MANAGEMENT CASE STUDY. The hiring process and the cost of turnover in an organization can be very expensive. Turnover refers to the number of employees who leave a company in a particular period of time. By creating a recruiting and selection process with cost containment in mind, HR can contribute directly to cost-containment strategies company wide. In fact, the cost of hiring an employee or replacing an old one (turnover) can be as high as $9,777 for a position that pays $60,000. 8 By hiring smart the first time, HR managers can contain costs for their organization. This will be discussed in "Recruitment (Page 78)"and "Selection (Page 112)". Reducing turnover includes employee motivational strategies. This will be addressed in "Retention and Motivation (Page 189)". In a survey reported on by the Sales and Marketing Management newsletter, 9 85 percent of managers say that ineffective communication is the cause of lost revenue. E-mail, instant messaging, text messages, and meetings are all examples of communication in business. An understanding of communication styles, personality styles, and channels of communication can help us be more effective in our communications, resulting in cost containment. In HRM, we can help ensure our people have the tools to communicate better, and contain costs and save dollars in doing so. Technology has greatly impacted human resources and will continue to do so as new technology is developed. Through use of technology, many companies have virtual workforces that perform tasks from nearly all corners of the world. When employees are not located just down the hall, management of these human resources creates some unique challenges. For example, technology creates an even greater need to have multicultural or diversity understanding. Since many people will work with individuals from across the globe, cultural sensitivity and understanding is the only way to ensure the use of technology results in increased productivity rather than decreased productivity due to miscommunications.

Question 61 Can carvedilol be used in an elderly patient who developed left ventricular failure after a very recent myocardial infarction, or should it wait until the condition becomes stable?

Question 62 I have seen some patients with chronic rheumatic heart disease with no obvious evidence of rheumatic fever (i.e. they could not recall if there was an episode of severe infection with subsequent fever and joint pain). So, actually, how is chronic rheumatic heart disease diagnosed?

Question 63 If a young patient presents with hemiparesis and rheumatic atrial fibrillation and is already on oral anticoagulant, with an international normalized ratio (INR)

3 and a normal computed tomography (CT) scan done 2 hours after onset, should he receive heparin for prophylaxis against further embolism? Should aspirin be combined with oral anticoagulant later, or should target INR be increased? Question 64 When treating mitral stenosis using a balloon valvotomy, how come no thrombus develops at the site of the atrial septum or at the separated commissure of the valve leaflets?

Question 65 Why does a mitral stenosis produce a loud S1?

Question 66 Why is the mitral valve more affected than any other valve in the heart in most valvular diseases?

Question 67 What is William's syndrome (supravalvular obstruction)? Why does hypercalcaemia occur with this syndrome?

Question 68 Kindly tell me all the causes postulated for the collapsing pulse seen in aortic regurgitation.

Question 69 Does pulmonary stenosis cause pulmonary hypertension?

Question 70 Under what conditions would a pulsatile liver be found and what is its clinical significance?