Power Of Images In Marketing Essay Example | Topics and Well Written Essays - 750 words

Power Of Images In Marketing - Essay ExampleIt is too worth noting that a bad picture may also affect negatively a callers merchandise. Therefore, it is very important that a family chooses a good trope one that washstand attract the consumers towards the product in question. The image chosen should stands out and should be able to provide an strain of the companys core values of what is being marketed. One such company that offices the image to market its products is the Nivea skin and strike care products. This paper will discuss the power of pictures in marketing of Nivea products. The seek will also explore how genuine pictures are associated with some ghosts, which motivate the node to buy the product. Finally, the turn out will explore why certain pictures make some consumers buy a certain product even though they may not need the product. Breiting (n.d) argues that a picture plays an important role in marketing a companys product in a number of ways. This inclu des documenting a companys offers, in which the picture can be used to portray a companys brand image. Therefore, the more it is attractive to the clients, the more customers will be willing to accept it. This is because it functions as an heart catcher, and persuades buyers in a positive mood. Nivea is a company that recognizes the power of image in promoting its skin and beauty products. The company understands that the picture they portray on the product gives its customers an impression regarding the product and the companys values, which has contributed to the uphill gross revenue volume of the product. For instance, Nivea has made use of picture in advertising of Nivea Visage Young from the condemnation of its launch in 2005. The images used in the advertisements are shown below Figures 1&2 Images used by Nivea This picture used by Nivea to promote its Nivea Visage Young has a lot of impression safe by looking at it. By portraying a beautiful woman with a pincer having sof t, smooth and attractive faces the company informs the customers that this good is a beauty and skin care product. The impression that the customer may have of this product is that it smoothes and softens the skin besides offering protection. The other impression that a customer may deduce of the image is that the product is suitable for both women and girls. The mood as portrayed by the picture also communicates a lot about the product. It has the impact of informing a customer that by applying Nivea Visage Young, one feels good, attractive and jovial. The flowers on the background are also a show of beauty, which many another(prenominal) consumers may want to associate with. Nivea recognizes image as one of the driving forces behind the increased sales turnover of the product since it was launch (Dinsdag 8 Maart, 2011).However, it is worth noting that the picture may also invoke the feeling that Nivea Visage Young is only meant for the ladies and not men. This is because, the mar keters of the product have only chosen to portray the image of a woman and a young girl. This implies that the image may be detrimental in plate men are also expected to use the product. This implies how important it is to choose the right image to use in promoting a given product (Dinsdag 8 Maart, 2011). Certain pictures make consumers buy a certain product even though in the actual sense they do not need the product. This scenario is car park in the world of sports and celebrities in which an individual may buy a t-shirt associated with

Managing Communication in Business Essay Example | Topics and Well Written Essays - 2500 words - 1

Managing Communication in Business - Essay ExampleOrganizational confabulation is very important as for a business to precede and expand, the management should have strong communication ties with its employees. Non-verbal communication is a category of communication that plays a crucial role in terms of organisational communication.In this paper, all kinds of non-verbal communication are described that go off affect organizational communication. Along with the commentary of forms of non-verbal communication, the factors such as gender, age and culture are also analyzed in the paper. After description of all the forms of non-verbal communication, a conclusion is given. The conclusion summarizes the whole essay in a short form.Kinesics plenty be explained as body movements (Pelachaud, et. al 1996). There are many kinds of bodily movements such as making work of emblematic signs through hands or fingers, making use of hands or legs to stress on or illustrate something, by regulat ing spoken or listened words and sentences, font of feelings through bodily movements and gestures and by making use of some adapter to indicate towards a significant situation (Depaulo 1992). Body movements are employed in many ways to expire non-verbally (Argyle 1988). Making use of emblems, adapters, illustrating, adjusting and revealing feelings and gestures, all come in kinesics.In an organizational setting, people groom use of kinesics to communicate and by repetitive usage of some bodily movements people identify them (Burgoon, et.al 1996). For different cultures, people make use of different emblems for the same message. For example, for admitting to some suggestion, many people make use of bowing the encephalon a little, while others can make use of hands to indicate, Yes (Gudykunst and Ting-Toomey 1988). Through body movements, people can communicate their feelings and expressions (Harbridge 1998). In case, a person is tense, he/she can move back and forth that is a c lear sign of

Government objectives for rural areas Essay Example | Topics and Well Written Essays - 3000 words

Government objectives for rural areas - Essay suite farming attains high ecological principles, minimising impression on natural resources, and administers appreciated landscapes and biodiversity supplies both instantly and indirectly to rural economic multiplicity is itself ready for action and money-spinning and offers high quality products that the public needs. prep authorities have an imperative accountability to take part in distributing the Governments objectives for rural district, through their serve well of the planning system and the submission of the policies specified in Planning Policies.(ii) Good characteristic, cautiously-sited reachable development at bottom obtainable towns and villages should be permitted where it payback the local economy and/or community (e.g. reasonable housing for recognise local requirements) maintains or improves the local surroundings and does not discord with early(a) planning policies.(iii) Convenience should be a key deliberation in all development result. Most developments which are probable to pee large numbers of trips should be situated in or subsequently to towns or other help centres that are available by public transport, pass and cycling, in line with the policies specified. Results on the position of other developments in rural areas should, where achievable, provide people the maximum prospect to approach them by public transport, walking and cycling, dependable with attaining the most important motive of the progress.(iv) New building development in the set off countryside away from on hand settlements, or outside regions owed for development in development strategy, should be heavily proscribed the Governments in general objective is to defend the countryside for the sake of its inherent character and attractiveness the multiplicity of its landscapes, legacy and wildlife, the prosperity of its natural resources and so it may be benefited from by all.(v) Main concern should be specified to the re-use of beforehand -developed

Human Resource Strategy Case Study Example | Topics and Well Written Essays - 2750 words

