Evangelism Vision: a Lifetime Change

Liberty Baptist Theological Seminary Evangelism Vision: A Lifetime Change A Paper Submitted to Dr. Harold D. Bryant In Partial Fulfillment Of the Requirements for the Course Contemporary Evangelism EVAN 565 By Michael McKelvey 19 August 2011 What is the first thing that pops into your head when you think of evangelism? That’s scary! Am I going to be rejected? It’s not my spiritual gift! This paper explains the Great Commission and its relationship to evangelism on the vision and challenge of what God is doing in my life in the area of evangelism. It also looks at how I think of evangelism, gives explanation of evangelism and challenges my rethinking on how evangelism could be done in a way to help me begin to share my faith in new and natural way. The Christian interpretation of the Great Commission to share God's Word through evangelism is defined outside the walls of the church and best understood by first discussing the nature of evangelism in Christianity. The writing of Dr. David Earley and Dr. David Wheeler, Dr. Jerry Pipes and Victor Lee, Richard Leach, William Fay, and the videos from Dr. David Wheeler have helped my fears of evangelism. This semester I have learned and developed new perceptions and challenges about evangelism which has challenged my way of thinking. The way I think centers around three aspects of Christian witness: Physical Service, Spiritual Conversation, and Intellectual Conversation. The first aspect of evangelism can be characterized as physical includes things like: Social Justice, Acts of Service; feeding the hungry and clothing the poor—anything that embodies benevolence and/ or philanthropy. It is the physical service that we provide for people who have needs anywhere at any time. For example Dr. Wheeler says that â€Å"Ministry evangelism and servant evangelism . . . intentionally seek to meet people’s needs in order to open the doors for the gospel message. † This act of caring service will lead to a Spiritual conversation resulting in the Holy Spirit taking charge. The second aspect of evangelism deals with making spiritual conversation a priority. I think the gospel itself is expressed during this phase. I regularly look at my day and wonder about the conversations I might have with people. I look at my list of friends that I’m praying for and see if I’m being led to go have the next conversation with them. I’m at a stage of life where I don’t have enough contacts; therefore I’ll work at making some. Furthermore, following the Holy Spirits’ lead by verbally proclaiming the gospel and inviting the listener to respond is what we can call proclamation or declaration—it is the verbal expression of the gospel message. McRaney states that, â€Å"Ultimately, only God opens and prepares the heart to receive the gospel. It’s also the actual evangelism aspect. I list this second because it then leads into the third aspect. The third aspect of evangelism is intellectual conversation, where I must be able to possess and capable of utilizing Systematic Theology and Apologetic. Saying I use Systematic Theology or Apologetic technique is just a fancy way of organizing my thoughts on what I believe about God and why I am a Christian. Apologetics is how you answer questions concerning the faith that you have and explaining your reasons for holding them. At this point, the use of Fay’s â€Å"Share Jesus Without Fear† book will come in handy. But I have learned that ultimately we have to rely on the Holy Spirit—remember our role: we are responsible for contact, while God is responsible for conversion. However, part of that contact doesn’t necessarily involve being prepared to use the intellectual aspect of our Christian witness, but mainly relies on one’s testimony. Dr. Earley says, â€Å"Sharing your story makes evangelism personal and relational . . . because when people listen to you, instead of being a professional salesman, you are a satisfied customer. All three are important aspects of the Christian witness, but it is important to understand that, while demonstrating and explaining your faith contribute to the evangelistic process, only proclaiming the gospel is evangelism. As we know from Scripture, where there is not a vision, the people will perish. With this in mind, my personal vision as it relates to the integration of vangelism into every part of my life has become a great burden upon my heart. The vision that I hold not only for the coming days but more so as a way of life can be described utilizing the concentric circles of concern as outlined by Thompson. Describing the concentric circles Thompson states, â€Å"Many of us come to study evangelism to go from Circle one how to Circle seven to save our consciences because there are r uptured relationships encircles two through six that we prefer to skip over. † With this in mind, starts my vision for integrating evangelism into every part of my life. First is my relationship with Jesus Christ, second is my relationship to my wife and then to my children. Third, is to my brother and my sisters followed by my relatives and so on such as neighbors and associates, acquaintances, and person X. One of the most significant impact this class has had on my views on future ministry, evangelism, and multiplication, involvement in church planting as a teaching minister is my desire to answer the call of the Great Commission as I incorporate my teaching duties toward fulfilling the commandment. The Great Commission of making disciples of all nations has been a burden and vision shared by me. A prime component of my conversion experience and of the Lord bringing me to repentance was embracing the responsibility to be a doer of the word and not a hearer (or talker or knower) only. As I began to take small steps to align my life and walk with God’s word, great changes occurred in my method of ministering to the lost. Leach and Wheeler noted that ignoring the opportunities for ministry or have done things for others without having a servant spirit is a sin. So, how can I overcome this guilt of not aggressively sharing my faith? My hope is that by God’s grace, He will keep me sensitive to where He is at work. As I consider a church plant and having an â€Å"evangelism ministry† to my community I know my personal walk with the Lord Jesus is where it all begins. The kingdom of heaven begins first, in my own heart. My desire is to be consistent in prayer even when it feels like He doesn’t hear me. To read and study God’s word even when new and fresh insights are not coming. To resist temptation when passions are strong and no one (except God) is watching. To serve others when I am weak, tired, or out of energy. This is where evangelism to my community begins sharing the fruit of a changed life. In order to answer the call to evangelize, one must first understand what the Great Commission is. In the book â€Å"Evangelism is . . . † by Dave Early and David Wheeler, Earley explains the word commission as â€Å"a military term meaning an authoritative order, charge, or direction. † I have learned servant evangelism by creating a hunger to share my faith with others. Evangelism has gone from being a fear inducing concept to becoming the way I want to live in Christ: as walking testimony to Him and answering the call of the Great Commission with my words, my daily actions, my servicing others, and by disciplines others to answer the call to evangelize. Most Christians want to share the gospel, but never envision a future in ministry that involves evangelism multiplication or church planting as it relates to developing true disciples who passionately desire to multiply their witness. In the near future I hope to develop a workshop that focuses on how to build relational bridges to those with whom you want to share the gospel. Reading Dr. Leach and Dr. Wheeler’s â€Å"Minister To Others† enlighten me to the fact that, â€Å"No matter what your role is in ministering to someone-whether building a bridge, praying, meeting a need, relieving a burden, encouraging, or sharing the gospel-God is inviting the person into His kingdom through you. † To live a lifestyle of evangelism I must live â€Å"Incarnational† by reflecting my faith in the truths of the Bible through my attitudes and actions. According to Dr. Wheeler, â€Å"Incarnational† Apologetics is the representative public and private life style of a Christian that validates to the world the absolute truths of the Bible. Living an â€Å"Incarnational† life style is a problem with today’s church members who are reluctant to share their faith. This is another area where I admit to being guilty due my many church activities. Learning how to share Jesus without fear is accomplished by learning to be effective communicators in all that we say. For example, in â€Å"the Art of Personal Evangelism† William McRaney Jr. eminds us that, â€Å"our goal is to be effective communicators and clarifiers because people matter to God† William Fay’s â€Å"Share Jesus Without Fear† is one of the most impacting books I have ever read. Fay says that there are two types of people â€Å"Those who talk about the lost and those who talk to the lost. † Because of this course, I have lea rned how to spend time with family and understanding its importance has increased greatly because of this course. Dr. Pipes noted that, â€Å"88 percent of the children who grow up in our churches leave the church and never return. In other words, discipleship must