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In John Updike’s essay AP Sammy Is telling the Son Technical Whitepaper, story from | Character, his perspective witch makes the Example 3 - It Resume, Resume, essay less interesting in my opinion. Character Template | Character. On the Registered Nurse | Writing Writer, Other hand with James Joyce’s essay Arbay he is a little bit more Experienced and very articulate with his words witch makes the essay more interesting. Sammy from Character Reference Letter Template Reference, AP has become very aggravated at his job because the customers are very inconsiderate for many different reasons: As he mentions “She’s one of the these cash register witches” (227). That gave him hell beause he rang up a box of Hiho crackers two times by mistake. Sammy really got aggravated after that incident happened at work I think that really started to get him aggravated at To Download Accounting Coordinator, that point he was really starting to 7 Top Character Letter | Character Reference think rationally and Here To Download Accounting Professional not in 7 Top Character Reference a mature manner. We see the author and main character of Araby as he battles with his adulthood. Emotions as he tries to Son Technical In Pdf understand his feelings towards Megan’s sister every morning He follows her but hardly speaks to Character Reference | Character Reference her Still “her name was like a summons to all my Foolish blood” (227).
He is still a boy, since he is too scared to approach her but dealing With adult feelings which he does not understand? His anger is shown at Of Resume Templates | Dignityofrisk.com, the end of the Character Reference, Story, since the Whitepaper In Pdf, bazaar is closed and 7 Top Reference Letter Reference there is nothing he can get for Letter her and he says “he Sees himself as a creature driven and derided by 7 Top Reference vanity” This again shows the battle of. Click Here This Accounting Professional. Hormones as he sees his feelings being based on how he can impress Megan’s sister. 7 Top Character Reference Letter Template | Character. Both boys are going through growing into adulthood differently in 93 Exciting Usa Jobs Format Resume their stories Sammy being at Reference Letter Reference, the AP sees his store as the average place where the boring, ugly Average people go the Of Resume, girls he sees come in 7 Top Reference Reference represent a fantasy of his the better Merchandise that is better than average the main character of Araby also has a fantasy But in his turn to adulthood he tries to buy the Usa Jobs Resume Examples Of Resumes. Resume, girl of Character Reference, his dreams an object Therefore, It’s a subject shown as the boys are growing into Resume adulthood it is Character Template | Character frustrating to both. Since the boy in And Logistics Cover Letter Araby is unable to attain anything for 7 Top Character the sister, and Sammy sees the Merchandise at AP as average and meaningless anyway Vanity is Resume Template Resume Visualcv frustrating because a lot of Character Reference Letter, girls like physical things and gifts from Registered Wolf - Resume, boys and for the boy in Araby he is not able to 7 Top Letter Template | Character get this and Awesome Dance Template Resume therefore has failed in being able to impress the girl Sammy sees the AP as not being good enough for the bathing suit girls which maybe why he decides it is not good enough for him either. One thing I want to point out is that in 7 Top Letter | Character Reference AP we see the difference between omeone in Manager Letter adulthood and someone growing into Character Reference Reference it While Sammy wishes to A Complete 4 Step Branding Strategy see the girls in 7 Top Character Letter | Character Reference their bathing suits that come into Procurement Letter AP, his manager scolds the girls, telling them they have too little clothing Sammy here represents one side of pre-adulthood, where in his mind the Character Reference Letter Reference, girls are better than the average woman who shop in A Complete 4 Step Online Web Guy AP, the ones who are “house slaves in Reference Template | Character Reference pin curlers” and Awesome Dance Template Resume Samples Visualcv “women with six children and varicose veins mapping their legs” (64). His manager is the 7 Top Letter Template | Character, other side well into his adulthood who sees the girls as being indecent, and even says something about the Procurement And Logistics Cover, next time they will ave to Reference Template | Character Reference come in “with their shoulders covered” (64) Sammy is so angered at this he quits which shows the Usa Jobs Examples Of Resumes., level of emotion in the theme of Reference Letter Template | Character Reference, growing into adulthood His Hormones have gotten the Sample Resume Example It Resume, Software Development, best of 7 Top Letter | Character Reference, his reason and Registered | Writing Writer he acts upon his emotions.
Although there are definite differences in “Arabay” and “AP,” we see the same theme of 7 Top Template | Character Reference, growing into Dance Resume Samples adulthood in both stories This is Reference Letter Template not an easy task Both Sammy and Wolf - Resume the boy from Arabay find themselves frustrated as they go through their thoughts Sammy is | Character Reference concerned with quality which is Development Resume something he sees little of in the. 7 Top Template Reference. AP, in both his judgment of the AP and women that usually are shopping in it The author of Son Technical In Pdf, Arabay is also concerned with quality on a different level He hopes to get a good present for 7 Top Character Letter Template Reference his friend’s sister that is the Development, girl he is feeling his adulthood directed on. 7 Top Character Letter Template Reference. He is Usa Jobs Examples Of Resumes. unhappy when he comes to Reference | Character the bazaar, and sees that most of the things are gone and 93 Exciting Usa Jobs Of Resumes. Resume he is unable to provide something to the girl of Reference, his dreams that satisfies him. In both stories the boys share a common frustration with their feelings and change in attitudes, which show the inner turmoil of Whitepaper, hormones, and 7 Top | Character Reference their progress to adulthood.
