont want to experiment new things which acts as a barrier to change. Another major reason found which resists change was the job security and the job status of the employees. Here the fear is that the individual could lose their strong position and command due to change being adopted and most of the e mployees in the organization are not really keen to risk their status or job itself. As far as literature is concerned on this topic Lewins (1940) views were in support of this research, he presented his views on resistance to change linked to the human behavior which was also the case at shell, the staff resisted when the idea was presented to implement SAP over JD Edwards. Besides that the findings can also be related with the research of Schermerhorn, Hunt, and Osborn (2005) who said that the individuals resist change to protect their interests and also to defend the elements which are valuable to them, findings in this research present a similar picture as it can be concluded from the research that individuals resist change mainly because of fear of losing and protecting their job and job status. Eight step reasons identified by Schermerhorn, Hunt, and Osborn (2005) are also very similar to all the reasons for resistance to change mentioned in the findings section. Coch French (1948) also researched on this topic and their research was conducted in Virginia in a Harwood, manufacturing company, their findings suggests that the individuals lack of interest in the change process and no participation from their side is the major cause of resistance to change. Somehow there is a disagreement with his concept on this as the findings above do not include any such factor of lack of interest or participation in the list of resistance to change. His work was also challenged by Lawrence (1954) and he said that the findings of Coch and French were misleading as they were away from the reality in their research. He then suggested a list of reasons why people resist change, that list is mentioned in the literature review section and again a disagreement on his concept as his reasons given were also close to the findings above. The most important reason suggested by Lawrence was that people resist change because the outcome is unknown to them and the other m ajor reason given was that there is a lack of trust amongst staff and thus they resist change and this reason was also mentioned in the findings so the idea of Lawrence on resistance to change is in support of this research . 5.2-Models for dealing with resistance to change There are many models which have been suggested by different scholars to deal with the resistance to change. Kotter Schlesingers six step model is widely accepted in the industry besides that Lewins 3 stage model is very popular as well. Few other models for dealing with resistance covered in the research are force field analysis, Greminis 4 Rs, Greniers Organisational growth for organisational learning etc. However after conducting the research and surveying in the industry and getting feedback from individuals from different organisations, it can be concluded that the Kotter six steps and Lewins three stage model of unfreezing, change and refreezing are the most accepted and understood models for change used in the organisation. These two models cover all the important aspects which are normally required in an organisation when dealing with change. Discussion has been made in the findings on the concepts of organisational learning and organisational growth and the Greniers model f or organisational growth since these topics are no different from the subject of change management. The findings from the research conducted in Barclays and Reckitt Benckiser is in support of Kotter idea of managing resistance, the commonly found resistance in both the companies is usually managed by one of six steps presented by Kotter or sometimes multiple steps could be used to deal with resistance. 5.3-Business Process Re-engineering The topic has been covered in the literature review since the case study of Shell is an example of business process re-engineering. BPR usually involves radical redesigning of a process in terms of cost, quality, speed or service to improve the conditions dramatically within no time, the BPR process also requires fundamental rethinking of the ways operations are carried out in an organisation. Shell desired to change its ERP system JD Edwards and implemented SAP over it in order to standardize its process and remove complexities, this could be termed as an example of BPR. The primary findings of this research can be related to the literature presented by Hammer and Champy, and Wenrich and Ahmed, they felt that the concept of BPR is usually linked to the ERP implementation and the case in Shell was one example of this. Besides that this concept is also supported by the idea of Chan and Peel who conducted their research on this topic in many different companies and their findings sugge sts that the main reason for BPR is improving on the organisational efficiency in operations and also raising the level of customer service. Shell implemented the BPR to increase its efficiency. 