Third Party Conflict Resolution - 2113 Words

Third Party Conflict Resolution MGT/445 Organizational Negotiations March 11, 2013 | | | | Third Party Conflict Resolution Conflict is an omnipresent facet of human existence present at every level of society. Differences in culture, norms, beliefs, wants, needs, and personality causes conflict. Throughout history people†¦show more content†¦According to the â€Å"The Free Dictionary† (2013), intervention means â€Å"to come, appear, or lie between two things† (Intervene, para. 1). As acting senior vice president of operations and chief operating, Team A must intervene to resolve the conflict. Third Party Intervention Strategies and Selection In the Seatcor case, Team is considering using a third party. â€Å"The terms third party and intermediary are both used to refer to a person or team of people who become involved in a conflict to help the disputing parties manage or resolve it† (University of Colorado, December 2, 2005, p. 1) Third parties can take the role of intermediary, consultant, facilitator, mediator, or arbitrators. â€Å"T he various forms of observed third-party intervention are distinguished primarily by the degree of power that the intervener exercises over the process and outcome of the conflict† (Fisher, April 2001-03-30, p. 1. The role of a consultant is to analyze the conflict and develop a plan to help resolve the conflict. The role of a facilitator is to arrange and manage meetings until a reasonable agreement is reached. More serious conflicts may warrant a mediator. Mediators are more involved and impose more structure to the discussion process between both parties. The goal of the mediator is to get both parties talking so each side understandsShow MoreRelatedThird-Party Conflict Resolution1824 Words   |  8 PagesThird-Party Conflict Resolution University of Phoenix MGT 445 Organizational Negotiations Instructor Andrew W. Russo, MBA May 5, 2009 Third-Party Conflict Resolution Introduction In the negotiation process, the use of third-party conflict resolutions often comes into play when parties cannot seem to reach an agreement regarding resolving mutual interests. These types of third-party conflict resolutions are: arbitration, collaboration, litigation and mediation. For the SeatcorRead MoreThird Party Mediation in Conflict Resolution3121 Words   |  13 PagesTHIRD PARTY MEDIATION IN CONFLICT RESOLUTION Introduction The contemporary international system has witnessed dramatic increases in numerous conflicts. Specifically, of the six continents in the world, not even one is immune to one form of violent conflicts or the other. Of all efforts to explain the causes of these conflicts, a growing body of research findings highlights the association between economic deprivation and conflict. (Gurr 1970; Elbadawi 1992; Collier and Hoeffler 1998; StewartRead MoreThird Party Conflict Resolution Paper1408 Words   |  6 PagesUniversity of Phoenix Third Party Conflicts MGT 445-Organizational Negotiations Third Party Conflicts In this last week’s paper, we will study a case that has strong conflicts and we will see how we can analyze the possible intervention strategies used to solve the case. We will apply what we deem is the best plan and explain what would be the best strategy to find a solution to this conflict. We will utilize the seven stages of negotiation and see which of the five major negotiationRead MoreThird Party Conflict Resolution – Sick Leave Essay1453 Words   |  6 PagesThird Party Conflict Resolution – Sick Leave The case of sick leave involved Kelly, who was hired by Soto Board of Education in Japan. Her employment was with The Japan Exchange and Teaching Program (JET) and Conference of Local Authorities for International Relations (CLAIR) had taken over the contracts for the workers of JET. CLAIR’s role was to be a liaison during recruiting and selection, counseling and participant welfare. Their main function was to promote the exchange at the local levelRead MoreA Brief Note On Alternative Dispute Resolution And Other Forms Of Helping Professions1462 Words   |  6 PagesAlternative Dispute Resolution Conflict resolution is used in various aspects of counseling and other forms of helping professions. It is vital that conflicts between opposing parties are managed in order for progress to be achieved. By maintaining a controlled environment during the negotiation process, the two parties will often be able to come to a resolution of their differences. Sometimes it can be difficult for two parties to work together without the help of a third party to assist in the processRead MoreMajor Factors Determining Organizational Performance And Effectiveness1563 Words   |  7 Pages2004, p. 321).This can lead to conflict or a kind of tension between the organization and the employee. Mathieu and Zajac (1990) also found evidence for the relationship between organizational commitment and turnover. Yammarino and Dubinsky (1992) advocate an employee’s awareness of the immediate supervisor to be one of the major determinants of employee attitudes in the work place, including organizatio nal commitment. This can be more productively done by HR third party who is biased neither to theRead MoreDispute Resolution Processes Essay1240 Words   |  5 PagesDispute Resolution Processes Wherever there is a human-interaction, conflict is virtually unpreventable. For-instance, some conflict may well erupt a dispute in any structure of relationships, and other perhaps resulting in extremely compound international confrontation and hostility. It isnt that they cant see the solution. It is that they cant see the problem (G. K. Chesterton). Consequently, dispute resolution processes have been developed to manage and intervene in these types ofRead MoreMediation For A Second Party816 Words   |  4 Pages At times conflicts between the parties become difficult to manage or resolve among themselves. More and more employers and organizations are seeking to resolve these conflicts using a third party: mediator or arbitrator, (Meade, 2000). Disputes relating to discrimination of all kinds, harassment, or strikes can be extremely costly and time consuming when litigated in court. Arbitration or mediation can be a solution to seek an effective resolution to the conflict at hand without escalating or usingRead MoreHistory Of Adr And Conflict Management Essay1462 Words   |  6 Pagesreview of the literature discusses the history of ADR and conflict management. Additionally, this section discusses the four principal ADR processes Mediation, Arbitration, Negotiation and Conciliation as part of the conflict resolution mechanisms . The theoretical framework and guiding theories were explored. Finally, this chapter analyses the legislative framework in both at National and International arena. 2.1.1 Alternative Dispute Resolution ADR is a generic term that refers to a wide array of practicesRead MoreConflicts And Conflict Resolution Process1671 Words   |  7 PagesConflicts are inevitable in any human s’ interaction which makes their occurrence normal in the workplace. Conflict can be caused by imbalance of power and communication barriers that arise from the social structure or individual interpersonal’ perceptions, assumptions and expectations. The interpersonal conflict has a huge impact on the individual himself and extends to the workplace. The Human Resources (HR) role comes in light to attempt to help in the conflict resolution process. Human resources

Random Acts of Kindness Helping Homeless People - 734 Words

Random Acts of Kindness: Helping Homeless People I help people every day. Some of the things I have done for people have been big things. I helped my father build a home. I helped my relatives by co-signing on a car loan. These were big things, but they were not completely selfless actions because, when I help my family, I am also helping myself. When my family does better, it puts me in a position of doing better. Also, when I help my family or close friends, I do so knowing that they would help me, too. That is not the case when I help someone who is not in a position to help me and who is unlikely to be in a situation to repay the gesture. I consider those helping opportunities to be random acts of kindness. One of the random acts of kindness that I did was to help homeless people. Homeless people are easy to ignore. They do not go to the same places that I go. When we are in the same places, most homeless people that I have seen try to shrink into the background. Even those homeless people that are begging for money seem to try to do it in a non-intrusive way. They may have a hand-painted sign asking for help, but few of them make an effort to interact with others. They know that they are viewed with suspicion. Some people think of them as a nuisance. For the most part, they are dirty, many of them are suffering from mental illnesses, and it becomes easy to lump them into a category of people, rather than viewing them as individual human beings. Therefore, when aShow MoreRelatedMisha Collins is widely known as Castiel, angel of the Lord, from the CBS and Time Warner800 Words   |  4 Pagesbecome an influence worldwide with the creation of his organization The Random Acts, G.I.S.H.W.H.E.S., and from the awards he has won as a result. Misha co-founded his organization, The Random Acts in the winter of 2009. It all started