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The multiphase program that allows the synchronization of several levels of transaction can be categorized as a Collaborative Travel Agent System (CTAS). The analysis of this technology shows that a multiphase program integrates mobile and Internet services together to provide a safe, flexible and scalable service to clients (Baase, 2008). As an e-business strategy, it does not aim to serve tourist organizations, but rather to 7 Top Character Template Reference serve clients. It is logical to give clients the power of flexibility; this serves an organization in terms of attracting more transactions and creating surplus (Al-Qirim, 2006). More than ever, e-business strategies are used worldwide for all platforms and business models. Business models are of various types and involved in various operations as well.
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If a client is subscribed to 7 Top Character Reference Template Reference a mobile service provider, a part of the transaction that is important for financial needs of the Here Accounting Professional, client and forwarded as a copy through short message service. Reference Letter Template. The EDI is a connection platform that automatically exchanges data relevant to Doc.#600776: a client from one end to another in respect to real time transactions (Wang, 2010). This utility provides a basis for the application of the MAIS and defines e-business strategy management. E-business strategy management is organizational planning, and developing a concrete and applicable approach towards handling e-business models. As a utility, the ERP organizes, plans, and sustains the development of 7 Top Character Reference Letter Template Reference, organization-based services in terms of information, accessibility, target groups, customer responses, and performance-related data. The ERP is a formulation utility that gives organizations virtual management assistance in dealing with electronic-based data. The ERP is similar to the Web Analytics program, but it does not involve tallying of hits per page, but rather transactions per certain period.
The ERP coincides with the CTAS as it combines services offered by an organization and presents them in a smooth and simple manner that an organization management can understand and make adjustments for customized service provision (Krishna, Madon, 2003). The relevance of the utilities discussed above to the case study and A Complete, context of Character Reference Letter | Character, this research is based on the fact that they provide assistance in the management of Resume, e-business strategies applied in the case study. E-Business Strategy Management. In simple terms, management is the 7 Top Reference Template | Character Reference, process of organizing, planning, developing, assessing, and implementing. Strategy management is the process of organizing and planning strategies in response to their applicability. E-business strategy management is simply planning or formulating strategies that affect e-business in order to Nurse Wolf Writer maximize the Reference, potential and limit risks (Books LLC, 2010). Risks are involved in any business model and may cause a business fail to get any profit even after its management invests millions dollars to produce or promote a product. On the other hand, even if an organization makes profits, it does not mean, it is not incurring risks: expectations of an organization to get a certain amount of money from A Complete 4 Step Strategy Web Guy, profits may not be a practical case and may hinder plans of an organization (Baase, 2008). Management is a duty aimed at creating surplus in the production line and result in profits. An organization that does not accrue any profit is said to be operating at a loss. Loss may be directly caused, if some products are damaged and not covered by the insurance company.
It may also incur indirect losses through the influence of competition: an organization may have products to sell or services to offer and fail to make a sale. Despite the fact that it retains its products, no profit is made and operations to deal with in new financial years may fall short of a budget (Krishna, Madon, 2003). The relevance of the above point with the context of this research is that e-business strategies offer opportunities to Reference Template Reference an organization for its benefit. However, in order to And Logistics Manager Cover Letter maintain a sustainable growth, e-business strategies are managed to avoid overlaps and Character Reference, the loss of And Logistics Manager Cover Letter, focus by an organization. In the tourist industry, clients and booking fill up a supply chain. It is almost ironical how the service industry can have a supply chain. A supply chain in Character Reference | Character Reference the tourist industry does not exist in the traditional business environment. Wolf - Resume Writer. However, in Character Reference Letter | Character e-business strategies, supply chain management is a common phenomenon. Consider the fact that customers keep inquiring for vacancies and some are willing to wait until they can get a change to visit certain places.
The purpose of the Whitepaper, supply chain would be to create a mechanism that takes requests and prompts customers, when their requests have been processed. Organizations dealing with the tourism sector are not supplied with services; they supply other business models with customers as caterers. In this case, such an organization keeps supply chain management as a dual faced activity, since it supplies other business with customers, while it is supplied with orders and queries on Reference Template Reference, services it offers (Saunders, Lewis, and Thornhill, 2009). Doc.#600776: Examples Templates | Dignityofrisk.com. Considering the problem of researchers in the case study, it is 7 Top Letter Template | Character clear that there is the lack of researching as dragged e-business in Procurement Manager Cover spite of the availability of 7 Top Character Reference, sound technological backbone. Tactical operation alignment is a management tool for e-business strategies that deals with the operation of 4 Step Online Branding - Oliver, organizations in Character Letter | Character terms of connecting employees, employers, services and products, clients and stakeholders. However, the relevance of this management tool to e-business is to diversify the traditional sphere of business by hastening business activities and providing overhauled versions in dimension and Registered Nurse Resume | Writing - Resume, definition of businesses around the world (Gorodetski, 2005).
With the usage of the Internet, Intranet, cellular networks, and 7 Top Reference Letter Template | Character, other digital technology one can pay for services over Nurse Resume | Writing - Resume the Internet, access online advertising, and get involved in on-line trading and auction deals. The importance of this management tool is to generalize the e-business strategy by synchronizing organizational activities with customer’s needs. Electronic business processes take a format of a multiphase program, as a number of stages and processes are executed one after another or at the same time. Character Reference. From a business perspective, electronic business starts with personal assistance in terms of finding relevant information. Information is a backbone of electronic business, because customers and organizations use this information to Click Here To Download This get through to 7 Top Letter Reference each other. Samples. Organizations use various information sources and compile them to make databases. These databases are used as personal assistants for an organization.
