Think of someone you respect highly.

Then see if you agree with this: The need to feel genuinely
worthwhile, important, admired, trus-ted, valued, and appreciated ("liked") is universal in adults and kids specially in shame-based survivors of low-nurturance childhoods. Gen-uine (vs. pseudo) respect is a
requisite for friendship and love.
The opposite of respect is scorn, disdain, indifference, disgust, dislike, rejection, and disapproval.
Reality check: think of the last time you felt disrespected, and see if this feels true.
Respect can be global ("I respect you as a person") or partial ("I respect you as a fe/male / parent /
friend / neighbor / sailor / chef / listener / Muslim / citizen / musician / etc.) Respecting someone is
different than liking or needing them.
True respect must be earned via experience. It is often based on personal attributes like honesty,
compassion, courage, patience, generosity, integrity, optimism, wisdom, resilience, humor, and humi-lity.
Respect cannot be demanded, ordered, or expected, for it can only occur spontaneously. Mutual
respect is a primal need in any communication. Without it, listening falters, and defensiveness, hurt,
anxiety, and resentments quickly rise.
We judge others' respect for uds by their voice, words, face, and body language. Disrespect cannot
be hidden for long, despite earnest denials. Chronic disrespect for yourself and/ or others is usually a sign
of early trauma and major psychological Lesson 1 here offers an effective way of detecting and reducing
such wounds, and protecting kids from them.
More detail
plural pseudointellectuals
pseudointellectual
/sudontlktwl/
noun
plural pseudointellectuals
Learner's definition of PSEUDOINTELLECTUAL
[count] disapproving
: a person who wants to be thought of as having a lot of intelligence and knowledge but who is not really intelligent or
knowledgeable

She thinks her classmates are just a bunch of pseudo-intellectuals.

[+] more examples [-] hide examples [+] Example sentences [-] Hide examples

psuedointellectual
adjective
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Something Ive always dislike about my african culture is pseudo respect.

This afternoon I send the following private message via face book
Hi x! please stop sending me these stories. I dont read negative things like this which usually are
not well reported or even true. Thanks
Now put this into context. I sent this to a person I have never met. He introduced himself in a private
message with one line stating that he was the son of an Aunty (Ive never met her either). After that
one line hes sent about 6 links to horrible stories posted on a blog. Post with titles like AGONY OF
A MOTHER. WHY DID FESTUS KILLED MY DAUGHTER, grammar is clearly unimportant. From
what I can tell this is his personal blog, a collection of other stories where he writes most of the
comments.
As a response to my request he sent this;
And there you have it! I must respect this person because he thinks that he is older than me! He
doesnt actually know that he is older than me but assumes he is because some who doesnt know
me says so.

Hes promptly blocked me in his outrage.

This is the kind of useless notion of respect that irritates me about my Nigerian heritage.
He was not at all interested in getting to know his cousin he just made contact with me to fill my inbox
with promotion of his blog and when asked to stop doing so he falls into outrage.
Dude I dont even know who the hell you are!

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The Internet Journal of Gastroenterology
Volume 5
Number 2
The Internet Journal of Gastroenterology
Volume 5
Number 2

Original Article

Acute Colonic Pseudo-Obstruction In An Elderly

Alcoholic Man
V Ho, Y Lee

Citation
V Ho, Y Lee. Acute Colonic Pseudo-Obstruction In An Elderly Alcoholic Man. The Internet Journal of
Gastroenterology. 2006 Volume 5 Number 2.

Abstract
Acute colonic pseudo-obstruction or Ogilvie's syndrome is a rare clinical disorder of unknown aetiology which
responds well to conservative measures. Occasionally pharmacotherapy in the form of cholinesterase
inhibitors or colonoscopic decompression may be required. Acute colonic pseudo-obstruction has not been
reported previously to present with delirium in the non post-operative setting.

Introduction

Acute colonic pseudo-obstruction is a rare disorder characterised by clinical and radiological features of acute
large bowel obstruction in the absence of obvious colonic disease or mechanical obstruction.1 The precise
mechanism by which colonic dilatation occurs in patients with acute pseudo-obstruction is unknown. Acute
pseudo-obstruction is associated with conditions such as trauma, sepsis, neurological disorders, abdominal
and spinal surgery and alcohol abuse.2 We report a case of an elderly man presenting with delirium
secondary to acute colonic pseudo-obstruction on a background of longstanding alcohol abuse.

