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System engineering Coursework Example | Topics and Well Written Essays - 250 words - 1

Framework building - Coursework Example Once in a while change is typically capricious, coming at time that an association doesn't fo...

Tuesday, August 25, 2020

System engineering Coursework Example | Topics and Well Written Essays - 250 words - 1

Framework building - Coursework Example Once in a while change is typically capricious, coming at time that an association doesn't foresee it. In such a situation, the manner in which an association handles the change decides the flexibility that decides the recuperation of the association. Different proposals have been given on the best way to oversee change in frameworks building. To adequately manage change in frameworks building, it is prescribed to follow a basic rule. First recognize the zones that change is required in the procedures and legitimize the requirement for change. Besides, survey and assess the chance of positive outcomes from an adjustment as far as managing partners needs or concocting a superior item. Thirdly, change administrators should actualize the adjustment in a procedure that doesn't upset the entire framework. At the point when a change is at long last set up, it ought to be rehearsed to supplant the past procedure and made the standard. This should then be trailed by intermittent checking of the change as it is being actualized and assessment of the entire procedure (Habhouba, Cherkaoui, and Desrochers, p.

Saturday, August 22, 2020

Italian Degree of Comparison Adjectives

Italian Degree of Comparison Adjectives There are three kinds of level of correlation descriptive words in Italian: positivo (positive), comparativo (relative), and superlativo (standout). Positive Adjectives (Aggettivi di Grado Positivo)Italian positive descriptors are those that don't give any correlation: Il clima à ¨ mite.The atmosphere is gentle. La poltrona à ¨ comoda.The seat is agreeable. Similar Adjectives (Aggettivi di Grado Comparativo)An modifier is relative when it communicates a correlation between individuals, creatures, things, various degrees of value, or differing activities. As for the sort of correlation offered, the similar can be: of maggioranza-communicated by the intensifier piã ¹ (set before the descriptive word) and the relational word di or the combination che (put before the second term of correlation): Piero à ¨ piã ¹ studioso di Andrea.Piero is more contemplative than Andrea. Carlo à ¨ piã ¹ pigro che volenteroso.Charles is more sluggish than enthusiastic. NOTE: Che is favored rather than da before a descriptive word, participle, or infinitive. of uguaglianza, communicated by the correlative qualifiers (tanto)†¦quanto, (cosã ¬)†¦come: Giulia à ¨ (tanto) bella quanto sua madre.Julia is as lovely as her mom. Marco à ¨ (tanto) gentile quanto premuroso.Mark is as delicate as he is astute. Luigi à ¨ (cosã ¬) alto come Giorgio.Luigi is as tall as George. of minoranza - communicated by the qualifier meno (set before the modifier) and the relational word di or the combination che (put before the second term of correlation): Sono meno paziente di te.Im less patient than you. Ti considero meno volenteroso che intelligente.I think of you as less excited than savvy. NOTE: The comparatives of maggioranza and minoranza can at times be changed, strengthened, or debilitated by the verb modifiers molto, poco, troppo, assai, tanto, alquanto, parecchio, and un po: Mario à ¨ poco piã ¹ grande del fratello.Mario isn't a lot greater than his sibling. Sono molto meno stanco di te.I am considerably less worn out than you. Standout Adjectives (Aggettivi di Grado Superlativo)Superlative descriptive words show an excellent or phenomenal quality. The standout degree might be assoluto (supreme) or relativo (relative): assoluto when it offers no correlation with others or things or characteristics. It is framed:  »Ã¢ by adding the completion issimo to the descriptive word dolce-dolcissimo-dolcissimiamara-amarissima-amarissime NOTE: The descriptive words finishing off with co and go hold or lose their throaty sound as indicated by the applicable principles of plural arrangement: ricco-ricchissimopratico-pratichissimo NOTE: descriptive words finishing off with io, in which the I is tonic, keep the letter in the standout structure: pio-piissimo NOTE: modifiers finishing off with io, in which the I is atonic, lose that letter in the standout structure: saggio-saggissimo  »Ã¢ in a couple of examples by adding the closure errimo to the descriptive word: section of land acerrimo aspro-asperrimo (asprissimo) celebre-celeberrimo integro-integerrimo misero-miserrimo (miserissimo)  »Ã¢ by adding the consummation entissimo to descriptors that end in dico, fico, or vole: benefico-beneficentissimo benevolo-benevolentissimo maledico-maledicentissimo malevolo-malevolentissimo magnifico-magnificentissimo munifico-munificentissimo  »Ã¢ by reiteration of the descriptor: un stick piccolo piccoloa little pooch unandatura lenta lentaa moderate pace  »Ã¢ prefacing the modifier with intensifiers, for example, molto, assai, estremamente, straordinariamente, enormemente, or oltremodo: un libro molto interessantea exceptionally fascinating book una gita assai movimentataa exceptionally significant outing un film estremamente realisticoan amazingly reasonable film  »Ã¢ placing phrases as quanto mai or oltre ogni desperate previously or after the descriptor: una giornata quanto mai noiosaa exceptionally irritating day un uomo abitudinario oltre ogni direa animal of propensity amazing  »Ã¢ by including prefixes, for example, arci, extra, iper, sopra, sovra, stra, super, or ultra: unopera arcinotaa very notable work una matita extrafineextra-fine pencil un giornalista ipercriticoa excessively critical columnist uno sforzo sovrumanoa superhuman exertion un uomo strariccoan very rich man un motore superpotenzea super-amazing motor una politica ultraconservatricean ultra-traditionalist government official  »Ã¢ with the utilization of articulations that strengthen the importance of the modifier: bello da impazzireso attractive that it makes one insane matto da legaremad as a hatter pazzo furiosomadman ricco sfondatofilthy rich stanco mortodead tired ubriaco fradicioblind alcoholic, crushed, blotto relativo when it shows an excellent or uncommon quality; in any case, it must be according to a characterized gathering or limited to individuals or things of a similar kind. It is framed:  »Ã¢ by introducing the comparativo di maggioranza or comparativo di minoranza with a clear article and setting a term, for example, di, tra, or che before the second term of examination: il piã ¹ serio tra I colleghithe generally genuine among associates il meno spiritoso della compagniathe least clever of the gathering NOTE:  »Ã¢ the positive article may go before the thing rather than the relative standout: Quello à ¨ il treno piã ¹ veloce del mondo.That is the quickest train on the planet. Quel treno à ¨ il piã ¹ veloce del mondo.That train is the quickest on the planet.  »Ã¢ the second term of correlation can be inferred: Carlo à ¨ il piã ¹ fortunato (tra gli amici, I colleghi)Charles is the most fortunate (among companions, partners) There are someâ aggettiviâ qualificativiâ (qualifying modifiers) that, notwithstanding the ordinary type of the relative and standout, have a Latin-inferred structure that is favored in allegorical articulations (see table underneath): laâ cimaâ pi㠹â altathe most elevated pinnacle ilâ sommaâ poetathe incredible artist ilâ piã ¹ piccoloâ sforzothe littlest exertion laâ minimaâ importanzathe least noteworthy There are a few modifiers that come up short on the positive (gradoâ positive) and different structures: POSITIVO   COMPARATIVO   SUPERLATIVO ASSOLUTO- â â - â â primo- â â anterioreâ â â - -  â â posterioreâ â â postumo- â â ulterioreâ â â ultimo Ilâ primoâ dellanno (il giorno che go before tutti gli altri)The first of the year (the day that goes before all the others) iâ fattiâ anterioriâ allaccaduto (precedenti)the realities before the episode le zampeâ anterioriâ del cavallo (davanti)the forelegs of the pony un documentoâ posterioreâ (successivo)a ensuing archive le zampeâ posterioriâ (di dietro)the rear legs unoperaâ postumaâ (pubblicata dopo la morte)a after death work ulterioriâ chiarimenti (successivi e aggiuntivi)further explanations lultimoâ treno (che viene dopo tutti gli altri)the last train (which comes after all the others) lultimaâ casa della strada (la piã ¹ lontana)the keep going house in the city (the most distant) Modifiers that come up short on a near and standout structure include:  »Ã¢ adjectives that demonstrate material attributes or characteristics: chimicochemical romboidalerhomboidal ironferreo  »Ã¢ adjectives that demonstrate timespans: giornalierodaily settimanaleweekly mensilemonthly  »Ã¢ adjectives communicating nationalities, religions, or political convictions: statunitenseU.S. protestanteProtestant comunistaCommunist  »Ã¢ adjectives effectively changed: grassoccioplump piccolinolittle one grandicellogrown-ups Elective FORMS OF AGGETTIVI QUALIFICATIVI POSITIVO COMPARATIVO SUPERLATIVO ASSOLUTO alto superiore sommo/supremo basso inferiore infimo buono migliore ottimo cattivo peggiore pessimo grande maggiore massimo piccolo minore minimo interno interiore intimo esterno esteriore estremo vicino (viciniore) prossimo