On the other hand, clients use information available from an organization’s database as their assistants to making informed decisions (Singh, 2009). Character Reference. However, some traditional means of outsourcing information are witnessed in the electronic business. A client can hire an agent to find relevant information about a specific topic, in which he/she is interested. Doc.#600776: Examples Templates. Agents may be personal assistants or they can be corporate if hired from an organization. The importance and Template, the role played by Procurement Manager, personal assistants and corporate agents is to easy the work of finding information. The quicker a client is Reference Letter Reference supplied with sufficient information, the Wolf - Resume, quicker he or she can make decisions (Baase, 2008). Information and service resources are parties or databases that a customer can find information from and use it to make decisions.
Service resources are the third parties that are consulted to provide information or assist in finding information. Most of these resources are online service providers aiming at assisting tourists with travel planning and outsourcing of relevant information. The placement of Character Reference Letter Template Reference, information and Awesome Template Samples, service resources is in the multi-layered infrastructure of the CTAS. The multi-layered CTAS infrastructure gives a precise chronological order of events and 7 Top Template Reference, processes that take place in typical e-business architecture. Dance Resume Resume Visualcv. Planning is a major step in Character the installment of the Awesome Resume Samples, multi-layered infrastructure, as it provides the client and the system a time-sensitive chronology of Character Reference Letter Template | Character, events and processes. A tourist information system is Awesome Dance Template Samples Visualcv provided to Template Reference the client through planning, whereby stages, processes, and schedules are managed for A Complete 4 Step Online Web Guy him or her. Systems are not necessarily provided by organizations that arrange and plan tourists’ service packages; they can be arranged and provided by affiliate or hired. Concerning the processes discussed above, a multi-agent information system (MAIS) is developed to make e-business processes a pattern that allows different parties, services, and installments to work in unison to provide a flexible, fast, scalable, and intelligent information service to clients and organizations (Wang, J2010). Belief, desire, and intention (BDI) agents are computational models that monitor and update their information on Character Template | Character, environmental changes. BDI agents are proactive in achieving their goals, while adapting to Resume Resume Samples new environmental changes to provide up-to-date information.
The accumulation of experience by dealing and 7 Top Letter Reference, associating themselves with previous interactions with the environment makes BDI agents flexible and goal-oriented. They act as informative systems that control customer’s choices by updating them through available channels and electronic devices that mediate databases of BDIs with customers’ interfaces (Gorodetski, 2005). Several e-business strategies are managed differently and serve different purposes. Various strategies are applied through different platforms and are meant to serve specific purposes. Platforms are simply fields, in which an Registered Resume | Writing - Resume, application, a mechanism or a strategy works best. Technology has made different platforms, through which applications work, and devices that should be used. Operating systems define a type of applications and capabilities, which can be rendered by an application in terms of flow, security, display, and user experience. With the Internet as one of the most resourceful interfaces, clients use it as a medium to interact with databases. 7 Top Character Reference Template | Character. Applications that enable devices to Doc.#600776: Of Resume Templates | Dignityofrisk.com make connections are used. 7 Top Character Letter Reference. The use of applications is almost adapted by all users; however, languages, in which these applications are written help e-business transactions to be relevant to the parties that use them (Rekhter, et, al. 2002).
Some technologies come in the form of And Logistics Letter, programming languages. They assist in rendering and executing various duties in either computers or mobile devices. Some of these technologies include OWL, XML, HTML, UTML, HTTPS, DAML-S, KQML and W3C. Reference | Character. Most of them are programming languages and formats for orienting, rendering, presenting, and filtering information on devices and web-pages. Some languages are connected with formats to enable smooth rendering and presentation of web-pages. Among the most common formats and web-protocols there are HTTPS, UTML and HTML. HTTPS is a hypertext markup protocol that is used for displaying secured web-pages. The latter are pages that do not use data from various databases; they only use data from specified databases and at times reformat other websites for hosting within a secured console.
UTML and HTML are web rendering protocols from mobile devices and computer platforms. The difference between them is in the way they render pages and the amount of traffic loaded per page (Rekhter, et, al. Templates. 2002). The connection between the 7 Top Character Reference Template Reference, W3C, OWL and XML is that the World Wide Web Consortium (W3C) has adapted the Web Ontology Language through an extended Markup Language format to define web-ontologies. It means that the OWL is a useful language and Awesome Visualcv, the most important component among these three. The OWL describes classes, properties and their instances and logical semantics for the derivation of consequences. As a description language, the OWL manages primary e-business processes of | Character Reference, information rendered for clients and request processing for organizations. As an MAIS approach, the KQML is a multi-agent-based kiosk that provides customers with information from the Internet on specified categories of hotels, shopping centers and cinema’s.
The KQLM is a primary interface that can be integrated into applications to provide restricted search results and A Complete 4 Step Branding Strategy, relevant results to influence informed decisions of clients. Its inclusion in e-business strategies helps organizations and clients maximize needs and benefit from Letter Reference, e-business processes. DAML-S was designed to serve as the basis for presenting descriptions of inverses, unambiguous properties, unique properties, lists, restrictions, cardinalities, pair-wise disjoint lists and data types. The use and the application of DAML-S takes place in web-application as a plugin, or it is integrated to the website of an organization to formulate data according to the above tasks. To Download Accounting. As a plugin or as integrated to web-sites, DAML-S sorts out data according to their types and renders them according to a type of platform used by clients. The importance of this language is that is can be executed to go through an application or can be linked with a website to limit numbers of clicks and traffic. One shortcoming of this technology is 7 Top Character Letter | Character Reference that it favors specific types of platforms and singles out recent technologies. This technology is Dance Template Resume Samples Visualcv not a recent one.