Human Resource Strategy - Case Study ExampleThis comp either is a worker co-op. It is one of the most exemplary companies when it comes to implementation of opera hat practice strategies. This is because all the employees inside the geological kneadation are part owners of the organisation. The organisation focuses on addressing all their needs whether in the reward section or elsewhere. On the other hand, the employees pay back these efforts through commitment and beat out performance. Best practice has organize one of the organisations key strengths.John Lewis partnership has made sure that educational activity is part of its human choice and development efforts. This is because it realises the value of this best practice strategy. Pfeffer and Velga (1999) explain the importance of training and development of skills within any organisation. A company that takes its employees through training solidifies their contribution to the company. This is because such employees get equ ipped with the ability to brand decisions in their work. On top of this, such employees have high levels of initiative and will try their level best best to improve their organisational contribution. Skill development is a characteristic part of the John Lewis Partnership because employees who impression the need to improve their skills are given opportunities to do so through training schemes.Youndt et al (1996) punctuate that training is one of the most fundamental looking ats of best... They claim that no amount of training will afford towards organisational development if employees are not granted the permission to practice those acquired skills. This means that an organisation should try its best to grant work autonomy to its employees and to empower them through training. John Lewis has achieved this very well. In other sell companies, line managers are given minimal responsibilities. Most of them are expected to consult with higher authorities in order to decide on iss ues. However, the company under study has eliminated that problem by training those members of staff (so that they can have necessary skills) and then allowing them to make independent decisions. They believe that this is a form of investment into human capital since most of these employees feel valued. According to the Classical and Human relations approach, an organisations bodily structure and operation are affected by certain situational factors such as technology, size and environment. However best practice advocates like Burnes (2000) came up with a contingency theory. He believes that a reward system within any company can affect the way it operates or how it is structured. Pfeffer (1994) believes that best practice companies should have a structure that places staff members into groups. Those groups should be such that they have the ability to make their own decisions. Another aspect of best practise firms is that they ought to have reward systems that are compact in nature . This implies that there should be minimal differences between different members of staff so that most employees within the organisation operate in a relatively independent manner with the ability to make their own decisions. John Lewis strategic capability in this aspect of structure is

Evolving ideas of freedom by different historical time frames Essay

Evolving ideas of license by different historical time frames - Essay ExampleFrom freedom as a mazy combination of individual freedoms and rights to freedom as the full abolition of slavery, ideas of freedom in America little by little evolved to become the main guiding principle in the development of democracies in all parts of the world. The beginnings of state in America were marked with a hot debate between Federalists and anti-Federalists on what it really meant to be free. The time of Washington and Monroe, that was also the time when the idea of freedom was still in its infancy, but the fancy of individual freedoms and rights was slowly turning into the central ingredient of future democracy. Anti-Federalists argued that the Constitution had to give Americans full protective cover of their individual rights, including the right to speak freely, the right to enjoy the benefits of free religious choice, and the right to be saved against unreasonable searches. In the meanti me, nothing was done to battle the issue of slavery apparently, then political leadership were confident that freedom and slavery could continue walking hand in hand.

CASE STUDY Example | Topics and Well Written Essays - 500 words - 6

Case Study ExampleDIAD V allow be smaller in size as compared to DIAD IV automatic jumping between cellular ne bothrks and this will enable DIAD V to provide high rate of connectivity WI-FI project for faster data steer rates (Anonymous p.592). Further, the new DIAD V will have color, autofocus flash camera that will enable drivers to sap bar codes and capture signatures for delivery processor that will increase storage and color display for GPS support navigation (Anonymous p.592).Development of technology by any company depends on numerous factors. However, the critical among these factors is the cadence of resources the company has to channel to the technology and the business and customer needfully the technology will meet. Given these two big factors, it rout out be deduced that shipping industry is very dynamic and customer and employee needs can be regarded to be fluid. Therefore, designing its own technology, UPS is able to tailor-make technology that resonate with bot h organisational needs, available resources and customer needs and also that has room for modification in future as the needs in the market change.Globalization is exerting pressure on businesses to adapt information management systems that are efficient, cost-efficient and that result into customer satisfaction. As a result, UPS as a shipping company has become a leader in technology and innovation as a way of improving customer services, leverage competitive advantage over its competitors, and minimizing costs of doing business.The company created a program known as My SHC familiarity Customers of Sears and Kmart (Anonymous p.636). Members were encouraged to become part of something new, which also was different. The program facilitated online interactive community, where members were supposed to give their views and opinions on what they valued (Anonymous p.636). As

Nokia mobile services and applications Essay Example | Topics and Well Written Essays - 500 words

Nokia peregrine services and applications - Essay ExampleWith regard to social fluent services, Nokia has positive legion(predicate) mobile services applications as part of its mobility in society drive. The purpose of these services is to accession availableness to mobile services and applications in emerging markets and to marginalised sectors of society. The mobility in society drive includes the following categoriesThe tuition tools of Nokia are intended to increase ways for student accessibility to learning. A prime example of this is the Nokia mobile learning for Mathematics in South Africa through collaborations with the South African government and the Nokia Siemens Networks. other educational mobile service is a partnership with the Pearson foundation to provide schemes where students between 11and18 can give mobile devices and services to film, mix and edit through collaboration.The Nokia data gathering solution is targeted towards helping organisations accurately c ollect data on vital issues such as disease outbreaks or disaster residuum initiatives via mobile. The data gathering software is open source and available for everyone free of charge and can be used for multiple purposes such as questionnaires, surveys and GPS geo-tagging.Accessibility mobile services provided by Nokia have been developed to service the more marginalised aspects of society. Nokia states that approximately one fifth of the worlds population lives with a recognised disability and there is also and increasing ageing population. Therefore, Nokia has developed mobile services to address accessibility concerns such as enhanced voice functions, a Braille reader and video calling enabled with narrow language calls.The financial services applications are a direct result of increase in mobile users and Nokia consumer research has indicated that many consumers in emerging markets have indicated that they would like to connect to the internet

System Analysis and Design Essay Example | Topics and Well Written Essays - 500 words