Monday, August 10, 2020

12 Examples of Native Ads (and Why They Work)

12 Examples of Native Ads (and Why They Work) Native ads have gained a lot of popularity in the last couple of years, even overtaking display ads as the most popular form of advertising. There is a good reason behind this growth in popularity.According to HubShout, 85% of internet users don’t mind native ads because they don’t interrupt their browsing.Unless you have been living in a cave for the last decade and are reading this article on a stone tablet, you have probably come across several examples of native ads â€" even though you might not have realized it.While native ads are virtually everywhere on the internet, they are becoming harder and harder to spot.WHAT IS NATIVE ADVERTISING Native advertising can be simply described as paid content that aligns with the look, function and feel of the publication on which they appear.According to Neil Patel, native advertising is a form advertising that is so interwoven into the site on which it is being promoted that site visitors cannot tell that what they are viewing is nativ e advertising.The aim of native ads is to sell to your audience without making them feel like you are selling to them.Native ads are prevalent on social media sites and on website content. They don’t often look like ads, and it might be difficult to point them out as such. They are usually entwined with the editorial content of the site.Native ads come in the form of article, infographics, videos, and so on. They might appear as:Editorial Content: These appear the same way as the other editorial content on the site, with the only difference being that they are branded or sponsored by the advertiser.In-feed Ads: These appear as news feeds that appear on your social pages (Facebook, twitter).Search And Promoted Listings: These ads appear on your results page (at the top before your results) when you search for content.Content Recommendations: Recommended articles appear below or within the article audiences are currently reading.The thing about native ads is that they are non-disrup tive compared to display ads.They do not even require the reader to click on the ad as they browse through a website. Advertisers and brands love native advertising.This is because they increase the click-through rate and engage audiences than display advertorials do. They can also be used on a range of platforms.FROM DISPLAY TO NATIVE ADSDisplay ads are no longer working for consumers.There is a funny but popular stat in digital marketing that a person is 475 times more likely to die in a plane crash than they are to click through an ad.However hyperbolic that statement sounds, it is true that potential customers find click-through ads, banners and pop up ads totally irritating, annoying and disruptive.As a result, 80% of United States adults have turned into ad-blocking methods. 50% of these individuals have two ad-blocking software on their PCs.Another 10% are using four or more ad-blockers at the same time and can be termed as adlergic. The heaviest blockers appear to be people between eighteen to thirty-four years.Reuters also reported that at least 45% of the global population find display ads irritating and have consequently installed one ad-blocker in their PC’s and smartphones. Source: Wall Street JournalThis aversion to ads calls for an ad format that is more woven with the experience of the user, and that is where native advertising comes in.According to a report by FIPP, Native advertising accounted for 31% of the gross publishing output in 2017.That number shot to a staggering 69% for some companies in 2018. Buzzfeed, The New York Times, Cracked and Forbes are some of the companies extensively employing native advertising.Another study by eMarketer showed that companies used up to 3.5 billion dollars on native ads on the open internet in 2017. There was a forecasted 28% increase in 2018. In 2018, the numbers surpassed the projection by 28%.The same study revealed that 80% of consumers are more comfortable with native ads compared to banner ads. Native ads create a symbiotic relationship between readers, advertisers and publishers.They are rapidly becoming a friendly transaction that not only gains money for the sponsors and publishers but also extends r espect to the reader.THE CONTROVERSY WITH NATIVE ADSDespite their popularity, there is a huge controversy surrounding native advertisements.The fact that consumers are not aware that they are consuming ads â€" since the ads look like regular content â€" denies them the chance to decide whether or not they want to view the ad.This also brings into question the credibility and neutrality of the editor. If Dell has sponsored an article on Forbes, Forbes is unlikely to write anything negative about them.This has created the need for a way to notify consumers when serving them native ads. In addition to robbing consumers of the chance to decide whether to consume the ad or not and bringing into question the credibility and neutrality of the editor, there is also chance that the consumers might feel cheated or betrayed.Here they were, thinking that they were consuming an educative or entertaining piece of content, only to realize that it was a piece of advertising. If this happens, it can have a negative impact on the marketer.There are currently few guidelines and rules that stipulate the way that advertisers should conduct native ads.Consumer watchdogs like the Interactive Advertising Bureau (IAB) and the Federal Trade Commission are in the process of finding a regulative framework that ensures consumers do not fall prey to advertisers.Nevertheless, consumers should not panic because there are certain distinguishing features that can help them identify native advertising. These include:The words “promoted stories” or “suggested post”The words “sponsored” or “sponsorship credit”“Suggested” or “recommended” videosThe tag “Ads” on the contentBENEFITS OF NATIVE ADVERTISINGFor the few years that native advertising has existed, it has grown value for companies that team up with publishers to produce and disseminate content.Some of the benefits of native ads include:Millennials seem to trust native ads more than they do display ads.Native ads are more engaging.Native ads lead to greater sales. A recent survey showed that a third of millennials have purchased products after seeing a form of native ads.Native ads have been proven to increase the click-through rate by up to eight times.12 EXAMPLES OF NATIVE AND WHY THEY WORKEDIn this section, we will go through twelve great examples of Native adverts and point out why they worked.1. Laurel and Yanny DebateThe Laurel vs. Yanny debate was one of the biggest viral debates on the internet in 2018, and VentureBeat decided to take advantage of the viral debate to promote an Artificial Intelligence conference that was coming up.The debate was about a viral video clip that mentioned a word that some people heard as Laurel while others heard it as Yanny.The clip was posted on Reddit asking readers what they heard. Even celebrities such as Ellen DeGeneres contributed to the argument with most of her studio audience saying they heard Laurel. JJ Watt also brought it up on his show and his team surprisingly heard Yanny.The dispute went on for a while and ranged on the internet for the next few days. Even researchers went to work and different professionals giving their insights on the same.Venture Beat â€" a technology news website â€" rode on this hype to promote their artificial intelligence conference. They ran an article on their website explaining how artificial intelligence had been used to solve the Laurel-Yanny debate.The article explained how the language detection algorithms of various digital assistants worked to determine what was being said in the clip, and explained some of the challenges experienced in settling the debate.The article brought up some of the challenges and limitations of algorithms, which would of course be discussed in greater detail at the Transform Conference that VentureBeat was promoting.This is a great example of native advertising because VentureBeat took a viral piece of content, created engaging content around it, and then us ed it as an opportunity to promote their conference on artificial intelligence. You can read VentureBeat’s article here.2. Woman Takes Bathroom Break After Filling Out Tax FormsThis article was written for HR Block by The Onion and published on The Onion. It was framed as a short article highlighting how the woman took a break after filling the Tax forms to unwind. You can check out the article here.The article might appear to be useless to a reader because of the aimless story but it reminds them about filling taxes.When the article came out in 2012, it was surrounded by HR banner ads and even though consumers were unlikely to click through them, it resulted in massive brand awareness.This ad worked because the story engaged audiences in an entertaining way and also reminded them of filing their task returns even though there was no clear call to action. It addressed a boring task in a fun and relatable way to the audience.Even if the article did not specifically mention HR Block , the fact that it addressed a subject that HR Block deals with, coupled with the surrounding HR Block banners helped increase awareness for the company.3. How to Transform to a Total Nerd Babe â€" GawkerThis is another great example of native advertising. The article, which was posted on Gawker and was meant to publicize the TBS show King of the Nerds, is the kind of article you would expect to find on Gawker and matches the design and editorial style of other articles on Gawker.The story points out the mindset shift on how girls who war specs can transform themselves from nerdy to sexy, and but has a clear call to action near the top of the article asking the reader to watch the show.On the article, just below the headline, one can see the word “Sponsored” which shows that it is an ad, even though the “sponsored” tag is not conspicuous from the other items on the page.4. Altran Engineering in the Financial Times This is one of the best examples of native advertisement, com bining a human interest story, video advertising, and cutting edge tech, with billionaire entrepreneur Elon Musk thrown in for good measure.What distinguishes this as a piece of native advertising is the fact that the video â€" which was published in the Financial Times’ Industrial Tech section â€" was created by the Altran Engineering company and shows the same kind of content you would expect to find in the Industrial Tech section of the Financial Times.Rather than coming off across as an ad, it comes across as a news story that tells about the SpaceX Hyperloop Pod Competition, the team of students from the Technical University in Valencia who are taking part in the competition, as well as the staff from Altran Engineering who are giving these students support in the competition.It is an entertaining video that is unlikely to be viewed as a piece of advertising, yet in actual sense it is promoting both the SpaceX Hyperloop Pod Competition and Altran Engineering.5. Mercedes in th e Washington PostMercedes also pulled off a smooth attempt at native advertising with their “The rise of the superhuman” campaign, which was published on the Washington Post. You can view the article here.The content, which is highly engaging and designed to pique the reader’s curiosity, talks about the various technological advancements that are eradicating human error and turning us into superhumans.The article goes on to discuss these technologies, which include robotic exoskeletons, virtual and augmented reality, computer vision, and facial recognition technology.Inside the article, Mercedes manages to slip in their new Intelligent Drive System, which comes with their new Mercedes Benz E-Class series as one of these technologies that will help eradicate human error and turn us into super humans.The article is the kind of content that you would expect to find on the Washington Post, and were it not for mentioning their new Intelligent Drive System, it wouldn’t have been c lassified as an ad.Actually, most people reading through the article do not realize that it is an advertisement.To make it even more engaging and interactive, the article has quizzes and sections that the reader can click on to access more information on the subject.It’s also amazing how Mercedes manages to create a connection between the E-Class series and cutting edge, superhuman technology.6. Colored Corn on Business InsiderThe best pieces of native advertising look like stories rather than advertisements, and this is what Glass Gem Corn did with this article on the Business Insider.The story talks about a multi-colored variety of corn that took the internet by storm a couple of years ago.In a bid to find his Native American roots, the founder of Glass Gem Corn embarked on a journey to develop the colored corn.In the article, Business Insider tells his story in the same fashion it would with any other story they would publish on their website, the only difference being that thi s story is also an advertisement.In the article, Business Insider added links to a website where people could buy the seeds for the colored corn, effectively making the article a sales page hidden inside an amazing story.7. Hennessy on Vanity FairIn this ad, Vanity Fair, which is known for its trendy lifestyle journalism, teams up with Hennessy to retell the story of Malcolm Campbell, “The Fastest Man on Earth.” Campbell, who in 1935 broke the 300mph land speed record has always been a symbol of ambition, making his story a perfect opportunity to promote a top-shelf liquor.Hennessy collaborated with creative agency Droga5 to create the ad, which was then published in perfect timing with Hennessy’s “Never Stop, Never Settle” Campaign.This ad worked for a number of reasons. First, it was engaging to the audience because it was in line with Vanity’s outlook and the regular features published on the site. Second, the story itself was compelling and throbbing.In addition, the comparison between Hennessy and Campbell’s spirit of adventure is subtle yet striking, driving home the message that Hennessy unlocks your adventurous spirit. You can check out the ad here.8. Fidelity Ad on ForbesForbes putting Fidelity on their cover magazine tested the limits of native advertising. It also introduced us to another concept of native ads on Print, which is still alive and kicking.Forbes put up an ad on their actual cover which highlighted two pages of branded content and infographic in the magazine.The ad was a teaser to an infographic talking about retirement, which was the editorial theme for that month. Fidelity had paid for the infographic to appear on the two-page space they had been given which as a part of the larger agreement between the two parties.Though the ad was posted on the cover, it was in line with other teasers appearing on the cover, and Forbes asserted that the content went hand in hand with their theme and provided more information about the contents of the magazine.Funny enough, Fidelity had not paid for the cover treatment. Instead, Forbes said it was added value for the client.9. Sexually Deviant Us Presidents â€" Cracked Virgin MobileCracked is a fun-style humor magazine who have been doing native adverts since 2008. Cracked success is attributed to their approach to native advertising â€" rather than leaving content creation to the advertiser, their editorial team works together with brands to create sponsored content that will resonate with their readers.One of their greatest pieces of native advertising on Cracked Magazine is as amazing as it is crazy.The article dubbed “The 4 Most Impressively Weird Sex Lives of US Presidents” goes on to talk about the weird sexual behaviors of some former American presidents. Now, who wouldn’t want to know about the sexually deviant US presidents?Weirdly enough, the article was sponsored by Virgin Mobile, and its aim was to encourage voters to use the Virgin Mobile netwo rk to find voting stations near them.However, this information doesn’t come till the very last part of the article. This ad was a massive success, generating over 1.1 million views, 2600 likes and 710 comments.10. Washington College on BuzzFeedBuzzFeed is well known for its native advertising antics. One of their best examples of native marketing on BuzzFeed came as a collaboration between them and Washington College.Hoping to attract high school students considering which colleges to apply to, Washington College had a series of native posts published on BuzzFeed, a media site that is quite popular with the youth.The theme of these posts was “You’ll love this place.” The articles discussed various things that might interest a high school student looking for college options, while at the same time showcasing Washington College as a favorable option.Following the campaign, views on Washington College’s Facebook page increased by 77%, page views on their website grew by 94%, and over 373 applications were directly attributed to the campaign.Following the campaign, the college won the 2018 Content Marketing Award for native advertising.11. VMware on the AtlanticVMware â€" A software company â€" teamed up with The Atlantic to produce editorial content on using smart technology to help factory workers. It makes sense for such content to be produced by VMware owing to their expertise on the subject.The editorial content maintains an informed voice throughout referring to credible sources and data from actual research.It was part of an ongoing discussion they had about emerging technologies, and there are no advertisements by VMware anywhere within the article.However, the header clearly shows that the content was paid for by VMware, and the footer is distinctively marked with the VMware logo. The Atlantic goes further to assert the article does not necessarily reflect their views.The aim of the article was to create brand awareness for VMware. You can check out the article here.12. Promoted/Sponsored Social Media PostsA promoted tweet. Image courtesy of authorIf you are active on social media, especially Facebook, Twitter and Instagram, you have definitely come across the promoted/sponsored posts.These posts have the same format as regular posts by your friends/followers, and they appear on your timeline the same way regular posts do.The only difference between them and regular posts is that they are usually tagged as promoted or sponsored. Without these tags, you wouldn’t tell that the posts are sponsored.Such ads have been hugely successful, and it is no wonder that every social media platform today implements some form of sponsored/promoted posts.WRAPPING UPWith internet users becoming blind to display ads, and others using ad-blockers to filter out ads, the most effective way to get your products, services, or brand in front of customers is through native ads.These are ads that match the content of the site on which they are pro moted and therefore do not interrupt the consumer’s browsing.If you haven’t been using native ads, it might be time for you to start, and to help you with that, we have shared with you 12 great examples of native ads and why they work.Now all you need to do is to go out there and replicate the same on your business.

Saturday, May 23, 2020

Benefits Of Promoting Growing Your Own Food And Its...

Currently, in the Denver Metro area, there are more than 40 school-based community gardens. These are projects on a much smaller scale than what I’m proposing. The benefits of teaching youth the importance of growing your own food and its nutritional value would have a positive effect for decades to come. The Colorado School of Public Health has data on Denver Urban Garden efforts and how it has led to a tangible, positive change in the community’s health and food security. School-based community gardens help to create a bridge between the school and the surrounding community by offering space for gardening to students, parents, teachers and neighbors. Teachers could even have an outdoor classroom where students are given the opportunity†¦show more content†¦This program could be partnered with the Denver Public Schools, Denver Urban Gardens, Learning Landscapes, and Slow Food Denver. Let’s start with the guidelines. School and educational based gardens provide spaces for experimental hands on education. This also allows for incorporating the full cycle of learning associated with healthy food; from growing, to nutrition, and then to cooking. The school gardening program would be designed to involve teachers and certain primary curriculums in subjects such as economics, social studies, and science. This in turn would create respect for diversity and also promote self-growth. The primary purpose would always be education. Having the school and the garden be a cohesive program that would be included in the day-to-day culture of school would promote sustainability with the administration, neighborhood volunteers, and parents who are all essential to the function of this plan. Stewardship opportunities for the students could be provided through the outdoor classroom by utilizing the grounds of the school site. 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Tuesday, May 12, 2020

Tuesdays With Morrie Words Of Wisdom - 1334 Words

Tuesdays with Morrie: â€Å"Words of Wisdom† â€Å"The value of life lies not in the length of days, but in the use we make of them†¦ whether you find satisfaction in life depends not on your tale of years, but on your will† (Michel De Montigne). Morrie would agree with this statement, because Morrie believes that everyone can live a great life no matter how many days they may have left. No one knows the days they exactly have left in their life. In life people should make the best of it and not worry about how much time they may have left to live, they should focus on making things better for themselves and others. They should also impact and do the right thing and be a great example in others lives. Morrie teaches people to love life through accepting death, valuing money less and forgiving others. First, Morrie teaches people to live life through accepting death. Morrie’s opinion on death is that everybody dies at some point in their life; it will come s ome day. Learning to accept it instead of dwelling on it will make life more enjoyable. Dwelling on dying only makes it tougher to focus on the things that matter before it is too late to say goodbye. Death can happen at any point in life, not a single person knows the given time they will pass.. â€Å"Once you learn how to die, you learn how to live† (Albom 84). My belief is that when someone is focusing on life ending for them, they are prone to not enjoy their last days. When someone comes to realization that death will be comingShow MoreRelatedTuesdays With Morrie, By Mitch Albom1638 Words   |  7 Pages Throughout the novel Tuesdays With Morrie, the author, Mitch Albom, reflects on his Tuesday meetings with his old professor, now consumed with a terminal illness, and, using many rhetorical choices, reveals â€Å"The Meaning of Life,† which they discussed profusely and divided into several categories. Topics such as Death, Emotions, Aging, Money, Forgiveness, an d more are all discussed in their weekly conferences, Morrie passing on his wisdom to one of his favorite students. And Albom, writing aboutRead MoreTuesdays With Morrie Film Analysis949 Words   |  4 PagesThe film Tuesdays with Morrie ( TWM) has shaped my understanding of the consequences of change through the main themes of change in perspective, change in relationship power dynamics, Mitch’s increased commitment and the ripple effect that change causes. The representation of mitchs perspective throughout Tuesdays with Morrie, has shifted my understanding of the consequences of change through the importance of various relationships Mitch has developed and the importance of an alternative perspectiveRead MoreWisdom of Realization1746 Words   |  7 Pages15 The wisdom of realization One can say that wisdom can truly be found through a realization in one own life and even through suffering. In Shakespeare’s â€Å"King Lear† and Mitch Albom’s â€Å"Tuesdays with Morrie†, we see that both main characters Morrie Schwartz and King Lear gain wisdom through realizations of certain aspects of life and through their own personal sufferings. Both Morrie and Lear gain wisdom firstly through suffering. Morrie gains wisdom through suffering physicallyRead MoreTuesdays with Morrie Essay1333 Words   |  6 PagesCassandra Stephens December 3, 2012 Psy. 120- Book Review Professor Dr. Priebe Summary: Tuesdays with Morrie, was based on a true story about friendship and lessons learned. It’s about a sports writer, Mitch and former sociology professor, Morrie, who is in his last days of life after being diagnosed with Amyotrophic Lateral Sclerosis (ALS) and their rekindled relationship after many years. They first met on the campus grounds at Brandeis University. This never forgotten relationship wasRead MoreCritical Analysis Of Tuesdays With Morrie999 Words   |  4 PagesTuesdays with Morrie Synthesis and Analysis Tuesdays with Morrie is a memoir written by Mitch Albom that documents his last thesis with his old college sociology professor, Morrie Schwartz. The story captures the compassion and wisdom that Morrie represents, but as he slowly contracts a disease known as ALS, his time is about to run out. It isn’t until 16 years later when Mitch sees his old professor being interviewed on ABC’s Nightline that this begins to change. Mitch was a student to Morrie SchwartzRead MoreThe Meaning Of Life In Tuesdays With Morrie By Mitch Albom1078 Words   |  5 Pagesand has come to terms with his disease and upcoming death. In the story â€Å"Tuesdays with Morrie† by Mitch Albom, the protagonist Morrie Schwartz impacts thousands of lives. Morrie Schwartz, a sociology professor who developed ALS, feels the need to share his words of wisdom on the meaning of life through taking pride in the way he has lived, making use of his experiences, and being optimistic about his upcoming death. Morrie was an inspiration for many as he took pride in the way he lived his lifeRead More Dealing With Death Essay1434 Words   |  6 Pagespicture of life has come into focus. If an individual suddenly becomes aware that their time on earth is coming to a close or is suddenly thrust into a meaningful relationship with someone trying to deal with such a phenomenon, as is the case in Tuesdays With Morrie, a contemporary book written by the popular sports journalist Mitch Albom, serious personal change can occur as a result. In fact, a person is only able to reach such a tangible state of enlightenment and understanding of the world around themRead MoreTuesdays With Morrie Essay1111 Words   |  5 Pagesthings such as important people, mistakes you made, things left undone or words left unsaid guilt, regret etc. The aim of this story Tuesdays With Morrie, by Mitch Albom is to encourage the individual to live a better life why you have time, in order to avoid some of those later things such as guilt and regret. We learn this concept of living through the wisdom of one of Mitch Alboms old teachers, Morrie Schwartz, who is suffering from ALS knowing he doesnt have much time leftRead MoreSummary Of Tuesdays With Morrie By Mitch Albom1305 Words   |  6 PagesFunerals have been a long running tradition in many cultures and societies after a loved one has passed. In the book â€Å"Tuesdays with Morrie†, by Mitch Albom, the main character, Morrie, chose to have a living funeral after receiving the news that he had ALS. Amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, is a nervous system disease that weakens muscles and impacts a lot of physical functions finally proceeding to death. A living funeral is held before the person has passed, soRead MoreFriday s With Morrie By Mitch Albom Essay1701 Words   |  7 PagesTuesday’s with Morrie by Mitch Albom is a wonderful book that focuses on the struggle life and how to lead through them. Morrie, once a lively professor at Brandeis University, now suffers from ALS. This incurable disease begins to suck the ability t o do the things he loves, and soon confines him to the quiet rooms of his house. Mitch, a favorite student of his, comes back upon hearing the news and the two continue to discuss the true meanings of life and how to effectively uphold one’s character