5.4-Risks related to change management in Shell There are various risks related to the transformation process in Shell which have been identified in the findings section, the major ones being the reputational risk, high project cost and desired results not being achieved. As Shell is a big name in the global market and holds a respectable reputation in the industry so failure to carry out this process would have damaged the reputation of the organisation and as the investment was of more than 100 billion euros so the level of risk went higher with the massive cost. Primary findings of this report are more close to the views presented by Butterworth-Heinemann, as he has described the risks related to the system changeover in his research and the risks covered by him are very similar to findings above. He has only focused on the risks related to the system changeover and the common risks identified in the findings above and his research are data conversion, user acceptance of change, system interfaces and integration and end user in volvement. So in comparison to Proscis concept discussed above, it is clear that Butterworths idea of risks faced in change management is more agreeable as the literature is more similar to the research above. On the other hand Proscis view on risks is more general and related to the specific project and the organization as a whole. The risks identified by him are more general like the customer and supplier view, resistance in general, budgeting issues, negative impact, stress, conflicts and misunderstandings amongst staff, etc, it is not specifically linked to the system changeover so the primary findings are in more support of Butterworths work over Proscis concept 5.5-Change Process at Shell Shell transformed its ERP JD Edwards to SAP as discussed above, and the primary reason being to increase the efficiency and to standardize the global policies. The reasons for the change have already been discussed above and to sum up, the major factors which pushed Shell towards the change were simplification of processes and make the use of latest technology. The change at Shell would be classified as a planned change, various views have come in front regarding planned change but the most attractive view on the topic was presented by Burke George Latwin, and Kotter. Burke George presented a model in which the change was classified as transactional or transformational. The change adopted in Shell could be termed as transactional change, as the fundamentals of the organisation remained same and only some features of the company changed. Another scholar making sense is Kotters, he presented his ideas on planned change in the eight steps model and all of the components in that model are all completely linked to the heart of the organisation and are specifically focused on the concept of change. The other theories discussed in the literature review are mostly the example of incremental change which is the change applied in steps, and after conducting the research on the types of change it was found that Quinn concept seemed appropriate, he suggested that the incremental change was leading to a slow death while the radical change headed towards irreversible transformation. The change at Shell was not an incremental change. In Shell Pakistan the change was implemented in formal steps and a proper procedure was being used which has been discussed above in the findings. At the end of the research it was found that the process of change in Shell was much organised as the management conducted surveys, authorities and responsibilities were very clearly defined and they made the use of a change agent who initiated the process and pushed the others to follow it. The chan ge at Shell in terms of organisational level was an example of operational change. This can said since the operational change talks about the concepts of BPR, TQM, continuous improvements, JIT etc, and all these were considered at Shell during the transformation stage. Pettigrew differentiated the types of change and said in his research that the operational level change are taken at a small score and are not important in the organisation. I firmly disagree with his ideas and feel that the operational level change is equally as important as change at any other level. The change in Shell was an operational level change but it was very much required and wasnt a small scale project since a massive investment was made, the findings suggest that the change implemented was very effective and the organisation succeeded in achieving their goal. 5.6-JD Edwards From the findings above it can be concluded that the employees in Shell Pakistan were not very satisfied with the performance of JD Edwards as an ERP. The feedback was taken through a questionnaire completed by them to find out how they feel about the system and to summarize their views in a nut shell they did not feel that JD Edwards was a flexible enough tool for the product reconciliations and it they also felt that it was not the ideal system which could be used for reporting purposes. Rowena Hawksley had a different view about the system and She said it is a valuable system for the business to use for Asset lifecycle management, inventory control, supply chain execution, manufacturing and engineering purposes etc, but a disagreement is reached from his ideas as the findings in this report on Shell differs from the views presented. 5.7-ERP With regards to ERP many scholars have presented their views and few of them have also been covered in my literature review, ERP was best described by Gale, he viewed ERP as an important tool for business to manage operations, which will integrate used in Shell Pakistan during the implementation of SAP. According to Richard Goekey and Robert Faley the SAP implementation in chemical and Pharmaceutical industry has not been very successful in terms of inventory management in the organisation, it can not be agreed as the implementation of SAP in organisation from any industry has resulted in dramatic turnarounds and even in Shell the results obtained after the SAP implementation has been positive and the objectives were achieved. Duplagia and Astani said that the integration between functional areas and information system is the primary reason for companies implementing ERP, the same was the case at Shell as the organisation planned to standardise its processes so implemented ERP, there fore the views of Duplagia and Astani could be related to the research conducted above. 