with a tweet to his â€Å"minions†, asking for a â€Å"â€Å"minion stimulus† project. The goal was to obtain US government stimulus money for non-profit initiatives† (The Random Acts, â€Å"History of Random Acts†). However, the idea was altered to become a privately organized charityRead MoreCase Reaction : I Baked A Pumpkin Pie And Brought It Into Work For My Co Workers Essay1460 Words   |  6 Pages 1. Act: I baked a pumpkin pie and brought it into work for my co-workers Reaction: I went out of the way to do something nice for my co-workers during the holidays to boost morale. They appreciated me doing this because it made their day especially during such a busy time of year for us at work. It made me feel good because I love to bake and it was great to see the smile it put on everyone’s face. 2. Act: I gave a homeless man my Reese’s candy I had just bought Reaction: I was walking outsideRead MoreEssay on Community Service1756 Words   |  8 Pagestwelve kind-hearted individuals that went on an AWOL trip to Denver, Colorado. We worked at various places including Girls Inc., Urban Farms of Denver, Boys Girls Club, visiting a home for cancer children, and even made 120 sack lunches for homeless people. Our group was able to come up with many great ideas on how to help out the organizations. The Denver group also met with one of the creators of AWOL Libby Rau. Libby was an amazing BV student who graduated last spring. She came up with theRead MoreThe Attitude of Giving in Rambam’s Obligations to the Poor Essay2052 Words   |  9 Pagesâ€Å"Obligations to the Poor† from the Mishneh Torah help us understand how we should interact with the people who are less fortunate than us. As Professor Isador Twersky has said, â€Å"Maimonides’ [treatment of tzedakah] illustrates the need for sensitivity, tact, and graciou sness in the act of charity. The formal, objective act of giving charity is deficient and defective if it is not characterized by kindness and sympathy.† This directly relates to the chapter in the Mishnah that we have been studying inRead MoreThe Roman Catholic Church2519 Words   |  11 PagesThere are always issues in the world that we have to face, they change with time but a lot of them seem to have a common theme and that is indifference. I cannot help but think that people are uncomfortable with anything that is different from the norm. Many of us are set in our ways and we quickly remove any one who threatens that. A lot of us come from a set of foundations that help create who we are. While doing research for this paper I searched for topics that interest me. I also searched forRead More_x000C_Introduction to Statistics and Data Analysis355457 Words   |  1422 PagesCrisis for European Sports Fans? 347 Activity 6.3 The â€Å"Hot Hand† in Basketball 347 Gr aphing Calculator Explorations 351 7 Random Variables and Probability Distributions 7.1 Random Variables 358 357 7.2 Probability Distributions for Discrete Random Variables 361 7.3 Probability Distributions for Continuous Random Variables 367 7.4 Mean and Standard Deviation of a Random Variable 372 7.5 Binomial and Geometric Distributions 386 7.6 Normal Distributions 397 7.7 Checking for Normality and NormalizingRead MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 PagesChallenges and Opportunities for OB 15 Responding to Economic Pressures 15 †¢ Responding to Globalization 16 †¢ Managing Workforce Diversity 18 †¢ Improving Customer Service 18 †¢ Improving People Skills 19 †¢ Stimulating Innovation and Change 20 †¢ Coping with â€Å"Temporariness† 20 †¢ Working in Networked Organizations 20 †¢ Helping Employees Balance Work–Life Conflicts 21 †¢ Creating a Positive Work Environment 22 †¢ Improving Ethical Behavior 22 Coming Attractions: Developin g an OB Model 23 An Overview 23 †¢ InputsRead MoreLibrary Management204752 Words   |  820 Pages279 Violence and Crime in the Workplace . . . . . . . . . . . . . 280 External Impacts on Human Resources—Legal Protections . . . . . . . . . . . . . . . . . . . 282 Equal Employment Opportunities . . . . . . . . . . . . . . . . 283 The Civil Rights Act of 1964 and Other Important Federal Legislation . . . . . . . . . . . . . . . . . . . 284 Affirmative Action and Comparable Worth . . . . . . . . . 285 xii Contents Sexual Harassment . . . . . . . . . . . . . . . . . . . . . . . . . . . 289Read MoreOne Significant Change That Has Occurred in the World Between 1900 and 2005. 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Impact of Economic Factors on Engagement with Pro-Environmental Measures Free Essays