System Analysis and approach pattern - Essay ExampleAnother major recognition I have had related to system depth psychology and excogitation is the relation of magisterial inputs and their workplace functionality. Indeed, Alter (2006, p. 1) indicated that one of the primary challenges of system analysis and design is ineffective design of inputs within the system. Dick & C ary (2009) indicated that the single some important factor of whether a systematic training input will be incorporated into the workplace milieu is the context of that workplace. Many multiplication in my past experience I have received training in an element that was subsequently not directly relevant or supported in the workplace environment. Upon entering the workplace environment this systematic component was then disregarded because of ineffective structures. Ultimately, then I recognize that one of the most essential elements of systems and systematic design is ensuring that each of the components opera te together in a functional and mechanistic way.While on that point are not customers in the traditional sense, there are similar components. In this way there are students achieving and receiving the learning. There are parents interested in their childrens education. There are administrators and state education board members interested in ensuring the education provided reflects well on their professional competency. Finally, there are business organizations concerned with ensuring that there is an educated workforce to choose from.The products and service are rail specific. In terms of a mathematics classroom it is important that students learn algebraic functions, geometry, and potentially calculus. Additionally, they pee critical thinking and problem solving abilities. In this way the products and services are the education that is provided for the students. This info is a value entity as it can potentially be exchanged by the student for public life advancement or

Is Ham correct that connection between science and naturalism is Thesis

Is ham it up correct that connection between experience and naturalism is arbitrary - Thesis ExampleNye supports science by citing evolution theory to prove that creationism or naturalism is not connected to science. Scientists based their evidence on evolution theory that explains the origin of works and fauna. Nye also confirms the arbitrary connection between science and naturalism when he says in the debate that creationism should not be offered in school alongside the scientific theory coursework. While Nye argues that the scientific theory is false, jambon arguments are based on religious beliefs that have been captured in the book of Genesis. Additionally, Hams exposition about the creationism in Genesis shows that the earth was created 6,000 years ago through supernatural powers. On the new(prenominal) hand, Nye describes the earth that was formed 4.5 billion years ago by using proof such as homologies, fossil, and distribution of time and space. The disparities in Eart hs age brought forward by Ham and Nye confirms get along that the link between naturalism and science is a random occurrence (Etchells).scientific theories are necessary because they are used to explain the historical origin of the phenomena under study. The criteria debunk myths when they provide consistent results to the public. Scientific theory is used in creating awareness through education about the essence of science as a whole. Students use the theories as point of reference when they are given scientific-based prompts. Additionally, scientific theories promote lessons of cognizance and research. Observations that are made are based on theories brought forward by ancient scientists. There would be limited knowledge about natural phenomena if there were no existing theories such as evolution. Ham makes his remarks by quoting importance of science and creationism in school. He reveals that researchers such as Stuart Burgess have embraced both(prenominal) science and creati onism as separate entities. However, the professor uses scientific

Marketing database Essay Example | Topics and Well Written Essays - 250 words

Marketing database - Essay ExampleThis is because profitability levels of different client differs, and thus beingness able to detect the most rewarding customers is essential. Based on the number of consumers under investigation, LTV can be carried out on the whole customer base or through segmentation (Hughes, 2014). Although the latter is more than demanding, its more effective in analyzing clients. For royalty program, acquisition cost is considered as sunk cost, and thus not used in the calculation, as the customers are part of the current customer base. To effectively contemplate the customers, analysis need to be executed at a group level using the running game versus control situation approach. In this case, the tests are used to realize the loyalty program, an aspect not turn to by control. In this regard, for success to be realized, the lifetime value should be higher than the investment costs. Therefore, LPV is an expeditious tool in evaluating the worthiness of a f uture royalty program (Rodgers & Peppers,

Public Adminstration Essay Example | Topics and Well Written Essays - 500 words

Public Adminstration - Essay ExampleHowever, this idea changes with a little geographic expedition into the term and what it means. According to them, Public means the citizens of a given area-the people of a town, county, state, or country. If an give up is considered in the globe domain, information and discourse about that issue are available to the people and potentiometer be known to all. The word public as well as refers to activities the state administers on behalf of the entire community (Rouse & Berkley, 2003, pg. 4).Rouse and Berkley also let readers know that serving the people is the job of public administrators. Organized collectives of citizens constitute a mixed bag of public communities in the United States. These include national, state, and local governments, townships, state recreation areas, public utilities, school, sanitary, water districts, public libraries and parks, public defenders, public roadways, and public students (Rouse & Berkley, 2003, pg. 4).Th ere is much debate regarding whether public administration should be considered a craft, art, or science. First it is essential to look at the definitions a craft is the skilled practice of a practical occupation or a skill in an occupation or trade (Wikipedia, 2008, pg. 1). guile is a skill that is attained by study, practice, or observation (Wikipedia, 2008, pg. 1).

Story of Noah (Genesis 510) and its afterlives Essay

Story of Noah (Genesis 510) and its afterlives - Essay ExampleThe drool of Noah is presented throughout the five chapters of the book of Genesis. The 5th chapter is about Adams genealogy and at the give the sack of it we find out that Noah is a relative of Adam and Eve. At the beginning of the 6th chapter the author explains that pile have become spoiled and immoral. They started forgetting their Lord and give up His life principles, so god realize that there was no elan for Him to save His people from sinfulness as the whole Earth was already filled out with their sins (New Jerusalem Bible, Gen. 61-3). But there was a decent man Noah who has been elect by the Lord to save life on the Earth. That is why God inspired Noah to build a huge ark that would save a certain amount of living creatures including humans. In such a way the chosen one should have created a whole new knowledge base. Noah listened to his Lord. When the time for the Flood had come God told Noah to gather thos e species of animals and birds on the arks board. Noahs family was supposed to be at that only safe address too, so his wife and three sons with their wives had also got into the ark after which the Flood started. The Flood lasted 40 days and 40 nights and destroyed every single living creature on the Earth. And then the rain stopped, nevertheless, Noah and others had to spend cl more days adrift at sea until the Lord sent Noah the sign that he arsehole find lands to start the new world. After Noah and his family landed the Lord arranged the Covenant between Him and people, match to which there will be no flood anymore on the earth. In this new world His people should have lived under the Lords guidance (Mallowan 62). The very last episode of the news report is about act (one of Noahs sons) who committed offence to Noah. Ham and his brothers came to their father when he was drunk and naked. Ham saw his father without clothes and he told everything to his brothers, but his broth ers acted decently and covered their father with cloth. They didnt tincture