begin within the home with parents spending time with and instilling Christian values in their children. Learning the importance of family in evangelism firmly believes that relationships and community are the essential qualities of the Christian life. More importantly, they are the characteristics of the will of God in our lives as Christians. As McRaney states in his book The Art of Personal Evangelism, â€Å"God’s call for restoration is not a call to live out the Christian faith in isolation. God desires to restore community and family among the redeemed. We have been made in the image of God and that includes the desire for relationships. As the Triune God, He is perfectly relational within himself yet He afforded us the ability to become part of that relationship through His son, Jesus Christ. Recognizing and developing a successful evangelism ministry to my community first starts with a healthy family life. God, in his divine wisdom, h as prearranged the perfect boot camp for future evangelists. It is called your family. I need abundant life in my home before I can offer abundant life to the community. You see, I have a daughter who is 28 and has not accepted Christ. As the aforementioned composite statement of the great commission by Pipes and Lee says, it â€Å"begins in our own home. † However, my endeavor is not only to realize this vision in my home, but also help the other households in our church to rise to the call. By multiplying Godly households that are full of life can and will change our communities. This class has been without a doubt the single most impacting class I have ever taken. One of the biggest changes thus far has been in the way I pray. Successful evangelism greatly depends on daily prayer. In addition, I have learned to pray for the guidance of the Holy Spirit to make me sensitive to opportunities to share the Good News. It requires me to live out the charge of the great Commission through servant evangelism, information apologetics, and incarnation apologetics. I have started carrying a pocket-sized New Testament with William Fay’s â€Å"Share Jesus Without Fear† model written in it everywhere I go. Now that I realize I can’t fail whenever I share my faith. I’m ready to take the step of obedience. By acknowledging the power of the Holy Spirit the individual has the confidence to witness. Jesus said, â€Å"When the Helper comes, whom I will send to you from the Father, that is the Spirit of truth who proceeds from the Father, He will testify about Me, and you will testify also because you have been with me from the beginning† (John 15:26-27 NASB). Right after he received the baptism of the Holy Spirit, Peter spoke a powerful message to the Jews. His empowerment by the Holy Spirit resulted in 3,000 getting saved in one day (cf. Acts 2:14-41). Later Peter filled with the Holy Spirit testified boldly to the rulers, elders and scribes of the Jewish nation (cf. Acts 4:5-12, 18-22). After Peter and John were threatened they prayed. These verses prove that Holy Spirit definitely equips us with power to witness. We will go as Christ went, teaching of repentance and forgiveness, baptizing those who trust in Christ by the name of the Father, Son, and Holy Spirit, and making disciples by teaching them to obey all that He commands. † Ministering to the non-believer through the power of the Holy Spirit prepares the hearts of unbelievers for the gospel. E. W. Kenyon states that â€Å"It is necessary that we understand how the Holy Spirit deals with an unsaved man, so that we can let Him work freely through us. The Holy Spirit today is making real to human hearts the work of the Son of God. The Spirit’s teachings and communications are not his own; they are Christ’s. The Holy Spirit’s ministry is to reveal to men what Jesus brought about by His death and resurrection. To show every man that Jesus became sin on man’s behalf so that they may become righteous. He also shows every man the tragedy of rejecting Christ’s substitution sacrifice. He further describes the Holy Spirit’s work in the following manner, â€Å"The Holy Spirit comes to impart the nature of God to the spirit of man in the new birth (John 3:3-8) and then fill the new creature (II Co. :17) with the fullness of God (Eph. 3:19). † As a result of studying evangelism this semester, I have learned the importance of following-up with newly saved believers. Jesus did say, â€Å"Go and make disciples of all nations, baptize them and teach them all that I have told you† (cf. Mat. 28:19-20). He did not say â€Å"Have them say a salvation prayer and they will be just fine. † Many in the evangelistic world are concerned about the â€Å"Back Door Syndrome. † This involves people coming to church and getting saved, but then they leave out the back door without any further or very little church involvement. Others are rightly concerned about people saying the prayer, but these people do not follow through with their commitment. Some church leaders have found ways to resolve this issue. But these solutions require the body to have vision and they normally involve establishing relationships which require considerable commitments of time. Mentoring, new believers groups, home meetings, life groups and special interest groups are some the methods that have been successfully implemented. New believers need to belong to a church where they will be encouraged in their new life with Christ. While at church the Holy Spirit assists in their maturing process by ministering to them through the five-fold ministry. It is through fully understanding the totality of the above (relationships, community, and evangelism), that my heart became burdened. I recall the questions asked by Dr. Adrian Rogers in one of his sermons on evangelism, â€Å"Are you loving people straight to hell? † It was at this time that I realized my personal failure in sharing the Good News. Nonetheless, there was still a great deal of fear within me when it came to the issue of personal evangelism. However, that fear was starting to change as I was introduced to the principle of servant evangelism. Oddly enough, I had been practicing the servant action but without the evangelism. Now it is time to combine the two for effective and practical servant evangelism. In conclusion, the Christian interpretation of the Great Commission to share God's Word through evangelism is defined outside the walls of the church and best understood by first discussing the nature of evangelism in Christianity. Building strong relational bridges based on trust and mutual respect will allow you to lovingly speak God’s truth into a person’s life without damaging the friendship. Relational evangelism begins by seeing people as Jesus does, spending time with them, having Christ-like attitudes, and learning to communicate so people understand. In the context of authentic Christian community everyday Christians experience the power of the Holy Spirit and bear fruit for the kingdom. As Dr. Adrian Rogers has said many times, â€Å"I am a nobody, telling everybody, of somebody that can save them. I believe that Saint Francis of Assisi put it best, â€Å"Preach the Gospel at all times and when necessary use words. † Bibliography Earley, Dave and David Wheeler. Evangelism Is†¦ How to Share Jesus with Passion and Confidence. Nashville: B & H Academic, 2010. Fay, William. Share Jesus Without Fear. Nashville, TN: B&H, 1999. www. derrick-martin. com. A Personal Look at Evangelis m. Kenyon, Edward. The Bible in Light of Our Redemption-Basic Bible Course Lynnwood, Washington: 1999. McRaney, William. The Art of Personal Evangelism. Nashville: B & H Academic, 2003. Pipes, Jerry and Victor Lee. Family to Family, Families Making a Difference. Lawrenceville, GA: Jerry Pipes, 1999. Thompson, W. Oscar, and Carolyn Thompson Ritzmann. Concentric Circles of Concern: Seven Stages for Making Disciples. Nashville: Broadman & Holman, 1999. Wheeler, David and Richard Leach. Growing Disciples Series: Minister to Others. Nashville, TN: Lifeway, 2009. Wheeler, Dr. David. Incarnational Apologetics. Liberty University, (Accessed May 10, 2011). ——————————————– [ 1 ]. Dave Earley and David Wheeler. Evangelism Is†¦: How to Share Jesus with Passion and Confidence (Nashville, TN: B&H Academic, 2010), 300. 2 ]. Will McRaney Jr. , The Art of Personal Evangelism (Nashville, TN: B&H Group, 2003), 215. [ 3 ]. bid,. 248. [ 4 ]. Oscar Thompson, â€Å"Concentric Circles of Concern† (Nashville, TN: B & H 1999), 20. [ 5 ]. Richard Leach and David A. Wheeler, Growing Disciples Series: Minist er to Others (Nashville, TN: Lifeway, 2009), 57. [ 6 ]. bid. , 75. [ 7 ]. Earley and Wheeler, Evangelism Is†¦ How to Share Jesus with Passion and Confidence, 21. [ 8 ]. Leach and Wheeler, Minister to Others,73. [ 9 ]. Dr. David Wheeler, â€Å"Incarnational Apologetics† Liberty University (Accessed July 26, 2011), 1. 10 ]. McRaney Jr. , The Art of Personal Evangelism, 70. [ 11 ]. William Fay, Share Jesus Without Fear (Nashville, TN: B&H Publishing Group, 1999), 8. [ 12 ]. Jerry Pipes and Victor Lee. Family to Family, Families Making a Difference. (Lawrenceville, GA: 1999), 1. [ 13 ]. McRaney Jr. , The Art of Personal Evangelism 17. [ 14 ]. Pipes and Lee, Family to Family, 32. [ 15 ]. bid. [ 16 ]. Edward Kenyon, The Bible in Light of Our Redemption-Basic Bible Course (Lynnwood, Washington: 1999), 265. [ 17 ]. bid. [ 18 ]. bid. , 254. [ 19 ]. www. derrick-martin. com

Why Can’t Kmart Be Successful While Target and Walmart Thrive?