Wednesday, May 6, 2020

Richard Branson †Paper Free Essays

Hence, Brannon has very strong leader-member relations. Second, task structure must be analyzed In a course of four 1. Can a decision be demonstrated as correct? Steps: 2. We will write a custom essay sample on Richard Branson – Paper or any similar topic only for you Order Now Are the requirements of the task understood by everyone? 3. Is there more than one way to accomplish the task? 4. Is there more than one correct solution? Based on the environment that Brannon has created at Virgin, assumptions can be made about situational traits. Brannon makes sure that he acknowledges his employees’ hard work. That means when a decision Is correct, the appropriate staff ill be praised for making the correct decision. Brannon also encourages his management to continue to challenge employees to come up with new creative ideas to attack the present situation. This means not only will employees understand the task requirements, but they will also be encouraged to find alternate ways to accomplish the task as well as alternate solutions. Using the Graph below, when Richard Brannon keeps a situation at moderate control his effectiveness as a leader and fearlessness as a leader Is maximized. If you have a demoralized staff your company will soon disappear† (Management Skills 1: leadership and motivation). Motivation is the process that accounts for an individual’s intensity, direction and persistence of effort toward attaining a goal. Richard Brannon has never lacked self motivation as a result of continuously creating and seeking new challenges to overcome. Brannon transcends his natural self motivation into his unique, hands off management style which emphasizes employee Job happiness and comfortable relationships. Self motivation was never an issue in Abrasion’s career as an entrepreneur and business man. From starting Student magazine at age 16 to creating a dominant rower in the recording industry, Brannon always had a desire to seek out new challenges. This may have rooted from his parents because they did not view his learning troubles as a limitation and encouraged him to find and pursue his venture, Student Magazine, his convictions were the underlying motivator. Brannon wanted people to hear his views and was willing to exude hard work in order to assure this happened. Brannon soon began to feel a sense of enjoyment and purpose–a major theme in all of Abrasion’s motivation techniques– which transitioned his efforts into the music and recording business. Of course, love and passion is not always a the best self motivator if success is never attained. Thus, Abrasion’s second key to self motivation is moving forward, rather than moving back. For example, in the wake of the U. KS recession of the sass’s Brannon had a choice to consolidate or keep growing. In response Brannon bought two night clubs and invested profits back into his music industry in order to create success and limit losses. The third key for Brannon was to always have goals. Once current goals are attained, new goals must be formed. This is demonstrated as Abrasion’s goals were reddened from creating one of the world’s most respected brand to investing in large-scale philanthropic endeavors such as the creation of Virgin Unite. Finally, perhaps the most appropriate rule to Abrasion’s success: â€Å"Screw it. Let’s do it† (Brannon)! When one man owns a record company, a soft drink company, and is pursuing space tourism there self motivation must never be deficient. Abrasion’s self motivation is an extension of how he motivates others. Despite running such an extensive array of companies, he takes on a very â€Å"hands-off,† management style. He says, â€Å"l don’t look at any figures or projections, if he [Patrick Ezekiel] wants to do it that’s fine by me. That’s very much the approach we take, there’s a lot of trust† (Management Skills 1: leadership and motivation). The trust he displays in his management demonstrates that Brannon is a Theory Y manager. Theory Y managers assume employees can view work as being natural behavior and are committed to the objective. They tend to be less controlling and have a more hands-off approach. As a result, Brannon believes that his management can do their Jobs to the best of their ability without his constant supervision. In addition, Brannon has a knack for surrounding himself with a very capable staff and creating a work environment in which they thrive. † Although Brannon is â€Å"hands-off,† he does create a particular environment that is very affective in motivating his employees. He does this by participating in lots of direct personal communication with his employees. Even though he is a corporate leader, he displays compassion for all employees in the Virgin family and pushes them to become leaders themselves. An example of this is Abrasion’s involvement in public relations. Whether its extreme stunts or press leases, Brannon sets aside 25% of his time for public relations. He explains, â€Å"If your staff works enormously hard to create something they are proud of, it’s foolish if you don’t let the world know about it. This social involvement gives his employees the impression that Brannon greatly appreciates his employees’ success and hard work. Certainly an employee will be more motivated to work extremely hard for Brannon and Virgin, if Brannon is doing the same for that employee. Analyzing Abrasion’s motivational techniques more closely, Mascots Needs Pyramid comes to mind. Brannon looks past physical needs and safet y needs, or at least assumes these will be taken care of. Instead, Brannon focuses his efforts most on social and esteem needs. For example, Virgin attempts to fulfill employees’ social needs by holding a party employees, whether they are security guards or executives. This not only gives employees a chance to associate socially outside of a work environment, but also links employees regardless of social status. He also targets esteem needs. According to Richard Brannon, â€Å"Junior people are as important as senior employees. Staff should e praised, not criticized they know when they have done something wrong† (Management Skills 1: leadership and motivation). How to cite Richard Branson – Paper, Papers

Saturday, May 2, 2020

Mutual Gain Approach to Bargaining

Question: Discuss about theMutual Gain Approach to Bargaining. Answer: Introduction: Companies have their own terms and conditions, at times, which may be dissatisfying to the employees thereby consequently affecting their performances. An effective tool, which allows the employer and the employees to settle dispute, is the method of collective bargaining using the technique of mutual gain approach. So collective bargaining is collective approach of negotiation in between the employees represented by the trade union to which the employees belong and the employer of the respective firm, so briefly collective bargaining is the outcome of negotiation(Carrell Heavrin, 2013). Mutual approach being collaborative is 'Win-Win' approach, where the both the parties should have a shared understanding of the complexity and the scope of the project. It involves a five step principles: Identify interest, consider all options, Develop criteria, understand your alternatives, and Build relationships . Saturn partnership is a separate wholly owned subsidiary corporation of general motors. It offers an excellent example of mutual gains approach to workplace conflict. It incorporates the tactics of mixed bargaining along with integrative problem solving, one such conflict occurred in the year 1991. In Saturn organization the union leaders give substantive expertise and an independent view to a problem, they increase the value by incrementing the quality of decision making in several joint committees to strategic action plan, where union leaders speak up directly to confront their problems. In Saturn organizations there are many instances of conflicts and their resolutions through partnership, here the problems are clear cut, bilateral and labor versus management conflicts. Two undoubted form oforganizations governance system is its traditional form of labor management conflict resolution and problem solving against the traditional decision making. Therefore,this is what makes the Sat urn unique for its incredible and nevertheless strategic method of conflict resolution (Cornette, 2016). Now, the BC ministry of social services and housing which is renowned for confronted approach to resolve labor related issues. In the year 1994, an effective measure to utilize tax payer monies in a better manner, the BC government agreed for a partnership which resulted in mutual gain approach in workplace problem resolution. They employed a five-step problem solving strategy for both the parties to examine the current relation issues and create schemes to foster changes. Both participants had a lot more in common than they originally imagined. It actually was a strategy to resolve issues from win loose to cooperative decision making for the problem solution. Considering the Canadian case of the Northern Telecom and communication, the mutual bargaining process was deployed by the company in order to prevent the closure of the plant and through this process, the company was able to pass the resolution and avoid the plant closure. The mutual bargaining approach employed the use of the negotiation process. The BC ministry of social services and the Saturn organization also followed the mutual approach to bargaining to resolve the matter as against the traditional decision making. Reference: Carrell, M. R., Heavrin, C. (2013). Labor relations and collective bargaining. Cornette, G. (2016). Saturn: Re-engineering the.Teamwork in the Automobile Industry: Radical Change or Passing Fashion?, 85. Rubin, J. Z., Brown, B. R. (2013).The social psychology of bargaining and negotiation. Elsevier.

Monday, March 23, 2020

Dead Man’s Cell Phone Essay Example

Dead Man’s Cell Phone Essay Name: Course: Instructor: Date: We will write a custom essay sample on Dead Man’s Cell Phone specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Dead Man’s Cell Phone specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Dead Man’s Cell Phone specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Dead Man’s Cell Phone What does the â€Å"Cell Phone† represent to each character? Why is it the â€Å"Cell Phone† important to the play? How does it help us understand the themes of the play? Be specific. Use examples from the play to support your answer. Essentially the cell phone is used as an illustration of the changing generation and the transition into a digital age. The actors illustrate the impact of technology and more so the effects of the use of the mobile in the lives of people and more in society. In addition, the cell phone is used variedly to illustrate different meanings to the characters. The moral theme of the story behind the ownership of the cell phone is the importance and secretive lives led by people in society by the mere use of the cell phone. The importance of the cell phone in the life of the dead man could be termed as astronomical in terms of the operations that he maintains using his cell phone. He manages to operate an illegal trade, manage and maintain a mistress as well as cater for his family using the mobile phone. The use of the cell phone is used to illustrate the effects of technology on a personal level. This is illustrated by the increased social interactions by the owner of the cafe after acquisition of the mobile phone. This includes the interactions with the dead man’s mother, mistress, his illegal trade in body parts and his role as a husband. Thus, the cell phone could be termed as the lifeline of majority of people such as the dead man, to whom the cell phone was a lifeline for his interactions with the mistress as well as the lifeline in terms of his illegal operations as seller of illegal body parts. Jean’s role is affected by the presence of the mobile phone. This is an illustration that the mobile phone can affect people’s lives in a positive or negative manner. Jean’s life is interrupted and affected by the mobile phone given that she can engage in other social interactions with the various callers of the mobile phone. These include meeting the dead man’s widow Hermia, his mother Mrs. Gottlieb, and his mistress. Jean is left with a predicament of solving the problems left behind by the dead man. Does the play still have meaning? Why? Be Specific? Use examples from the play to support your answer. The play is highly relevant in that it provides an illustration of the problems the mark social interactions despite the efficiency provided by the use of electronic media. Additionally, the use of the mobile phone illustrates despite the ease in the method of communication society or people are unable to communicate with effectiveness due to barriers of effective interactions brought about by reduced social interactions because of busy schedules and engaging careers. The story also highlights the sincerity of people in their respective social interactions. The sincerity of communication among people is one of the highlights of the use of the cell phone. It is evident that people use cell phones as a means of masking their identities given that mobile phones limit physical communication people. In addition, the mobile phone is one of the most noteworthy technological gadgets of the modern society. It is an express illustration that the mobile phone is one of the most influential gadgets in society. It also illustrates the essence of physical social interactions and preferably communication. This is a means of ensuring sincerity in social interactions. After the demise of the owner of the cell phone, it interferes with the cafe business and slows down the business operations in the cafe. This is because the owner is nagged in talks with a variety of callers in the play. Hence, it is an illustration that the cell phone is highly engaging and an impediment in the execution of business as well as fruitful social interactions.

Friday, March 6, 2020

The Ku Klux Klan- A Brief History

The Ku Klux Klan- A Brief History The Ku Klux Klan is perhaps the most famous of all hate groups in America. Originally founded at the end of the Civil War, the Ku Klux Klan was a white supremacist group that used violence and intimidation in order to reassert white domination in the United States. The Klan's attacks were directed at Blacks, Jews, Catholics, immigrants and other minority groups. It has long been notorious for its unmistakable symbols of the KKK , the white robes and hoods, horses coverd in white clothes and the burning of large crosses at the klan's gatherings.In 1865, following the War between the States former Confederate General Nathan Bedford Forrest founded the original Ku Klux Klan along with five other confederate soldiers just out of uniform, in Pulaski, Tennessee. He named the group "Kuklos Klan," a mixture of Greek and Scottish meaning "family circle." The soldiers had full of ideas for their new society now that the civil war had ended.Cartoon from 1868 ("'Tis but a change of banners -...T he organization was originally social in nature, however it soon turned sinister.The different branches of the KKK, all held a common goal: to maintain the supremacy of the white race over Black Americans. White supremacy was an ideology which held that the white race was superior to all other races. It was for this reason that only WASP's White Anglo-Saxon Protestants, could belong to the Ku Klax Klan.While membership in the Klan has risen and fallen during its 130 year history, the scope of its hatred has expanded. The American Supremacist movement had four fundamental principalsThe hatred of Blacks and other minoritiesThe hatred of people with disabilities/hereditary conditionsThe hatred of JewsThe hatred of homosexualsBranches of the group sprang up across the South, and many white Southerners, frustrated over Federal Reconstruction policies, used...

Tuesday, February 18, 2020

Immunolocalization of the microtubule cytoskeleton Essay

Immunolocalization of the microtubule cytoskeleton - Essay Example The most prominent methods are: Western blot, spectrophotometry, enzyme assay, immunoprecipitation and immunostaining. In immunostaining, the method used during this procedure, an antibody is used to detect a specific protein epitope. These antibodies can be monoclonal or polyclonal. Then enzymes such as horseradish peroxidase or alkaline phosphatase are commonly used to catalyse reactions that give a coloured or chemiluminescent product. Fluorescent molecules can be visualised using fluoresence microscopy. During this experiment, the distribution of the protein tubulin in normal rat kidney (NRK) cells is explored. A monoclonal antibody that is specific for the -subunit of tubulin is used. Tubulin polymerizes into long, 25-nm wide microtubules that we will visualize with tubulin antibodies. The formation and maintenance of microtubules is cold sensitive. At 4C, microtubules are destabilized and they depolymerize. At 37C, human body temperature, they remain polymerized. Photograph 1 shows cells incubated at 4 0C, while photograph 2 shows cells incubated at 37 0C. At this stage of the procedure, microtubules cannot be detected in either of the photographs. 3 separate plates are used to create the NRK cells culture. ... The coverslip is then immersed in 3.7% formaldehyde (in PBS) at room temperature. Immersion in 0.2% Triton-X 100 (in PBS) detergent at room temperature follows. To prevent the subsequent antibody from sticking non-specifically to the cells on the coverslip, the coverslips should be incubated with cell-side-up with a 100-l droplet of 3% (w/v) bovine serum albumin (BSA). The incubation is done on a piece of Parafilm in a humid Petri dish for 15 minutes. An anti-tubulin dilution is prepared with 1 part antibody + 75 parts 1% (w/v) BSA in PBS. A 200 l total of antibody is necessary for the three coverslips. This tubulin antibody is a monoclonal antibody (12G10) and recognizes the -subunit of tubulin. Then each coverslip is overlayed each with a 100-l droplet of the diluted tubulin antibody. After that, a secondary antibody with 1 + 200 in 1% (w/v) BSA in PBS is used. The coverslips are placed back into the Petri dish chamber and overlay with a 100-l droplet of secondary antibody and they are incubate for 30 minutes at 37C. Therefore, we have 3 coverslips, all treated with the secondary antibody, 2 of them are treated with the primary antibody (one of them is incubated at 37C, and the other incubated at 4C) and 1 that is not treated with the primary antibody (incubated at 37C). The coverslips then are placed back into the Petri dish chamber and are overlaid for 30 minutes at 37C with a100-l droplet of Vectastain ABC reagent. This reagent contains a complex of avidin and the enzyme horseradish peroxidase (HRP). They are washed again with PBS. The drops of DAB (diaminobenzidine; a carcinogenic compound) are applied to the coverslips and incubate at room temperature for 5 minutes. After DAB incubation,