ERP Story Write Up Case Study Example | Topics and Well Written Essays - 1500 words

ERP Story Write Up - Case Study Exampleementation of the ABC software package but worry processre-engineering.ABS is looking forth to merge its three entities shell out old ways of doing melodic line and adopt best practices in order to push growth of the company.ABC software package is only a helping tool in this process. In my opinion two things need to be done immediately the first is that ownership of the count on should be taken by business IT psyche should only help as finally the business testament not be done by IT persons. (Bernard Grabot) The project manager can be a person from the good side but ownership of the project should not be with him, he should be seen as doing something which the top management wants. The news of the implementation and the final authority should be with a person who is well respected within the three firms and has a lot of functional knowledge about business practices of the three companies. IT knowledge is secondary in such business reen gineering projects even consultants can provide that. last the project implementation team should be comprised of both IT persons as well as functional raft from the three companies. This will ensure a proper implementation. (Bernard Grabot)Finally the presentation should contain success stories motley companies in which the consultants implemented ERP and how they turned around their business. Most of these stories should be from insurance firms as well as service sector firms.In order to choose the best project manager from the list which has been provided we will use the following grading rubric for the three prospects - functional knowledge, ABC implementation knowledge and start out Project management experience Change management experience (managing changes caused due to ERP implementation) experience of various technical systems (Bill Holtsnider) (needed in order to understand which legacy systems need to be preserved.)On the basis of the above points we will examine the three candidates By

Lean Manufacturing Research Paper Example | Topics and Well Written Essays - 3000 words

break away Manufacturing - Research Paper ExampleIn manufacturing, the fruit of cost has become one of the most significant aspects for major(ip)ity of organizations. The contemporary period of conducting business has for certain become harder which demands high level of cost efficiency and productivity. Lean manufacturing not only decreases the operational expenses however also enhance organizations attractiveness (Bourque & Fox, n.d.).Lean manufacturing is often recognized in refining functional efficiency. Lean manufacturing is the progression, method, approach and initiative being applied by organizations globally in place to reduce scanty and unproductive activities which can result in extra expenses. Therefore, it enhances the workplace productivity and develops better working environment. The write up will describe the use of extend manufacturing in organizations to save cost and increase efficiency. In straddle to analyze the issue the paper will discuss three case s tudies of Toyota, Motorola, and Park Nicollet that operate in different industries, and have successfully improved productivity and reduced costs by implementation of lean manufacturing system in their workplace.Nowadays, economic affordability concerning customer price sensitivity, product quality, and price be gradually motive organizations to apply lean manufacturing system. International competition is growing in almost every commercial segment. The internalization of capital market, decline in trade obstructions and increased business expansion where production costs are lesser can be proved as significant obstacles for competition. For any organization, the first mover benefit and rapid response to customers requirements, enhancement of product quality, and decrease in production costs in order to keep the price of products low are vital for success in the competitive market. Lean manufacturing with its major concentration on the organized abolition of waste has rapidly

Global marketing Research Paper Example | Topics and Well Written Essays - 750 words

Global marketing - Research Paper Example& Carl (2010) the shaving pricing strategy is most effective in market conditions where the customers are more than willing to payment above average market price for goods and services. They also note that this strategy is effective for copyrighted, patented or trademarked products and sophisticated technological breakthrough. Apple has in effect employed the shaving strategy by introducing innovative technological products at a relatively high price (Smith, 2011).Penetration pricing strategy involves charging a depresseder price for a product relative to competitors price level, with the main objective serving the atomic pile market and increasing the firms market appropriate (Smith, 2011). The rationale for charging low price is that it would sum up market share and economies of scale thus significantly lowering the overall take costs. In counterpoint to the skimming pricing strategy, charging lower prices implies that the firm reli es on higher sales volume to attain break-even because of the low profits per unit of production (Tellis, 1986). Similarly, firms tend to take a longer period to recover the production costs using penetration strategy as compared to the skimming strategy. In addition, penetration pricing differs from skimming pricing because it tends to discourage entry of competitors in the market. Lamb, Joseph & Carl (2010) argue that penetration pricing strategy is more operable and effective in price sensitive market conditions. Smith (2011) observes that the penetration pricing strategy has been effectively implemented by Wal-Mart retail stores and android in order to capture the mass market and append their market share.Holding pricing is a pricing decision that seeks to retain and maintain the market share (Smith, 2011). Currency fluctuations in the global business context may encourage firms to initiate price variations and adjustments in order to hold or maintain their market share. These price adjustments may affect the firms profitability, at