Case Report
A 73-year-old man who lives alone presented to hospital with confusion and agitation. His past medical history
was significant for a longstanding history of alcoholism consuming 2-3 litres of beer a day for 15 years and for
the absence of prior surgery. He had ceased alcohol intake a year ago. Blood tests detected hypokalaemia
(2.9 mmol/l). The rest of his laboratory investigations were unremarkable. His heart and lung examination was
normal. On abdominal examination he had a markedly distended and tympanic non-tender abdomen with
diminished bowel sounds. His abdominal x-ray showed the presence of dilated colonic loops and air
throughout all colonic segments. His caecal diameter was recorded at 12 cm. The diagnosis of acute colonic
pseudo-obstruction was made.
During admission the patient developed increasing abdominal distension with associated generalised
tenderness. Abdominal x-ray revealed an increase in his caecal diameter to 15 cm in the absence of
intraperitoneal free air (Figure 1 and 2). Initial conservative management included potassium replacement, the
withholding of enteral feeding, instituting intravenous fluids, nasogastric suction and positioning the patient
prone.
After 24 hours of failure of passage of faeces/flatus, pharmacological measures were trialled. Neostigmine 2.5
mg was administered intravenously under cardiac monitoring without a clinical response. Subsequent
colonoscopic decompression revealed a grossly dilated colon with small submucosal ischaemic
haemorrhages seen in the mid transverse colon. Colonoscopic decompression produced a dramatic reduction
in colonic diameter and abdominal girth, with prompt passage of air and faecal matter.
The patient gradually recovered from his delirium and remained free of further abdominal distension and pain.

Figure 1
Figure 1: Abdominal X-ray supine: A massively air-filled dilated large bowel consistent with pseudo-obstruction

Figure 2
Figure 2: Chest X-ray erect: Elevation of the diaphragm bilaterally due to the pseudo-obstruction with no free
intraperitoneal air

Discussion
We described a case of a geriatric patient presenting with delirium caused by an acute colonic pseudoobstruction. The symptoms of acute colonic pseudo-obstruction vary. Mild to moderate abdominal pain is
present in the majority of cases and nausea and vomiting, constipation and even diarrhoea can be clinical
manifestations.2 Abdominal distension is always present and often progressive. Delirium to date has not been
reported as an initial presenting feature in the non post-operative setting.
The pathophysiology of acute colonic pseudo-obstruction is unclear but is thought to relate to an autonomic
imbalance either with increased sympathetic tone or parasympathetic suppression resulting in decreased
motility.3 It is more common in elderly patients and associated with underlying diseases such as trauma,
infection, cardiac disease, spinal surgery, neurological disorders and may occur in patients with a history of
alcohol abuse.2 Alcohol use may contribute to the development of colonic pseudo-obstruction via a toxic
enteric neuropathy.4
Mechanical obstruction must be ruled out when making the diagnosis of acute colonic pseudo-obstruction.
There is an argument for the use of a barium contrast enema in this respect although in the appropriate
clinical context plain abdominal radiographs with classic findings are seldom incorrect.5 Plain abdominal
radiographs show marked colonic distension with the finding of air throughout all colonic segments including
the rectosigmoid.
The majority of patients with acute pseudo-obstruction resolve with conservative measures. These include
treating concomitant disease such as infections, maintaining the patient on intravenous fluids, withholding
enteral feeds, positioning manoeuvres, correcting electrolyte imbalances, discontinuing any offending drugs
especially opiates and anticholinergics, and consideration of a nasogastric/rectal tube.6
Intravenous neostigmine has been demonstrated to be an effective pharmacological agent in the treatment of
acute pseudo-obstruction when conservative measures have failed.7 Neostigmine increases the availability of

acetylcholine at neuro-neuronal synapses and neuromuscular junctions in the enteric nervous system and this
effect is accompanied by enhanced smooth muscle contractions.8 The administration of neostigmine must be
carried out under appropriate cardiac monitoring, as bradyarrhythmias are a recognised complication. Atropine
should always be immediately available.
Colonoscopic decompression is indicated in patients such as ours who fail neostigmine or who have
contraindications to neostigmine use. Surgical referral is indicated once pharmacological and colonoscopic
measures are unsuccessful or if there is evidence of significant ischaemia or perforation.6