Tuesday, February 4, 2020

Cultural Competency in Health Promotion Essay Example | Topics and Well Written Essays - 750 words

Cultural Competency in Health Promotion - Essay Example In this way, communication during health care is limited because the patient has no obligation to communicate his/her feelings. Lack of health education in our culture has led to poor medical care hence the inadequacy in the knowledge about the health services being offered. Some cultural groups have a poor decision leader who must be available for a decision to be arrived at. To overcome the above problems, there must be a development of culturally competent practices that involve self analysis and change of attitude in various cultures. Health care providers should expand their knowledge and not only focus on culture differences while striving to understand the cultural dynamics affecting medical practice and healthcare in general. They should learn about cultures they sever through, they ought to know patients assessment techniques, readings and community activities. Medical practitioners should improve on the cross-cultural communication by being aware of the difference in social norms and knowledge of different languages and lifestyles. The use of assessing health literacy, interpreters and the bilingual patient education materials in educating the community on health matters (Spector, 2009) can play an important role especially from the training period of the medics. Involvement of the community in health matters through health fairs, ethnic festival participation and constant communication with cultural decision makers. These leaders help in providing cultural competent care by strengthening communication ties. It is important for nursing practitioners to work towards cultural competency through provision of culturally competent patient care. Nurses should therefore, be sensitive and open-minded to avoid being compromised by the cultural differences in perception of illness. While communication skills should be used in the best interest of the patient, limits must be set to ensure that the patient does not manipulate the treatment required. Nurses can de velop cultural competency by understanding individual and organizational views of different cultures. Acquisition of background knowledge about a patient on the cultural views can help in decision making. Having collective communication skills will then enable one to get the real meaning of words even if the patient is from a different culture. There should be strong ties between the nurse and the community. However, nurses must be aware of national and professional priorities for caring of cross culturally populations. Responses from 3 families from different cultures The three families interviewed were from middle-class status of life. The families interviewed were an African family, a Latino family, and a white American family. The interviews were contacted at the community hospital. It was to understand their take on cultural differences in medication and modern treatment. Health maintenance The African family did not have better ways to maintain their health compared to other f amilies. They only look for health services when they are sick. It was the responsibility of the family to take the sick person to the hospital when other alternatives have failed. Latinos families have an average medical attention towards maintaining their health. They rely very much on health centers for the services. The white American fa

Sunday, January 26, 2020

Cadbury Competitor Analysis

Cadbury Competitor Analysis INTRODUCTION: Cadbury Dairy Milk is a brand of drain chocolate right now fabricated by Cadbury, aside from in the United States where it is made by MondelÄâ€Å"z International. It was presented in the United Kingdom in 1905 and now comprises of various items. Each item in the Dairy Milk line is made with solely drain chocolate. It is offering around the world. The slogan is Free the Joy. Dairy Milk is 23 percent cocoa solids. A number of the more up to date Dairy Milk assortments are presently fabricated in France. Dairy Milk itself is likewise made in France and these items are sold in the UK. In June 1905 in England, Cadbury made its first Dairy Milk bar, with a higher extent of drain than past chocolate bars, and it turned into the organizations smash hit item by 1914.George Cadbury Junior, in charge of the advancement of the bar, has said A wide range of names were proposed: Highland Milk, Jersey and Dairy Maid. Be that as it may, when a clients little girl recommended Dairy Milk, the name stuck. Fruit and Nut was presented as a major aspect of the Dairy Milk line in 1928, soon took after by Whole Nut in 1933. By this point, Cadburys was the brand pioneer in the United Kingdom. In 1928, Cadburys presented the glass and a half trademark to go with the Dairy Milk bar, to promote the bars higher drain content. Cadbury has constantly attempted to keep a solid relationship with drain, with trademarks, for example, a glass and a half of full cream drain in each half pound and promotions that element a glass of drain spilling out and framing the bar. In 2004, Cadbury began a progression of TV promotions in the United Kingdom and Ireland highlighting a human and a creature (speaking to the humans bliss) debating whether to eat one of a scope of included bars. CADBURY COMPANY RESOURCES: Worldwide sustenance producer Kraft Foods burned through $207.3 million on Cadburys New Zealand operations as a major aspect of its  £11.9 billion takeover of the chocolate creator in 2010, money related explanations appear. The Cadbury resources commanded income for Krafts New Zealand holding organization, Kraft Foods Investments (NZ), which detailed a benefit of $3.5 million in logbook year 2011, the primary outcome for the amalgamated element. Income of $316.6 million thinks about to Cadburys 2010 offers of $274.1 million. New Zealand deals a year ago made up around 1.4% of Krafts $US15.82 billion income in creating markets, which incorporates the Asia Pacific district. Kraft says expanded territorial deals originated from higher estimating over the locale, the Cadbury procurement and more good trade rates. The money thought esteemed Cadburys goodwill at $43.8 million, as indicated by the monetary explanations. Krafts New Zealand unit had $87.6 million in share capital as at December 31. The New Zealand unit spent a further $1.1 million on the Cadbury rebuilding activity to lay off around 145 staff and present mechanized assembling frameworks. The move was reported in August 2008 and is required to be finished for the current year. Rebuilding has fetched Kraft and Cadbury an aggregate $25.3 million in the course of recent years, as per their announcements. The worldwide business referred to the Cadbury takeover as an explanation behind expanded income no matter how you look at it in its 2010 and 2011 money related years, and it supported first-quarter deals 4.1% to $US13.1 billion in the initial three months of this current year. A month ago, Kraft quit its New York Stock Exchange posting for the Nasdaq in an offer to cut expenses. That comes in front of its arranged demerger, where it will turn out and independently list its North American basic supply business, which will keep the Kraft name, while the worldwide nibble nourishments business will work under Mondelez International. Krafts shares rose 0.8% to $US39.21 in exchanging New York on Monday, esteeming the organization at $US69.52 billion. CADBURY TANGILE RESOURCES:- COMPTITORS OF CADBURY:the main competitors of Cadbury are mars and Nestle, Hershey. MARS: Mars is a conspicuous name, however as a privately owned business, it hasnt been one financial specialist can get behind. In 2014, Mars had a piece of the pie of 29.5% in the United States for the chocolate showcase. Some of its best-known brands are MMs, Snickers, Starburst, Twix and Skittles. Mars was the seventh-biggest privately owned business in America in 2014, with offers of $33 billion. The organization contends in six sections: chocolate, pet care, nourishment, Wrigleys (gum), drinks and symbioscience. Alongside contending with Mars for the chocolate piece of the overall industry, Cadbury now goes up against the monster for partake in the worldwide gum showcase on account of Mars procurement of Wrigleys in 2008. Mars $23 billion procurement gave it control of brands, for example, Extra, Orbit and Eclipse, which delivered offers of $5.4 billion preceding the deal. Cadbury has gum marks that incorporate Dentyne, Stride and Trident. Both organizations have solid piece of the overall industry in a gum market that has seen deals decrease. https://www.google.co.nz/search?q=mars+chocolate+companyespv=2site=webhpsource=lnmstbm=ischsa=Xsqi=2ved=0ahUKEwjxzpaJ7OvSAhWCwbwKHRRRBHUQ_AUIBigBbiw=1366bih=662#imgrc=x3_VqJg0MLa7VM: Nestle: Nestle is the biggest nourishment organization on the planet, covering various subsectors of the market. The organizations chocolate market is one of its littlest, however it was adequate for a 5.8% piece of the pie in the U.S. Settle has developed through numerous acquisitions that have given it control of brands that incorporate Kit Kat, Smartys and Gerber infant nourishment. Settles sweet shop fragment was its 6th biggest in 2014. With offers of $9.7 billion comprehensively, Nestle held the number three piece of the pie position. Offers of the organizations chocolate items totalled $7 billion, including $4 billion from the Americas. Like its arrangement with Cadbury, Hersheys additionally licenses a few brands from Nestle for U.S. conveyance rights. This incorporates Kit Kat and Rollo, two Nestle brands. HOW CADBURY MADE IN FACTORY: two primary items are Cadbury Dairy Milk chocolate and Cadbury Old Gold dim chocolate. The exceptional taste and surface of Cadbury chocolate depends on long conventions of skill in chocolate formula and preparing techniques remarkable to Cadbury. Methods are enhancing constantly and new innovation empowers the procedure to be very tuned to buyers advancing tastes and inclinations. Chocolate generation is an exceptionally advanced, PC controlled process, with a significant part of the new pro hardware being delivered to our own plan and particular. https://www.cadbury.com.au/about-chocolate/chocolate-making.aspx CADBURY MAIN PLANT: well Dunedlin industrial facility is the biggest chocolate producing plant in New Zealand. It supplies completed items for the local markets in New Zealand and Australia and, also, sends out chocolate morsel to Cadbury completing plants in Australia, Pakistan and China. For instance of the potential in developing markets, Cadbury Schweppes piece of the pie for chocolate in the Indian market has expanded from 18% in 2002 to more than 75% in 2006. Despite the fact that these business sectors speak to just a little piece of the entire gathering deals (around 20%) they have been distinguished as having the best potential. Dunedin in New Zealand was picked by Cadbury in light of its phenomenal framework and an abundant supply of rich drain for chocolate creation. Chocolate morsel is an item that is sought after internationally as the utilization of chocolate per capita overall increments to record levels. https://www.google.co.nz/webhp?sourceid=chrome-instantion=1espv=2ie=UTF-8#q=what+machines+do+cadbury+use+in+nz* INTENGIBLE RESOURCEES:- CULTURE OF CADBURY: Corporate culture of the association is the thing that the firm says its way of life is, for instance its statement of purpose; while hierarchical culture is what is truly occurring in the firm, and the way things are really done. The idea of authoritative culture is presently more broadly acknowledged that it was in the eighties when the majority of the writing characterizing society and examining how it creates were developed. It is to a great degree hard to build an exhaustive meaning of hierarchical culture, in spite of the fact that Hatch (2006) characterized it as a lifestyle in an association, it can be considered as the magic that binds an association through a sharing of examples of significance. The way of life concentrates on the qualities, convictions and desires that individuals from the association come to share (Siehl and Martin 1984). Distinctive definitions may point at various parts of the association however they share a couple of things in like manner, for example, the conduct of individuals in the association and what they share as aftereffect of working in the association. The idea of hierarchical culture can be broke down utilizing an assortment of models. In this paper, Edgar Scheins hierarchical culture model is utilized to direct a social examination of Cadbury and Lewins administration change model will be utilized to break down the social change after Krafts takeover. Our discoveries depend on different research strategies including books, inquire about papers, online articles and recordings, perceptions and conversing with individuals at the firm. Cadbury is a British-based driving worldwide ice cream parlor organization. It has been a privately-run company since John Cadbury made it in 1824 until Kraft an American nourishment goliath, assumed control in 2010. The Cadbury familys Quaker convictions are what roused the offering of tea, espresso and cocoa as contrasting options to liquor. Cadbury have long and soli d social values that were started from the authors Quaker convictions of advancing human uniformities and judges. Along these lines, it is fascinating to study how that unique qualities have stood the trial of time. Examination OF CADBURY S CULTURE Edgar Scheins model of authoritative culture is a standout amongst the most compelling hypotheses of hierarchical culture, which started in the eighties. As indicated by Scheins model, hierarchical culture comprises of three particular levels which are the essential presumptions, qualities and convictions and antiques. CADBURY REPUTATION IN MARKET:-their notoriety with slips this way, on top of the 2009 family piece estimate decrease, which they somewhat threw in the towel from in 2013 after a shopper kickback, or the as of late reported Crà ¨me Egg formula change. Expelling Dairy Milk drain chocolate from the Crà ¨me Egg formula is another case of individuals having something taken off them, said Wilcox. The main champ will be Whittakers. Whittakers have supplanted Cadbury as the quintessential Kiwi mark. Each time Cadbury lurches, Whittakers win. Whittakers as of late confronted a similar choice and chose to build the cost of their chocolate pieces as opposed to decrease the size. Their believe Whittakers have settled on preferred choices over Cadbury for no less than 10 years, said Wilcox. Theyre a decent case of how to do things right. CADBURY SUPPLY CHAIN: key store network systems, and change and modernisation ventures in progress, while underlining the significance of joint effort amongst retailers and providers. Their motivation is to interface providers to stores, securely and proficiently, to meet their client needs, productive, and ready to contend now and later on. Give likewise took the gathering through the Supply Chain Partnership Framework, concentrating on stock accessibility, value-based effectiveness, course to-market choices, and shared stock administration. There was a solid concentrate on security, and Vaughn called attention to extra staff preparing is being given to guarantee representatives go home safe consistently. Talking in the interest of Foodstuffs South Island, Mullins said there had been fruitful exchanging comes about alongside the many difficulties related with a store network in a seismic tremor inclined area. Their -manufactured flexibility has seen us get by through yet another tro ublesome period bringing about an extremely tasteful move upwards in our piece of the pie, Mullins stated, discussing the current Kaikoura shake. In the interim, the co-agent keeps on putting resources into new vital openings, for example, West Melton, Christchurch and Queenstown. The move brought about huge volume and esteem development, which represented a couple of additional difficulties for the security of supply. To diminish item taking care of and improve benefit conveyance, the organization has put intensely in new streamlined frameworks. Transport Management is a centre concentration for them theyre about enhancing transport deceivability and understanding where they provisions are to guarantee we keep on meeting client desires. http://supermarketnews.co.nz/foodstuffs-takes-stock-of-its-supply-chain/ ORGNIZATIONAL STRUCTURE OF CADBURY:-Cadbury Organization depends on an equitable. Administration style choices are made therefore of a discussion procedure including different individuals from the association (Cadbury). Cadbury Schweppes likewise have two distinct structures. The structure that they use for their directorate has been re-intended to illuminate responsibility and empower swifter expression making. (Quote taken from www.cadburyschweppes.com). Taking a gander at the enhanced association structure it is clear to see who is responsible for which divisions inside the business. (123Helpme, 2012) Taking a gander at Cadburys it is clear to see that the organization, after some time, has conveyed the measure of: Workforce it representatives and supplanted them with more proficient machines. Outsourcing zones of the organization like upkeep and statistical surveying. Representatives are presently multi-talented, along these lines ready to work in more than one region of the busi ness. The organization has expanded its generation and gainfulness or the rebuilding. The Cadbury production lines all work autonomously and the organization as an opening is decentralized as every manufacturing plant utilizes the assets (E.g. drain) of the nation they are in. (123Helpme, 2011) CADBURY HUMAN RESOURCE: Human Resource Management (HRM) has been through a considerable measure of changes the extent that administration of individuals is concerned. Individuals or representatives are frequently seen in three ways: cost, asset, and resource. Additionally, associations these days understand that workers are likewise a determinant variable to the execution of the association. Alongside the many changes in the business condition: new innovation, work enactment, monetary subsidence, society; Strategic changes: more prominent client centres, diminished levels of administration, reception of TQM and group working; customary HRM has likewise advanced. The need of an incorporated and sound way to deal with overseeing individuals brought forth Strategic Human Resource Management (SHRM). MARKET STRETEGY OF CADBURY: Competitive analysis in the Marketing strategy of Cadbury The confectionaries business is much focused and is packed by nearby and national players. While Cadburys parent organization Modeless International is the world pioneer in Bars and chocolates for middle age wage amass, different players like Nestle, Ferrero Rocher , Perfett, Amul , Kraft nourishments and soon have item classifications and client aggregates in which they are represented considerable authority in. Because of high R D and change in organoleptic of drain, changing way of life of Asian markets, dietary patterns and so forth this industry will watch high development energy in the coming yearsMarket analysis in the Marketing technique of Cadbury Confectionaries business is continually developing and because of the changing utilization of drain and daily items, there is more and greater open door that is lying ahead in this industry. The market is administered by few organizations, for example, Cadbury, settle, Mars, Heinz, Perfecta van and so forth. Cadbury has a wide item portfolio in the chocolate fragment like dairy drain, Bourneville, Cadbury crunch, Éclairs and so forth because of which they can lead the market in this section however their other item classes like scones and cakes are enduring because of the restricted item portfolio. customer analysis in the Marketing methodology of Cadbury Customers of Cadbury are from all portions and individuals from all age bunch devour chocolates, scones and refreshments however it is the developing centre salary gather and also the youths who shape the real purchaser fragment. CADBURY NEW PRODUTS: Cadbury Dairy Milk has launches new tablet mixture, which is set to offer purchasers another, energizing various taste understanding. Cadbury Dairy Milk Medley consolidates obvious incorporations with a delicate chocolate focus, wrapped in Cadbury Dairy Milk chocolate. It will be accessible in two 93g tablets the first with dim chocolate chips, scone and fudge pieces; and the second with dull chocolate chips, caramelized hazelnuts and raspberry with a suggested retail cost of  £1.49. It is likewise accessible in  £1 cost checked packs. The new nibble will plan to support incremental development in little tablets, Cadbury stated, especially among ladies matured in the vicinity of 25 and 44 who are searching for something uncommon for a night treat. http://www.foodbev.com/news/cadbury-dairy-milk-launches-new-medley-bar-as-evening-treat/ Moreover Cadbury as launched three new, colossal Dairy Milk bars loaded down with favour new flavours. Energizing chocolate news section one the flavours are Oreo Crunch, Toffee Whole Nut and Triple Choc Sensation. Energizing chocolate news sections two the bars are an incredible 300g each. Only for correlation, their exemplary Dairy Milk is 45g, while the greater bars are generally 200g. The bars are called Cadbury Dairy Milk Big Taste since, well, theyre huge. CADBURY PERFORMANCE IN MARKET: Cad bury Schweppes, the worlds biggest sweet organization, today revealed a 1% ascend in 2004 benefits, supported by a solid execution in key markets including the US. The organization, whose items incorporate Dairy Milk chocolate, Trident gum and Dr Pepper drinks, made fundamental per-charge benefits of  £933m, generally in accordance with experts conjectures of among st  £927m and  £953m. Cad bury said its basic 2004 deals had ascended by 4%, with working net revenues expanding by 0.5%. 2004 was a decent year for Cadbury Schweppes, with brilliant advance in key markets, especially the US, the CEO, Todd Sitter, said. We effectively fabricated deals energy in drinks and candy parlour while incorporating Adams [the sweet shop business procured by Cadburys in 2002] and executing real cost diminishment programs. Cadbury said its US fizzy beverages business had appreciated an effective year, on account of solid interest for beverages, for example, Dr Pepper and eating routine brands, despite the fact that it cautioned that maintaining these exceptional development rates would challenge. The gathering announced that 2004 had not been a simple year for its European beverages business, however said it was starting to see the consequence of changes including an enhanced inventory network. While the outer business condition stays focused, we are sure that we have the system, brands and individuals to convey inside our objective ranges in 2005, Mr Stitzer said. Cadbury partakes in which have ascended on theory that it could draw in a takeover offer said it expected to stay as an autonomous organization. As they have trust they can develop as an autonomous organization, and that is the goal of their self and the board. https://www.theguardian.com/business/2005/feb/23/cadburyschweppesbusiness PART TWO:- POTER FIVE FORCES (LEVEL OF COMPITITIN) Five Forces model of Porter is a system apparatus that is utilized to make an examination of the engaging quality of an industry structure. The Competitive Forces examination is made by the recognizable proof of 5 key aggressive strengths: INDUSTRY RIVERLY :- Numerous organizations are going up against Cadbury and wanting to assume control over the matchless quality the organization has for quite a while. A few contenders are persistently building up their items and advancing thoughts to make contending considerably harder. Organizations, for example, Nestle, Hersheys, Ferrero and so on are Cadburys fundamental adversaries since they are additionally since a long time ago settled confectionary brands and like Cadbury are growing new scopes of items new advancements. Competition will dependably be solid among these organizations since they offer from similar sorts of stores and there items are comparable in a few regards. ENTRY OF COMPITITORS:- The section of contenders will be troublesome on the grounds that there are as of now entrenched organizations inside this market these incorporate, damages, settle, Ferrero, Kraft, Hersheys and Lindt. These organizations overwhelm the confectionary advertise with their own specific sorts of chocolates. This makes the boundary for section hard for another new organization to begin Cadburys rivals have the ability to pull in and impact the clients by more alluring substitute, costs and advertising strategies. THREAT OF SUBSITITUTE:- The primary danger of substitutes which Cadburys and whatever other confectionary brand is the grocery store possess brands this is on the grounds that they watch out for copycat well known chocolates for instance settle Kit Kat and give their own particular image on the racks at a less expensive cost. Besides, the main deterrent that may influence the creation of Cadbury is to locate a decent area and accumulate the prerequisites for the smooth passage and the remote arrangement that may influence its operation. BARGNING POWER OF BUYERS:- For Cadburys they have a substantial purchasing force being one of the biggest confectionary makers on the planet, however this might be undermined because of the June 2006 review of chocolate bars which contained salmonella this has been said to influence Cadburys and ought to lose some of their purchasing power. However Cadburys purchasers are scattered all around the globe and they are in billions. The cost subjectivity of the items is not a question for the general population but rather the expanding number of contenders that offers a similar sort of items at a lower cost may be the reason for client steadfastness adjustment. Hence Cadbury must be exceptionally precautious in choosing about costs and keep the clients fulfilled. BARGNING POWER OF SUPPLEIRS:- Cadbury prides itself on making and keeping up positive associations with its providers everywhere throughout the world. It has an extensive buying power and the providers of farming wares offer an item that is a long way from extraordinary and henceforth Cadbury has higher haggling power than its providers as the business depends intensely on a complex agro business store network. In spite of the fact that there is a current rivalry, crude materials like nuts, drain, cocoa or exceptional fixings are sufficiently adequate to fulfill Cadburys generation. Cadburys have the primary control over its providers since they are so vast organizations providing them require their business so Cadburys can utilize economies of scale and purchase there crude materials for less expensive and more in mass than a medium measured business could. https://www.google.co.nz/search?q=what+is+industry+rivalry+in+cadburyespv=2site=webhpsource=lnmssa=Xved=0ahUKEwjirNiy4uvSAhXKJpQKHYlzBCgQ_AUIBygAbiw=1366bih=662dpr=1 IMPACT OF TECHNOLOGY:- Technology elements that will influence the brand are the web as the item will be advanced utilizing web promoting. The automated assembling will likewise help in speedy creation. Economic components that will influence it are intrigue and expansion rates as it will influence generation, world financial development and current subsidence will likewise impact it. There will be likewise some natural components that will influence like vitality and condition and reusing of the plastic and different items like chocolate can be stuffed in totally recyclable bundle. Legal/Educational variables will likewise impact like view of individuals and what individuals consider the wealthier drain chocolates. ENVIORNMENTAL IMPACT: Cadbury has declared a 17-percent decrease in water utilization since 2006 by expanding its effectiveness underway, recuperation, collecting and reusing water. The organization detailed that by 2008 it met its objective of executing water diminishment programs at 100 percent of water rare locales as a component of its Purple Goes Green activity, propelled in 2007. Other key focuses under Cadburys natural activity incorporate a 50 percent lessening in its outright carbon outflows, a 10% decrease in standard item bundling, and a 25 percent focus for regular and blessing bundling. http://economics-on-cadbury.blogspot.co.nz/2013/10/economics-analysis-of-cadbury.html CONCLUSION: Cadbury has had much market control in the candy parlor industry everywhere throughout the world. Cadbury understands their prosperity depends fundamentally on the estimation of the Cadbury mark while depending on its phenomenal notoriety for their item quality and enhances, available, and reasonable cost. In the current monetary state, they are as yet confronting and need to deal with the issue of the shortage of cocoa and the cost increments in cocoa. Plus, they have to contend with other chocolate marks the same number of firms has entered uninhibitedly in the market. To remain a noteworthy player in the ice cream parlor industry, they should be compelling in the present market by presenting all the more new items and respond to the choices inside the market. REFERENCES: https://www.google.co.nz/search?q=mars+chocolate+companyespv=2site=webhpsource=lnmstbm=ischsa=Xsqi=2ved=0ahUKEwjxzpaJ7OvSAhWCwbwKHRRRBHUQ_AUIBigBbiw=1366bih=662#imgrc=x3_VqJg0MLa7VM: https://www.cadbury.com.au/about-chocolate/chocolate-making.aspx https://www.google.co.nz/webhp?sourceid=chrome-instantion=1espv=2ie=UTF-8#q=what+machines+do+cadbury+use+in+nz* http://supermarketnews.co.nz/foodstuffs-takes-stock-of-its-supply-chain/ https://www.google.co.nz/search?q=what+is+industry+rivalry+in+cadburyespv=2site=webhpsource=lnmssa=Xved=0ahUKEwjirNiy4uvSAhXKJpQKHYlzBCgQ_AUIBygAbiw=1366bih=662dpr=1 http://economics-on-cadbury.blogspot.co.nz/2013/10/economics-analysis-of-cadbury.html