What drives some companies to succeed while others languish? Successful companies develop a system of a few truly unique capabilities that help them create differentiated value for their chosen customers. Retailers provide many case studies in capabilities-driven success, one of the most compelling of which is the big discounter triad of Walmart, Target and Kmart. And in this fourth-quarter retail season, we thought it would be helpful to take a closer look at what really distinguishes these competitors because they provide valuable insight into the key components of a winning corporate strategy. We believe that all successful companies — Walmart and Target included — know precisely how they provide value for customers. They make a deliberate choice about their â€Å"way to play† in the market, guided primarily by what those companies do uniquely well: their distinctive capabilities. We define capabilities not as â€Å"people capabilities,† but as the interconnected people, knowledge, systems, tools and processes that create differentiated value. They then select a set of products and services that best leverage those unique capabilities and optimally suit their chosen way to play. Most important, they avoid markets, products or services that require new or disparate capabilities, and thus threaten the company's focus. Focus for us, therefore, is not about picking just one market, but rather about choosing one coherent way of competing. The true story about Walmart's and Target's success is that they have gone to great lengths to focus internally on building capabilities and product offerings that suit their way to play. Kmart, by contrast, has failed to develop a unique or differentiated way to play, and all that goes with it. Let's take a closer look. Walmart's success doesn't just stem from impressive logistics, aggressive vendor management and its position as a low-cost retailer. What really underlies Walmart's advantage is a coherent and differentiated approach to the market. †¢ Their well-defined way to play focuses on â€Å"always low prices† for a wide range of consumer items, from food to prescriptions to electronics. †¢ They support their low-cost way to play with an integrated system of capabilities, including: real estate acquisition; no frills store design; and superior supply chain management involving among others expert point-of-sale data analytics. Their product and service mix is kept tightly aligned with their way to play and capabilities system: avoiding big-ticket items (e. g. , furniture or large appliances) where it has no cost advantage, or where new service capabilities might be required. And it innovates constantly within its chosen constraints: e. g. , tailoring product assortments to loca l trends. Target caters to a similar â€Å"money-saving† market, but offers a very different value proposition, focuses on different capabilities and has a different product portfolio. Target's way to play emphasizes design-forward apparel and home decor for image-conscious consumers. Everything from store layout to advertising to inventory conveys an eye for style. †¢ Its capabilities system supports this way to play with image advertising, â€Å"mass prestige† sourcing (with the use of private brand and exclusive offerings), pricing, and the management of urban locations. †¢ In product and service mix, Target is similar to Walmart in many ways, but Target satisfies the needs of its younger, image-conscious shoppers by stocking more furniture, clothing and exclusive designer merchandise than Walmart. Kmart, the least successful of the group, is struggling to define its way to play, describing itself as a â€Å"mass merchandising company that offers customers quality products through a portfolio of exclusive brands and labels. † Yet, that definition could describe just about any retailer. As a Walmart customer, you know you'll save money and still feel welcome. At Target, you know you'll get fashionable products at prices that feel reasonable. What, then, is Kmart's niche? Walk through a Kmart store and you'll discover designers like Jaclyn Smith in the low-budget ambience of a warehouse. They carry Kenmore appliances, which may require high-touch sales assistance that many Sears customers expect and many Kmart stores lack. In short, Kmart has not established an identifiable way to play that reflects both customers' needs and its own capabilities. Harry Cunningham, the founder of Kmart, allegedly admitted that Sam Walton (the founder of Walmart) â€Å"not only copied our concepts, he strengthened them. † The lack of a clear concept about how to reach the market, in our view, is the single most important factor in explaining why Kmart's fortunes have fallen so far, compared to its two rivals. Without a clear way to play, and capabilities to support it, a company cannot achieve the coherence it needs to truly excel at what it does, and thus outpace competitors. http://blogs. hbr. org/cs/2010/12/why_cant_kmart_be_successful_w. html Kmart (sometimes stylized as K-Mart), is an American chain of discount stores headquartered in the United States. The chain purchased Sears in 2005, forming a new corporation under the name Sears Holdings Corporation. The company was founded in 1962 and is the third largest discount store chain in the world, behind Walmart and Target, with stores in the United States, Puerto Rico, the U. S. Virgin Islands, and Guam (which houses the world's largest Kmart). [2] As of January 29, 2011, Kmart operated a total of 1,307 (6 closing by early 2011) Kmart stores across 49 states, Guam, Puerto Rico, and the U. S. Virgin Islands. This store count included 1,278 discount stores, averaging 93,000 sq ft (8,600 m2), and 29 Super Centers, averaging 169,000 sq ft (15,700 m2). [3] Kmart became known for its â€Å"Blue Light Specials. † They occurred at surprise moments when a store worker would light up a mobile police light and offer a discount in a specific department of the store. At the height of Kmart's popularity, the phrase â€Å"attention Kmart shoppers† also entered into the American pop psyche, appearing in films and other media such as Troop Beverly Hills, Six Days Seven Nights, Rain Man, Beetlejuice, and Dawn of the Dead. Kmart's world headquarters was located in Troy, Michigan, but since the purchase of Sears, has been relocated to Hoffman Estates, Illinois. Kmart also exists in Australia and New Zealand (see Kmart Australia), although it now has no relation to the American stores except in name, after U. S. equity in the Australian business was purchased in the late 1970s. https://en. wikipedia. org/wiki/Kmart As outlined in â€Å"Private Equity May Be The Only Way To Save Sears,† as restructuring and turnaround advisers and investors, we here at ACM Partners are often asked about the big retail â€Å"stories of the day† (meaning companies on the brink of distress). GAP, Tiffany & Co. and now Sears and Kmart are the most recent â€Å"big cases† we’ve received the majority of inquiries about. Here, then, is our take on what’s in store for Kmart (which hedge fund manager Eddie Lampert officially took control of in 2003, post-bankruptcy): Do we need Kmart anymore? While â€Å"during the early years, Kmart was the fastest-growing of the â€Å"big three† discounters (Kmart, Wal-Mart and Target), easily outpacing their key competition,† Kmart, like its parent-company Sears (which acquired the discount retailer in 2005), has lost significant market share through a ombination of poor market strategy and by being â€Å"squeezed out† by â€Å"sexier† (ie Target) or more affordable (ie Wal-Mart) competitors. In short, â€Å"Kmart is trapped between Wal-Mart and Target, becoming the merchandiser in the middle — and ultimately, the discounter in the muddle. † On the consumer side, it's difficult to say Kmart would be particularly missed – since the retailer provides few unique product or experiential offerings – except in geographic areas particularly dependent on the retailer. On a personal note, while I worked at a Kmart as a teenager, I don't believe I've stepped foot in one in more than decade (nor would have any particular reason to). I do, however, visit Target almost monthly. If yes, can Kmart be turned around? What does the executive team need to do? Here, then, it's a question again of â€Å"Where did Kmart go wrong? † Let's take a look at some core areas in which Kmart could generate a turnaround. Strategy, Strategy, Strategy: Kmart failed to see the writing on the retail wall before initially filing bankruptcy in 2002 (and, some would argue, continues to ignores it). All retailers, even discount ones, must have a coherent pricing-and-product strategy in order to appeal to core consumers. As the brand stands now, Kmart offers very little in terms of â€Å"must-have† items for any particular consumer segment. †¢ Management â€Å"Expansion†: By all accounts, Kmart is an exceptionally insular company, meaning very few outsid ers have been brought in to â€Å"refresh† the store's brand. Consequently, errors in judgment and purchasing have been magnified by continued mismanagement, while fights and fiefdoms have prevented the company from moving forward into the 21st century. Instead of squeezing every last penny from the dying brand, Lampert must insist on reviving both methods and management if Kmart is to reassert its relevance. †¢ Logistics: As a discount player, Kmart has lost nearly every round of the logistics game, from management of its supply-chain to in-store sku measurements. For instance, because Kmart measured potential profitability by gross margin ercentages rather than by sales-per-square, the retailer has and continues to stock higher-margined goods in place of faster-moving products, leading to a decrease in inventory turn-over. Furthermore, inefficient ordering and supply-chain management means everything's cost more and arrives later than at Kmart's competitors. Combine these factors, and you get a dying retailer on the brink of disappearing from the American landscape. Like we outlined in â€Å"Private Equity May Be Only Way To Save Sears,† â€Å"With a market cap of only $3. 5 billion, it wouldn’t be tough to get the financing for a going-private transaction † for Sears Holdings Corporate. In short, the market is not going to allow a $40B+ asset-based retailer simply disappear. Ergo, once again, private equity may end up being the only answer for what ails these dying retailers. Margaret Bogenrief is a partner with ACM Partners , a boutique crisis management and distressed investing firm serving companies and municipalities in financial distress. She can be reached at [email  protected] com.

The Diagnosing Diabetes Mellitus Health And Social Care Essay