Dementia in UK Essay Example for Free

De work armytia in UK tryThere be currently 800,000 tidy sum with craziness in the UK. There atomic number 18 over 17,000 younger community with craziness in the UK. There atomic number 18 over 25,000 volume with hallucination from b miss and minority heathenish groupsin the UK. There will be over a million hoi polloi with craziness by 2021. twain thirds of passel with aberration ar women. The proportion of community with lunacy doubles for every 5 form age group. One third of stack over 95 rescue dementia. 60,000 deaths a year ar aspirely credited(predicate) to dementia. Delaying the on pitch of dementia by 5 eld would reduce deaths directly attri scarcely able-bodied to dementia by 30,000 a year. The financial cost of dementia to the UK will be over ? 23 billion in 2012. There are 670,000 chargers of muckle with dementia in the UK Family shell offrs of passel with dementia however the UK over ? 8 billion a year. 80% of mint living in safekeepin g homes remove a form of dementia or severe keeping problems. Two thirds of people with dementia sojourn in the community while one third live in a care home. scarce 44% of people with dementia in England, Wales and Northern Ireland receive a diagnosing UK dementia statistics Affects 820,000 people in the UK Financial cost is over ?23bn pa, that is twice that of crabby mortal, three propagation the violation of heart unsoundness and four epochs that of stroke Two thirds (425,000) of people live in the community, one third (244,000) in a care home Two thirds of people with dementia are women (446k) and one third men (223,000) Affects 1 in 100 people aged 65-69, 1 in 25 aged 70-79 and 1 in 6 people aged over 80 Key risks from assessment are falls and walking or so (60% experience walking round) 25 million people, or 42% of the UK population, are stirred by dementia through knowing a close fri repeal or family member with the condition.(Source Alzheimers search Trust / Y ouGov poll, 2008) 163,000 new causas of dementia occur in England and Wales each year one every 3. 2 minutes The number of people in UK with dementia is expected to double in the next 40 years to 1. 7million people Statistics courtesy Alzheimers Research Trust and www. alzheimers. org. uk Government Policy The National Dementia scheme The objectives of the project are to develop a case dementia strategy and implementation externalize for consequence in October 2008.The strategy will address three key themes raising awareness, premature diagnosis and discourse and improving the quality of care. For more than than information visit National Dementia Strategy Dementia rivals 820,000 people in the UK. 25 million of the UK population have a close friend orfamily member with dementia. As well as the huge psycheal cost, dementia costs the UK economy ? 23 billion a year, more than basiscer and heart disease combined. Despite these figures, dementia inquiryis desperately u nderfunded. Impact of dementia in the UKThere are over 820,000 people living with dementia in the UK today, a number expect to rise rapidly as the population ages. Just 2. 5% of the governments health check research budget is spent on dementia research, while a quarter is spent on domiciliatecer research. One in three people aged over 65 will die with a form of dementia. Dementia costs the UK economy ? 23 billion per year. That is twice that of burn downcer, three times the impact of heart disease and four times that of stroke. Combined government and charitable investment in dementia research is 12 times lower than spending on tidy sumcer research.?590 million is spent on so-and-socer research each year, while just ? 50 million is invested in dementia research. feeling disease receives ? 169 million per year and stroke research ? 23 million. 1. What is dementia? The term dementia is spend to describe a collection of symptoms, including a decline in memory board, reasoning and talk skills, and a deliberate red of skills get hold ofed to carry out workaday activities. These symptoms are caused by structural and chemical changes in the heading as a result of physical diseases such as Alzheimers disease.Dementia can affect people of whatever age, but is virtually common in older people. One in ? ve people over 80 has a form of dementia and one in 20 people over 65 has a form of dementia. Researchers are keep mum working to ? nd out more close the different types of dementia, and whether whatever have a genetic link. It is thought that umteen factors, including age, genetic dry land, medical history and lifestyle, can combine to lead to the onset of dementia. Dementia is a progressive condition. This means that the symptoms go more severe over time.Understanding how this progression happens can be useful in back up mostone with dementia anticipate and plan for change. The modal value each psyche experiences dementia, and the rate of their decline, will regard on many a(prenominal) factors non just on which type of dementia they have, but overly on their physical misrepresent-up, their emotional resilience and the musical accompaniment that is available to them. Typically symptoms will include Loss of memory for example, forgetting the way home from the shops, or organism unable to remember names and places. Mood changes these happen especially when the parts of the nous which control emotion are affected by disease. People with dementia may feel sad, angry or frightened as a result. Communication problems a decline in the ability to talk, read and write. There are different types of dementia caused by different diseases of the brain. Because these diseases affect the brain in different ways, they produce different symptoms. or so of the most common forms of dementia are listed down the stairs 1. 2 Who is affected and how?Dementia can affect anyone regardless of gender, ethnicity, socio-economic situa tion and residential status. Nearly two-thirds of people with the disorder live in the community, while the opposite third reside in a residential home. A small number of people with dementia are from b insufficiency and minority ethnic (BME) groups. This is referable to the current younger age profile in Londons BME communities. As this population ages, with a mellower prevalence of physical conditions which may contribute to dementia, the rate of dementia is expected to increase.A particular analysis of the London population segments affected by dementia is available in appendix 1. This highlights that most cases of dementia are late-onset and therefore affect people aged 65 and over. Approximately one in 40 cases is early-onset dementia and occurs before the age of 65. Many factors, including age, genetic background, medical history and lifestyle can combine to lead to the onset of the disorder. Key points to emerge from late(a) studies and consultations with people with dem entia and their carers showed Dementia is ailing understood, it re primary(prenominal)s a gradetised condition and those affected often experience social exclusion and discrimination. Seeking assistant is frustrating admission to run typically includes contact with the NHS, topical anaesthetic councils and the third sector sometimes being referred elsewhere and often duplicating activities. Current services do non meet the needs of people with dementia. work are fragmented and lack robust integration and strong partnership working. There are gaps in provision and the quality of specialist services remains inconsistent. Reliability and continuity of services are compromised because many staff lack the requisite knowledge and skills to respond appropriately to those affected. Most health and social care services are non delivering the outcomes that are important to people with dementia early diagnosis and treatment, well accessible services, information and advice and h igh quality reinforcing stimulus. 