Saturday, January 18, 2020

You Might Want to Do Some Introspection

You might want to do some introspection. For each of the eight intelligences in the Howard Gardner list, think about your own level of talents and performance. For each intelligence, decide if you have an area of expertise that makes substantial use of the intelligence. For example, perhaps you are good at music. If so, is music the basis of your vocation? Students can also do this type of introspection, and it can become a routine component of PBL lessons.Students can come to understand that they are more naturally gifted in some areas than in others, but that they have some talent in all of the eight areas identified by Howard Gardner. Curriculum and instruction can be developed to help all students make progress in enhancing their talents in each of these eight areas of intelligence. Robert Sternberg Many teachers have provided testimonial evidence that PBL encourages participation on the part of their students who do not have a high level of â€Å"school smarts. They report that some of their students who were not doing well in school have become actively engaged and experienced a high level of success in working on projects. These observations are consistent with and supportive of the research of Robert Sternberg. As noted earlier in this chapter, different researchers have identified different components of intelligence. Sternberg (1988, 1997) focuses on just three main components: Practical intelligence–the ability to do well in informal and formal educational settings; adapting to and shaping one's environment; street smarts.Experiential intelligence–the ability to deal with novel situations; the ability to effectively automate ways of dealing with novel situations so they are easily handled in the future; the ability to think in novel ways. Componential intelligence–the ability to process information effectively. This includes metacognitive, executive, performance, and knowledge-acquisition components that help to steer cognitive processes. Sternberg provides examples of people who are quite talented in one of these areas but not so talented in the other two.In that sense, his approach to the field of intelligence is somewhat like Howard Gardner's. However, you can see that Sternberg does not focus on specific components of intelligence that are aligned with various academic disciplines. He is far more concerned with helping people develop components of intelligence that will help them to perform well in whatever they chose to do. Sternberg strongly believes that intelligence can be increased by study and practice. Quite a bit of his research focuses on such endeavors. Some of Sternberg's work focuses specifically on â€Å"street smarts† versus â€Å"school smarts. He notes that some people are particularly talented in one of these two areas, and not in the other. This observation is consistent with the work of Lev Vygotsky (Fosnot, 1996) who argues that the type of learning that goes on outside of s chool is distinctly different than the type of learning that goes on in school. While some students are talented in both informal and formal education, others are much more successful in one rather than the other. A teacher who is skillful in developing PBL can help students to design projects that are consistent with their learning abilities and interests.David Perkins In his 1992 book, Smart Schools, David Perkins analyzes a number of different educational theories and approaches to education. His analysis is strongly supportive of Gardner's theory of multiple intelligences. Perkins' book contains extensive research-based evidence that education can be considerably improved by more explicit and appropriate teaching for transfer, focusing on higher-order cognitive skills, and the use of project-based learning. Perkins (1995) examines a large number of research studies both on the measurement of IQ and of programs of study designed to increase IQ.He presents detailed arguments that IQ has three major components or dimensions. Neural intelligence. This refers to the efficiency and precision of one's neurological system. Experiential intelligence. This refers to one's accumulated knowledge and experience in different areas. It can be thought of as the accumulation of all of one's expertises. Reflective intelligence. This refers to one's broad-based strategies for attacking problems, for learning, and for approaching intellectually challenging tasks. It includes attitudes that support persistence, systemization, and imagination.It includes self-monitoring and self-management. There is substantial evidence to support the belief that a child's neural intelligence can be adversely affected by the mother's use of drugs such as alcohol and cocaine during pregnancy. Lead (such as from lead-based paint) can do severe neural damage to a person. Vitamins, or the lack thereof, can affect neural intelligence. Moreover, there is general agreement that neural intelligence has a â€Å"use it or lose it† characteristic. It is clear that neural intelligence can be maintained and, indeed, increased, by use.