This was a instance control survey, which was conducted at the Mahatma Gandhi Medical College and Research Institute Hospital, Puducherry, a rural Tertiary attention infirmary with an one-year volume of above 1,00,000 patients over one twelvemonth period. The Institutional Medical Ethics Committee approved this survey. From January 2011 until April 2012 we enrolled patients between the ages of 14 and 86 old ages of age. 100 diabetes mellitus patients and 50 healthy not diabetic controls without any urinary ailments viz dysuria, frequence, urgency, strangury, tenesimus, nocturia, nocturnal urinary incontinence, prostatism, incontinency, urethral hurting, vesica hurting, nephritic gripes, prostate hurting, and who attended Mahatma Gandhi Medical College between August 2010 to July 2012 were enrolled for this survey. These patients did non hold any old vesica catheterisation, instrumentality of urogenital piece of land or old urogenital surgery. WHO criteria was applied to name diabetes mellitus.WHO criteria for naming diabetes mellitus.Methods and standards for naming diabetes mellitus1. Diabetess symptoms ( ie polyuria, polydipsia and unexplained weight loss ) plus a random venous plasma glucose concentration & A ; gt ; 11.1 mmol/lora fasting plasma glucose concentration & A ; gt ; 7.0 mmol/l ( whole blood & A ; gt ; 6.1mmol/l )ortwo hr plasma glucose concentration & A ; gt ; 11.1 mmol/l two hours after 75g anhydrous glucose in an unwritten glucose tolerance trial ( OGTT ) . 2. without symptoms diagnosing of DM should non be based on a individual glucose trial but requires collateral plasma venous finding. At least two glucose trials result on a another twenty-four hours with a value within the diabetic scope is indispensable. It can be either fasting, random sample or the two hr station glucose trial. If the fasting glucose or random glucose values are non diagnostic of DM so the two hr value should be used.MethodDuring initial visit relevant facts were elicited from patients sing history, age, continuance of diabetes, absence of urinary symptoms. H/O old catheterisation, instrumentality and surgery of urogenital piece of land. With respect to female patients, their catamenial history, H/O white discharge. H/O pruritus vulva were elicited. Then elaborate scrutiny of patients carried out peculiarly with respect to complications of diabetes. In male patients, per rectal scrutiny was carried out to govern out prostate expansion routinely. In female patients elaborate gynecological scrutiny carried out to govern out any gynecological jobs, cystocele etc. After these preliminary scrutinies, patients non suiting into choice standards were omitted, and 100 diabetes mellitus patients, and 50 non diabetic control were proceeded to following phase of survey. During subsequent visits, patients and command group random blood sugar degrees, blood carbamide, serum creatinine trials were done. On the same twenty-four hours patients urine samples were collected for civilization and microscopic scrutiny. In female patients urine civilization sample were collected during their non-menstural periods.METHODS OF URINE SPECIMEN COLLECTIONClean gimmick mid watercourse urine aggregation method was adopted. Patients were explained about the methods of roll uping clean gimmick midstream piss and aged female patients were provided with nursing helpers for cleaning the external genital organ. Urine was collected in a unfertile wide-mouthed prison guard cap bottle for civilization intent and microscopic scrutiny. Two back-to-back urine specimens were obtained, and refrigerated instantly, because it was non possible to plate all the samples of urine instantly. One civilization of a clean-voide specimen of midstream piss from an person without symptoms of a UTI with at least 105 cfu/ml of the same individual bacterial species was considered equal to name ASB [ 30 ] . The ground to civilization a 2nd clip is to know apart between true bacteriuria and taint. In most surveies, merely the positive civilizations are repeated to name [ 30 ] .Quantitative CULTURE OF URINEUrine was cultured quantitatively by graduated cringle technique. The civilization home bases were read at the terminal of 24 hours and no. of settlements counted in positive civilizations. If there was no growing the civilization home bases were reincubated for another 24 hours and figure of settlements calculated if growing was noted.ANTIBIOTIC SENSITIVITY TESTSThese were done utilizing the standard sums of ( nitrofurantoin, tetracycline, aminoglycosides, co-trimaxazole,3rd coevals Mefoxins, fluroquinolones, ? lactams and nalidixic acid in all civilization positive instances ) and study obtained at the terminal of 48 hours. It was non possible to gauge HbA1C in all the patients in our set-up. Written informed consent was obtained from the patients and controls. We excluded all patients who had factors favoring exclusion standards and included patients who satisfied inclusion standards.Data CollectionAll information was entered into a Data Collection Proforma Sheet ( Appendix 1 ) and were entered into Excel ( MS Excel 2011 ) . The Sheet had a ocular map for taging and divided into indicants for both genders. Other biographical inside informations were besides collected including day of the month of birth, weight and tallness.Statistical MethodsStatistical analysis was carried out utilizing SPSS version 19.0 ( IBM SPSS, US ) package with Regression Modules installed. Statistical methods such as odds ratio and chisquare trials were applied to happen the significance between different variables. ASB Case control Positive 42 [ a ] 3 [ B ] negative 58 [ degree Celsiuss ] 47 [ vitamin D ]Oddss ratio:ad/bc = 42Ãâ€"47/58Ãâ€"3 = 11.34 Diabetic patients have 11.34 times the hazard to develop symptomless bacteruria than a non diabetic person.Chisquare:X2 = ? ( o-e ) 2 vitamin E df = 1 X2 = 20.564 P =DiscussionIn this survey an effort was made to find the incidence of symptomless bacteriuria in diabetes mellitus patients with comparing to non diabetic control group, common organisms doing infection and their antibiotic sensitiveness. On reexamining the literature the undermentioned surveies conducted in similar mode to the present survey noted.WriterYearSexual activityPrevalence Rate %Veljlasgaard 1966 Both 9.3 1986 Both 6.3 Schmitt 1986 F 9.1 Keane 1988 F 3.5 Fold addition Kelestimor 1990 F Meter 31.3 17.4 Zhanel 1955 F Meter 3 fold rise Equal to non diabetic male Zhanel 1955 F 7.9 Kayima 1996 F Meter 28 16 Balasoiu 1997 Meter F 16 32 Very few surveies of this type were carried out in our state. As noted above, most of surveies were conducted merely in female type II diabetes patients. Prevalence of symptomless bacteriuria in female diabetes patients varies from 7.9 % to 32 % . Relatively in the present survey the incidence of asymtomatic bacteriuria in female Type II patients is 35.38 % . Merely few surveies were conducted in male Type II patients. Most of the surveies showed the prevalence of symptomless bacteriuria as equal to non-diabetic work forces. But in the present survey incidence of symptomless bacteriuria in male Type II is 20 % compared to 0 % incidence in non-diabetic control. A survey conducted in Type II patients of both sexes showed the prevalence of symptomless bacteriuria as 9.3 % . In the present survey the incidence of symptomless bacteriuria in Type II patients is 26.66 % ( Male 20 % ; Female 40 % ) . In the present survey incidence of symptomless bacteriuria in both female and male diabetic patients are high when compared with non diabetic control group ( 36 % and 20 % and 0 % ) Both Type II ( insulin ) and Type II ( OHA ) patients are every bit affected ( 26.66 % and 28.33 % ) . Percentage of male patients with diabetes mellitus on insulin with positive civilization – 20.00 % Percentage of male patients with diabetes mellitus on OHA with positive civilization – 20.00 % Percentage of female patients with diabetes mellitus on insulin with positive civilization – 40.00 % Percentage of male patients with diabetes mellitus on OHA with positive civilization – 35.00 % Percentage of patients with diabetes mellitus on insulin with positive civilization – 26.66 % . Percentage of patients with diabetes mellitus on OHA with positive civilization – 28.00 % Percentage of male patients with positive civilization – 20.00 % Percentage of female patients with positive civilization – 36.00 % In control group no. of male patient with positive civilization – 0 In control group no. of female patient with positive civilization – 3 Percentage – 12.00 % Many surveies have found that the commonest being doing symptomless bacteriuria is E. coli 40 % , and gram negative B made up 66.7 % of the isolates. Relatively in the present survey, the common being is E.coli ( 57.14 % ) . Other beings isolated include Klebsiella ( 33.33 % ) Enterococci ( 4.76 % ) , Proteus ( 2.38 % ) , acinetobacter ( 2.38 % ) . Bacteriuria appears to hold no relation to increasing age. In the present survey symptomless bacteriuria occurred in all age groups. About 55 % of civilization positive causes are in the age group of 41-60 old ages. Bacteruria is common among aged life in non- instituitional community scenes, particularly among adult females, although non every bit common as among the aged in institutional scenes [ 16 ] . The feeling that true bacteruria in the diabetic is chiefly confined to aged diabetic adult females. Furthermore, the prevalence of bacteriuria among them was significantly greater than that of aged non diabetic females [ 22 ] . Contaminated piss is defined as the presence of at least 3 different micro-organisms in 1 urine specimen. [ 4 ] The prevalence of ASB is increased in adult females with diabetes [ 26 % vs 6 % ] and might be added to the list of diabetic complications in adult females [ 4 ] . Longer the continuance of diabetes with the presence of complications apparently increases the hazard of ASB in type 1 diabetic adult females [ 4 ] . The rate of ASB is non influenced by quality of diabetic control [ glycosylated hemoglobin, fasting glucose degree ] or nephritic map [ 40 ] . Longer continuance of diabetes, but non glucose control, is associated with bacteriuria prevalence. A statistically important longer diabetes continuance was found for diabetic topics with bacteriuria than without. Prevalence of bacteriuria additions 1.9 – crease times in every 10 old ages continuance of diabetes. However, there was no association between long – term glucose control, as reflected by glycosylated hemoglobin degree, and bacteriuria prevalence [ 34 ] . Asymptomatic bacteriuria is common, particularly in functionally impaired aged patients with multiple medical morbidities. If symptoms or marks of infections are absent testing with everyday dipstick and subsequent antimicrobic intervention is neither recommended. Early acknowledgment and direction of assorted hazard factors of ASB is really of import to potentially cut down its happening [ 6 ] . Sing all results there is no benefit of testing for and intervention of bacteriuria [ 7 ] . It is hard to turn out that ASB is more frequent among adult females with diabetes than among those without diabetes [ 8,12 ] . Prevalence of ASB is about three times higher in patients with diabetes when compared with the control subjects [ 11 ] . Prevalence of bacteriuria was 4.4 times higher among diabetic than non diabetic topics [ 23 ] . The prevalence of ASB among patients with diabetes is higher than in an seemingly healthy group [ 24 ] . The prevalence of bacteriuria in diabetic adult females is 7 % to 13 % , approximately three times higher than not diabetic adult females [ 28 ] . ASB is improbable to be a effect of hapless control of diabetes [ 11 ] . Damage of metabolic control of diabetes as revealed by an addition in HbA1c degree increases the hazard of developing ASB [ 8 ] . Duration of diabetes, high HbA1c degree, glucosuria and pyuria are risk factors for ASB in patients with type 2 diabetes. E.coli and K.pneumoniae are the most often stray bacteriums in diabetes patients with ASB. Routine urine civilization might be recommended in diabetic patients who show no urinary symptoms but who have one or more of the hazard factors mentioned [ 42 ] . The prevalence of ASB and leukocyturia ( & A ; gt ; 5 cells / high power field ) was higher in kids and immature grownups with diabetes than those of control topics and the spectrum of bacteriums in ASB was different from the usual spectrum of UTI. There was a inclination in the diminution in nephritic map in type 1 diabetic adult females who had ASB [ 44 ] . Asymptomatic urinary infection can non with certainty be correlated with increasing continuance of diabetes. The prevalence rate of symptomless bacteriuria increased with longer continuance of diabetes. In the present survey 30 % of positive civilization instances had diabetes for 1-3yrs continuance. Another 24 % instances had diabetes for 5 to 10 year. continuance. Even 33.33 % of freshly detected diabetes patients had positive urine civilization. Any patient with diabetes can hold symptomless bacteriuria irrespective of their continuance of disease. The prevalence of symptomless bacteriuria is non affected by steps of glucose control. In the present survey 40 % civilization positive instances had random blood sugar value in the scope of 201 to 250 milligram % . Another 24 % had in the scope of 151 to 200 % . 