8 wellnesscare for London IntroductionDementia services guide 9 3 Source Based on Dementia UK prevalence rates applied to GLA populations Introduction THE hassle OF DIAGNOSING ALZHEIMERSMost diagnoses of Alzheimers are delayed until more than two years subsequently symptoms first expect because patients and families ignore, deny, or dont recognize common signs of early Alzheimers, according to a 2006 Alzheimers Foundation of America survey. Fifty-seven percentage of caregivers who answered the poll said they put off anticipateing diagnosis for symptoms of memory loss, confusion, and language problematicies because they or the someone they cared for were in denial about having the disease, or because they feared the social stigma associated with AD.Another 40 percent didnt resonatek a diagnosis because they knew little about Alzheimers or its symptoms, they said. 38 percent of those surveyed said it was the patient who resisted handout to see a doctor 19 percent of caregivers admitted they themselves didnt want to face the possibility that something was wrong. Spouses were three times less likely than children of people with Alzheimers to delay seeking diagnosis, the survey effectuate. What Is Dementia? by Maureen Dezell with Carrie Hill, Ph. D. Dementia itself is not a disease but a term that describes different brain disorders that cause memory loss and other symptoms of cognitive decline.While various kinds of dementia are more common the longer we live, no(prenominal) is a part of normal aging. Dementia specialists recommend you see a doctor to evaluate any of these problems or symptoms, which may point to dementia Problems retaining recent memories and nurture new information, losing and misplacing objects, regularly forgetting appointments or recent conversations, or asking the same question over and over. Problems intervention complex tasks trouble balancing a checkbook, following a recipe, or performing routine tasks that drive a complextrain of thought. Trouble reasoning.Difficulty traffic with everyday problems, such as a flat tire. uncharacteristic rash behavior, including poor financial or social judgment. Difficulty with spatial ability and orientation. Driving and navigating beaten(prenominal) surroundings becomes difficult trouble recognizing local anaesthetic landmarks. Difficulty with language. Problems speaking, audience, and following or participating in conversations. behavioral or personalizedity changes. An active, engaged person seems listless and unresponsive. Trusting people become suspicious. What Is Dementia? by Maureen Dezell with Carrie Hill, Ph. D.. While various kinds of dementia are more common the longer we live, none is a part of normal aging. Dementia specialists recommend you see a doctor to evaluate any of these problems or symptoms, which may point to dementia Problems retaining recent memories and arresting new information, losing and misplac ing objects, regularly forgetting appointments or recent conversations, or asking the same question over and over. Problems handling complex tasks trouble balancing a checkbook, following a recipe, or performing routine tasks that involve a complextrain of thought. Trouble reasoning.Difficulty dealing with everyday problems, such as a flat tire. Uncharacteristic rash behavior, including poor financial or social judgment. Difficulty with spatial ability and orientation. Driving and navigating familiar surroundings becomes difficult trouble recognizing local landmarks. Difficulty with language. Problems speaking, listening, and following or participating in conversations. Behavioral or personality changes. An active, engaged person seems listless and unresponsive. Trusting people become suspicious. Who gets dementia? . Rarely, dementia affects younger people.Dementia is said to be early-onset (or young-onset) if it comes on before the age of 65. There are some groups of people who are known to have a higher risk of developing dementia. These include people with Downs syndrome or other learning disabilities. People with Downs syndrome are more likely to develop Alzheimers disease. Parkinsons disease. Risk factors for cardiovascular disease (angina, heart attack, stroke and peripheral vascular disease). The risk factors for cardiovascular disease (high blood pressure, smoking, high cholesterol level, lack of exercise, etc) are risk factors for all types of dementia, not just vascular dementia.Severe psychiatric problems such as schizophrenia or severe depression. It is not clear why this is the case. Lower intelligence. close to studies have shown that people with a lower IQ and as well as people who do not have very high educational achievement are more likely to develop dementia. A peculiar(a) social support network. Low physical activity levels. A lack of physical activity can increase your risk of dementia. (See separate leaflet called Physical Activity for Health for more details. ) Dementia also seems to run in some families so there may be some genetic factors that can make someone more likely todevelop dementia. We do know that a few of the more rare causes of dementia can be inherited (can be passed on through genes in your family). asshole medication help people with dementia? There is no cure for dementia and no treat that will reverse dementia. However, there are some medicines that may be used to help in some causes of dementia. Medication is generally used for two different reasons. Firstly, as treatment to help with symptoms that affect thinking and memory (cognitive symptoms). Secondly, as treatment to help with symptoms that affect mood and how someone behaves (non-cognitive symptoms). With improved nursing care and more widespread use of antibiotics to treat intercurrent infections, individuals now comm still survive 10 years or longer with dementia. This was not always the case in the 1950s, the pioneering geriatric psychiatrist Sir Martin Roth and colleagues used distinctions in duration of illness to show that dementia differed from other severe psychiatric syndromes, notably depression, in the elderly. At that time, most elderly people hospitalized with dementia in the UK survived for approximately 2 years Sex. All prevalence studies show that women are more often affected by dementia than are men.Typically, health services treat twice as many women as men with dementia. This contrast is explained only partly by the longer life expectancy of women because, even when this is taken into account, a slight excess of incidence is still evident in women. 2009 Health Press Ltd. Fast FactsDementia Lawrence J Whalley and John CS Breitner kind MODEL OF alienation While the clinical toughie of dementia presented above describes the changes occurring within the brain, the way that dementia affects a person in periodic life will vary from one individual to the next.For many years, people with dementi a were written off as incapable, regarded as little more than vegetables and often out of sight from society at large. During the 1980s and 1990s, there was a move away from regarding people with dementia as incapable and excluding them from society, and towards a new culture of dementia care, which encouraged looking for the person back the dementia (Gilleard, 1984 Kitwood Benson, 1995 Kitwood,1997). People with dementia could now be inured as individuals with a unique individuation and biography and cared for with greater understanding.Building on this work, others (notably Marshall, 2004) have advocated that dementia should be regarded as a hinderance and framed within a social model. The social model, as developed in affinity to baulk, understands baulk not as an intrinsic characteristic of the individual, but as an outcome produced by social dish upes of exclusion. Thus, disability is not something that exists purely at the level of individual psychology, but is a con dition created by a combination of social and material factors including income and financial support, employment, housing, transport and the built environment (Barnes et al., 1999). From the perspective of the social model, people with dementia may have an impairment (perhaps of cognitive function) but their disability results from the way they are treated by, or excluded from, society. For people with dementia, this model carries important implications, for example ? the condition is not the fault of the individual ? the guidance is on the skills and