Friday, January 10, 2020

Dementia: Alzheimer’s Disease and Social Care Diploma

Unit DEM 301 Understand the process and experience of dementia This unit provides you with the knowledge on the neurology of dementia including the causes, difficulties and needs of the person with dementia. This will help to support your understanding of how people may experience dementia. With the development of improved health care and healthier lifestyles, people are living longer. With an increase in an ageing population come age-related conditions such as dementia. Age is not the only cause of dementia as you will discover within this unit. In this unit you will learn about: the neurology of dementia he impact of recognition and diagnosis of dementia how dementia care must be underpinned by a personcentred approach. 1 Level 3 Health & Social Care Diploma 1. Understand the neurology of dementia 1. 1 Causes of dementia The word ‘dementia’ is a term which describes a serious deterioration in mental functions, such as memory, language, orientation and judgement. How ever, the causes are still not yet fully understood. Research in this area is ongoing and to date a number of types of dementia and their causes have been identified. The brain is a complex organ and is divided up into different areas that control different functions within the ody. The brain contains around 100 billion cells. In dementia some of these cells stop working properly. The part of the brain that this occurs in will affect how that person thinks, remembers and communicates. Senile dementia is a term that refers to dementia in people aged over 65. It is not uncommon for people under the age of 65 to develop dementia. This is known as early onset dementia. Cerebral cortex Ventricles Healthy brain Hippocampus Cortical shrinkage Moderately enlarged ventricles Mild Alzheimer’s disease Dementia is a major health condition which affects over 820,000 people in the UK. Worldwide, more than 35 illion people are estimated to have dementia, with 4. 6 million new cases being di agnosed every year. Shrinking hippocampus Severe cortical shrinkage Severely enlarged ventricles Types and causes of dementia Alzheimer’s disease Many people ask if dementia and Alzheimer’s disease are the same thing. The short answer is no. Alzheimer’s disease is the most common cause of dementia. It is responsible for approximately two-thirds of dementia in older people. Dementia is a contentious topic, with many proponents wishing to enable rights and choices of individuals with dementia Alzheimer’s is caused by nerve cells dying in certain areas of the brain. In addition to this, the connections between affected nerve cells deteriorate. As he disease progresses, it spreads and affects cells in other parts of the brain. The cause of the brain cells dying and the deterioration of the connectors is not fully known. 2 Severe Alzheimer’s disease Severe shrinkage of hippocampus Brain affected by dementia and unaffected brain. Vascular dementia Vascul ar dementia is a form of dementia caused by damage to the brain through deprivation of oxygenated blood. Oxygenated blood is carried around your body and brain through arteries. Deoxygenated blood is carried through your body in veins. It is these arteries and veins that make up part of your vascular system.When an organ in your body is deprived of blood, that organ (or part of it) will die. This is what happens to the brain in vascular dementia. The conditions which can cause these problems are preventable and include high blood pressure, heart problems, diabetes and high cholesterol. When supporting people into leading a healthy lifestyle, it is important to bear this condition in mind, in the hopes of preventing the onset of vascular dementia. Understand dementia Rarer forms of dementia Creutzfeldt-Jakob disease (CJD) CJD is a form of dementia caused by prion disease. Prions are proteins which are found in mammals.When these proteins cluster together in the brain, they cause brai n cells to die. When these cells die they leave holes in the brain called spongiosis. Examining the brain under a microscope reveals the cells to appear spongelike. This damage to the brain causes neurological difficulties and dementia. There are four forms of CJD: †¢ †¢ †¢ †¢ sporadic familial iatrogenic variant. Although each of these conditions is very rare, their prognosis is extremely poor. The affected person’s life expectancy is radically reduced, with death occurring usually within 6 to 24 months from early diagnosis. The isease can take many years from the time it infects a person to it causing recognisable symptoms. The cause of Sporadic CJD is unknown and its onset is very fast. It affects people over the age of 50 and can cause death within a matter of months. Familial CJD is an inherited form of the disease. Its symptoms usually affect the person at an early age from 20 to 60 years. Death occurs between two and ten years of symptoms beginning. Iatrogenic CJD occurs as a result of contaminated blood or tissue entering the healthy person’s body. This can take place with corneal transplants, grafts or the use of growth hormones.To prevent the risk of contamination, transplants are no longer taken from people known to have the disease and growth hormones are now developed artificially. Because prions cannot be destroyed using normal sterilisation procedures, any surgical instruments used on people with CJD are not used on other patients. The last form of CJD is known as Variant CJD. This form affects people at a younger age with the average age of death being 29 years. The average time the person is affected by this disease is 14 months. Variant CJD is caused by bovine spongiform encephalopathy (BSE) – a form of prion disease which affects cattle.The person contracts this disease by eating infected beef products. Unit DEM 301 To reduce the risk greatly of infected beef products reaching the market, manufacturer s now remove the animal’s brain and spinal cord from general sale. Functional skills Maths: Recording data This information can be used to record data in a chart and shows the use of working out averages for statistical purposes. Biswanger’s disease This is a form of vascular dementia in which damage occurs to the blood vessels in the deep white matter of the brain. It affects people over the age of 60 and is often as a result of long-term hypertension or high lood pressure. Dementia and learning disabilities Some people with learning disabilities are at risk of developing dementia in adult life. People with Down’s syndrome are at risk of developing Alzheimer’s disease. The risk of Alzheimer’s increases as the person gets older. It is estimated that over half of the people with Down’s syndrome will develop Alzheimer’s disease when they are in their 60s. Fronto-temporal dementia Fronto-temporal dementia is a rare form of dementia. It t ends to affect younger people and is more common within men. The condition is caused by damage to the frontal lobe and/or the temporal parts of the brain.These areas are responsible for the person’s behaviour, emotional responses and language skills. The condition includes those known as Pick’s disease, Frontal Lobe Degeneration and dementia associated with motor neurone disease. Dementia with Lewy Bodies (DLB) Lewy Bodies are tiny protein deposits which are found inside the nerve cells of the brain. These deposits alter the way the brain functions and can be found in people with either dementia or Parkinson’s disease. Approximately four per cent of the older population who have dementia are affected by DLB. This form of dementia has characteristics of both Alzheimer’s andParkinson’s disease. 3 Level 3 Health & Social Care Diploma 1. 2 Types of memory impairment commonly experienced with dementia Within humans, the term ‘memory’ refers to information stored in the brain. Apart from storage, it also includes the retention or keeping and recalling of that information. A person’s brain is extremely complex and can store, retain and recall many, many pieces of information for many, many years. The ease with which the person can remember information will vary depending on the subject, the person and their state of mind. If the information is unusual or interesting, they ay remember this more so than information which is uninteresting or mundane. Memory loss can be defined in different ways depending on the situation it is being used for and the type of memory which is lost. Memory loss can be the inability to retrieve information from the long-term memory. This type of memory loss usually happens when the person is distracted or is not fully concentrating when the memory is formed. Another form of memory loss is when new memories are stored within the brain replacing older memories. Think of your brain as a fil ing cabinet; there is only so much information you can store n it at any one time. To make room for new information, you will need to take out or discard some old information. This type of memory loss is normal and is experienced by everyone. Memory loss can also be described as the fading away of memories. This sort of memory loss can occur with telephone numbers, facts or people’s names if you have not used them for a while. Think back to when you were at school. You would have known the names of many of the students and teachers. Can you recall all of the students’ and teachers’ names now? You may barely remember what their faces looked like and you may be truggling to remember everyone’s names. This could be because you have not had any reason to remember this information. It is not something you have had to use on a regular basis. Memory loss due to the ageing process can be defined as being the shrinking of the hippocampus, which is responsible for the storage of long-term memories. The hippocampus is usually the first part of the brain which suffers damage, leading to Alzheimer’s disease. Hippocampus Location of the hippocampus. Case study Recognising normal memory loss Christine is 43 years old and is concerned about her memory. She is a very busy lady with a stressful job.Christine is walking down the corridor at work heading to yet another meeting. She is going over in her mind what she needs to raise in the meeting and checking through her diary to see what time she needs to leave to get into town for her third meeting of the day. Carol, one of Christine’s colleagues, bumps into her and tells her that Mark has telephoned and would like to see Christine later today at 3. 15pm in the staff canteen. Christine says, ‘OK,’ and carries on to her meeting. 4 At 3. 30pm Christine is sat at her desk writing up the minutes from a meeting last week when the telephone rings.It is Mark; he is in the staff can teen waiting for Christine and he is not very happy. He asks if she had received his message. This jogs her memory and she realises she should be in the staff canteen. She apologises and tells him she is on her way. 1. Explain in detail why you think Christine forgot about meeting Mark. 2. Why is it that Christine is able to remember what was discussed in a meeting a week ago, yet cannot remember what she was told earlier that day? Understand dementia Functional skills English: Writing; Reading In this unit there are a number of examples of case studies. These studies have all been laid out using a uitable format and attention has been paid to ensure that spelling, punctuation and grammar are accurate. You will need to use these skills when writing case studies in your place of work. You will need to read and understand both straightforward and complex texts, and use the information in an appropriate way. Within psychology, memory loss is usually defined as the inability to retrieve declarative memories from the long-term memory. An example of this could be amnesia. The person experiencing amnesia may not be able to remember facts or declarative memories, but they retain their procedural memory which is responsible or remembering skills such as riding a bicycle, reading or talking. People with dementia may experience short-term memory loss. Their ability to store, retain and recall information may be affected due to the damage of the cells within their brain. Short-term memory loss Short-term memory can differ from one person to another. Research has been carried out on this by asking subjects to remember numbers. A list of numbers is read out at approximately one per second. The subject is then asked to recall these numbers and on average it has shown that a person can remember seven consecutive numbers.A person with dementia may have difficulties remembering things that happened only a short while ago. However, the same person may be able to remember things that happened many years ago. Other memory difficulties could include: †¢ †¢ †¢ †¢ †¢ †¢ a difficulty in recognising people or remembering their names the inability to find the right words for things or objects repeating conversations that they have already had asking the same question in a short space of time forgetting appointments or recent events misplacing items, forgetting where they have put things or where they are usually kept †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢Unit DEM 301 the inability to recall what they have had to eat or even forgetting they had eaten the loss of skills such as self-care, washing, dressing, putting clothes on in the wrong order, shopping and cooking the inability to judge time, thinking it is time to get up when it is the middle of the night forgetting where they live becoming unaware of their surroundings forgetting to take medication, possibly thinking they have already taken i t forgetting their disabilities such as getting up to walk even though they are not able, which results in their falling an inability to have empathy which could make the erson appear selfish personality changes – if previously extrovert, they could become introverted and vice versa the loss of social etiquette including making thoughtless comments, being rude or exhibiting sexual behaviours in public. Initially people experiencing these memory losses may feel frustrated or angry with themselves. They are angry because they know that they have forgotten, and frustrated because they are unable to remember as they used to. Activity 1 Memory impairments Think about the people you support. What types of memory difficulties do they experience and how do you know about this? Functional skillsEnglish: Speaking and listening Have a discussion with colleagues about the types of memory difficulties that people you are working with have. Ensure you take an active part in the discussion and that you show effective listening skills. It is important to keep in mind that no two people’s memories will be affected by dementia in the same way. The inappropriateness of their behaviours is caused by a physical change to the brain and therefore the person has no control over it. 5 Level 3 Health & Social Care Diploma 1. 3 How individuals process information with reference to the abilities and limitations of ndividuals with dementia The workings of the brain are very complex. As stated previously, the human brain is made up of around 100 billion cells. In the main these cells are called neurons. It may be easier to think of these neurons as switches which are either switched on or switched off. If the neuron is switched off it is resting; when it is switched on it fires electrical impulses along its body known as the axon. At the end of this axon there is a small part which releases a chemical. The chemical travels over a gap known as the synapse where it turns on ano ther neuron. These chemicals are known as eurotransmitters. There are 60 identified chemicals involved in the brain’s activity. The following are some important neurotransmitters relating to the process of memory and associated functions. Dopamine The chemical dopamine is critical for controlling your body’s movements. If you do not have enough dopamine, you will not be able to move or control your movements very well. Dopamine also controls the flow of information from other areas of the brain, especially memory, attention and problem-solving tasks. Serotonin The chemical serotonin is the neurotransmitter enhanced by many antidepressants, such as Prozac, nd has become known as the ‘feel-good’ neurotransmitter. It has a profound effect on mood, anxiety and aggression. Acetylcholine (ACh) ACh controls activity in the areas of the brain that are connected with attention, learning and memory. People with Alzheimer’s tend to have low levels of ACh in th eir brain. Glutamate Glutamate is vital for making the links between neurons that are the centre of learning and long-term memory. Reading about these chemicals and what they do can help towards explaining how the person with dementia, 6 who has damage to these neurons, has difficulty with their memory.Because the neurons are damaged or destroyed, they are not able to produce or transmit important chemicals which are required for the person to function fully. Nerve cell Synapse Axon Dendrite The amount of electricity the human brain produces when each of its neurons is firing is equivalent to a 60-watt light bulb. Left-sided and right-sided brain The collection of 100 billion cells or neurons in the brain is divided into two halves, known as hemispheres. The right side of the brain is responsible for putting information together – for example, information received from eyes. If you see a lady the information goes from our eyes to the right side of your brain, firing neurons, putting the information together so you are able to say, ‘I can see a lady. ’ The left side of the brain analyses information which is collected by the right side of the brain. It enables you to expand on what you see so you are able to say, ‘I know who that lady is, it’s my sister Michelle. ’ People with dementia who have damage to the neurons on the right side of the brain will have difficulty putting information together. They will be able to ‘see’ things, items or people, but will not be able to make the connection of what those things, items or people are.People who have damage to the neurons on the left side of the brain tend to be affected by depression. They will have more organisational problems and will have problems using language. Understand dementia 1. 4 How other factors can cause changes in an individual’s condition that may not be attributable to dementia Experiencing a loss or reduction in memory does not always i ndicate a form of dementia. There are other health conditions which could affect somebody’s level of memory. These are often referred to as reversible dementias. The part of the brain that has become damaged will determine how the person will be affected.Unit DEM 301 Drug and alcohol induced memory loss The effects of drug misuse including excess alcohol can cause damage to the neurons in the brain, resulting in neurological difficulties including memory disruptions. Myalgic Encephalomyelitis (ME) Conditions affecting memory ME, otherwise known as Chronic Fatigue Syndrome (CFS) or Post-Viral Fatigue Syndrome (PVFS) is a chronic, disabling neurological disorder. It is characterised by persistent fatigue and muscle pain. Symptoms can include cognitive problems such as loss of memory and concentration, recurrent sore throat and enlarged neck glands, disturbed sleep patterns and ersistent headaches. Brain injury Medication Injuries to the brain can be caused by external trauma su ch as a blow to the head, or internal factors such as a result of a stroke or aneurism. The level of brain injury can be anything from mild to severe. This can result in both short-term and long-term or permanent difficulties. Some prescription medications can have side effects which can affect somebody’s memory. Brain tumour A tumour of the brain can be benign (slow-growing, non-cancerous) or malignant (invasive, often growing rapidly and cancerous). sensation hearing movement speech, movement and sensory functions Parietal obe Frontal lobe Occipital lobe Temporal lobe Cerebellum hearing and vision Brain stem Parts of the brain and their primary functions. Diet Some foods can have an effect on a person’s memory. It is believed foods such as those containing vitamin C and sugars can have an effect on memory. Encephalitis Encephalitis is an inflammation of the brain, usually occurring as a result of viral infection. Huntington’s disease Huntington’s diseas e is a hereditary, neurodegenerative disorder of the central nervous system. It can cause emotional, intellectual and movement problems. The course of Huntington’s is characterised by involuntary ovement of the limbs, trunk and face, progressive loss of mental abilities, and the development of psychiatric problems. Huntington’s disease usually appears in middle age (30–50 years) but can develop in younger and older people. Hydrocephalus Hydrocephalus is usually associated with Spina Bifida and is caused by a build-up of cerebro-spinal fluid (CSF) in the brain. This condition can also be caused by infections such as meningitis, premature birth, head injury or stroke. Hydrocephalus can lead to problems with concentration, short-term memory, organisation and coordination. Lack of sleep/insomniaPeople who have difficulty sleeping may experience various health problems including memory difficulties. 