Therefore, it is Character Reference Letter Template | Character Reference limited to information rendering rather than processing: a factor that e-business does not operate well on. Card-reader on Dance Template 16 Dancer Visualcv, the go. Signing up e-business is Reference Template as simple as registering personal information someone a website or service provider and one is ready to go. This seems easy, given that everyone can spare a few minutes to fill in his/her information. Procurement And Logistics Manager Cover. Finding information in the Internet can be done through various means without the need to register accounts or giving out credit-card numbers.
In this case, e-business is not established until transactions are made from one party to another. As a solution to the slow pace of payments, credit card readers should be used to analyze and authenticate barcodes. Character Template | Character. The above method seems simpler, but it requires buying of card readers. Click Here Accounting. It is easy for Template a tourist to spent months in the Caribbean Sea on a cruise ship. Here To Download This Accounting. Therefore, getting a little gadget that will ensure fast and secure transactions is not a task one cannot handle. After all, does anyone doing business over the network or the Template | Character Reference, Internet have to risk his or her account numbers (Holbrook, Reynolds, 1998)? ID login mechanism. Take for example a couple travelling across the Atlantic to South Africa expecting to experience a bright sunlight and clear beaches. It is almost unimaginable how much these people will be looking forward to getting their vacation started.
Money for tourists is not a problem, but rather a type of transactional means and Here Accounting, modes that are involved. As an IT solution to 7 Top Character Reference the problem of imprecise and slow transactions, tourism organizations should adapt a system that delivers safe and fast services through available networks. An ID login should be a method that organizations provide their clients with to enhance a high speed of transactions. Buying books and movies on Amazon requires a tedious registration process and provision of bank or credit account numbers. In this case, a tourist visiting South Africa and Nurse Resume - Resume, using Organization X to cater for him/her does not need to register accounts that require bank or credit card numbers. Instead, by 7 Top Letter Reference, using a card reader, a client can be supplied with a unique ID login to enter the website of an organization serving him or her. In this case, any time an ID login is entered into the card reader on Procurement And Logistics Cover, the go, the system is ready for transaction.
This provides the Reference Template, power to change, define, and control ones transactions on the part of a client (Books, 2010). The Internet, as it has been discussed earlier, is a network of networks. This means that networks that are operating at different locations are connected with others through the Click To Download Accounting Professional, Internet making a web of networks. Organizations and online service providers are known for asking for classified information from clients in order to process transactions or to verify them. Through the Internet, according to the nature it is created, a hacker can join and leave a network anytime he/she would like. This does not entirely mean that the Internet is an unsafe place for business; it means that it can be a dangerous place. Organizations using various online services must and should use a safe hypertext transfer protocol (https).
It means that online transactions can be safe and secure in addition to being faster. Information Filters and Isolators. Registering personal information online is not always successful when there are transactions to 7 Top Character Letter Template | Character Reference make. The social media allow people to register free profiles and Click Here Coordinator, manage their own privacy modules. Many people do not restrict access to their personal information and risking their identities. E-business registrations can be linked with the Reference, social media and Dance Template 16 Dancer Samples, controlled by e-business. 7 Top Reference Template | Character Reference. This way, sensitive information, which is freely accessible to the social media, can be restricted to the public; therefore, it secures identities of clients. Filtering information on the Internet is a solution for Click This Accounting Coordinator Professional the problem of identity theft.
It is through search results that wrong parties access people’s private life from a certain point (Gorodetski, 2005). Most online businesses guarantee their clients secure and safe handling of sensitive information. However, these businesses do not investigate whether sensitive information they possess might be publicly accessible. Security is an 7 Top Character Template Reference, expensive installment that many organizations struggle to pull off. However, the Procurement Cover Letter, safer and keener an organization’s service is, the better response from customers such an organization gets (Wang, 2010). Adverts are methods, used by organizations to promote their products and services. However, from a personal perspective, have you ever noticed that many adverts start with the question, “Did You Know?” Clients make decisions according to how much they know and how they are involved in investigative activities regarding what they have not known. Among things that these customers do not know there is a fact that credit card numbers are safe in the hands of e-business organizations, only if organizations do not have unscrupulous individuals working for them. Banks are not safe either, as attendants who serve people on a daily basis may steal from clients. Reference | Character Reference. What everyone knows is that everyone else looks forward to making as much money as he or she can. Something that some people and Doc.#600776: Examples Templates, clients do not know is that ethics in an organization is not always observed, when it comes to the privacy of clients.
Therefore, the mechanism that is used in the ATM service can be applied through Card on Character Template | Character, the Go technology. Only in this case, fortransferring funds regarding services are provided (Curtin, 2010). 4 Step Online Branding Strategy. To attain maximum security, safety, fast services, and Letter, flexible mechanisms, the power to control transaction variables should be placed in the hands of clients. Visa Card is Son Technical In Pdf one of the most recognized cards in the world and can be used in almost every country and many organizations accept transactions paid by means of Character Letter Template | Character, this card. It is easy to carry Visa across the world and even easier to lose it. To avoid the Procurement Manager, probability of losing a credit or debit card, a technology that allows the use of an alternative method can be a solution to this problem. 7 Top Reference Template | Character Reference. In addition, most clients do not like the fact that they have to produce their cards making any type of payment. Electronic transactions are types of transactions that do not involve traditional methods of doing business. Walking to the ATM to Whitepaper withdraw cash is a traditional method of Character Letter, doing business; it is the same as walking to a bank and getting a check with solid cash. A Complete 4 Step - Oliver. With the introduction of a barcode technology, a client will be recognized remotely by a system that links a client with a certain organization allowing hotels, tours, and other services of payment without the Character | Character, need to enter numerous digits. This technology can only be used by clients; and provided by an organization.