15 % patients had in the scope of 251 to 300 % . The determination that quality of diabetic control does non impact the prevalence of symptomless bacteriuria is confirmed. The prevalence of symptomless bacteriuria additions as diabetic retinopathy becomes more terrible [ 33 ] , 2 instances of diabetic retinopathy are civilization positive in the present survey. Of the 6 patients with diabetic nephropathy 4 instances are civilization positive. A instances of diabetic pes in present survey non had any urinary piece of land infection. Of the 4 instances with ischaemic bosom disease, 2 instances are civilization positive. Certain surveies found that isolates were ill sensitive to on a regular basis available antibiotics – Achromycins ( 33 % sensitive ) , cotrimaxazole ( 33 % sensitive ) . Other disinfectants with over 80 % sensitiveness degree included aminoglycosides, nitrofurantoin, 3rd coevals cepholosporins and fluroquinolones. All the beings that are grown in civilization in the present survey are immune to normally used antibiotics like Achromycins, cotrimaxazole, and nalidixic acid. Almost all isolates are sensitive to quinolone group of drugs. Some are sensitive to aminoglycosides. Most of them were sensitive to nitrofurantoin. Some of them were even immune to nitrofurantoin and 3rd coevals Mefoxins. Some of them were merely sensitive to drawn-out spectrum ?-lactam antibiotic. No benefit was idenitified in continued showing and intervention of symptomless bacteriuria. Antimicrobial therapy cleared bacteriuria in the short term, but did non diminish the Numberss of diagnostic episodes and hospitalizations during long term follow up, and the high rate of recurrent bacteriuria led to markedly increased usage of antimicrobic agents. Increasing antimicrobic opposition is a major concern [ 13 ] . Antimicrobial direction of urinary piece of land infection in diabetic adult females should concentrate on the prompt designation and effectual intervention of diagnostic episodes [ 13 ] . Isolated E.coli strains were immune at similar rates to ampicillin, cotrimoxozole, Cipro and Macrodantin in both diabetic and non-diabetic patients. Hence diabetes mellitus could non considered per se a hazard factor for the outgrowth of a non E.coli being and for antibiotic opposition [ 43 ] . Diabetes has a considerable public wellness impact on the hazard for and forecast of enterobacterial bacteriemia acquired in the community [ 45 ] . Screening for or intervention for ASB is non indicated in adult females with diabetes and intervention with antibiotics did non detain nor diminish the frequence of diagnostic UTI untill 3years of follow up [ 10 ] . The clinical significance and direction of ASB differs harmonizing to different groups of patients as listed below [ 36 ]Indications for the intervention of patients with symptomless bacteriuriaDefinitive Possible Not indicated Pregnancy Diabetess mellitus elderly Before an invasive GU process Short- term Indwelling catheterisation Intermittent catheterisation School misss and premenopausal adult females Children with reflux Renal graft Long term indwelling catheter Patients with unnatural urinary piece of land In most of the old surveies E.coli was the most prevailing micro-organism and klebsiella the 2nd most common [ 12 ] . Analyzing the diabetic adult females with ASB showed that diverse E.coli strains are capable to be colonized in piss. Perennial infections were common chiefly after handling ASB most often with a new E.coli strain [ 14 ] . In patients who had frequent E.coli causation ASB, repeated intervention did non decide the vesica infection [ 14 ] . When compared to non diabetics ASB is more prevailing among females with type 2 diabetics in Sagamu, Nigeria [ 35 ] . Womans with ASB had a significantly higher opportunity of developing a diagnostic UTI than not bacteriuric adult females [ 41 ] There is an increased susceptibleness to urinary piece of land infections in female diabetics above the age of 50, and diabetes likely in association with ripening, accentuates factors which allow the constitution of infection in non diabetic individuals instead than specially predisposing the kidney to infection [ 37 ] . Guidelines published by the IDSA in 2005 province that there is no mensurable benefit in testing or handling ASB in the undermentioned patients: diabetic patients, premenopausal adult females who are non pregnant, older patients populating in the community and in the long term attention installations, and with spinal cord hurt patients or patients with indwelling vesica catheters [ 31 ] . Screening and handling is appropriate for adult females during gestation and for patients who have a positive urine civilization consequence prior to surgical use of the urinary piece of land to avoid precipitating sepsis [ 31 ] . In the past diabetes mellitus was regarded as a status in which ASB predisposed to renal papillose mortification and nephritic inadequacy but recent retrospective and prospective surveies indicate that does non transport a nephritic hazard. Therefore the possible benefit from antibacterial intervention of ASB is dubious. However we emphasize that one time diagnostic urinary piece of land infection is present, it tends to run a more aggressive clinical class in the diabetic patient [ 40 ] . From all the surveies, past attacks to direction differed between U.S and European doctors. In the U.S. , intervention of bacteriuria was recommended whereas in Europe, bacteriuria is non treated. Even if diabetic adult females with symptomless bacteriuria are at hazard for diagnostic urinary infection, the overall cost benefit of testing and handling big Numberss of symptomless diabetic adult females at frequent intervals was in the demand to be evaluated. The inquiries were complex and broad -ranging. There was a demand to construct the current clinical observations and prevalence studies to make a foundation of cognition that is sufficient for developing rational and appropriate attack for caring for diabetic patient who has a urinary infection [ 3 ] . Long term follow up surveies will demo whether ASB becomes diagnostic and affects nephritic map in diabetic patients and whether intervention of ASB is warranted [ 4 ] . Recently [ IDSA ] Infectitious Disease Society of America came out with a guidelines in the twelvemonth 2005 for diabetic adult females follows asDiabetic WomansMany prospective and cohort surveies done in diabetic adult females for ASB which was followed up for 18 months to 14years of showed no differences in rates of occurence diagnostic urinary infection, patterned advance to diabetic complications.There was no hold, lessening in urinary infections nor the no of hospitalizations in persons with bacteriuria after 3 old ages of follow up was clearly proved by a randomized, controlled test for bacteriuria reported after a upper limit of 3 old ages of follow-up. There was no acceleration or patterned advance of diabetic complications like nephropathy etc. , in bacteriuric patients who did non have antimicrobic therapy. However, diabetic adult females who received antimicrobic therapy had significantly more inauspicious antimicrobic effects. Thus continued testing and handling symptoml ess bacteriuria in diabetic adult females ne'er showed any benefits and there was even grounds of some injury due antibiotic use.Recommendatio:Screening and intervention of symptomless bacteriuria in diabetic adult females is non indicated ( A-I ) . The guidelines besides mention that antimicrobic therapy is frequently unsuccessful in eliminating the micro-organisms and may, in fact, consequence in occurence of immune micro-organisms, such as drawn-out spectrum ?-lactamase immune bacteriums, vancomycin – immune enterococci, and other multidrug-resistant bacteriums. In add-on, intervention of patients will subject them to the hazard of an allergic reaction, diarrhea, and other inauspicious reactions ensuing from usage of the antimicrobic drug. Finally, clostridia difficile infection may develop, because the intestine vegetation is altered when handling ASB [ 31 ] . Endothelial disfunction, oxidative emphasis, and the increased formation of advanced terminal merchandises, lower urinary cytokine concentration and hence decreased urinary leucocyte Numberss compared with nondiabetic adult females may play a function in the development of diabetic complications [ 4 ] . Defective polymorphonuclear leucocyte maps [ opsonization, chemotaxis, phagocytosis and killing ] are possible conducive factors. Changes of bacterial adhesion to uroepithelial cells, partially explained by alterations of the chemical science and concentration of Tamm-Horsfall protein besides promote urinary – piece of land infection [ 24 ] . The vesica disfunction due to diabetic neuropathy taking to impaired vesica elimination could play a function in the prevalence of ASB among adult females with diabetes and in the natural history of UTI [ 8,28 ] . Clinical tests covering with the intervention of symptomless bacteriuria in diabetes are limited. The undermentioned decisions can be made from these tests. Frequent reinfections occur instead than backslidings. Long term suppressive therapy is effectual, nevertheless when discontinued, perennial infections occur comparatively quickly. Few patients sustain a permanent remittal from bacteriuria. Trying obliteration of bacteriuria in patients with anatomic abnormalcies may be ineffectual. Therefore, there are no benefits in continued showing and handling diabetic persons with symptomless bacteriuria and as there is possibility of some injury with antibiotic overusage.Restrictions:In this survey we could'nt step HbA1c for all the patients as it was non executable and so could'nt assess the relationship between glucose degrees and symptomless bacteriuria. We besides have no thought whether there would be any opportunity of development of complications in the persons diagnosed with symptomless bacteriuria as this is non a follow up survey. Hence measuring of HbA1c degrees and a follow up of these civilization positive patients would give a better apprehension in the relationship between glucose degrees and asmptomatic bacteriuria and the presence or absence of complications in civilization positive patients.SummaryThere is a high incidence of symptomless bacteruria in diabetes patients, chiefly in females than males in this survey. Therefore, there are 2 subjects to inquiry, whether symptomless bacteriuria is associated with inauspicious results. ? , whether the intercessions of showing and antimicrobic intervention better these results? The inquiries whether they develop complications or non and whether antibiotic therapy is needed or non necessitate to be assessed by farther follow up surveies. However latest guidelines suggest that antimicrobic therapy did non detain nor diminish the frequence of diagnostic urinary infection, nor did it diminish the figure of hospitalizations due to urinary infections nor it prevented the acceleration of patterned advance of diabetic complications, therefore periodic proving for symptomless bacteriuria is non recommended for individuals with diabetes mellitus.DecisionBased on the consequences and the methodological analysis employed, we have concluded that: High incidence of symptomless bacteriuria has been observed in both diabetic males and females. High incidence of symptomless bacteriuria occur in both diabetes mellitus on insulin and unwritten hypoglycaemic agents. Causative beings in diabetic and non diabetic symptomless bacteriuria are similar. E.coli is the commonest being. Most of the symptomless bacteriuria instances occurred in the age group of 41 to 60 old ages. Asymptomatic bacteriuria occur inspite of good glycemic control. . Preventive steps for diabetic patients include increased surveillance and turning away of well-known hazard factors for urinary piece of land infections. Asymptomatic bacteriuria can be present even in freshly diagnosed diabetic patients. Most of the being are sensitive to nitrofurantoin. Some are sensitive to aminoglycosides, fluroquinolones. Some beings are merely sensitive to drawn-out spectrum ?