7 Level 3 Health & Social Care Diploma Lyme disease Lyme disease is an infectious disease caused by the bacterium Borrelia Burgdorferi. The disease is transmitted to humans through the bite of an infected tick. If left untreated, Lyme disease may affect a person’s memory. Multiple sclerosis (MS) MS occurs as the result of damage to myelin – the protective sheath surrounding nerve fibres of the central nervous system. This damage interferes with messages between the brain and other parts of the body.Parkinson’s disease This is a progressive neurological condition, which can affect the person’s ability in talking, walking, swallowing, writing and memory. Stress Stress is the emotional and physical strain caused by your response to pressure from the outside world. Stress can affect your health in many ways, including memory difficulties. Stroke A stroke occurs because of a disruption to the blood supply to a particular area of the brain, causing damage to that area of the brain. 1. 5 Why the abilities and needs of an individ ual with dementia may fluctuate Each person may experience dementia in different ways.There is no definitive direction or path that the condition will follow and there are no exact timescales in which the condition may progress. You have examined how the person’s condition will deteriorate over time, but during that time it can also fluctuate or come and go. Fluctuation of needs and abilities It is not fully known why somebody with dementia can have ‘good days’ and ‘bad days’. Part of the answer for this could be because we all have good and bad days. This very much depends on how we are feeling, how much sleep we have had, what activity we are doing and how much we want to do that activity. 8When you are having a bad day, everything you do seems to go wrong. Could this be simply because you are feeling so negative? Can your attitude have an effect on the outcome? Think about this for a while. If you do not like doing something, it seems to take fore ver to get it over and done with. The time drags and your level of boredom or uninterest rises. On the other hand, when you are doing something you enjoy, the time rushes by so that before you know it the activity comes to an end. This theory could also relate to the person with dementia. If the person is doing something that is familiar to them, something that they have done many imes and have developed a routine for, the person may appear very confident and able to do it with ease. They may appear to show no signs of dementia. However, take the person out of their familiar surroundings and out of their routine, and their confusion will grow, causing their symptoms to be more obvious. Stress has been identified to have an effect on our memory. In the early stages of dementia, the person may be fully aware that they have forgotten where they have put things. This can cause their stress levels to rise, resulting in added memory difficulties, frustration and confusion.In these earlier stages it is important for you as a care worker to give the person emotional support. Do not be tempted to take over what they are having difficulty with. Help them to calm down and think about what they are doing. The more the person becomes agitated, the greater their difficulties will become. As the condition progresses, the more support the person will require. This will include support with day-to-day activities. You can give support through reminding the person what they need to do. Do not overload them as this will increase their stress and therefore their symptoms. If the person asks you a question and epeats it several times within a short space of time, answer it as though it is the first time you have heard the question. Do not show your frustrations as this will only cause them to become upset when they see how their behaviour is affecting you. In the later stages, the person will become emotionally and physically frail. Their reliance on care will increase to the point where they are no longer able to care for themselves. They may lose their ability to eat, walk or speak, with only the occasional word being shouted or crying out. Understand dementia Unit DEM 301 2. Understand the impact of recognition and diagnosis f dementia 2. 1 The impact of early diagnosis and follow-up to diagnosis For most people, receiving the diagnosis of dementia is very distressing. It is also very upsetting for their family. Many people today still think of dementia as being a condition which causes people to go ‘mad’. It is these negative images that can add unnecessary distress to both the person and their family. funeral through the drawing up of a will. They can be encouraged and supported to sort out any bills and arrange for future bills to be paid for by direct debit so that important bills are not overlooked. The person may ind comfort in keeping busy during the initial stages and they may feel reassured that their future has been planned to meet t heir needs. If you are supporting somebody who is exhibiting any signs or symptoms of forgetfulness, confusion or the inability to find the right words when communicating, it is important that they see their GP. Diagnosis can be difficult to make in the early stages as the symptoms of dementia can develop slowly. They can also be similar to symptoms of other health conditions. The GP or health professional will be able to monitor any pattern of symptoms and undertake tests over a period of time o measure any changes in the person’s mental ability. A brain scan can help with diagnosis; this could be a CT scan or MRI. If a diagnosis is made, the person may be referred to a specialist for further treatment. Early diagnosis The early diagnosis of dementia is essential in order to: †¢ †¢ †¢ rule out other conditions that may be treatable access advice, information and support allow the person with dementia and their family to plan and make arrangements for the futur e. Receiving an early diagnosis of dementia can help the person and their family to plan and prepare for the future. Although there is no cure at present, there are arious medications available which can help improve symptoms and, for some, slow down the progression of the disease. Early diagnosis can help the person to identify and access sources of advice and support for their condition. The early education of the person and their family can help them to develop a better understanding of what the future may hold. The person will have time to put their finances in order and to make wishes for their Discussing the future with the person can help with understanding and accepting. Following diagnosis, the person may want to live as independently as they can for as long as they can.They may not appreciate someone taking over their life in these early stages where they are still able to care for themselves. To enable the person to remain as independent as possible, it may be an idea to encourage them to contact social services, if they have not already done so, to find out what support they could be entitled to. In order to aid their memory the person could place a list of important telephone numbers by their phone. This way they will always know where a telephone number is if they need it. Labels could be placed on cupboard doors to remind them of the contents. Notes could be placed n doors as a reminder to lock them. Lists could be put on a noticeboard of things to do and days to do them on, such as putting the rubbish out for the refuse collectors. 9 Level 3 Health & Social Care Diploma The most important thing to support the person with is in continuing to enjoy their life. Support them to continue with their hobbies or interests. One good activity which will help them in the future is the development of a life history book. Encourage and support them to collect together photographs of people who are important to them, events which hold important memories such as the birth of their first randchild, their wedding day or family holidays. Encourage the person to label each photograph clearly in the book so that they can look back at it at any time and be reminded of good memories. Early diagnosis can enable the early introduction of specialist services. The services may include: †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ family GPs – referring the person for further tests, reviewing medication district nurses health visitors community psychiatric nurses consultants memory clinics neurologists geriatricians neuropsychiatrists physiotherapists dieticians clinical psychologists speech and language therapists.In the very early stages of dementia the person may have days or episodes of forgetfulness which could be put down to the person being off-colour or having an off day. These episodes may be masked by their ability to recall past events easily. They may be able to give a re ason as to why they cannot remember what you have just said to them. They may say that the television was too loud and they did not hear you. They may even be adamant that you had not told them anything, giving rise to you questioning your own memory. The person may have difficulty understanding or following new ideas or regimes. To cover these ifficulties they may say that they preferred the old way, as it is not as confusing. They could hide occurrences of misplacing items, making out that someone has moved the item or someone has taken it. All of these events, happenings and reasons could be very genuine and indeed the person themselves may believe in what they are saying to be true. If they were all true, the person would be a very unlucky person to be experiencing all of these negative events. The likelihood of them all occurring to the same person in a short space of time would be rather remote. Recording all of these occurrences would enable you nd the team to build up a pict ure of the person’s mental and physical health. Recording times that they In many cases, the earlier the diagnosis and follow-up, the sooner the person can start regaining their life again. This is not to say that they will receive a cure – at this moment in time the only option open to people is acceptance and treatment in slowing down the progress of the condition. 2. 2 Recording possible signs or symptoms of dementia in line with agreed ways of working The health and well-being of a person should be monitored on a regular basis to ensure any resulting needs can be actioned without delay.When monitoring somebody’s condition, it is important to record any findings in line with your organisation’s policies and procedures. 10 Misplacing items can be one of the first symptoms of dementia. Understand dementia needed reminding to do something or became confused or disorientated would enable you to look back and identify frequencies to ascertain if their memor y is deteriorating. Involving the family When supporting somebody with dementia, it may be of immense benefit to involve the family. Encourage and support the family to keep a diary of the person’s symptoms. As a care worker, you may not see the erson as much as their family do and therefore they can help to give you a better picture of the person and their needs. The diary that the family compiles could help them and you to identify changes in the person that may be otherwise missed. The diary could also aid in monitoring any current interventions and the resulting benefits to the person. Unit DEM 301 Suggested monitoring and recording The person’s GP or neurologist may benefit from the information recorded in altering any medications or treatment the person receives. The following areas are those which it is important to monitor and record in the erson, as these will show what changes have occurred and over what period: †¢ †¢ †¢ †¢ †¢ †¢ †¢ memory behaviour personality ability to cope with daily living skills care-giving strategies – have they worked? activities the person enjoys any medications they have taken that day (including prescriptions, over-the-counter and herbal remedies) with details of medication name, dosage, and when and how many taken daily. Case study Identifying dementia Geoffrey had been living in sheltered housing for a number of years following a stroke. His confidence in his own abilities since the stroke had been very low and he as often heard mumbling to himself. Geoffrey is visited every morning by the warden Leona to check that he is OK. Geoffrey always met Leona on his doorstep as he put out his empty milk bottle. One morning Geoffrey was not on his doorstep as usual, which concerned Leona. She rang his doorbell and waited. Geoffrey came to the door and greeted her with his usual smile. ‘Are you all right Geoff, you haven’t put out your empties? ’ she asked . Geoffrey nodded, scratched his head and replied, ‘I’m fine, I haven’t finished the bottle yet as I didn’t drink much yesterday. ’ ‘As long as you are all ight then,’ Leona replied, waving goodbye as she turned and walked away. The following day, once again Geoffrey was not on his doorstep. Leona rang the doorbell again and was greeted by Geoffrey still wearing the same clothes as he had on the previous day. ‘No milk bottles to put out again today? ’ she asked. Geoffrey agreed, saying he had decided to drink more water: ‘I’m cutting down on my cups of tea, getting a bit of a beer belly,’ he joked. Leona was a little concerned but then shrugged it off, believing Geoffrey was always getting his words mixed up, due to his age. As the weeks passed Geoffrey had days when he did ot put out any empty bottles, and then he would put out three or four at a time. Some days Geoffrey looked unwashed or unshaven, whi ch was unlike him. Leona was concerned but on talking to Geoffrey she felt she was worrying about nothing. Geoffrey’s behaviour had been up and down for over 12 months when Leona announced she was changing her job and a new male warden, Patrick, would be taking over. Geoffrey did not take this news very well and he became agitated, blaming Leona for the death of his wife. Leona was very shocked by this, especially as Geoffrey had never been married. She mentioned this to Patrick during her andover and explained she thought something was not quite right but she could not quite put her finger on it. Patrick asked how long had this been going on for and then said he would take care of it. 1. After visiting each resident in the sheltered housing, what actions should Leona have taken? 2. What concerns would you have had regarding Geoffrey? 3. How would records of Leona’s visits to Geoffrey have been of benefit? 4. What actions should Patrick take now, especially regarding G eoffrey? 11 Level 3 Health & Social Care Diploma The diagnosis of dementia does not generally occur following the first visit to the GP.Generally there is a process in which the person goes through in order to receive a definitive diagnosis. During this process it is vital that any potential signs of dementia are reported following your organisation’s policies and procedures, and in line with government guidelines. National Institute for Health and Clinical Excellence (NICE) NICE has devised detailed guidelines in supporting people with dementia. This also includes the early diagnosis of dementia. Within this guide it states that primary health care staff should consider referring people who display any signs of mild cognitive impairment (MCI) for ssessment. MCI is a relatively new term to describe those who show some difficulties with their memory but do not have dementia. Studies have shown that 50 per cent of people with MCI go on to develop dementia later in life. NICE al so includes in its guidelines information regarding the diagnosis and assessment of dementia. It states that diagnosis should only be made following assessment to include: †¢ †¢ †¢ †¢ the person’s history a cognitive and mental state examination a physical examination a review of all medication including over-the-counter remedies. As a care worker, your input in reporting possible signs f dementia would go towards the person’s history. Your input can help them receive the care that they need, when they need it. It is for this reason that you should ensure timely reporting of any observations you make or concerns you may have. To report a concern, you must follow your organisation’s guidelines. If you are unsure of what these guidelines state, you should speak with your line manager as soon as possible to ensure your actions follow best practice for the person. In general terms, most reports are given to a designated member of staff. This may be your line manager, supervisor or manager.Your verbal report should be factual and to the point. Try to avoid giving your own opinions. Although opinions can help to look 12 at and clarify various issues from differing viewpoints, they can also be unhelpful if used inappropriately. Once you have given a verbal report, you should back up what you have discussed with the appropriate person, by writing a written report. Again your written report should be factual and detail all of the actions you have taken. Some reports will have an increased impact if they are delivered in a certain way. For example, you may have been asked to monitor somebody over a set period of ime and report back your findings. Simply writing those findings down may not have the same effect as plotting your findings on a graph. A graph or chart will give a visual representation of your findings, which may give a better explanation as to the person’s mental state and any changes that have occurred. 10 Inc idence of wandering 2. 3 Reporting possible signs of dementia within agreed ways of working 8 6 4 2 0 Week Reporting occurrences such as wandering can have a greater impact if plotted on a graph. Activity 2 Process of reporting Speak with your manager or line supervisor to identify our organisation’s policy and procedures on the process of reporting information. Functional skills English: Speaking and listening This discussion can be either formal or informal and can give you the opportunity to practise taking part in a one-to-one discussion. Understand dementia Reflect Imagine you, or someone you love, had just been given the news that you or they had dementia. Being honest, what would be your initial thoughts or feelings? Do you feel it is OK to feel or think this way? Is there anything you feel that society can do to help with the acceptance or understanding of dementia?Unit DEM 301 2. 4 The possible impact of receiving a diagnosis of dementia on the individual and their f amily and friends Receiving news which you know will have a major impact on your future and those who are close to you can be very frightening and overwhelming. The person may feel very insecure at the time, despite possibly having family and friends around them. The impact on the person and their family and friends can vary; some may see it as a relief that the cause of their difficulties has been diagnosed, while others may be in disbelief, preferring not to acknowledge what they have been told.Many older people fear becoming a burden on their family more than they fear death. 13 Level 3 Health & Social Care Diploma Feelings NICE requirements The person may be shocked on first hearing the diagnosis; this can often turn to denial. One theory on loss or grief shows that the process usually goes through five stages including: NICE guidelines state that following a diagnosis of dementia, health and social care professionals should provide the person and their family with written infor mation regarding: 1. 2. 3. 4. 5. †¢ denial anger bargaining depression acceptance. It is felt that the person may not necessarily go through ach stage in this particular order, and indeed can go backwards and forwards, repeating various stages a number of times before reaching and remaining at acceptance. The person may experience fear or the concern that they will lose control over their lives and their future. They may also fear becoming a burden on their family and friends. Some may feel guilty, blaming themselves, thinking that they could have prevented their condition happening. Whatever feelings the diagnosis creates in the person, you should encourage and support them to talk about their feelings. Some may not feel comfortable voicing heir feelings to their family and friends, preferring to talk with someone they do not know. The person’s family and friends should not be upset by this decision and should respect the wishes of their loved one. Initially the person may simply want to curl up and lock out the world around them. Family and friends need to be supportive in these situations. Telling the person to ‘get a grip’ or that what they are doing is silly is not going to be of any benefit – in fact, it will often make things worse. 