THE ENVIRONMENT Introduction: On most occasions, conservationist, and authorities bureaus tell us on the benefits of conserving the environment. This is because the universe is witnessing a series of environmental devastations, which range from devastation of woods, pollution of rivers, lakes and air. People argue that it is of import to continue the environment because they play a large function in prolonging the lives of persons. We will write a custom essay sample on Impact of Economic Factors on Engagement with Pro-Environmental Measures or any similar topic only for you Order Now For illustrations, trees help in the formation of rainfall, which is an indispensable demand for agribusiness to last. Forests are natural home grounds of animate beings, and on this footing, destructing woods, will intend the devastation of wild animate beings. This in bend will interrupt the environmental eco-system ( Brooks, 2010 ) . Despite the importance of conserving the environment, most people still prosecute in its devastation. The grounds advanced for their engagement in destructing the environment are, poorness, population growing, and hunt of income. This paper identifies the grounds as to why people still prosecute in the devastation of the environment, despite the of import function that the environment plays in our society. Search for beginnings of income/ gross: Search for beginnings of gross and income is one of the major factors that lead to the devastation of the environment. Take for illustration oil geographic expedition and excavation is a factor that makes people to destruct the environment ( Tisdell, 2005 ) . Oil is an of import natural resource that all most all the economic systems of the universe demand. Oil is needed to drive the transit industry, which is indispensable for the growing of a country’s economic system ( Leydesdorff, 2007 ) . Oil plays a large function in using 1000000s of people all over the universe, and states such as Saudi-Arabia, Qatar, Libya, etc depend on oil production to prolong their economic systems. This is because oil is the major beginning of foreign gross for these states ( Tachibana, 2000 ) . It is of import to denote that oil geographic expedition and excavation play a great function in the devastation of the environment. Oil has the capableness of destructing the lives of animate beings, and human existences. Take for case the 2010 Gulf of Mexico oil spill which was responsible for leaking about 60,000 barrels of oil into the ocean ( Harper and Fletcher, 2011 ) . This had an effecting of killing sea animate beings, which included mahimahis, sea polo-necks, giants, etc. This oil spill was chiefly caused because of oil geographic expedition by BP Oil Company. The ground of these geographic expeditions was to mine oil, for commercial intents. Petroleum companies are besides accused of dumping toxic oil wastes on nearby rivers and Waterss. This has a cause of fouling the environment, and destructing the lives of Marine animate beings populating in these H2O systems ( Imanaka, 1997 ) . Petroleum companies are commercial companies, whose chief purpose is to sale oil merchandises for intents of doing net incomes, and grosss. Income net incomes and gross is non merely restricted to oil geographic expedition, but besides to the devastation of woods, and killing of wild animate beings. For illustration, people cut down trees for intents of acquiring wood. Wood is used to do lumber, a resource that is used to fabricate chairs, and edifice of houses ( Colson, 2011 ) . These are for commercial intents. The violent death of wild animate beings is besides carried out for intents of doing gaining an income, and due to poverty. For illustration, poachers normally kill elephants and rhinos for their ivories, and horns. Elephant Ivories are ever sold in Asia, and are used as beauty merchandises, and for intents of doing medical specialty. The same happens to the horns that poachers get from rhinos. Population Growth: Population growing is besides another factor that deters the preservation of the environment ( Newing, 2010 ) . Because of population growing, world has been forced to look for other topographic points of abode ( Likar, 2011 ) . This will do them to unclutter and destruct woods, as a consequence taking to the devastation of trees, and break of the eco-system. As celebrated earlier, woods are home grounds of wild animate beings, and birds. Destroying woods will take to the decease of some of these animate beings, because they may non happen other home grounds. The devastation of woods is non the lone negative environmental harm that population growing causes. Due to the high figure of people, there is the overconsumption of natural resources such as H2O, oil, nutrient, and even land ( Imanaka, 1997 ) . This consequences to doing