-lactam antibiotics. Periodic proving for symptomless bacteriuria is non recommended for individuals with diabetes mellitus as per latest guidelines.AbstractionAim: To analyze the incidence of symptomless bacteruria between diabetics and non diabetics, the common beings and their antibiotic sensitiveness Methods: A sum of 100 diabetic patients and 50 non diabetic controls without any history of urinary piece of land infection and catheterization was enrolled in this survey Consequences: The incidence of ASB was 39 in diabetic and 3 in control with the significance of P & A ; lt ; 0.001. Diabetic patients have 11.34 times higher hazard in developing symptomless bacteriuria than non diabetics. Decision: The incidence of ASB is significantly increased in diabetic patients as compared to non diabetic controls.A larger survey with a longer follow-up is needed to turn to the issue of handling such patients who are symptomless

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Research Summary and Ethical Considerations Essay Example for Free

Research Summary and Ethical Considerations Essay â€Å"According to statistics presented by the National Interview Survey (2010) there are approximately 7.1 million children in the United States who have asthma.† (U.S. Department of Health and Human Services [USDHHS], Centers for Disease Control and Prevention National Center for Health Statistics [CDCNCHS], 2010). â€Å"Asthma is an inflammatory disease that is characterized by airway obstruction and may cause episodes of wheezing, coughing, and difficulty breathing.† (Walker, 2012). â€Å"Studies have shown that these symptoms are difficult to manage in obese asthmatic children as the medications used to treat asthma are less effective on them due to the added weight. This paper summarizes a quantitative study showing that enhanced physical activity and asthma management education can reduce asthmatic symptoms in children.† (Haines Kim, 2013). It includes introduction, background, methods, results, ethical considerations and conclusion summary of the study. Introduction â€Å"Children with asthma are at risk for obesity and resultant severity of the disease due to their reluctance towards physical activity. In order to prevent this risk an educational and activity program was developed for elementary schoolchildren with moderate persistent asthma utilizing a quantitative study design. The introduction of this program resulted in significant improvement in lung conditions and reduction of the number of emergency room visits while potentially reducing the risk of obesity later in life.† (Haines Kim, 2013). Background of Study â€Å"Reports show that seventy five percent of all children in the United States who need emergent care due to their asthma are overweight. Children with  moderate to severe persistent asthma have a higher incidence of also being obese. Obese asthmatics are less responsive to medications used to treat asthma. The reluctance to physical activity is due to the fear of asthma attack with exercise. This leads to obesity and obesity leads to more severe asthma symptoms. In order to break this cycle effective intervention is necessary. The most effective intervention is increased physical activity. Developing and evaluating understanding the mechanisms of asthma control and promoting physical activity in participating asthmatic elementary school-aged children was a pilot program resulting in reduced severity of asthma symptoms which was also the purpose of the study.† (Haines Kim, 2013). This study is significant for nurses as they take care of children with asthma in clinics an d hospitals effectively intervening to improve their health. Methods of Study â€Å"A quantitative, non-experimental, longitudinal design was used to evaluate a pilot asthma program with emphasis on physical activity in order to improve asthma control among children with moderate persistent asthma. Asthma symptoms, lung condition, and willingness to participate in physical exercise were compared before and one month after the six week asthma program. As a pilot study, this program was an intervention-only program without a control group. The sample was collected from participants of Breathe LA’s Lung Power program with moderate persistent asthma. Ten children between the ages of seven to twelve years old both males and females who volunteered for the study were selected for a six week asthma program. Barriers to proper asthma management were identified and treated by parental interviews. Introductory and concluding spirometry tests were done to assess the actual improvement in lung volume post program. Physical activity was closely monitored and performed only after sufficient management skills were taught to and reinforced by the participants and parents. Six lessons were prepared and delivered over two hours weekly sessions.† (Haines Kim, 2013). Results of Study â€Å"Throughout the six week program the participants’ asthmatic attack rates dropped significantly. Weekly and monthly asthmatic incidences also decreased significantly. Although not statistically significant, emergency  room visits dropped after the six week program and the participants also engaged in significantly more physical activities in a given week and month compared to pre-program activities. The spirometry test post-program results showed a slight, but significant increase in lung volume.† (Haines Kim, 2013). The implications of this study to nursing are very significant. Being the caregiver to children with asthma in clinics and hospitals nurses can make a huge difference in their lives by sharing the significant findings of the study and incorporating it in their daily care regimen. Teaching proper symptom management and physical activity to parents and children will significantly improve their health. Ethical Considerations of Study The authors are affiliated with California State University Fullerton and the study was reviewed by editorial board, blind peer, and expert peer. The study sample was a sub-group of pre-existing participants of the Breathe LA’s Lung Power program. In adherence to the code of ethics for the research study patient privacy was protected through the initial program. Only patients who volunteered were included in the study and the program was held in the Breathe LA facility located in Los Angeles. â€Å"Facilitators present throughout the program included a respiratory therapist and volunteer respiratory therapy students.† (Haines Kim, 2013). Parents were to observe at all times and intervene as appropriate to the study. The article fails to mention approval acquired from an institutional review board. There is a possibility that there may be a blanket consent that covers the research study via the initial Lung Power program which was in accordance to laws in Los Angeles. Conclusion â€Å"Children with asthma represent a population group more prone to becoming obese than their non-asthmatic counterparts. Understanding the mechanism of what causes asthma and being able to control asthma enough to engage in physical activity is significant. Therefore, future asthma management programs should incorporate more supervised physical exercises. Educators, therapists, nurses, parents and coaches need to understand that moderate physical exercise is a remedy for asthma symptoms, not the cause and should take an active role in providing asthma education for children with moderate persistent asthma. Increasing supervised, moderate physical exercise for  these children can reduce asthmatic symptoms and risk for obesity later in life.† (Haines Kim, 2013). References U.S. Department of Health and Human Services, Centers for Disease Control and Prevention National Center for Health Statistics. (2010). Summary health statistics for U.S. children: National Health Interview Survey, 2009. (DHHS Publication No. (PHS)-2011-1575). Retrieved from http://www.cdc.gov/nchs/data/series/sr10/sr10247.pdf Walker, V. (2012). Factors Related to Emotional Responses in School-aged Children Who Have Asthma. Issues In Mental Health Nursing, 33(7), 406-429. doi:10.3109/01612840.2012.682327 Haines, M. S., Kim, D. H. (2013). A Study of the Effects of Physical Activity on Asthmatic Symptoms and Obesity Risk in Elementary School-Aged Children. American Journal Of Health Education, 44(3), 156-161. doi:10.1080/19325037.2013.779905

Steps To Plan An Effective Business Presentation English Language Essay

Steps To Plan An Effective Business Presentation English Language Essay Business presentation is any presentation of factual information and its interpretation using the spoken word. By this definition, business presentations include much of the information and analyses exchanged daily in the conduct of business. Business presentations may be primarily informative, offering data without recommendations; or may be analytical, offering investigation and recommendations for solving a problem. No matter what kind of presentation it is, the presenter is responsible for showing relationships between his research findings and management objectives. Whenever a person plans, prepares, and creates a message to deliver to others, he makes a presentation. During these presentations, speakers may often need to convince the listeners that their findings are pertinent, valid, reliable, and useful to the organization and to the people they serve. Types of business presentations Informative- In this type of presentation the main objective is to educate the audience for example some new plan, products, services etc. Persuasive- These presentations are given to convince the people for a common viewpoint. These presentations are common to the various levels in the organizations. Motivational speeches or presentations in an organizations are also the example of this type. Group- These are the presentations given by the groups or teams to disclose their findings and results. Special occasion speech- This type of speech is given in honour or welcoming some special group or delegates or introducing another person to the audience. Steps To Plan an Effective Business Presentation Set Objectives What do you want the end result of your presentation to be? Do you want to convince people to buy something? Do you want to instruct them? The objective of your presentation will determine most of your substance; the simple act of writing down your objectives will make it that much easier to organize what youre going to say and when youre going to say it. Keep Audience in mind The next step is to keep in mind that to which type of persons you are to give presentation. Presenter must prepare its presentation which is understandable by the audience. For example if a sales person is selling a product to a labor class then he must use words as simple as can be used and avoid technical words if possible and also emphasize on demos and slides in layman language. Note Key Points The next step