5.8- Effectiveness of SAP implementation SAP implementation has been successful in Shell Pakistan and the results obtained have been positive. The moral level of the users has improved and the implementation has resulted in cost saving and reducing complexities in the organisation. Suzanne Gaut, presented a best practice approach for the SAP implementation, the approach was split into two major categories defined as the key individual required in the SAP implementation and the important elements needed in the implementation stage. The details have been discussed above and the best practice support was pretty much followed in Shell Pakistan during the implementation of SAP. Suzanne focused on the fact that the project manager, users of the system, maintenance member, account member, etc should all be involved and participate during the implementation phase to get the desired results. The findings of this report suggests that yes Shell had most of its key members involved during the implementation and the survey undertaken de scribes the attitude of staff towards of change, it says that most of the members were open to change and welcomed the idea of SAP implementation. The line managers were assigned responsibilities in Shell for the SAP implementation and the staffs expressed their satisfaction with their performance and accepted that the managers fulfilled their responsibilities properly and also were keen to provide training and transfer knowledge on the project in order to help the group as a whole and make this project successful. The other part of the practice suggested by Suzanne was including important elements required in the SAP implementation. Few of the important elements were aim and objectives of the project, people expectations, purchasing, operational, financial and contracting strategies, and computer based training etc. Again the case at Shell seemed to be following all these instructions and the management got all the important procedures completed before and during the implementation. The change agent appointed by Shell helped in carrying out the process and helped in selling the idea of change and recorded the vital steps to be understood and carried out. At Shell the control methods were in place to protect the data loss and only authorise individuals were granted access. The use of multiple passwords of ten digits each was made to maintain the integrity. Results obtained in Shell post implementation of SAP were better and the issues of product traceability, reconciliations and flexibility were resolved which was not the case when JD Edwards was in use. The views of Suzanne Gaut are more related to the implementation process carried out in Shell, most of the points presented by Suzanne have been covered by Shell during the implementation.

INDIVIDUALS VS SOCIETY IN THE MIDDLE AGES Essay -- Essays Papers

INDIVIDUALS VS SOCIETY IN THE MIDDLE AGES The feudal society of the Middle Ages, from 300 AD – 1300AD, created instability that resulted in civil wars and the Crusades. This culture is what caused the changes and development of individuals and their society. Feudalism was a type of government in which political power was treated as a private possession and was divided between many lords during the Middle Ages. Only nobles were to rule until knights could build up lordships. 1 Empires were becoming too vast and too complicated. They began to split in half and then subdivide again without stopping for long centuries until 1300. This brought about a decline in public spirit. Causes of destruction multiplied with the level of conquest. Emperors became worried about their personal safety and the public peace. 2 Aristocrats took responsibility for defense against invaders. A family that fought for a certain area became hereditary rulers of that area. This seemed to be the best way for them to preserve their wealth, standard of living, and political position in an unstable world. Kings were losing control, as political power had become private, heritable property for counts and dukes. The weakening of the kings gave the aristocracy the opportunity to gain the service of most knights. The knights were nothing by themselves. They had no prestige, no political power, not even much military significance. They had to have a lord to function effectively and they had to serve the lord regularly and faithfully. Members of the aristocracy gave loyalty and services only when he felt it was to his advantage. 3 Civilization was completely engulfed by the inflow of barbarous elements from outside, partly by penetration, partly by... ...ld 300-1300. 2d ed. Toronto, Ontario: MacMillan Company, 1968. 3. See Hoyt 4. See Cantor 5. See Cantor 6. Contamine, Philippe. War in the Middle Ages. New York, New York: Basil Blackwell Ltd, 1984. 7. "Medieval Crusades." The Crusades. 22 October 1999. http://www.Kent.pvt.k12.ct.us/Department/General_Studies/ contents.htm. 8. See Contamine 9. Peters, Edward. Europe: The World of the Middle Ages. Englewood Cliffs, New Jersey: Prentice Hall INC, 1977. 10. See Contamine 11. See Cantor 12. See Cantor 13. See Contamine 14. See Peters 15. See Contamine 16. See Contamine 17. Riley-Smith, Jonathan. The Crusades – A Short History. Great Britain: The Athlone Press Limited, 1987. 18. See Riley-Smith 19. See Riley-Smith 20. See Medieval Crusades 21. See Peters 22. See Peters

Palm oil stalemate: who is responsible Essay