these resources scarce. Scarcity of these environmental resources might take to unhealthy competition amongst people, in order to entree the resources under consideration. Peoples besides emit waste merchandises, because of their ingestion activities. This includes H2O, and air pollutants, toxic waste stuff, extra foods, and green house gases. Waste substances such as untreated sewerage may take to the devastation of an individual’s wellness. Other waste merchandises, such as inordinate N have an impact of doing the blooming of algals, in H2O supplies. This will take to the depletion of O, taking to the decease of marine animate beings such as fish ( Calhoun, 2005 ) . To protect the environment by restricting the growing of the environment, states such as China have adopted the one kid policy. This is whereby all twosomes are forced to bear to give birth to merely one kid. India besides has such sort of a policy, and the chief purpose of presenting these types of policy is to cut down the population growing of persons(Environmental issues. 2010 ). There has besides been some unreal method of commanding population growing, and this includes the usage of household planning methods ( Chancellor, 2009 ) . As a method of commanding the population growing in their states, authorities normally promote the usage of household planning methods. Poverty: Poverty is besides another factor that makes people to destruct the environment. In most states of the universe, specifically in the development states, there is the devastation of croping lands, dirt and woods because of over graze. These methods are ever efficient in commanding the population of a province, and therefore protecting an environment. As the growing rate of poorness additions, people destroy the environment faster, and more rapidly. The people over use the environment, such as dirt, land and woods, because they do non hold other beginnings of income, except by utilizing the natural resources under their range ( Harper and Fletcher, 2011 ) . It is of import to denote that because of poorness, the hapless will utilize the natural resources under their range for intents of fulfilling their footing demands. This will include fetching and utilizing firewood to cook, overdriving land for agricultural production, and usage of wild workss and H2O for medical specialty ( Canava ri and Food, 2002 ) . Poor people lack good and better instruction which can assist them to procure good occupations and beginnings of income. On this footing, they lack the quality of life that can do them to utilize electricity for cookery intents, or for other sectors of their domestic life ( Michna, 2010 ) . Electricity can assist in restricting the firewood concern that these people engage in. This is because persons will non depend on firewood as their beginnings of energy. To undertake poorness, the assorted authoritiess need to ordain policies aimed making employment, and bettering the instruction system of a province. The authorities can promote the usage of their trade accomplishments in assisting the hapless to gain income ( Hambler, 2004 ) . But this should happen in a mode that is suited for the saving of the environment. To cover with poorness, policies from the authorities are non sufficient. The authorities needs to spouse with private establishments and non-governmental organisations for intents of promoting them to educate people on the assorted ways of undertaking poorness ( Takeuchi, 2006 ) . This will be effectual because non-governmental organisations usually have an entree to the people, because of their grass root connexions. The hapless can be educated on the importance of continuing the environment ( Graetz, 2011 ) . This will do the hapless to hold knowledge on the benefits of the environment, doing them to utilize the natural resources under their range in a sustainable method. Decision: In decision, poorness, hunt for income, and population growing are some of the factors that encourage people non to prosecute in pro-environmental steps. As discussed in this paper, due to poverty, people will seek to unsuitably utilize the environment for intents of prolonging themselves. This includes film editing of woods for intents of acquiring lumber, over-using the land resource under their ownership, for agricultural intents, and over-grazing. However, with the usage of appropriate authorities policy, it is possible to cut down the degrees of poorness within a province. Search for income is another ground for depletion of the environment, and this usually takes the signifier of geographic expeditions and excavation. This is a really hard issue to work out, because authoritiess are ever