It will ensure safety, swiftness of 4 Step Branding - Oliver, transaction and minimal usage of paperwork or bulky gadgets (Baase, 2008). Website and Network Firewalls. HTTPS is a web protocol that integrates firewalls from the 7 Top Character Template Reference, website-level and Nurse | Writing Wolf, renders secure web-pages to a client. Firewalls are security measures used in networks to shield them from attacks or unsafe commands. Once secured from attackers, networks that use common or varying databases can communicate with each other through secured networks.
In this case, clients, who emphasize security, will have their information secured on an e-business platform (Baase, 2008). The emphasis on security and the rate of transaction execution do not present security as a problem or basis of integration on an e-business platform. Active Control Plugins and Technologies. Filtering information accessed through the Internet or local networks does not depend on the ability of a client, but rather on Character Letter Reference, a service provider. Organizations that deal with tourism activities are responsible for providing secure platforms that filter and shield sensitive information from the public domain. Click Here This. Security provided by firewalls can be bypassed using tiny urls and other mirror applications.
In this case, websites developed by Character | Character Reference, organizations should be shielded from the public domain by the use of active control plugins and technologies. Registered Nurse | Writing Writer. These are security measures provided by organizations to a client to access pages in order to shield suspicious behavior and searches originating from the public domain (Baase, 2008). OUTLOOK AND CONCLUSIONS. The tourism industry is 7 Top Character Letter Template one of the most dynamic sectors in terms of growth and generation of revenue. The tourism industry is run by organizations that coordinate such activities as bookings, hotel selection, tour services, and provision of information regarding various tourism destinations. Cover. Depending on the nature, upon Reference, which tourism industry operates, traditional methods of Doc.#600776: Examples Of Resume | Dignityofrisk.com, doing business are not efficient enough to drive the future of tourism. On the other hand, e-business strategies have enabled people to contact businesses over Character Reference Template the Internet, through cellular networks, and using digital gadgets. And Logistics Manager Cover Letter. However, minimum research has been done on how to enhance flexibility, speed, security, and scalability of e-business strategies. In this case, this research has identified various platforms responsible for hosting e-business. Some of them include:
Operating systems on various devices to | Character Reference allow access to information from the Internet; Applications that allow rendering web-pages at the client level for access to Son Technical Whitepaper information; Devices that support various operating systems and applications acting as a medium between databases and clients; Management platforms that organize and plan various e-business strategies to work in unison and limit the risk of incurring uncertainties; and Universal programs applied to systems to coordinate interconnectivity between clients and service providers. Depending on 7 Top Character Reference | Character Reference, available platforms for conducting e-businesses, the management of Son Technical Whitepaper In Pdf, strategies allows the elimination of slow transitory insecurity of networks, inflexibility by Reference | Character Reference, clients, non-scalable variables, and the lack of preciseness when finding relevant information. With a multiphase transactional interface, payments and confirmation of transactions are done in various analogous phases enabling smooth and fast transaction. | Writing Wolf - Resume. On the other hand, information access is provided by various providers, both traditional and virtual. This architecture is known as multi-agent information systems (MAIS), and is complemented by Template | Character Reference, Collaborative Travel Agent Systems (CTAS). However, the Doc.#600776: Templates, above architectures are more information- and research-oriented than flexibility- and reliability-oriented. Without the need to apply too many programmed languages, this research recommended various technologies that can solve problems outlined above. These technologies include:
Card Reader on the go: a technology that allows clients to control business transactions on the go; ID login to Character Letter Template | Character Reference organizations’ websites: an organization provides an ID login for accessing various services and And Logistics Manager Cover, products; Barcode transitory technology: a technology that connects transactions with parties in one scan or reading; Secured hypertext transfer protocol: an Internet-based service that renders secured web-pages that protect classified clients’ information; Active Control Plugins and Technologies: technologies that allow censorship of classified information on public domains with the ability to trace transactions attempted from unfamiliar locations.
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Case Study: A Patient With Uncontrolled Type 2 Diabetes and Complex Comorbidities Whose Diabetes Care Is Managed by an Advanced Practice Nurse. The specialized role of nursing in | Character Reference, the care and education of people with diabetes has been in existence for more than 30 years. Diabetes education carried out by nurses has moved beyond the hospital bedside into a variety of health care settings. Among the disciplines involved in diabetes education, nursing has played a pivotal role in Registered Resume | Writing Wolf Writer, the diabetes team management concept. This was well illustrated in 7 Top | Character, the Diabetes Control and Complications Trial (DCCT) by A Complete 4 Step the effectiveness of nurse managers in coordinating and delivering diabetes self-management education.
These nurse managers not only performed administrative tasks crucial to the outcomes of the DCCT, but also participated directly in patient care.1. The emergence and subsequent growth of 7 Top Character Reference Letter | Character Reference, advanced practice in nursing during the past 20 years has expanded the direct care component, incorporating aspects of both nursing and medical care while maintaining the teaching and counseling roles. Both the clinical nurse specialist (CNS) and nurse practitioner (NP) models, when applied to Dance 16 Dancer Resume Visualcv, chronic disease management, create enhanced patient-provider relationships in which self-care education and counseling is provided within the context of Character Reference Letter | Character, disease state management. Clement2 commented in a review of diabetes self-management education issues that unless ongoing management is part of an education program, knowledge may increase but most clinical outcomes only minimally improve. 4 Step Branding - Oliver? Advanced practice nurses by the very nature of their scope of practice effectively combine both education and management into their delivery of care. Operating beyond the role of 7 Top Reference Template, educator, advanced practice nurses holistically assess patients’ needs with the understanding of patients’ primary role in Template Samples Visualcv, the improvement and maintenance of their own health and wellness. In conducting assessments, advanced practice nurses carefully explore patients’ medical history and perform focused physical exams. At the completion of assessments, advanced practice nurses, in conjunction with patients, identify management goals and 7 Top Character Reference Letter Template | Character Reference determine appropriate plans of care.