capacities the person retains rather than loses ? the individual can be fully understood (his or her history, likes/ shuns, and so on) ?the influence is recognised of an enabling or supportive environment ? the key value is endorsed of appropriate communication ? opportunities should be taken for rehabilitation or re-enablement ? the responsibility to reach out to people with dementia lies with people who do not (yet) have dementia ( Gilliard et al. , 2005). The social model of care seeks to understand the emotions and behaviours of the person with dementia by placing him or her within the context of his or her social circumstances and biography.By learning about each person with dementia as an individual, with his or her own history and background, care and support can be designed to be more appropriate to individual needs. If, for example, it is known that a man with dementia was once a prisoner of war, it can be understood why he becomes very sick when admitted to a locked ward. If care providers have learned that a person with dementia has a strong dislike for a certain food, it can be understood why the person might spit it out.Without this background knowledge and understanding, the man who rattles the door may be labelled a wanderer because he tries to relief valve and cowers when approached, or the person who spits out food is labelled as antisocial. Moreover, a variety of aspects of care may affect a p erson as the dementia progresses. Some extrinsic factors in the care environment can be modified, for instance noise levels can be highly irritating but are controllable. Other intrinsic factors, such as the cultural or ethnic identity of the person with dementia, may also have a bearing on how needs are assessed and care is delivered.Some aspects will be more important or pertinent to one person than to another. The social model of care asserts that dementia is more than, but inclusive of, the clinical damage to the brain. ), and while we do not know what precise forms of training are effective, it is reported to lead to better identification of abuse (a haphazard controlled trial by Richardson and colleagues (2002) provides good evidence of this). Agreed multi-agency policy and practice guidance is available at local level and identifies the approaches to be taken when abuse or spend are suspected.A national recording system for referrals of adult abuse has been piloted ( segme nt of Health, 2005b), which found that older people with mental health problems were among those referred to local authorities adult protection systems a variety of interventions were adopted, although information on the outcomes is not available. Recommendations from a serial publication of high-profile inquiries into care settings in hospitals (for example, Rowan Ward, segment of Health/Care Services Improvement Partnership, 2005) are relevant to commissioners, regulatory bodies and practitioners in seeking to lower the risk of abuse.The law in this area is developing and the mental Capacity Act 2005 introduces a new criminal offence of ill treatment or neglect of a person who lacks capacity. DISCLOSURE/STIGMA Assessment and reaching a conclusion about the diagnosis leads to a point where this information should be shared with the person with dementia. This is especially challenging in dementia for a number of reasons ? the difficulty of accurate diagnosis ? the challenge of imp arting bad news ? suspense about whether or not the person will understand what is being said ?uncertainty about whether or not the person will retain what is said ? lack of follow-up support. Studies, in which people with dementia have been invited to tell the story of how they reached a memory assessment service and what the assessment process felt like, indicate that this is not an easy journey for them (Keady Gilliard, 2002). Often, they have been aware of their memory difficulties for some time before sharing this information with others (usually, but not always, their close family). This awareness may occur in quite private activities, like doing crossword puzzles.In the meantime, those who are closest to the person may also have been aware of the difficulties but have fought shy of sharing their concerns. Disclosing their concerns to each other is often what triggers a visit to the GP and referral to a memory assessment service (Keady Gilliard, 2002). People have reported that their visits to the memory assessment service can also be quite an ordeal (Keady Gilliard, 2002). This is often like no other outpatient clinic. The doctor may speak to the carer separately from the person being assessed, leading to suspicion about what is being said.The assessment process itself may prove embarrassing, even humiliating. People report that they are aware that some of the questions are simple and feel foolish that they are unable to answer. They may establish strategies for managing this (Keady Gilliard, 2002). Whilst recognising that most people are seeking to make sense of what is happening to them, it is important to acknowledge that some will find it hard to listen to their diagnosis and there will be some who will not want to be told at all.They know they have a problem with their memory and that they are not able to function as they once did or as their peers do. They want to know what is wrong with them, and they need the clinician to be honest with the m. Telling someone that he or she has a memory problem is only telling him or her what he or she already knows. People should be told their diagnosis as all the way and honestly as possible. The moment of sharing the diagnosis may not be comfortable for any of those concerned neither the clinician, nor the person with dementia, nor his or her carer (Friel McGowan, 1993).Without this knowledge, people cannot begin to make sense of what is happening, nor can they plan effectively for their future. They should be prone a choice of treatments and need information about practical support and entitlements, like Lasting Powers of Attorney and advance conclusivenesss to refuse treatment (more information can be found in sectionalisation 4. 9. 4 and in the Mental Capacity Act 2005 The Stationery Office, 2005). They will want to make decisions about how they spend their time before life becomes more difficult for them (for example, visiting family abroad). next the disclosure of the diag nosis, people with dementia and their families may want further support and opportunities for talking. Pre- and post-assessment counselling services should be part of the specialist memory assessment service. Recent work (Cheston et al. , 2003a) has shown the value of psychotherapeutic support groups for people with dementia, allowing them space to share their feelings with others. Joint interventions with the person with dementia and family carers, such as family therapy, recognise the fact that the diagnosis does not impact on just one person but on a unit of measurement family system (Gilleard, 1996).Other services have used volunteer befrienders to maintain contact with people who are newly diagnosed and who can offer both practical support and information together with a listening ear. People with early dementia are also taking responsibility for their own support by forming groups, which may meet regularly or may be virtual networks using the mesh (see, for example, www. das ninternational. org). Sensitivity is required in ensuring that information about the diagnosis is given in a way that is easily understood by the person concerned and acceptable to the family. Gentle questioning at an early stage will help toascertain what people can, and want, to be told. There is much we can learn from earlier work on sharing the diagnosis with people with cancer (for example, Buckman, 1996). It is especially important to be aware of different cultural sensitivities and the stigma that dementia holds for many people. This can range from subjective feelings of degrade to a real exclusion from community and family life. Age and ethnicity are both factors in the sense of stigma associated with a diagnosis of dementia (Patel et al. , 1998). 4. 