in a quandary. That is, whether to halt the geographic expeditions or whether to go on with the geographic expeditions. Stoping the geographic expedition will intend losing a beginning of gross, while go oning with the geographic expedition will intend destructing the environment. Population growing on the other manus is easy to work out. All that a province demands to make is to make a policy restricting the figure of kids an person can give birth to. Mentions: Brooks, J. S. ( 2010 ) . Economic And Social Dimensions Of Environmental Behavior: Reconciliation Conservation And Development In Bhutan.Conservation Biology,24( 6 ) , 1499-1509. Calhoun, Y. ( 2005 ) .Conservation. Philadelphia: Chelsea House Publishers. Canavari, M. , A ; Food, A. ( 2002 ) .Economic surveies on nutrient, agribusiness and the environment: Joint Conference on Food, Agriculture, and the Environment, Bologna, Italy, June 12- 14, 2001. Dordrecht: Kluwer Academic/Plenum. Chancellor, D. ( 2009 ) .Food waste. London: Wayland. Colson, M. ( 2011 ) .The environment. Chicago, Ill. : Raintree. Environmental issues. ( 2010 ) . New Delhi: IFA Publications. Graetz, M. J. ( 2011 ) .The terminal of energy the unmaking of America ‘s environment, security, and independency. Cambridge, Mass. : MIT Press. Hambler, C. ( 2004 ) .Conservation. Cambridge, UK: Cambridge University Press. Harper, C. L. , A ; Fletcher, T. H. ( 2011 ) .Environment and society: human positions on environmental issues( Canadian ed. ) . Toronto: Pearson Canada. Imanaka, T. ( 1997 ) . Global environment. How protect and surrogate? Interaction between environment and being. Both environment and organisms support on changing.. Kagaku to Seibutsu,35( 3 ) , 178-181. Leydesdorff, L. ( 2007 ) . Environment and Planing B: Planning and Design as a diary: the interdisciplinarity of its environment and the commendation impact.Environment and Planning Bacillus: Planning and Design,34( 5 ) , 826-838. Likar, L. E. ( 2011 ) .Eco-warriors, nihilistic terrorists, and the environment. Santa Barbara, Caliph: Praeger. Michna, J. ( 2010 ) .Risk direction on energy and enviromental preservation in CCE states. New York: Heinmman. Newing, H. ( 2010 ) . Interdisciplinary preparation in environmental preservation: definitions, advancement and future waies.Environmental Conservation,37( 04 ) , 410-418. Tachibana, H. ( 2000 ) . Engineering chance for environment in 2000. Prospect of sound environment. Technological reappraisal of sound environment..Journal of Environmental Conservation Engineering,29( 2 ) , 149-156. Takeuchi, K. ( 2006 ) . Hydrology uniting planetary environment and human environment. Proceedings of the Symposium on Global Environment,14, 307-307. Tisdell, C. A. ( 2005 ) .Economicss of environmental preservation( 2nd ed. ) . Cheltenham, UK: Edward Elgar Pub.. How to cite Impact of Economic Factors on Engagement with Pro-Environmental Measures, Essay examples

Case Study On Susan Cushing Syndrome- myassignmenthelp.com

Question: Discuss about theCase Study On Susan Cushing Syndrome. Answer: Introduction Cushing syndrome is the clinical depiction as a result of increased levels of plasma glucocorticoids. This condition is rare but most frequently occurs in adults aged 25-50. It may be Adrenocorticotropic hormone (ACTH) reliant or in other instances autonomous. ACTH dependent causes include adrenal tumors that secrete glucocorticoids, diffuse ACTH secreting tumors, micro nodular hyperplasia of the adrenal gland (90% being unilateral) and prolonged exposure to exogenous steroids in the management of autoimmune diseases including Systemic Lupus Erythematosus and rheumatic arthritis. ACTH independent often involve receptor signaling and expression by adrenocortical cells a case seen in Beta adrenergic agonists, ADH, gonadotrophin releasing hormone (GnRH)and in ACTH producing anterior pituitary adenomas (70% of cases). It is also commonly associated with obesity and Diabetes Mellitus Type II and hypertension (National Endocrine and Metabolic Diseases Information Service (NEMDIS), July 200 8). Presentation Individuals with Cushing syndrome present with truncal obesity, fatty buffalo shoulder, facial obesity hence the moon face appearance, poor muscle development, unproportioned arms and legs. Visible purple striae may be seen on the abdomen, arms, thighs and breasts. Women may report of infertility, irregular periods and susceptibility to fractures especially if premenopausal. In some cases, depression and anxiety disorders, hyperglycemia, fatigue and in about 85% hypertension may occur. The female-male sex based incidence ratio of Cushing syndrome due to adrenal or pituitary tumors is about 5:1. Pathophysiology Of