Weakness

This presentation is based on a traditional Indian parable about the relationship between a spiritual seeker and his or her spiritual teacher. In the original myth the seeker cannot believe that he or she is actually spiritual and strong. The spiritual teacher is to convince the student that he or she is potentially pure spirit and invincible. The imagery used is that of a senior, wise and deeply spiritual lion, the symbol of fearlessness and strength, who meets another, younger soul who is a young and inexperienced, inherently strong and fearless like a lion, but is under the impression that he is weak and silly like a sheep.

This research study was conducted to investigate the potential of a virtual project-based simulation game for being used as an educational tool, from the viewpoint of construction students. For this purpose, 135 undergraduate construction students played Skyscraper Simulator, which is a virtual project-based simulation game focused on construction management. After playing, the students completed a questionnaire to share their opinions on the game " s strengths and weaknesses. For assessing their responses, the comments were categorized by means of the constant comparative method of qualitative analysis and were counted for each category. The results indicate that the participants believed that Skyscraper Simulator has the potential to help substantially with comprehension of main concepts in construction management, and so it has positive effect on educating undergraduate construction students.

Teniendo en cuenta el poder atribuido a los demonios en los postulados de la demonología cristiana, el trabajo se propone analizar la apropiación llevada a cabo por Teresa de Ávila. Necesitada de comprender qué era el demonio y cómo contrarrestarlo, la monja abulense abordó una tarea de reflexión que tuvo como resultado la construcción de un endeble Enemigo frente a la oración contemplativa.

LEARNING OBJECTIVES: 1) To recognize symptoms of ectopic ACTH
syndrome. 2) To understand pathophysiology and treatment of ectopic
ACTH syndrome
CASE: A 56 year old Caucasian male with a history of Type 2 diabetes
and hypertension was admitted to the hospital for poorly controlled
blood glucose, high blood pressure, pedal edema and severe lemia. He was known to have localised prostate cancer which was
diagnosed 1 year ago. Significant physical findings included blood
pressure of 170/100 mm Hg, pitting pedal edema and proximal
muscle weakness. His admission investigations revealed glucose of
425 mg/dl, potassium 2.7 mmol/L and bicarbonate 30 mmol/L.
Prostate specific antigen (PSA) was elevated at 11.6 ng/ml (nanogram/
milliliter) and recurrence of prostate cancer was suspected. Computed
tomography of abdomen and chest showed wide spread metastasis
to liver, lung and osteoblastic lesions in lumbar spine. Biopsy
of the liver lesions revealed undifferentiated small cell carcinoma.
Immunohistochemical stains for prostate cocktail (PSA/Prostate acid
phospatase) and chromogranin, a marker for neuroendocrine tumor
were negative. Further work up revealed severely elevated morning
cortisol of 72 ug/dL (4–24 ug/dl) and 24 hour urinary cortisol of
1872 ug/24 hrs (3.5–40 ug/24 hr). ACTH level was high at 501 pg/ml
(0–46 pg/mL).With this constellation of findings, a diagnosis of
ectopic ACTH secretion from metastatic small cell cancer was made.
He received chemotherapy with Cisplatin and CPT-11[Irinotecan] and
was started on Ketoconazole for suppressing the synthesis of glucocorticoids.
However this resulted in QT prolongation on follow up electrocardiogram,
so Ketoconazole was discontinued. Therapy with
Octreotide 100 micrograms three times a day was started. In 5 days,
ACTH decreased by 23 percent and 24 urinary cortisol decreased by 73
percent. Patient was switched to long acting Octreotide 20 mg once a
month. His muscle strength improved significantly. He had better
glycemic and blood pressure control and potassium level normalized.
After 2 months on Octreotide therapy ACTH was 11 pg/ml and 24 hour
urine Cortisol was within the normal range
DISCUSSION: Cushing’s syndrome caused by ectopic production of
ACTH should be considered in all patients with a malignancy,
associated with peripheral edema, hypertension, raised blood glucose
and hypokalemic alkalosis. This patient had all these typical
manifestations. In patients with ectopic ACTH syndrome due to
aggressive small cell cancers, onset of Cushing’s syndrome can be
rapid and this can explain absence of classic manifestations such as
fat deposition in clavicular fossa and interscapular area. These
patients have extreme hypercortisolemia which causes, marked salt
retention (contributing to edema and hypertension), increased glucuneogenesis
(producing glucose intolerance), and hypokalemic alkalosis
(causing profound muscle weakness). Surgical excision or debulking of
the tumor is the definitive therapy of ectopic ACTH syndrome. Medical
therapy with adrenal enzyme inhibitors, such as Aminoglutethimide,
Ketoconazole or Metyrapone can be used to reduce cortisol production.
Octreotide, a long-acting analogue of somatostatin can be
effective in suppressing ACTH levels. The long acting analog of
Octreotide (Sandostatin LAR) given once monthly is effective and
preferred once efficacy of Octreotide is documented (This is an off
label use of Octreotide).