Correspondence to
Dr Vincent Ho Department of Medicine Hutt Valley Hospital Private Bag 31907 Lower Hutt New Zealand Fax:
(04) 570 9234 Email: impresarius@yahoo.com.au

References
1. Dudley HAF, Sinclair ISR, McLaren IF, et al. Intestinal pseudo-obstruction. J R Coll Surg Edinb. 1958;3:20617
2. Vanek VW, Alsati M. Acute pseudo-obstruction of the colon (Ogilvie's syndrome). An analysis of 400 cases.
Dis Colon Rectum. 1986;29:203-10
3. Vantrappen G. Acute colonic pseudo-obstruction. Lancet. 1993;341:152-53
4. Uc A, Vasiliakus E, Piccoli DA et al. Chronic intestinal pseudo-obstruction associated with fetal alcohol
syndrome. Dig Dis Sci. 1997;42(6):1163-7
5. Vavilala MS, Lam AM, Abbasakoor F et al. Neostigmine for acute colonic pseudo-obstruction. N Engl J
Med. 1999;341:1622-23
6. Eisen GM, Baron TH, Dominitz JA et al. Acute colonic pseudo-obstruction. Gastrointest Endosc.
2002;56:789-92
7. Ponec RJ, Saunders MD, Kimmey MB. Neostigmine for the treatment of acute colonic pseudo-obstruction.
N Engl J Med. 1999;341:137-41
8. De Giorgio R, Barbara G, Stanghellini V. Review article: the pharmacological treatment of acute colonic
pseudo-obstruction. Aliment Pharmacol Ther. 2001;15(11):1717-27

{full_citation}

Author Information
Vincent Ho, MBBS Bsc(Med)
Department of Medicine, Hutt Valley Hospital
Yun Cheong Lee, FRCP FRACP
Department of Medicine, Hutt Valley Hospital

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Project Summary:
CARE has been working with various private sectors and social entrepreneurs to develop win-win business models that connect poor
producers to profitable markets, enhance incomes for the poor, expand business opportunities for the private sector and stimulate
economic growth. The proposed action will build on these experiences to stimulate linkages and engagement between actors involved in
eco-friendly production and marketing of jute diversified products (JDPs) for local as well as European markets. CARE is particularly
committed in Market Engagement Strategy; Value Chain based integrated agriculture and economic sub-sector development. CARE has
been successfully implementing the SWITCH Asia - Jute Value Chain (JVC) Project in the Northwest and Southwest Bangladesh targeting
16,000 Farmers, 2,000 Jute Diversified Product (JDP) Workers, 60 Organic Fertilizer producers and various private sector entrepreneurs.
The action will be building on CARE's value chain based programming to create income and employment opportunities. This program is
funded by the European Commission.
Position Title, Location & Contract Duration
Technical Manager Enterprise Development for SWITCH Asia Jute Value Chain Project (01 Position, Location: Based at
Dhaka/Rangpur).
The duration of the proposed contract is up to February, 2016.

Job Summary:

The Technical Manager- Enterprise Development is entrusted with the responsibility of developing and
implementing jute and JDP value chain development strategy. The strategy should strengthen the production,
supply and marketing chain for JDP Workers, SMEs, National Entrepreneurs and acquire broader access to Local,
National and International markets. The Project has the mandate to develop jute value chain in four districts of
Northwest and Southwest regions of the country in partnership with 4 partner NGOs (UTTARAN, SMKK, ESDO
and DCPUK). The incumbent is required to work closely with partner NGOs, producer groups, market actors,
private and public sectors. The Technical Manager- Enterprise Development will be responsible for management,
coordination, implementation, and monitoring of project activities at field level. S/he will represent the project at
multiple levels, ensuring productive stakeholder relationships with the private sector, rural entrepreneurs, local
government, and communities. The Technical manager will facilitate coordination work among private sector and
rural entrepreneurs as well as oversee their services. S/he will ensure promotion of gender equality, womens
empowerment in operation and managing of different project activities.