Cushing Syndrome Extended exposure of body tissues to elevated levels of cortisol(glucocorticoid) causes Cushing syndrome. ACTH-dependent causes are mainly endogenous and include Cushings disease (60-70%), CRH-producing hypothalamic tumors and macro nodular hyperplasia. In ACTH-independent cases foundations include ectopic cortisol production by ovarian carcinomas, small cell lung carcinomas and neuroendocrine tumors resulting in high ACTH levels. Overproduction of endogenous glucocorticoids independent of ACTH is on most occasions due to adrenocortical neoplasms(adenomas). In a homeostatic body system, the hypothalamus secretes Corticotrophin releasing hormone(CRH) to the anterior pituitary which releases Adrenocorticotrophic Hormone that act on the Zona fasciculata producing cortisol from the progenitor cholesterol. The plasma reference levels are 140-700nmol/L in the morning and 80-350nmol/L at midnight (Biochemistry Reference Ranges Goodhope,2012). Cortisol functions to stimulate gluconeogenesis in fasting state, downregulates the production of interleukin-12and Tumor Necrosis Factor Alpha by antigen presenting cells upregulating the production of IL-4, IL-10 and IL-13 by the T helper cells resulting in prevention of an overactive immune response. Furthermore, cortisol antagonizes the functioning of insulin. This results insulin resistance and decreased energy dependent translocation of glucose by the GLUT-4 transporter this in the case of Cushing syndrome the hyperactivity of cortisol results in the manifestation of diabetes mellitus type II. In calcium homeostasis in bone, cortisol results in increased resorption, there is also increased potassium efflux and reduced intestinal calcium absorption. Excess of cortisol causes osteoporosis and hyperkalemia in this case (The Journal of Clinical Endocrinology and Metabolism. 15 (2): 17681). Cortisol also functions to increase the level of free amino acids through protein catabolism. It also inhibits immunoglobulins IgA and IgM, in hypercortisolism, there is evident hyperlipidemia and decreased peripheral glucose utilization as a result of liberated amino acids. There is also evident muscular atrophy, thin skin and subcutaneous tissues, scraggy thin hair and uneven fat distribution. Significant diuretic effects of cortisol occur in high cortisol levels in serum, the potassium ions are excreted and sodium retained. The salt and water retention results in the round moon face appearance seen in Cushing Syndrome The role cortisol in the CNS cannot be overlooked. In cognition it is involved the hippocampal formation on short term memory. The control of the circadian rhythm (McDonalds veterinary endocrinology and reproduction (5th ed) via control of the suprarchiasmatic nucleus. In Cushing syndrome sleep and mood disorders are common. Depression may also occur and psychologic stress exaggerated. In obese individuals there is elevated cortisol courtesy of cortisol regeneration from cortisone by hydroxysteroid 11-beta dehydrogenase 1. Susans respiratory rate was 30 breaths per minute which is higher than the normal range of 12-20 breaths per minute, she is also hypertensive with a recorded blood pressure of 160/90 mmHg (normal range of 90/60- 120/80 mmHg). Her body temperature was at 35.0C, this is below the normal reference range of 36.5C-37.3C. There is also a reported increase in the pulse, the recorded value is 128bpm, the value is elevated off the normal range of 60-100bpm. There is subclinical pain with a score of 0/10. The urinary output is reduced to 5mls per hour (normal 30-80ml/per hour). The respiratory recovery after anesthesia is slow and there is a reflex apnea due to the compensatory mechanisms of the surgically induced hypoxia. The recovery from the respiratory depression takes elimination of carbon dioxide and reduction in the ventilation to perfusion ratios in the lungs. The post-op hypertensive state was triggered by the reflex reaction to glucocorticoid suppression. There is also marked reduction of the production of aldosterone. This mechanisms involve a secondary adrenal insufficiency resulting from the suppression of the Hypothalamic-pituitary adrenal axis (HPA). Suppression of the renin angiotensin system and reduction of the diuretic mechanism of action of cortisol produce a resultant increase in the cardiac output thus an elevated blood pressure. Additionally, the basal body temperature is reduced, this is as a result of the suppression of the pontine temperature control centers and the recovery phase from the surgical anesthesia. Susan is also in a steroid crisis and the physiological mechanisms are sabotaged by the sudden withdrawal of he obviously high levels