A review of patients’ self-care management skills and application/adaptation to Son Technical, lifestyle is incorporated in initial histories, physical exams, and plans of care. Many advanced practice nurses (NPs, CNSs, nurse midwives, and nurse anesthetists) may prescribe and adjust medication through prescriptive authority granted to them by their state nursing regulatory body. Currently, all 50 states have some form of prescriptive authority for advanced practice nurses.3 The ability to 7 Top Character Letter | Character, prescribe and adjust medication is a valuable asset in caring for individuals with diabetes. Template Resume Samples Visualcv? It is a crucial component in the care of people with type 1 diabetes, and it becomes increasingly important in the care of patients with type 2 diabetes who have a constellation of comorbidities, all of 7 Top Character Reference, which must be managed for successful disease outcomes. Many studies have documented the Manager Cover, effectiveness of Character | Character Reference, advanced practice nurses in managing common primary care issues.4 NP care has been associated with a high level of satisfaction among health services consumers. In diabetes, the role of advanced practice nurses has significantly contributed to improved outcomes in Procurement And Logistics Manager Cover Letter, the management of type 2 diabetes,5 in specialized diabetes foot care programs,6 in the management of diabetes in pregnancy,7 and in the care of pediatric type 1 diabetic patients and their parents.8,9 Furthermore, NPs have also been effective providers of diabetes care among disadvantaged urban African-American patients.10 Primary management of these patients by NPs led to improved metabolic control regardless of whether weight loss was achieved. The following case study illustrates the clinical role of advanced practice nurses in the management of Character Letter Template | Character, a patient with type 2 diabetes. A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Doc.#600776: Of Resume Templates? Although he was diagnosed in 1997, he had symptoms indicating hyperglycemia for 2 years before diagnosis. Letter Template | Character? He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of Awesome Resume Samples Visualcv, “borderline diabetes.” He also remembered past episodes of nocturia associated with large pasta meals and Italian pastries. At the Reference Letter Template | Character, time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken.
Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and Click Coordinator Professional foot pain. He has been trying to lose weight and increase his exercise for Reference the past 6 months without success. He had been started on A Complete Strategy - Oliver Web Guy, glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of Character Reference Letter | Character Reference, mild agitation, in the late afternoon. A.B. also takes atorvastatin (Lipitor), 10 mg daily, for hypercholesterolemia (elevated LDL cholesterol, low HDL cholesterol, and elevated triglycerides). He has tolerated this medication and adheres to the daily schedule. Registered Resume? During the Reference Template, past 6 months, he has also taken chromium picolinate, gymnema sylvestre, and a “pancreas elixir” in an attempt to improve his diabetes control. He stopped these supplements when he did not see any positive results.
He does not test his blood glucose levels at home and expresses doubt that this procedure would help him improve his diabetes control. Manager Cover? “What would knowing the numbers do for me?,” he asks. “The doctor already knows the sugars are high.” A.B. states that he has “never been sick a day in my life.” He recently sold his business and has become very active in a variety of volunteer organizations. He lives with his wife of 48 years and 7 Top Reference Template | Character Reference has two married children. And Logistics Letter? Although both his mother and 7 Top Letter Template | Character father had type 2 diabetes, A.B. has limited knowledge regarding diabetes self-care management and states that he does not understand why he has diabetes since he never eats sugar. In the Son Technical, past, his wife has encouraged him to Character Reference Letter | Character Reference, treat his diabetes with herbal remedies and 4 Step Web Guy weight-loss supplements, and she frequently scans the Internet for the latest diabetes remedies. During the past year, A.B. has gained 22 lb. Since retiring, he has been more physically active, playing golf once a week and Reference Letter gardening, but he has been unable to lose more than 2–3 lb. He has never seen a dietitian and Son Technical has not been instructed in self-monitoring of blood glucose (SMBG). A.B.’s diet history reveals excessive carbohydrate intake in the form of bread and pasta. His normal dinners consist of 2 cups of cooked pasta with homemade sauce and three to four slices of Italian bread.
During the Reference Letter Template, day, he often has “a slice or two” of bread with butter or olive oil. He also eats eight to ten pieces of fresh fruit per day at meals and Click To Download Coordinator Professional as snacks. He prefers chicken and fish, but it is 7 Top Reference Letter Template, usually served with a tomato or cream sauce accompanied by pasta. His wife has offered to make him plain grilled meats, but he finds them “tasteless.” He drinks 8 oz. of red wine with dinner each evening. He stopped smoking more than 10 years ago, he reports, “when the cost of cigarettes topped a buck-fifty.” The medical documents that A.B. brings to this appointment indicate that his hemoglobin A 1c (A1C) has never been 8%. His blood pressure has been measured at 150/70, 148/92, and Online Branding Strategy - Oliver 166/88 mmHg on separate occasions during the past year at the local senior center screening clinic. Although he was told that his blood pressure was “up a little,” he was not aware of the need to keep his blood pressure ?130/80 mmHg for both cardiovascular and renal health.11. A.B. has never had a foot exam as part of his primary care exams, nor has he been instructed in Character Letter | Character, preventive foot care. However, his medical records also indicate that he has had no surgeries or hospitalizations, his immunizations are up to date, and, in general, he has been remarkably healthy for many years.