Responsibilities and Tasks:

Responsibility # 1: Project strategies and guideline development, management and

coordination

Takes overall responsibility for managing the PNGOs and development project
strategies and guidelines, and other upcoming projects in the areas of jute sector;
Establishes and maintains good working relationships with partner NGOs involved in
and supporting the project;
Coordinates with the organizations, institutions and companies involved in the
implementation of the project, ensuring the required synergy and linkage of the
different project components to achieve the project objective;
Ensures the timely development and implementation of results-based annual work
plans with Implementing Partners and other upcoming interventions to the project

% of Time

50%

Responsibility # 2: Technical assistance coordination

Liaises with Implementing Partners, including project personnel, to assess and

identify technical assistance needs for the project;

20%

In close collaboration with other project teams, including technical specialists of

different sector in CARE-B, ensures that coordinated TA and institutional capacity
building support are provided to implementing partners of the project;
Acts as the focal person on behalf of Country Office projects focal points;
Identifies, document, and disseminate lessons learned and best practices related to
project; and
Provides technical inputs to the alignment with project mandate, strategy and
principles relevant to the context

Responsibility # 3:Monitoring and evaluation relating to enterprise development

aspects, Model building, Scale-up, and Reporting

Takes overall responsibility for monitoring and supervision of the project planned
activities in order to identify best practices as well as constraints / implementation
bottlenecks and to take necessary actions to overcome the constraints;
Undertakes regular field visits to monitor the quality and timely implementation of
project activities, as well as arranges periodic project review with partners;
Works with PO and PNGOs managers to ensure regular monitoring and supervision
through joint monitoring field visits;
Regularly monitors and reports on the use of supplies, equipment and other resources
procured for the project;
Ensures that routine data / information are collected and analyzed with engagement
of project participants in accordance with the project monitoring and evaluation plan

15%

that allows for model building;

Leads the planning and preparation for scaling up the project;
Ensures reporting requirements of the project (both financial and programmatic) are
met timely and with high quality standard

Responsibility # 4: Supervision and performance management

Leads the project team officers and ensures high standard of staff management within
the team using a participatory style;

10%

Supervises, mentors and coaches the project and partners team members in order to
strengthen or further develop their capacity.
Ensures that regular team meetings take place and are recorded.

Responsibility # 5: Any other activities/responsibilities as assigned by her/his

supervisor.

5%

Reporting:

The Technical Manager - Enterprise Development will report to the Team Leader. S/he will deal administrative
and management issues of regional team of the project in consultation with the Team Leader.

Working Condition:

Based at Northern / Southern part of Bangladesh, with approximate 50% of his/her time to be spent in
coordinating, monitoring filed level activities, networking, liaison with the stakeholders in the field involving
regular travel to project geographic areas, while the remaining 50% will be used with desk work, including

managing, planning, supporting, reporting and other important activities as assigned by Team Leader based on
requirements of the program and Mission.
Qualification:
MBA/BBA/BSS or MA in Economics/Social Science or in any relevant disciplines if accompanied by
excellent experience on enterprise development/sound knowledge and experience on jute sectors
development
3-5 years Proven Knowledge /experience in enterprise/jute value chain sector development field
Sound knowledge on enterprise development sector value chain, constraints, opportunities, interventions,
sectors study and design
Excellent facilitation and negotiation skill
Good writing skills both in English and Bengali

Core Competencies:

Proven ability to work under partnership with NGOs/private/ public sectors

Good knowledge on planning, implementation, monitoring and reporting
Good knowledge on jute sectors development strategy and outcome
In depth knowledge on jute sector, its constraints, opportunities, market solution and jute diversified
product
Good communication skill in both English and Bangla
Excellent interpersonal skills and ability to lead and work in a team
Good understanding on Gender equity & women empowerment issues
Sound knowledge on sector study and project design

Strong interest to work with rural poor and frequent travel to different regions
Willing to work at regional level with frequent travel in rural areas