Summary Palm oil is a plant with various uses in human life (such as: tooth paste, Moisturizer and biodiesel). ïÆ' ¼Malaysia is one of the largest producers and exporters of palm oil. Gajah Berang Oil Palm Estate is one of the largest multinational palm oil conglomerates whose managers offer a balance between efficiency and employee satisfaction. The company has multicultural employee since its workers from Sri Lanka, Indonesia, India and Bangladesh. Melaka Palm Oil project presented one of the biggest ventures for the firm.   To enhance the balance between efficiency of the firms operations and employee satisfaction the company employed Abdul Aziz as the estate manager. Abdul Aziz shared common mother tongue with people of Malaysia thus making him to have a similar culture with the people of Malaysia. Hearing Abdul Aziz (Indonesian) was an advantage to the company since: His ability to control the operations of the company within the region since he possessed the shared culture with the people of Malaysia. He enhanced social responsibility by involving the people of the region to company affairs through hiring them Abdul Aziz used various leadership and communication skills to encourage employees to work effectively in the company. During the course of Abdul Aziz leadership, the workers went on strike asking for clean water and tank covers. He wanted to settle the issue but the Lee Peng who was his superior argued that this could compromise Abdul Aziz as a profession and as a result he looked for his replacement. 1. Describe Malaysian cultural attributes and how they might affect the operations of a multinational palm oil conglomerate doing business within Malaysia. Malaysia has diverse culture following different ethnic groups. Some of the cultural attributes of the people include beliefs, language, politics, and religion. This attributes would affect the operation of the Multinational palm oil positively or negatively depending on how it would satisfy this attributes. For Example, if the company focuses on satisfying all the cultural attributes of the people of Malaysia, then it will be in a good position to enjoy efficiency and wide market for its product. On the other hand, if the company does not satisfy the cultural attributes of the  people, then it would expect low efficiency in its operations. 2. What are some effective leadership and communication skills that lead to the development of a positive worker-manager relationship in international business? Aziz used various leadership and communication skills to enhance efficiency in the company: A)He allowed the employees to take part in decision making process. This acted as a motivation to the employees thus helped to increase their productivity. B)He also showed empathy to employees and shared much with them. He extended his gratitude to employees by listening to their issues. C)He used his troubleshooting skills to solve problems within the company. D)He was able to foster proper communication with employees something that ensured clear communication of information within the company. E)He used his mother tongue language to persuade employees to love the company more and more. 3. Would you describe the respective attitudes of Aziz, Krishnan, and Lee Peng as ethnocentric, polycentric, or geocentric? What factors do you suspect of having influenced their respective attitudes? Aziz, Krishnan and Lee Peng can be said to have polycentric attitude. This is because their decision to put Aziz on the Manager position was a focus to enhance openness towards the culture, opinions and ways of life to the people of Malaysia. Aziz was the main player in ensuring that the employees of the Multinational palm oil felt appreciated and recognized through their culture. Generally, this people ensured that the independence of the culture of the people of Malaysia was respected and appreciated. However, the attitude of Lee Peng can be said to be ethnocentric. This is because he wanted the issue to be solved professionally without focusing on the culture of the people. 4. Was Lee Peng correct in assessing Aziz ‘s controversial actions in the work stalemate? Should a palm oil conglomerate employ someone whose main function is that of liaison between its corporate culture and the culture of its host country? If so, was Aziz the right person for the job in the detailed scenario? Lee peng was not correct in assessing Aziz’s controversial actions. This is because Aziz’s aim was to balance the company’s operation efficiency with employee satisfaction. However, Lee  thought that Aziz would be compromised professionally by the employees for being so close to them. To some extend this could take place but in this situation such relation was very helpful for the company. Palm Oil conglomerate should not employ a person based on the function of liaison between corporate culture and the culture of the host county. However, It should focus on employing someone who is multicultural. This is because culture plays an important role to people of different countries. In this case, such employment was very vital since Aziz was multicultural and could listen to the needs and demands of the people of Malaysia as compared to his collogues (counterparts). In my opinion, Aziz was the right person for the job because he was multicultural and was professionally competent (MBA and he also worked in a small palm project in Indonesia). These two factors are very vital for a company to run smoothly. With these qualities he was able to control and satisfy the employees of the company. Professionally, he could lead employees to enhance efficiency in their work. On the other hand, he could motivate the employees by listening to their problems and allowing them to contribut e towards the company operations.