As the Church loses its dominant position in the Western world, much can be learned from the Early, Pre-Constantine world. Among others, the Early Church reveals the power that lies, paradoxically, in weakness.  Post-Christendom is therefore, perhaps, an excellent opportunity to re-discover the roots of what made Christianity strong: an attitude of weakness, absolute love, and service.

Three papers approach institutions and their relation to social norms from three different angles. In the first paper, I introduce the notion of an institution as a social norm that governs a social practice. In the second paper, I use this account to explain what it means for an institution to be strong or weak. And in the third paper, I discuss why and how equilibrium and rule theories of institutions should be unified. The Rules-and-Equilibrium Theory, as I call it, combines equilibrium theories such as that of David Lewis (1969) and rule theories such as that of Herbert Hart (1961). I compare it to other hybrid theories such as those of Cristina Bicchieri (2006) and Philip Pettit (1993, 2007).

The automotive industry includes all design, development, manufacture and selling accessories for motorised means of transportation. Iran is among the world's 20 largest automotive manufacturers and is in the number one position in the Middle East. Iran Khodro is the largest and most important car manufacturer in Iran and the Middle East, which was founded in 1341. It produces a variety of light and heavy vehicles in collaboration with foreign partners or alone. The aim of this study is investigating and analysing the internal and external environment of automobile manufacturing industry in Iran emphasising on Iran Khodro automobile manufacturing company. For the purpose of this study, the accumulated data of Iran Khodro automobile manufacturing company were analysed and the most important strengths and weaknesses point were compiled and presented in the aspect of internal environment and opportunities and threats in the aspect of external environment.

Upon the basis of selected examples of widely comprehended field studies (from the domains of ethnology, history, oral history, and sociology) the article analyses tactics applied by informants who in relations with the researcher hold a weaker position as regards cultural capital, communication tools, and interpretation. In such situations weakness becomes a stand used for severing contact, a maximum limitation of contents relayed to the researcher, or the concealment of selected motifs and themes. By distinguishing and discussing assorted tactics: silence, desultoriness and evasion, deceit and lies, the process of drawing attention away and “cunning complaisance” the author of this article pointed to a situation in which research is used by the informant for the sake of rendering his opinion public and empowering it. Finally, he indicated that the manner of approaching the weakness of the Other unintentionally reveals also the weakness of the researcher.

Penelitian yang peneliti lakukan ini bertujuan untuk mengetahui penerapan manajemen strategi perusahaan waralaba pada KFC (Kentucky Fried Chicken). Penelitian ini merupakan penelitian kualitatif deskriptif dengan metode yang peneliti gunakan dalam penelitian ini yaitu adalah content analysis atau yang merupakan analisis isi. Teknik pengumpulan data Yang peneliti gunakan dalam penelitian ini yaitu adalah metode simak dan catat Hasil dari perhitungan IFAS dan EFAS yang menunjukkan bahwasannya kekuatan dan juga peluang yang dimiliki oleh perusahaan waralaba KFC lebih besar daripada kelemahan dan ancaman perusahaan tersebut. Hal ini menunjukkan bahwa manajemen perusahaan waralaba KFC menerapkan manajemen strategi dengan baik. Hal tersebut perlu dipertahankan serta disarankan agar dapat meningkatkan strategi manajemen agar dapat terus bersaing di bidang waralaba