Candidates need to be highly motivated and committed to CARE Bangladeshs vision, mission, and long term development work
to significantly improve the lives of the most vulnerable and marginalized. Candidates must be capable of displaying great learning
agility, support and encouragement of knowledge sharing across projects, to the ultimate benefit of all of CAREs mission wide initiatives.
This is an interesting time in the development of CARE as an organization which is shifting towards a program approach where it has
developed longer-term impact visions to have MORE sustainable changes in the lives of the extreme poor and marginalized. CARE is
looking for a Technical Manager Enterprise Development who will play a key role in the leadership of the SWITCH Asia Jute Value
Chain Project whilst at the same time building a learning culture that promotes knowledge sharing across CARE and excellence.
Compensation
Monthly gross salary is Taka 73,154 plus other admissible benefits as per CARE policy.
Interested candidates meeting the above requirements should apply online through http://carebangladesh.org/why_join.php on or before
May 19, 2015.
Note: * Women are particularly encouraged to apply * Any persuasion will disqualify the candidates * Internal and external
applicants shall be treated equally in the entire selection process

Toggle navigation

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HOME

NEW REGISTRATION

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HOW TO APPLY

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Technical Manager-Enterprise Development

CARE Bangladesh

Career Opportunity
Position: Technical Manager-Enterprise Development
Project Summary:

CARE has been working with various private sectors and social entrepreneurs to develop win-win business models that connect
poor producers to profitable markets, enhance incomes for the poor, expand business opportunities for the private sector and
stimulate economic growth. The proposed action will build on these experiences to stimulate linkages and engagement between
actors involved in eco-friendly production and marketing of jute diversified products (JDPs) for local as well as European markets.
CARE is particularly committed in Market Engagement Strategy; Value Chain based integrated agriculture and economic subsector development. CARE has been successfully implementing the SWITCH Asia - Jute Value Chain (JVC) Project in the
Northwest and Southwest Bangladesh targeting 16,000 Farmers, 2,000 Jute Diversified Product (JDP) Workers, 60 Organic
Fertilizer producers and various private sector entrepreneurs. The action will be building on CARE's value chain based
programming to create income and employment opportunities. This program is funded by the European Commission.
Position Title, Location & Contract Duration
Technical Manager-Enterprise Development for SWITCH Asia Jute Value Chain Project (01 Position, Location: Based at
Dhaka/Rangpur).
The duration of the proposed contract is up to February, 2016.

Job Summary:
The Technical Manager- Enterprise Development is entrusted with the responsibility of developing and
implementing jute and JDP value chain development strategy. The strategy should strengthen the production,
supply and marketing chain for JDP Workers, SMEs, National Entrepreneurs and acquire broader access to
Local, National and International markets. The Project has the mandate to develop jute value chain in four
districts of Northwest and Southwest regions of the country in partnership with 4 partner NGOs (UTTARAN,
SMKK, ESDO and DCPUK). The incumbent is required to work closely with partner NGOs, producer groups,
market actors, private and public sectors. The Technical Manager- Enterprise Development will be responsible

for management, coordination, implementation, and monitoring of project activities at field level. S/he will
represent the project at multiple levels, ensuring productive stakeholder relationships with the private sector,
rural entrepreneurs, local government, and communities. The Technical manager will facilitate coordination
work among private sector and rural entrepreneurs as well as oversee their services. S/he will ensure
promotion of gender equality, womens empowerment in operation and managing of different project activities.

Responsibilities and Tasks:

Responsibility # 1: Project strategies and guideline development, management and

% of Time

coordination

Takes overall responsibility for managing the PNGOs and development project
strategies and guidelines, and other upcoming projects in the areas of jute sector;

Establishes and maintains good working relationships with partner NGOs involved
in and supporting the project;

Coordinates with the organizations, institutions and companies involved in the

implementation of the project, ensuring the required synergy and linkage of the
different project components to achieve the project objective;

Ensures the timely development and implementation of results-based annual work

plans with Implementing Partners and other upcoming interventions to the project

50%

Responsibility # 2: Technical assistance coordination

Liaises with Implementing Partners, including project personnel, to assess and

identify technical assistance needs for the project;

In close collaboration with other project teams, including technical specialists of

different sector in CARE-B, ensures that coordinated TA and institutional capacity
building support are provided to implementing partners of the project;