is to outline the main points of the presentation that you are going to present . This will be helpful when sometimes we get blank in between of the presentation. These key points are important because all the presentation revolve around the main idea of the presentation. Sequence Your Presentation Once you have an outline of all of the topics that you want to cover in your presentation then you need to determine the sequence of your presentation. A good way to do that is to use a simple flowchart which lays out the order of the ideas that youre going to present. Some people, usually hardcore PowerPoint users, prefer to use real storyboards where they produce mock-ups of each stage of the presentation. Determine What Visuals You Will Need The final step to preparing a presentation is to figure out what sort of visual aids youre going to need. You probably wont need a complicated visual for every single point of your presentation, but when it comes down to explaining something complicated, like how a business process works, then youre going to want to support yourself with a good visual. Importance of Business Presentation Planning It helps to explain the idea you want to convey in an effective manner. If presentation is good then it also acts as a tool of motivation. Means to connect to the stakeholders i.e. to provide information about new products or services. Means to share your business ideas. Steve Jobs Steve jobs is a great visionary and a great businessman or we can say a good dreamer. He is the co-founder of the well known brand APPLE INC. USA. He has developed products as Apple iphone, ipad, ipod, iMac etc. Another attribute for which Steve jobs was well known is his presentation skills, he is a great presenter and it was said that A Jobs presentation is like a carefully crafted, well-rehearsed performance that tells a story and shares a vision. He very much focus on selling dream not the product or services.   Steve Jobs Presentation Secrets 1. The Tagline. Steve Jobs positions every product with a Tag line that explains all the unique thing of the product. For example, Jobs described the Mac Book Air as the worlds thinnest notebook. This phrase appeared on his apple websites, presentations, and press releases of apple at the same time. 2. A villain. In every classic story, the hero fights the villain. In 1984, the villain, according to Apple, was IBM (IBM). Before Jobs introduced the famous 1984 television ad to the Apple sales team for the first time, he told a story of how IBM was bent on dominating the computer industry. 3. A simple slide. Apple products are easy to use because of the elimination of clutter. The same approach applies to the slides in a Steve Jobs presentation. Steve jobs believe in making simple slides , he never used bullets or lots of words in his presentation slides instead he use more pictures and images that are self explanatory. For example when he launched apple macbook air he displays it in an envelope. 4. A demo. Neuroscientists have discovered that the brain gets bored easily. Steve Jobs doesnt give you time to lose interest. Ten minutes into a presentation hes often demonstrating a new product or feature and having fun doing it. When he introduced the iPhone at Macworld 2007, Jobs demonstrated how Google Maps (GOOG) worked on the device. He pulled up a list of Starbucks (SBUX) stores in the local area and said, Lets call one. When someone answered, Jobs said: Id like to order 4,000 lattes to go, please. No, just kidding. 5. An Emotional moment. Every Steve Jobs presentation has one moment that neuroscientists call an emotionally charged event. The emotionally charged event is the equivalent of a mental post-it note that tells the brain, Remember this! For example, at Macworld 2007, Jobs could have opened the presentation by telling the audience that Apple was unveiling a new mobile phone that also played music, games, and video. Instead he built up the drama. Today, we are introducing three revolutionary products. The first one is a widescreen iPod with touch controls. The second is a revolutionary mobile phone. And the third is a breakthrough Internet communications deviceà ¢Ã¢â€š ¬Ã‚ ¦an iPod, a phone, an Internet communicatorà ¢Ã¢â€š ¬Ã‚ ¦an iPod, a phone, is you getting it? These are not three devices. This is one device! The audience erupted in cheers because it was so unexpected, and very entertaining. Humour and presentations In the business presentations humour is necessary but it must be in good taste. An original joke is better which the audience has never heard before. The joke must be related to the subject of the speech. If we take example of Steve jobs he uses humour in his presentations so that the audience may not get bored. This was his one of the skills in presentations thats why he was very popular in giving good or we can say awesome presentations. The 10 Presentation Tips of Steve Jobs Plan presentations with pen and paper. Storyboard the presentation first. Jobs initially prepares by brainstorming and white boarding ideas. Single sentence description for every service/idea. As an example, for the introduction of the Mac Book Air computer, Jobs said that it is simply, The worlds thinnest notebook. Create a villain that allows the audience to rally around the hero-you and your product/service. A villain doesnt necessarily have to be a direct competitor. It can be a problem in need of a solution. Focus on benefits. Your audience only cares about how your product or service enhances their lives. Make that connection. Stick to the rule of three. Almost every Jobs presentation is divided into three major parts. You might have 20 points to make in your presentation, but your audience will only remember three or four. Sell dreams, not your products or services. Jobs doesnt sell computers, he sells the promise of a better world. When he introduced the iPod, he said, In our own small way were going to make the world a better place. Create visual slides. Jobs dont use bullet points. Instead, he relies on photographs and images. When he unveiled the Mac Book Air, he showed an image of the computer fitting inside a manila inter-office envelope. Make numbers meaningful. Jobs always put large numbers into a context to make them relevant to his audience. The bigger the number, the more important to find an analogy or comparison that adds clarity. Use plain English. Steve jobs always uses simple English phrases in his presentations and rarely use jargon so it not create any confusion in the mind of audience. Practice, practice, practice. Jobs used to spend hours rehearsing the presentation and do it like a theatre performance artist. Conclusion We must learn from Steve jobs style of presentation. His presentations are not only of informative style but there is a complete mix of presentation styles such as motivational, humor etc. Generally for example most of people get bored in the presentations but it is the Steve job`s presentations that are well designed, planned, well structured sand also well rehearsed. One must fully take care when developing a business presentation because it is the presentation which tells about your dream, vision, product or services to the stakeholders and it is necessary to fully satisfy them to succeed in business. Key points to remember regarding presentations Be clear about your objectives Always keep in mind your audience Less is more. Research. Be concrete. Use Visuals.

Cultures And The Globalization Of Mcdonalds Cultural Studies Essay

Cultures And The Globalization Of Mcdonalds Cultural Studies Essay In this essay I aim to develop a better understanding of globalization through studying something vital to globalizationMcDonaldization. I am focusing on a McDonald s in Bradford in the United Kingdom and the categories of people who frequent it and why they go there. Meanwhile, I will contrast the McDonald s in Bradford with McDonald s in China on the basis of questionnaires, observation, communications and memory, indicating whether McDonald s in the two countries is similar or different. By highlighting on customers as well as staff nationalities and behaviours, menu, decoration, I would advise that the influence of McDonald s as a symbol of American culture has been increasing throughout the world, and it is clear to realize that it comes under the heading of globalization. Subsequently, this study therefore gives some support to the cultural aspects of globalization including the theory about Mcdonaldization. Description of the ethnographic study in McDonald s I went shopping in the city centre of Bradford on 13th December 2009. I was attracted by the obvious logo of McDonald s, the striking festive menu drawing as well as free-wifi drawing in the transparent windows. Subsequently, I entered the restaurant, as usual in China in my memory and waited in the team line as well as prepared to order. Meanwhile, I found the menu in UK roughly the same in china except for a slight difference. For example, McDonald s hamburger in china will not directly put the raw cheese into hamburger. The staff with a Christmas hat and the McDonald s uniform smiled at me to help me order the menu. Surprisingly, the waiting time was relatively short, the same as the McDonald s in China. Thus, I am reminded of the four elements for the success of McDonald s business systems that refer to efficiency, calculability, predictability and control. The decoration in McDonald s is warm with golden, white or mirror walls, light ivory wooden table tops, blue or deep red cushion with golden blackboard wooden chairs and upholstered armchairs in deep red colours. Contemporary art or framed photographs handing on the walls are also attractive. It is worth mentioning that in the corner, many paintings are displayed on the walls around the children playground area, especially those of McDonald s Characters such as Ronald McDonald Grimace, Ham burglar and Birdie the Early Bird. In general, the decoration of McDonald s is aimed at making the store look more casual and sunny, which is similar to Starbucks. Compared with McDonald s in China, the decoration style is similar, but in the children playground area, there are more facilities like slides, wooden horses in China. Apparently the facilities are the same in Bradford and China. Behind the food serving area there are numerous technologies like automatic French fry machines and various c ertain products like happy meal which are available to the customers almost instantaneously through the carefully regulated and controlled system. With respect to people, there are several nationalities such as British, China, Pakistan, and Africa among the customers and the staff. Most people wear leisure clothes and overall the colours of people s clothes are drab. It is clear that the area of age is extensive, up to eighty- year- old people, down to two- aged children. Interestingly, the most frequent combination is an adult accompanied by her or his child, who plays the toy from happy meal as well as eats food. Meanwhile, McDonald s is the best choice for young people to enjoy the foods after shopping as the food is inexpensive and convenient. It is worth noting that both in Bradford and China I found people are more likely to be treated similarly in McDonald s, irrespective of their race, sex, sexual orientation, or social class. Accordingly, they have a high awareness to take the empty boxes and litters to the trash before they leave. Specifically, the staff with a smile to everyone and provide efficient goods and service s to meet the customer. A brief overview of the perspective A summary of my chosen theory of globalization would then follow. This is such a vast topic that I would have to focus on just a small part of globalization theory. I am particularly