A physical examination reveals the following: Weight: 178 lb; height: 5?2?; body mass index (BMI): 32.6 kg/m 2. Fasting capillary glucose: 166 mg/dl. Blood pressure: lying, right arm 154/96 mmHg; sitting, right arm 140/90 mmHg. Pulse: 88 bpm; respirations 20 per minute. Eyes: corrective lenses, pupils equal and reactive to light and accommodation, Fundi-clear, no arteriolovenous nicking, no retinopathy.
Lungs: clear to auscultation. Heart: Rate and rhythm regular, no murmurs or gallops. Vascular assessment: no carotid bruits; femoral, popliteal, and dorsalis pedis pulses 2+ bilaterally. Neurological assessment: diminished vibratory sense to the forefoot, absent ankle reflexes, monofilament (5.07 Semmes-Weinstein) felt only above the Procurement And Logistics Cover, ankle. Results of laboratory tests (drawn 5 days before the office visit) are as follows: Glucose (fasting): 178 mg/dl (normal range: 65–109 mg/dl) Creatinine: 1.0 mg/dl (normal range: 0.5–1.4 mg/dl) Blood urea nitrogen: 18 mg/dl (normal range: 7–30 mg/dl) Sodium: 141 mg/dl (normal range: 135–146 mg/dl) Potassium: 4.3 mg/dl (normal range: 3.5–5.3 mg/dl) • Total cholesterol: 162 mg/dl (normal: 200 mg/dl)
• HDL cholesterol: 43 mg/dl (normal: ?40 mg/dl) • LDL cholesterol (calculated): 84 mg/dl (normal: 100 mg/dl) • Triglycerides: 177 mg/dl (normal: 150 mg/dl) • Cholesterol-to-HDL ratio: 3.8 (normal: 5.0) AST: 14 IU/l (normal: 0–40 IU/l) ALT: 19 IU/l (normal: 5–40 IU/l) Alkaline phosphotase: 56 IU/l (normal: 35–125 IU/l) A1C: 8.1% (normal: 4–6%) Urine microalbumin: 45 mg (normal: 30 mg)
Based on A.B.’s medical history, records, physical exam, and lab results, he is assessed as follows: Uncontrolled type 2 diabetes (A1C 7%) Obesity (BMI 32.4 kg/m 2 ) Hyperlipidemia (controlled with atorvastatin) Peripheral neuropathy (distal and symmetrical by exam) Hypertension (by previous chart data and exam) Elevated urine microalbumin level. Self-care management/lifestyle deficits. • High carbohydrate intake. • No SMBG program.
Poor understanding of diabetes. A.B. presented with uncontrolled type 2 diabetes and a complex set of 7 Top Template | Character Reference, comorbidities, all of Son Technical Whitepaper In Pdf, which needed treatment. Reference Letter | Character? The first task of the NP who provided his care was to select the most pressing health care issues and prioritize his medical care to address them. Nurse Resume Wolf - Resume? Although A.B. stated that his need to lose weight was his chief reason for seeking diabetes specialty care, his elevated glucose levels and his hypertension also needed to be addressed at the initial visit. The patient and Character Letter Template | Character his wife agreed that a referral to a dietitian was their first priority. A.B. acknowledged that he had little dietary information to help him achieve weight loss and Procurement And Logistics Manager that his current weight was unhealthy and “embarrassing.” He recognized that his glucose control was affected by large portions of bread and pasta and agreed to Character Reference Letter Reference, start improving dietary control by reducing his portion size by Dance Resume 16 Dancer Samples one-third during the week before his dietary consultation. Weight loss would also be an important first step in Character Reference Letter Reference, reducing his blood pressure. The NP contacted the Doc.#600776: Examples Of Resume Templates | Dignityofrisk.com, registered dietitian (RD) by telephone and referred the patient for a medical nutrition therapy assessment with a focus on weight loss and improved diabetes control. A.B.’s appointment was scheduled for 7 Top Reference the following week. The RD requested that during the intervening week, the Cover, patient keep a food journal recording his food intake at meals and snacks. She asked that the patient also try to estimate portion sizes.
Although his physical activity had increased since his retirement, it was fairly sporadic and weather-dependent. After further discussion, he realized that a week or more would often pass without any significant form of exercise and that most of his exercise was seasonal. 7 Top Template? Whatever weight he had lost during the Resume, summer was regained in the winter, when he was again quite sedentary. A.B.’s wife suggested that the two of them could walk each morning after breakfast. She also felt that a treadmill at 7 Top Character Letter | Character Reference home would be the best solution for Awesome Resume 16 Dancer Resume getting sufficient exercise in inclement weather. After a short discussion about the positive effect exercise can have on glucose control, the 7 Top Character Letter | Character, patient and his wife agreed to walk 15–20 minutes each day between 9:00 and 10:00 a.m.
A first-line medication for this patient had to be targeted to improving glucose control without contributing to weight gain. Thiazolidinediones (i.e., rosiglitizone [Avandia] or pioglitizone [Actos]) effectively address insulin resistance but have been associated with weight gain.12 A sulfonylurea or meglitinide (i.e., repaglinide [Prandin]) can reduce postprandial elevations caused by increased carbohydrate intake, but they are also associated with some weight gain.12 When glyburide was previously prescribed, the Awesome Dance Template Samples, patient exhibited signs and symptoms of hypoglycemia (unconfirmed by SMBG). ?-Glucosidase inhibitors (i.e., acarbose [Precose]) can help with postprandial hyperglycemia rise by blunting the effect of the entry of carbohydrate-related glucose into the system. However, acarbose requires slow titration, has multiple gastrointestinal (GI) side effects, and reduces A1C by only 0.5–0.9%.13 Acarbose may be considered as a second-line therapy for A.B. but would not fully address his elevated A1C results. Metformin (Glucophage), which reduces hepatic glucose production and improves insulin resistance, is not associated with hypoglycemia and can lower A1C results by 1%. Although GI side effects can occur, they are usually self-limiting and Character Letter Template | Character Reference can be further reduced by Nurse Resume Wolf - Resume Writer slow titration to dose efficacy.14. After reviewing these options and discussing the need for 7 Top Letter improved glycemic control, the NP prescribed metformin, 500 mg twice a day. Possible GI side effects and the need to avoid alcohol were of concern to A.B., but he agreed that medication was necessary and Online Branding - Oliver that metformin was his best option. The NP advised him to take the medication with food to Letter Template | Character, reduce GI side effects. The NP also discussed with the patient a titration schedule that increased the dosage to A Complete Branding - Oliver, 1,000 mg twice a day over a 4-week period.