20%

Acts as the focal person on behalf of Country Office projects focal points;

Identifies, document, and disseminate lessons learned and best practices related
to project; and

Provides technical inputs to the alignment with project mandate, strategy and
principles relevant to the context

Responsibility # 3:Monitoring and evaluation relating to enterprise development

aspects, Model building, Scale-up, and Reporting

Takes overall responsibility for monitoring and supervision of the project planned
activities in order to identify best practices as well as constraints / implementation
bottlenecks and to take necessary actions to overcome the constraints;

Undertakes regular field visits to monitor the quality and timely implementation of
project activities, as well as arranges periodic project review with partners;

Works with PO and PNGOs managers to ensure regular monitoring and

supervision through joint monitoring field visits;

Regularly monitors and reports on the use of supplies, equipment and other
resources procured for the project;

Ensures that routine data / information are collected and analyzed with
engagement of project participants in accordance with the project monitoring and
evaluation plan that allows for model building;

Leads the planning and preparation for scaling up the project;

Ensures reporting requirements of the project (both financial and programmatic)

are met timely and with high quality standard

15%

Responsibility # 4: Supervision and performance management

Leads the project team officers and ensures high standard of staff management

10%

within the team using a participatory style;

Supervises, mentors and coaches the project and partners team members in
order to strengthen or further develop their capacity.

Ensures that regular team meetings take place and are recorded.

Responsibility # 5: Any other activities/responsibilities as assigned by her/his

supervisor.

5%

Reporting:
The Technical Manager - Enterprise Development will report to the Team Leader. S/he will deal administrative
and management issues of regional team of the project in consultation with the Team Leader.

Working Condition:
Based at Northern / Southern part of Bangladesh, with approximate 50% of his/her time to be spent in
coordinating, monitoring filed level activities, networking, liaison with the stakeholders in the field involving
regular travel to project geographic areas, while the remaining 50% will be used with desk work, including
managing, planning, supporting, reporting and other important activities as assigned by Team Leader based on
requirements of the program and Mission.

Qualification:

MBA/BBA/BSS or MA in Economics/Social Science or in any relevant disciplines if accompanied by

excellent experience on enterprise development/sound knowledge and experience on jute sectors
development

3-5 years Proven Knowledge /experience in enterprise/jute value chain sector development field

Sound knowledge on enterprise development sector value chain, constraints, opportunities,

interventions, sectors study and design

Excellent facilitation and negotiation skill

Good writing skills both in English and Bengali

Core Competencies:

Proven ability to work under partnership with NGOs/private/ public sectors

Good knowledge on planning, implementation, monitoring and reporting

Good knowledge on jute sectors development strategy and outcome

In depth knowledge on jute sector, its constraints, opportunities, market solution and jute diversified
product

Good communication skill in both English and Bangla

Excellent interpersonal skills and ability to lead and work in a team

Good understanding on Gender equity & women empowerment issues

Sound knowledge on sector study and project design

Strong interest to work with rural poor and frequent travel to different regions

Willing to work at regional level with frequent travel in rural areas

Candidates need to be highly motivated and committed to CARE Bangladeshs vision, mission, and long term
development work to significantly improve the lives of the most vulnerable and marginalized. Candidates must be capable
of displaying great learning agility, support and encouragement of knowledge sharing across projects, to the ultimate benefit of all
of CAREs mission wide initiatives.

This is an interesting time in the development of CARE as an organization which is shifting towards a program approach where it
has developed longer-term impact visions to have MORE sustainable changes in the lives of the extreme poor and marginalized.
CARE is looking for a Technical Manager Enterprise Development who will play a key role in the leadership of the SWITCH
Asia Jute Value Chain Project whilst at the same time building a learning culture that promotes knowledge sharing across CARE
and excellence.

Compensation

Monthly gross salary is Taka 73,154 plus other admissible benefits as per CARE policy.

Interested candidates meeting the above requirements should apply online through http://carebangladesh.org/why_join.php
or before May 19, 2015.

Note: # Women are particularly encouraged to apply # Any persuasion will disqualify the candidates # Internal and
external applicants shall be treated equally in the entire selection process

Apply Online
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