14 †¢ †¢ †¢ †¢ †¢ †¢ †¢ the signs and symptoms of dementia the course and prognosis of the condition treatments ocal care and support services support groups sources of financial and legal advice, and advocacy medico-legal issues, including driving local information sources, including libraries and voluntary organisations. Any advice and information given to the person and their family should be recorded in the person’s care notes. The confidentiality of the person should be respected if they decide they do not wish any information to be given to their family. Understand dementia Unit DEM 301 3. Understand how dementia care must be underpinned by a per son-centred approach 3. 1 Person-centred and nonperson-centred approaches to ementia care It is important to remember that people with dementia are individuals first, with their condition of dementia coming second. They may also be mothers, fathers, brothers, sisters, sons or daughters. They may have led a fulfilling life before the condition of dementia took hold of their memories and personality. How could the care of any person be anything other than individual, specific to their needs, involving and respecting their views on how they want their care to be delivered? Person-centred care is a way of providing care with the person at the centre of everything you do. Another way f describing it is individualised care – care that is given to the person according to their needs, wishes, beliefs and preferences. One would hope that gone are the days when everyone in a care home got up at the same time, ate their breakfast at the same time, got washed and dressed at the same time , even going to the toilet at the same time. These regimented routines of care homes were devised for the benefits of the staff, not the people being supported. The day revolved around tasks, duties that had to be met, more often than not putting the people’s specific needs at the end of the priority list.If you needed support, which type of care home would you choose? Earlier on in this unit we looked at how dementia can affect people and identified that no two people would necessarily follow the same process through the condition of dementia. This being the case should automatically exclude all people with dementia being treated in the same way. Studies have shown that a person-centred approach can help reduce agitation in the person with dementia. Agitation is often caused by the person’s frustration in not being able to express themselves. The expression could be one of sadness, pain, thirst, hunger or tiredness.Other studies on a person-centred approach have shown that the person often remains living in their own home for longer. A person-centred approach can also ensure that the person does not endure the degrading, discriminatory and abusive practices which could otherwise occur. People and all those involved in their care should feel safe, feeling that they are a part of what is going on, receive continuity of care, have purposeful goals which they are supported to progress towards and have a feeling that they do matter. How does a person-centred approach benefit the person? As a care worker, you should identify the specific needs f the person with dementia. These needs could arise from their gender, ethnicity, age, religion and personal care. Other needs could also arise from their physical health or physical disability, any sensory impairment, communication difficulties, problems resulting from poor nutrition, poor oral health or learning disabilities. The person’s needs should be identified with input from the person, their fami ly, friends and any other persons that may be important in that person’s life. Once the person’s care needs have been identified, plans should be made to draw up a support plan which will describe how those needs will be met.As with the assessing of needs, the person must be at the centre of the support planning process. Nothing should be planned for them without them. 15 Level 3 Health & Social Care Diploma Case study The importance of a person-centred approach It is approaching lunch time but Mrs Lancaster is not really hungry. She would like a drink and would prefer to remain in her room as she is comfortable and her favourite television programme is about to start. Mrs Lancaster is not able to voice these preferences verbally, as she finds it very difficult to verbalise and so has given up trying. Tracy, one of the senior care workers, entersMrs Lancaster’s room and makes her jump, as Mrs Lancaster did not hear Tracy entering. ‘Come on then love, your dinner’s ready,’ Tracy tells Mrs Lancaster. She then promptly holds Mrs Lancaster under the arm and says, ‘Up you come chum. ’ Mrs Lancaster reels back in pain and cries out. Tracy responds saying, ‘Don’t be silly, now come on, your dinner’s going to get cold,’ again pulling up under Mrs Lancaster’s arm. Mrs Lancaster pulls away, which makes Tracy annoyed. She bends down and puts her face close to Mrs Lancaster’s and says, ‘I’ll leave you here to starve if you carry on like that. ’ Mrs Lancaster cannot take any more bullying or hreats from Tracy so she brings her head back and then sharply forward, head-butting Tracy. ‘You nasty woman, you ought to be locked up doing things like that! What have I ever done to you to deserve treatment like that? ’ Tracy shouts, leaving the room with a bloodied nose. 3. 2 Different techniques to meet the fluctuating abilities and needs of the individua l with dementia people with dementia. Seize the challenge and look forward to the unexpected. As the saying goes, ‘variety is the spice of life’. 1. Explain six things in detail that could have possibly led to Mrs Lancaster head-butting Tracy. 2.What should Tracy have done to prevent this occurrence? 3. Describe a way Mrs Lancaster could be supported to communicate in future. 4. Describe how her care could be given using a person-centred approach. Knowing the person Many people with dementia are able to live in their own homes for most of their lives with care being given to them by their families. It is important that the person is supported to recognise that the condition that they have is not the fault of anyone, especially not their own. When supporting the fluctuating needs and abilities of the person, it is very important that you recognise that hey are not responsible for the things that they do. It is not the person who is spitting out their food; it is the cond ition’s effects on the person’s ability to communicate which is preventing them from saying, ‘I don’t like that. ’ It is not the person who is constantly wandering around the environment; it is the condition that has taken away their spatial awareness. As a support worker, you must focus on the skills and abilities that the person has, rather than those that they have lost. Ensure that you are fully aware of and respect the person’s background, their history, likes and dislikes.Be prepared for changes and adapt a flexible approach. No two days may be the same in supporting 16 By learning about each person’s history and background, you can design the care and support you provide around their specific needs. For example, the person may have been a sergeant major in the army, which could account for his shouting out his orders. The person may have experienced a traumatic event in their lives such as being trapped in a collapsed building, which could account for them becoming agitated and screaming when the lights are switched off in their bedroom at night. Without this background knowledge, nd more importantly understanding, the person who shouts his orders may be wrongly labelled as being noisy and dictatorial. The person who screams in the dark may be wrongly labelled as disruptive and attention-seeking. A person’s physical condition can be affected by their dementia. Their mobility may be reduced as may the person’s ability to maintain their own personal care or diet. Combining these factors can increase the person’s susceptibility to other illnesses such as chest infections or physical conditions such as pressure sores. Understand dementia Ensure the person’s support plan is kept as up to date s possible and shows alternative methods to use for various fluctuations in their support needs. Support other care workers by sharing proven practices. As a support worker, you may have identif ied triggers to somebody’s behaviour. Do not keep this information to yourself; inform other care staff and have it recorded in the person’s support plan. This would be the same for identifying any new method or way of supporting the person to meet their fluctuating needs. Provide a stable environment and suitable surroundings One of the main triggers resulting in somebody with dementia becoming agitated and confused is a change n their routine. Any changes to the person’s life or daily routine can cause them to become unsettled, which could lead to inappropriate behaviours. To ensure stability it is important to: †¢ †¢ †¢ †¢ have consistent, regular staff. Unfamiliar faces can cause the person great upset. Ensure they know the staff and ensure the same staff member provides care to the person in their own home maintain a familiar environment. It is an eventuality in everyone’s life that their surroundings will change at some point. Th is could simply be through redecoration or changes in furniture. Where possible, if decoration needs to be undertaken within the erson’s environment, try to make the new decor similar if not the same as it was previously. If relocation is required for the person, ensure this is minimised by confirming the suitability of the new location. This will save on the person needing to be relocated again due to the environment not being suitable for their needs ensure the person is in a non-stressful, constant and familiar environment establish a regular routine, regular physical activity and adequate exposure to light to improve any sleep disturbances. Specific strategic support People with dementia may behave in a way that is completely out of character.Some of these behaviours can be disturbing to onlookers and especially the person’s family, seeing their loved one behaving in a way they have never seen before. The following are examples of the types of behaviours people wit h dementia may display. Unit DEM 301 Wandering People with dementia may tend to walk or wander apparently aimlessly for a variety of reasons. This could be because they are bored or they feel they need to escape or get out of the environment they are in. The person may simply need to use the bathroom but cannot remember where it is. On occasions this wandering may take them out of the house or even own the street. This could lead them into becoming ‘lost’ if they are unable to find their way back home. For most people, wandering may only be a short phase that they go through. And, although little comfort at the time, people with dementia often retain a good degree of road sense and are seldom involved in traffic accidents. To reduce incidents of wandering, promote physical activities to reduce the person’s boredom and to help use some pent-up energy. What dangers could wandering have for somebody? Incontinence Loss of bowel or bladder control usually occurs as th e dementia progresses. Sometimes these accidents may appen because the person cannot remember where the bathroom is or cannot get there in time. If the person does become incontinent, you need to help them to maintain their dignity and respect by being understanding and reassuring. Incontinence pads, sheaths or catheters can be obtained to help keep the person free from unnecessary embarrassment and frustration. 17 Level 3 Health & Social Care Diploma Agitation Agitation can include behaviours such as sleeplessness, verbal or physical aggression and irritability. These types of behaviour often increase with the stages of dementia and can become quite severe.Agitation may be triggered by a variety of factors including environmental factors, fear and tiredness. Most often agitation is triggered when the person feels as if they are no longer in control of the situation. You can help reduce episodes of agitation by reducing the intake of caffeine, sugar and processed foods. The reductio n of noise or crowds can also help, as does the maintenance of the person’s routines. is a list for further reading which will help your knowledge and understanding further. Doing it well Meeting the needs of people with dementia †¢ Know the person well, including their history and background. Keep their support plan up to date. †¢ Provide a stable environment and suitable surroundings. †¢ Ensure specific strategic support. †¢ Improve your knowledge and understanding. Repetitive speech or actions It is a common occurrence with those who have dementia to repeat a word, statement, question or activity more than once in a short amount of time. This repetition can be frustrating and stressful to the care giver and their family. Repetition is often as a result of the person becoming anxious, bored, fearful or agitated. One way of reducing this is to provide them with reassurance. Alternative strategies could include isplaying reminders of activities around thei r home such as ‘Dinner is at 6:30pm’ or ‘Dave comes home at 5pm. ’ This may assist with reducing anxiety and uncertainty about anticipated events. Paranoia People with dementia may suddenly become suspicious, jealous or start accusing others of things. When this happens, the person will believe in what they are saying and therefore you should not try to argue or disagree with them. Stay calm and encourage the person to calm down. Ask them what is wrong and let them know that you are there to help them. Improve your knowledge and understanding Many organisations have helpful information on nderstanding and supporting people with dementia. Set yourself a goal to develop your practices through research, talking to people who are in the early stages of dementia or family and friends of those who have it. Learning about dementia from those who have firsthand experience is often more beneficial than reading a book, although books have the benefit of being portabl e and accessible at any time. At the end of this unit there 18 3. 3 How myths and stereotypes related to dementia may affect the individual and their carers Dealing with the difficulties that come with the diagnosis of dementia is not going to be made any asier with the myths and stereotypes that society has created. Within society, dementia is often seen as a condition that causes the person to require 24-hour care in a secure environment so they cannot get out and wander aimlessly. People who are newly diagnosed with the condition are sometimes disbelieved because they appear ‘normal’ and are dribbling or babbling. Some myths or falsehoods can create an unrealistic hope within the person or their family. Some of these untruths profess to offer cures or preventions. The following information can help you to identify fact from fiction. Q – Can using aluminium saucepans affect the risk of eveloping Alzheimer’s? A – No, there is no convincing evidence that cooking with aluminium saucepans increases the risk of developing Alzheimer’s. Q – Is it true that people who follow a healthy lifestyle reduce the risk of developing dementia? A – Yes. Research shows that people who enjoy a healthy lifestyle by eating a well-balanced diet, not smoking and taking regular exercise reduce their chances of developing dementia. Recent research has shown that being healthy in mid-life can help lower our risk of developing dementia as we age. Understand dementia Q – Can Ginkgo Biloba help people with dementia? A – No.Unfortunately, the latest evidence shows that Ginkgo Biloba has no benefit for people with dementia. Q – Does eating meat have any connection with developing Alzheimer’s? A – There is no convincing proof that eating meat is linked to developing Alzheimer’s. Q – Do people who have dementia become childlike? A – No; it is very important to remember that people wi th dementia are adults and should be treated with the dignity and respect other adults receive. Many people, quite wrongly, have stereotypes when it comes to dementia. It is these stereotypes that can become the fear of reality for people newly diagnosed ith dementia. Sometimes it is the person’s own stereotyping of dementia that they have to face. Facing and resolving this can only occur with education and acceptance. Unit DEM 301 3. 4 Ways in which individuals and carers can be supported to overcome their fears Research has shown that many people fear the thought of developing a form of dementia. The worry of losing one’s identity, independence and mind for some is a greater fear than the fear of death. Worrying about a condition that you may not develop seems futile. Worrying about a condition which you have developed will not do your health much good.Simply telling somebody who has received a diagnosis of dementia or their family not to worry is insufficient. Advis ing the person and their family to talk about their fears will help towards them overcoming any uncertainties. Ignoring the condition or pretending it is not happening is simply denial. To help all those involved to overcome worries for the future, the person and their family should be supported to learn the truth, what they can expect from the future. Activity 3 Understand the condition What’s in a name? The person and their family should be supported to develop a true understanding of the condition they are acing. Information can be obtained from GPs’ surgeries, health centres, libraries and the Internet. When obtaining information from books or the Internet, you need to ensure it is up to date and reliable. Internet sites run by organisations such as the Alzheimer’s Society or NHS Direct can be seen as reliable sites, as can educational sites such as those ending with . org. Some of the facts relating to dementia do not always make for easy reading; however, the person and family need to know what to expect. Skirting around these issues will not enable the preparation that may be required. This could lead to a bigger shock when it ctually happens, which would not do anybody any favours. Devise a simple questionnaire which you can either send out to colleagues or staff within your organisation, or give to your family and friends. Ask questions such as, ‘Give the first word that comes into your head when you hear the word â€Å"dementia†. ’ Include a few questions that relate to the myths around dementia to see if your colleagues or family know the truth or not. Compile the results from your questionnaire and discuss these with your assessor. People’s inappropriate views or opinions on dementia often arise from ignorance. For many, the only portrayal hey have of dementia is that which they see on television. Storylines shown in films are often of people in the advanced stages of dementia. If this is the only per spective you have, then there is no wonder why society looks at this condition in the way it does. If the individual newly diagnosed with dementia or their family has only ever known of dementia in this way, then their fears will understandably be heightened. Encourage future planning Once the person and their family are aware of how dementia may affect the future, they should be supported to think ahead and be ready for the changes that will follow.The person and their family will need to prepare things not just materially but emotionally as well. At some point the person may require support with toileting and other personal care needs. They may not want their family attending to this sort of personal care, 19 Level 3 Health & Social Care Diploma preferring to have a care worker attend to their needs at home. There may come a point where the person is unable to stay in their own home due to the advancement of their condition. The fear of this eventuality can create a lot of worry f or them. Supporting the person to plan for this can help allay those fears.They and their family could be supported to identify a care home which the person may move into in the future. Simply knowing that this step has been arranged can help them feel a little easier, knowing that they will not be placing a burden on their family. Making life easier The person may have received a diagnosis of dementia because of their current memory difficulties. The family may worry that the person will not be able to cope very well at home, forgetting to take their medication, forgetting to lock doors and windows when going out and so on. These sorts of worries for the family will not necessarily lessen.As each day passes they may worry. As each day passes the person’s condition may increase, making the family worry all the more until it becomes a vicious circle. To help reduce these fears, the person can be supported to remain as independent as possible at home with the use of notes, labe ls, lists – any memory joggers. The environment in which the person lives can be made safer – for example, installing grab rails or an emergency pull cord system. Making these minor changes to the person’s home may reduce the natural worries of the family with regards to their loved one’s safety. Dealing with the diagnosis of dementia is never going to e easy. Some people and their families may benefit from receiving counselling. This can often b