of cortisol. The reduction is the metabolism by these two individual triggers result in the transient hypothermia. Coupled with the hypothermic state is the increased pulse rate. This is produced as a result of tachycardia and increased nervous stimulation after the surgical pressure. The body registers a shock which culminates in the increase in the heart rate. Reduction in aldosterone and altered feedback to the HPA axis causes a reduced production of urine. There is recorded retention of sodium of potassium ions thus a hypovolemic shock. A conglomeration of all these pathological cases result in Susans post-operative presentation. Considering the presentation, Susans management involve the monitoring of all her vital signs. The values are measured and recorded two hourly. Any notable change is reported for further intervention. Electrolyte values are also taken on a frequent schedule especially in the first 48 hours after the surgery. Administer intravenous fluids and account for the fluid intake and output at regular intervals. Pain is also monitored and analgesics administered accordingly to alleviate pain. To avert any episode of hypovolemic shock or Addisonian crisis, Cortisol is administered to replace the inadequate hormonal levels. Care for the laparoscopic site, the wound is drained and cleaned using a sterile technique to reduce the risk of an infection. The indwelling urinary catheter is removed on the first day post-op and a clear liquid diet is started on the first day. Dietary progression is made on a need-basis. Psychosocial support is given to relieve anxiety. On discharge, the Susan and any appropriate family members will get an explanation and schedule on the take home medication and prescription. General health messages on the effect of the surgical procedure and physiological response to the resultant procedure. The messages include dietary management of sugar, side effects of glucocorticoid therapy and the importance of physical exercise of the overall outcome of the recovery process. Details of the next checkup are also provided for .Susan also has to report any alarming signs in the process. Interdisciplinary Heathcare Team Susans condition requires an entire team approach to effectively manage her condition. Apart from her the primary medical and nursing team the social worker, nutritionist and the health educator are involved. The integration of the entire team is required to produce an outcome sufficient to make Susans life more productive and fruitful. The medical condition will become more lucid. The social worker provides is the backbone of the familial responsibility at hand. The care of all her three children verses her income from the casual employment. She does require an extensive monetary plan and linking up to more agencies to provide financial support and education to children. On the returns from her wages, the social worker provides liaises with monetary organizations that provide saving plans and insurance policies suitable to the financial muscle Susan has. The nutritionist evaluates and provides the nutritional needs of Susan. They assist in providing a treatment plan which may include special diets, foods that help ease swallowing, dietary changes as a result of the condition and also patient and family education on nutrition topics related to Susans condition. The health educator will also be of much importance in educating Susan and his family on topics related Cushings syndrome and other general health concerns. This include causes, prevention and even treatment. Topics concerning usage of over the counter drugs can also be handled by the health educator. Others include personal hygiene and general cleanliness. Conclusion Susan is obese and presents with a typical case of Cushing syndrome, determination of her differential diagnosis is based on her presenting case of primary depression and alcoholism. The diagnostic approach to the cause of the hypercortisolism involves a 24-hr urine sample collection and assay of cortisol levels. In elevated cortisol levels, a low dose of dexamethasone (2mg/day for 2 days) is administered and on the subsequent urine collection if the cortisol is suppressed by more than 50% then it is definitive case (European Journal of Endocrinology, vol. 176, no. 5, pp. 613624, 2017). When suppression is non-evident a repeat test is done with a higher dose of 8mg /day for 2 days and as in the case there would be no suppression because the cause of ACTH suppression secondary to an adrenal tumor. The adrenal tumor is visualized via a CT Scan and as indicated a surgical plan of a right adrenalectomy is done. 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