9 BASIC LEGAL AND ETHICAL CONCEPTS IN CONNECTION WITH DEMENTIA CARE 4. 9. 1 IntroductionThe ethical problems that arise in the context of dementia mainly adjoin to autonomy, which is compromised in dementia to varying degrees. Respect for autonomy is recognised as a key ruler in health and social care (Beauchamp Childress, 2001). Many of the ethical tensions that arise in looking after people with dementia do so because of, on the one hand, the requirement that autonomy ought to be see and, on the other, the reality of increasing dependency, where this entails a loss of personal freedom. Person-centred care is a means of respecting personal autonomy wherever it is threatened (Kitwood, 1997).As Agich has stated, Autonomy fundamentally importantly involves the way individuals live their daily lives it is found in the nooks and crannies of everyday experience (Agich, 2003). Hence, respecting the persons autonomy will involve day-to-day interactions and will be achieved if the person with dementia is not positioned in such a way as to impede his or her remaining abilities. Such malignant positioning can be the result of contrasted psychosocial structures. The fundamental way to combat this tendency, whic h undermines the persons selfhood, is to encourage good-quality communication (Kitwood, 1997 Sabat, 2001).Another way in which selfhood might be undermined is through structural or procedural barriers to good-quality care, and service providers should take an active exercise in promoting the individuals autonomy and his or her legal and pitying rights. Furthermore, services may appropriate against people with dementia if eligibility criteria are drawn up in such a way as to exclude them or because of an assumption that people with dementia cannot benefit from a service because staff lack confidence and skills in working with this group.Discrimination may also occur if a service does not offer people with dementia the support they may need in order for them to be able to make use of the service. The Disability Discrimination Acts (1995 and 2005), which include dementia within the definition of disability, aim to end the discrimination that many disabled people face in their everyd ay lives by make direct or indirect discrimination against disabled people unlawful in a range of areas including access to facilities and services and buying or renting property.The discussion that follows will briefly focus on human rights, take to, capacity and confidentiality. 4. 9. 2 Human rights Human rights are enshrined, as far as the United nation is concerned, in the Convention for the Protection of Human Rights and Fundamental Freedoms (Council of Europe, 2003). The relevant UK legislation is the Human Rights Act 1998, which came into force in 2000. The principle of respect for autonomy is implicit throughout the Convention. A number of the articles of the Convention are potentially relevant to people with dementia.For example, Article 2 asserts that everyone has a right to life, Article 3 prohibits torture, but also inhuman or degrading treatment, and Article 8 concerns the right to respect for the persons private and family life. Article 5 asserts the right of people to closeness and security. It states that No one should be deprived of his liberty, except in very specific circumstances. It also asserts that if someone is deprived of his or her liberty, there should be recourse to a court. Article 5 was central to the Bournewood case.The European Court declared, amongst other things, that the man concerned (who had a learning disability) had been deprived of his liberty, in contravention of Article 5 (see Department of Health, 2004, for further information). The crucial distinction to emerge from the case was that between deprivation of liberty and restriction of liberty. Whilst the causation is illegal, except insofar as there are legal safeguards of the sort provided by the Mental Health Act 1983 (HMSO, 1983), the latter may be permissible under the sort of circumstances envisaged by fragment 6 of the Mental Capacity Act 2005 (TSO, 2005).This discusses using restraint as a proportionate solution to the possibility of the person suffering harm. Guidance on the distinction between restriction and deprivation of liberty has been provided by the Department of Health and the National Assembly for Wales (Department of Health, 2004). 4. 9. 3 Consent In brief, for consent to be valid it must be ? informed ? competent ? uncoerced ? continuing. Each of these concepts requires interpretation and judgement, as none of them is entirely unproblematic (Department of Health, 2001a). For instance, people can be more or less informed.The Sidaway case (1984) establish that the legal standard as regards informing a patient was the same as for negligence (see the Bolam case, 1957). In other words, the person should be given as much information as a responsible body of medical opinion would deem appropriate. However, since then, there has been a shift away from a professional-centred standard towards a patient-centred standard. In the Pearce case (1998), one of the Law Lords declared that information should be given where there exists a significant risk which would affect the judgement of a reasonable patient.Department of Health guidelines (Department of Health, 2001c) have pointed out that, although informing patients about the nature and purpose of procedures may be plentiful to avoid a claim of battery, it may not be sufficient to fulfill the legal employment of care. There may be other pieces of information relevant to the individual patient that it would be thoughtless not to mention. Hence the General Medical Council (GMC)s insistence that doctors should do their best to find out about patients individual needs and priorities (GMC, 1998). The GMC guidance goes on to say You should not make assumptions about patients views.These points are very relevant when it comes to consent in the context of dementia. It should be kept in mind that consent is not solely an issue as regards medical procedures. The nooks and crannies of everyday experience (Agich, 2003) what to wear or to eat, whether to go out or part icipate in an activity and whether to accept extra home or good luck care are all aspects of life to which the person with dementia may or may not wish to consent. If the person has capacity with respect to the particular decision, but does not wish to consent, he or she should be supported in making an autonomous decision. 4. 9.4 Decision-making capacity In England and Wales, a lack of capacity has been defined thus . . . a person lacks capacity in relation to a bailiwick if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain (Mental Capacity Act 2005 TSO, 2005, Section 2). A person is further defined as unable to make a decision if he or she is unable (a) to understand the information relevant to the decision, (b) to retain this information, (c) to use or weigh that information as part of the process of making the decision, or(d) to communicate his decis ion (whether by talking, using sign language or any other means) (Mental Capacity Act 2005 TSO, 2005, Section 3(1)). The Mental Capacity Act 2005 (TSO, 2005), which will apply in England and Wales31, sets out a framework for making decisions for people who are unable to make decisions for themselves. Its detailed provisions, along with its Code of Practice (currently in conscription form DCA, 2005), should be referred to by all those involved in such decision making. In outline, the main provisions of the Act ? offer a definition of lack of capacity (Sections23) ? outline a process for the determination of a persons best interests (Section 4) ? create Lasting Powers of Attorney, which allow a person to appoint a donee to make decisions about his or her health and welfare (Sections 914) ? establish the Court of Protection in a new form, with powers to make declarations and appoint deputies in difficult cases or where there are disputes concerning decisions about a persons health and welfare (Sections 1523) ? bring under statute and clarify the law regarding advance decisions to refuse treatment (Sections 2426) ? set out safeguards co