She wrote out this plan, including a date and time for telephone contact and 7 Top Character Reference Letter Reference medication evaluation, and gave it to the patient. During the visit, A.B. and Click Here This Accounting Professional his wife learned to use a glucose meter that features a simple two-step procedure. The patient agreed to use the 7 Top Reference, meter twice a day, at breakfast and Registered Nurse - Resume Writer dinner, while the Reference, metformin dose was being titrated. He understood the Son Technical In Pdf, need for Template Reference glucose readings to guide the choice of medication and to evaluate the effects of his dietary changes, but he felt that it would not be “a forever thing.” The NP reviewed glycemic goals with the patient and his wife and assisted them in deciding on initial short-term goals for weight loss, exercise, and medication. Glucose monitoring would serve as a guide and assist the patient in modifying his lifestyle. A.B. drew the line at starting an antihypertensive medication—the angiotensin-converting enzyme (ACE) inhibitor enalapril (Vasotec), 5 mg daily. He stated that one new medication at a time was enough and that “too many medications would make a sick man out of me.” His perception of the state of his health as being represented by Coordinator Professional the number of medications prescribed for him gave the advanced practice nurse an 7 Top Letter Template | Character Reference important insight into the patient’s health belief system. The patient’s wife also believed that a “natural solution” was better than medication for treating blood pressure. Although the use of an ACE inhibitor was indicated both by the level of hypertension and by the presence of microalbuminuria, the Procurement And Logistics Cover Letter, decision to wait until the 7 Top, next office visit to Templates | Dignityofrisk.com, further evaluate the need for 7 Top Reference Letter Reference antihypertensive medication afforded the patient and his wife time to consider the importance of adding this pharmacotherapy. They were quite willing to read any materials that addressed the prevention of diabetes complications.
However, both the patient and his wife voiced a strong desire to focus their energies on changes in food and physical activity. The NP expressed support for their decision. Because A.B. Son Technical Whitepaper In Pdf? was obese, weight loss would be beneficial for many of his health issues. Because he has a sedentary lifestyle, is 35 years old, has hypertension and peripheral neuropathy, and is being treated for hypercholestrolemia, the NP performed an electrocardiogram in the office and referred the patient for an exercise tolerance test.11 In doing this, the 7 Top Reference Letter | Character, NP acknowledged and Son Technical In Pdf respected the mutually set goals, but also provided appropriate pre-exercise screening for Character Letter Reference the patient’s protection and safety. In her role as diabetes educator, the NP taught A.B. and his wife the importance of And Logistics Manager Letter, foot care, demonstrating to 7 Top Character Reference, the patient his inability to feel the light touch of the monofilament. Manager Cover Letter? She explained that the loss of protective sensation from peripheral neuropathy means that he will need to Character Reference Letter | Character Reference, be more vigilant in checking his feet for any skin lesions caused by poorly fitting footwear worn during exercise. At the conclusion of the 4 Step Online Branding Strategy - Oliver Web Guy, visit, the 7 Top Reference Letter Reference, NP assured A.B. that she would share the plan of A Complete 4 Step Branding Web Guy, care they had developed with his primary care physician, collaborating with him and discussing the findings of any diagnostic tests and procedures.
She would also work in partnership with the RD to 7 Top Letter Template, reinforce medical nutrition therapies and improve his glucose control. In this way, the NP would facilitate the continuity of care and keep vital pathways of communication open. Advanced practice nurses are ideally suited to play an integral role in the education and Son Technical medical management of people with diabetes.15 The combination of clinical skills and expertise in teaching and counseling enhances the delivery of Reference Template | Character Reference, care in Whitepaper In Pdf, a manner that is both cost-reducing and 7 Top Reference | Character effective. Inherent in the role of advanced practice nurses is the understanding of shared responsibility for health care outcomes. This partnering of nurse with patient not only improves care but strengthens the patient’s role as self-manager. Geralyn Spollett, MSN, C-ANP, CDE, is associate director and Registered | Writing Wolf an adult nurse practitioner at the Yale Diabetes Center, Department of Character | Character, Endocrinology and Metabolism, at Doc.#600776: Examples Templates Yale University in New Haven, Conn. She is an associate editor of Reference Letter, Diabetes Spectrum. Note of Of Resume, disclosure: Ms.
Spollett has received honoraria for speaking engagements from Novo Nordisk Pharmaceuticals, Inc., and 7 Top Character Letter | Character Reference Aventis and has been a paid consultant for Aventis. Both companies produce products and devices for the treatment of diabetes. 2017 by Dance Resume 16 Dancer Visualcv the American Diabetes Association. 7 Top Character Reference Letter Template? Diabetes Spectrum Print ISSN: 1040-9165, Online ISSN: 1944-7353 .