interested in theorizing the globalization of culture. Accordingly, I would be well-advised to consider the Mcdonaldization, as one of a number of globalization processes. Ritzer 2004 puts forward the view that globalization can be in general identified as the worldwide proliferation of practices, relations and social life, meanwhile, the people tend to share a new global consciousness across continents. In terms of the theorizing the cultural aspects of globalization, Pieterse (2003) suggests that there are three major approaches divided into cultural differentialism, convergence and hybrization. More specifically, first and foremost, with regard to lasting difference, Pieterse (2003) admits that the differences in culture perspective exist among the different regions and countries. To a great extent, in this theory area, some people like Huntington (1996) believe that the people tend to persist the local culture, civilization and remain culturally distinct. However, Ritzer (2004) believes that compare to the radically view of Huntington, the existence of a distinct attitude is due to a clash between the developed countries like the Unites States and the developing countries like China. With the advent of an increasingly modern development once the economic develop to a certain level, the developing countries like China will seek and adapt other cultures to enter the global market totally, while at the same time the developed countries tend to welcome what they provide. Therefore, in Ritzer s view, Huntington s opinion is likely to exist on the short time. Secondly, with respect to cultural growing sameness, Ritzer (2004) points out that global assimilation is a tendency, which means to some degree the cultures of the world are regarded as growing increasingly the same. To illustrate, Ritzer (2004) also figures that cultural convergence is characterized by the appearance of Cultural imperialism , westernization, Americanization, Mcdonaldization and world culture . Last but not the least, with regard to ongoing mixing of cultures, according to the view of Pieterse (2003), hybrization emphasized on growing diversity combination of the unique mixtures of local as well as global, thereby resulting in unique phenomenon in different areas. It is important to point out that to some extent it is the same meaning of the glocalization , which has been indicated by Robertson (2001). Also, Robertson (2001) distinguished the difference between globalization and glocalization, for example, the core concepts of globalization include capitalism, Americanization and Mcdonaldization whereas the main ideas of glocalization include hybrization, creolization and heterogeneization. To put it in another way, he believes that the outcome of globalization processes in future is likely to be the ongoing open-ended mixing that is glocalization. Accordingly, with respect to Mcdonaldization theory, it is critical to point out that the sociologist George Ritzer (1993) coins the McDonaldization in his book The McDonaldization of Society. He describes that McDonaldization is the process by which the beliefs of the fast-food restaurant seem to play a dominant role in the increasing number of sectors of American society and the rest of the world. On the one hand, Mcdonaldization is clearly closely related to a global cultural perspective as well as the influence of McDonald s and McDonaldization has a dramatic spread of the worldwide homogenization of societies. To illustrate, Bryman (2003) along with Ram (2004) indicates that McDonaldization is not only the extension of the sameness of food products but also the proliferation of a series of business principles as well as operation systems around the world. Moreover, it is worth noting that Big Mac Index is the significant index of McDonaldization, published by a prestigious magazine, the economist. It demonstrates the purchasing capacity of diverse currencies in the world dependent on the local price (in dollars) of the Big Mac as an identical basket of goods and services in each country. Meanwhile, Thomas (1999) in New York Times Magazine states that Big Mac Index creates the ubiquity and unique role of McDonald s around the world. On the other hand, Mcdonaldization may be considered as not only an illustration to drive the globalization process but also a major motor force in the future development of globalization. More specifically, according to the opinion of George Ritzer (2004), admittedly, a certain degree of glocalization happens with Mcdonaldization, but the majority of aspects of Mcdonaldization relate to globalization that the existence of homogeneity more than heterogeneity is related to the process of Mcdonaldization. For example, Robertson (2001) demonstrates that in glocalization theory, social processes are contingent and depend on the different geographic areas while in globalization theory, social processes are deterministic. Analysis of the McDonald s within Globalization model An analysis of McDonald s based on the theory of the globalization of culture as well as Mcdonaldization would then follow. To put it another way, the central issue would be discussed that the fact of ethnographic studies and a general sociological understanding of the globalization culture as well as Mcdonaldization, which is consistent or inconsistent. In terms of differences in cultures existing among the different regions and countries are demonstrated by Pieterse (2003), which is the same story. To illustrate, nowadays McDonald s for Chinese tends to be an excellent place to have fun together in particular the students group and parents comply with children while Mcdonald s for British is likely to be a convenient and inexpensive place to deal with hungry. More specifically, Mcdonald s for Chinese children is regarded as a pleasure ground more than a fast food restaurant. Thus, different cultures lead to the different decoration designs in the children playground area, which seems to provide more facilities like the slide and the wooden horse in China. However, whether Mcdonald s American culture will be constant in the long-term as suggested by Huntington (1996) or will last for in a short-term as indicated by Ritzer (2004) is still to be proved by time. It is worth noting the third possibility of Pieterse (2003), where it is may be likely to increase diversity association of the unique mixtures of local culture as well as Mcdonald s America culture and then leads to a unique phenomenon in Mcdonald s among different areas. With respect to Mcdonaldization and the influential globalizing flow, an illustration of global culture assimilation is argued by George Ritzer (2004), which is a true story. In the first place, it is universal acknowledge that McDonald s is the leading global foodservice retailer which occupies a central place in American popular culture. According to McDonald s official website, the statistics points out that McDonalds operates over 31,000 restaurants in 119 countries around the world and employs more than 1.5 million people. In the second place, in mentioning McDonald s worldwide operation system, the McDonald s staff in Bradford told me that in general McDonald s operation around the world is nearly the same because any McDonald s systems are associated with the centrally controlled system of American headquarters and every individual who is working in McDonald s knows what is expected of him based on uniform McDonald s operation and training manual. Specifically, the McDonald s staff in Bradford also told me some regulations and documents like 8 steps making a McDonalds Big Mac according to the McDonald s operation and training manual. Therefore, the situation in McDonald s for workers, customers and managers is around the same. For example, a year ago I lived in China or this year I live in England, McDonald s for me offers the best available way to get from being hungry to being full due to the similar convenience as well as efficiency both China and England. It is worth noting that it also corresponds to the theory of the dimensions of Mcdonaldization indicated by George Ritzer (2004), who claims that efficiency, predictability, calculability and control through nonhuman technology are the important elements of the McDonald s success. In other words, efficiency is generally beneficial to customers who are able to obtain what they need more quickly. As regards Mcdonaldization the core concepts of globalization demonstrated by Robertson (2001) during the observation, are found to be a little different. The main reason is that the local strategies of McDonald s in different countries reflect the integration of McDonald s American culture and local culture. For instance, McDonald s managers in 2008 realized that the spectacular Olympic Games would be held in Beijing began on August 8th 2008 at 08:08:08 PM, when the people around the world would be happy with excitement and pretension. Thus, McDonalds unveiled four new Olympic-themed television advertisements developing its im lovin it brand essence with the magic and ideals of the Olympic Games to attract people in particular Chinese. On the other hand, it is worth noting that George Ritzer (2004) who admitted there are some things which reflect the features of glocalization in Mcdonald s whereas the main characteristic corresponds to the globalization and the sameness more than difference in the process of Mcdonaldization in contemporary. To a great extent, it is true, that although there are some modifications based on different countries the demand for the marketing specific marketing strategies of Mcdonald s, the main business model and culture idea of Mcdonald s is constant like nonhuman technology service. Conclusion Overall, it is important to point out that the situation between McDonald s in Bradford and McDonald s in China was same similarities rather than differences, which takes into account abundant elements such as business system, nationalities, behaviour, menu and decoration based on the questionnaires, observation, communications and memory. Meanwhile, the fact of ethnographic studies and a general sociological understanding of the globalization culture as well as Mcdonaldization are likely to correspond with each other mainly. Subsequently, there are some points I am partial to reiterate as followed. First and foremost, admittedly, a comparison of McDonald s in Bradford and McDonald s in China on the basis of an ethnographic study reveals that McDonald s has become a symbol of American culture symbolising inexpensive, convenient and nonhuman technology service in people s minds with a global influence under the heading of globalization. Secondly, the situation of McDonald s and Mcdonaldization reflect the characteristics of global cultural homogeneity beyond the features of differentialism. To put it in another way, the Mcdonaldization is a type of the idea of worldwide homogeneity of societies through the influence of multinational corporations. Thirdly, in my personal perspective, the development process of McDonald s maybe considered as a process of dealing with the conflict of local culture and American McDonald s culture and assimilating each other in order to balance this paradox. Therefore, McDonald s paradox to a great extent can be considered as the rivalry between globalization and interregional in terms of cultural aspects. Last but not the least, nearly the same as Pieterse s (2003) opinion, as far as I am concerned, Mcdonald s in future may be likely to grow with diversity connection of the unique mixtures of local culture as well as Mcdonald s America culture and then create a unique phenomenon in Mcdonald s among different areas. Accordingly, the outcome of globalization processes is open-ended leading to a mixture in the future.