Ethical dilemmas Essay

Ethical dilemmas in the society have posted a major challenge to humanity since historical times. This has been contributed by the threats and immediate uncertainty that acts and reacts to kill the will and desire to do that which is good. Ethical dilemmas comprises of direct wrong acts in the society even when the correct acts are clear. However, the good actions are mostly never committed as they require dire commitment and are often interpreted in the wrong mode by the immediate peers and/ or work mates (Cyndi, 2008). In colleges, students are faced with major challenges related to their peers and the administration too. Ethics dictate that the students should not cheat in the exam rooms. Again, students are not supposed to steal others properties or sneak out of the school compound. The ethical thing to do in such a situation is reporting the case to the administration for disciplinary actions against the culprits. However, students do not report and remain silent in majority of the cases and therefore encourage repetition of the same acts. It is usually very hard to gather evidence since cases like those of cheating cannot have exhibits. Besides, there are long procedures to follow in filing such cases and therefore it appears as a waste of time by the students. Finally, it appears as a sabotage and betrayal of one’s peers and therefore one risks being segregated. Therefore, majority of the students though willing never acts ethically as they are torn between acting correctly or maintaining the demands of the immediate associations (James & Dean, 2008). Lawyers on the other hand are trusted with ensuring that the most ethical discourses are followed in the justice system. However, rarely does it happen as they defend their clients even when they are aware that he/she is on the wrong side. As a professional lawyer, bringing charges against another lawyer is hard even after clearly knowing that he/she has been on the wrong side (Scott & Ronald, 2008). This is because it demands involvement in terms of time and vast resources to effectively defend the case. Besides, one keeps off as the peer dislike people who go against one their ideologies in the societies. Like the students case, one may be left alone and therefore unable to operate in the profession which requires strong cooperation. As indicated earlier, lawyers know how to cover what is bad with good and lots of evidence may be required to win particular cases against them. Lawyers Johnnie Cochran and F. Lee Bailey defended O J. Simpson in his murder case with little challenges from other lawyers of their firms even understanding their client had committed the crime (Cyndi, 2008). Besides, accountants have also been strongly involved in unethical deeds where they inflate or deflate the books of accounts in solidarity with their partners to ensure that they make a company or project fail in favor of another one. In such cases, though there is enough evidence to launch major complains, the rewards are generally hefty and the members commit never to reveal it and exposing the deal would lead to threats by other members. This has been highly unethical as it may lead to loss of jobs and investments for innocent people (James & Dean 2008). An honor system application and use in the society has had many advantages to the immediate users and the society at large. It is cost effective as it is run by trust and enhancing efficiency is easy as it emanates from the individuals goodwill. For instance buses and trains can operate easily without waiting for routine tickets checking. Besides, it brings the groups together and promotes the spirit of team work in an organization or institutions thereby raising the efficiency of immediate operations. However, in the society where there is great tendency to do the wrong things than the correct one major businesses are bound to fail due to solidarity of the employees and staff. As a result, it promotes laziness and bad behavior as the employees act in solidarity to cover up their colleagues on the wrong sides in the organization or institutions (Scott & Ronald, 2008). This system breeds the major dilemmas and acts to kill the good people in the society by pushing them into the major peer cocoons. Conclusion. Ethical dilemmas have posted some of the major threats in the society to humanity and the production systems. They have far reaching impacts to the society especially if they are amongst the peers in institutions and other management units. To add to that, these dilemmas operates at all levels from school to high professionals and administration management realms therefore posing major risks to the whole society. To address the situation, institutions require embarking on strong campaigns to fight the unethical behaviors in the society. Cooperation and communication based on mutual trust and low coercion in organizations and schools should be established. Besides, the leaders should act as the major role models for all the people in their organizations or institutions. Reference list. Cyndi, B. (2008). Criminal Justice Ethics: Theory and Practice. New York: Sage Publishers. James, L. & Dean, B. (2008). Decision-making Near the End-of-life: Recent Developments and Future Directions. New York: CRC Press. Scott, A. & Ronald, R. (2008). Executive Ethics: Ethical Dilemmas and Challenges for the C- Suite. New Jersey: IAP.