Aab guidelines overview_06a
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Mental Disorders makeup 5 of the 10 leading causes of disability world wide – Anxiety being one of the major shareholders Likely increase approximately 50% by 2020 Most of the conditions respond well to treatment –right approach is vital.More than 90% of the patients turn up in General practitioners’ clinic initially.Socio-economic situation / social taboos resulting in avoidance to seek medical advice.Recent Earthquake disaster in Japan is likely to increase the number by thousands
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Let’s explore how the end-of-life decision occurs?
For Doctors
Bernacki & Block (2014) found in their review and synthesis of best practices that physician attitudes, training, and perceptions of feeling inadequate in managing the emotional and behavioral reactions of patients all play a role. A majority of trainees were not taught how to communicate and they express strong desires to learn more. Physician barriers also include not addressing psychosocial concerns, placing focus on diagnoses, treatments, and procedures during discussions about the medical care at the end-of-life.
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Conclusion
Bernacki & Block (2014) found that there is a large body of evidence demonstrating that early discussions of serious illness care goals are associated with:
♛ beneficial outcomes for patients,
♛ no harmful adverse effects, and
♛ potential cost savings.
Apply & Do
To prevent dying badly start early conversations, enhance your knowledge and establish goals. Dreams are only dreams until you write them down. When you write dreams down then they become goals.
Do ♛ The Conversation Project a collaboration with the Institute for Healthcare Improvement. http://theconversationproject.org/starter-kit/intro/
Do your conversation kit now and make your loved ones aware of your wishes.
Wishing you the very best, Michelle
Bernacki RE, Block SD, for the American College of Physicians High Value Care Task Force. Communication About Serious Illness Care Goals: A Review and Synthesis of Best Practices. JAMA Intern Med. 2014;174(12):1994-2003.
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This document discusses post-stroke psychiatric disorders. It describes five frontosubcortical circuits that are involved in cognition, behavior and movement. Common post-stroke psychiatric conditions include depression, anxiety, apathy, psychosis and pathological laughing/crying. Lesion location can impact the type of psychiatric disorder, such as left anterior lesions increasing risk of depression. Treatment involves pharmacotherapy, such as antidepressants, and psychotherapy. Screening and ongoing monitoring of symptoms is important after a stroke to identify and manage post-stroke psychiatric complications.
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This document discusses the demography and epidemiology of psychiatric disorders in elderly populations. It begins with an introduction to geriatric psychiatry and outlines some key statistics on aging populations globally and in India. Specifically:
- The proportion of those aged 60 and older is projected to increase dramatically in India, from 8% currently to over 20% by 2050.
- Psychiatric morbidity is high in elderly populations, with estimates ranging from 17-43% suffering from mental health problems in various Indian studies.
- Common disorders discussed include dementia, depression, anxiety, bipolar disorder, and others. Dementia prevalence is estimated to be around 3.5 million people currently in India, and this number is expected to rise dramatically with
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Addiction was traditionally viewed as a mental ailment rather than a physical disease. However, recent research has discovered physical changes in the brain of people prone to addiction. This has led the medical community to increasingly view addiction as a physical disease rather than just a mental condition. Treating addiction as a physical disease allows for management through a combination of medication and therapy, similar to other chronic diseases, enabling people with addiction to live productive lives.
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Geriatric Population. Geriatric Palliative and End-of-Life Care.
During your journey through this slide deck Geriatric Population. Geriatric Palliative and End-of-Life Care you will experience what it means to die badly.
After practicing as a Geriatric Clinician for over a decade what I know for sure is: Life is a tremendous gift. 100% of us are going to die. If you don't communicate your end-of-life plan, then you should plan on dying badly.
In The Cost of Dying: End-of-Life Care on CBS 60 minutes Steve Kroft interviews Doctor Ira R. Byock. “Families cannot imagine that there could be anything worse than their loved one dying, but in fact there are things worse, generally it’s having someone you love die badly.” ~Doctor Ira Byock
“Dr. Byock what do you mean dying badly?” ~Mr. Kroft
“Dying suffering, dying connected to machines, denial of death at some point becomes a delusion and we start acting in ways that make no sense whatsoever.” ~Doctor Ira Byock
A majority of Americans say they want to die at home. Why is this not happening?
Place of death should be regarded as an essential goal in end-of-life care.
Let’s explore how the end-of-life decision occurs?
For Doctors
Bernacki & Block (2014) found in their review and synthesis of best practices that physician attitudes, training, and perceptions of feeling inadequate in managing the emotional and behavioral reactions of patients all play a role. A majority of trainees were not taught how to communicate and they express strong desires to learn more. Physician barriers also include not addressing psychosocial concerns, placing focus on diagnoses, treatments, and procedures during discussions about the medical care at the end-of-life.
For Patients
Bernacki & Block (2014) found that patients who do bring up dying concerns with their physicians often meet barriers and often are not aware that they are at the end-of-life. Patients that have not set goals based on meaningful conversations about their desires may overuse life-prolonging treatment and underuse services that support quality of life.
Conclusion
Bernacki & Block (2014) found that there is a large body of evidence demonstrating that early discussions of serious illness care goals are associated with:
♛ beneficial outcomes for patients,
♛ no harmful adverse effects, and
♛ potential cost savings.
Apply & Do
To prevent dying badly start early conversations, enhance your knowledge and establish goals. Dreams are only dreams until you write them down. When you write dreams down then they become goals.
Do ♛ The Conversation Project a collaboration with the Institute for Healthcare Improvement. http://theconversationproject.org/starter-kit/intro/
Do your conversation kit now and make your loved ones aware of your wishes.
Wishing you the very best, Michelle
Bernacki RE, Block SD, for the American College of Physicians High Value Care Task Force. Communication About Serious Illness Care Goals: A Review and Synthesis of Best Practices. JAMA Intern Med. 2014;174(12):1994-2003.
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This document discusses counselling for those with terminal illnesses. It describes terminal illnesses as diseases that cannot be cured and will likely cause death within a few years. Common terminal illnesses include various cancers, heart disease, Alzheimer's, and ALS. The document outlines challenges of end-of-life care in hospitals, where death can be lonely and painful, and staff may experience burnout. It emphasizes the importance of counselling and support groups for terminally ill patients to help them process complex emotions surrounding their diagnosis and death. Counselling goals include informed consent, comfort, meaningful use of remaining time, and a timely, dignified death.
Schizophrenia
Schizophrenia is a severe mental disorder that affects a person's ability to think clearly, distinguish reality from fantasy, and interact socially. It is a long-term illness that requires extensive treatment and rehabilitation. The document discusses what schizophrenia is, how widespread it is, its symptoms, why rehabilitation is needed, and treatment aspects like biological, psychological and social support. It notes schizophrenia cannot be cured but can be managed through proper long-term treatment involving medicines, therapy and social support. Non-compliance with treatment is a major challenge and can lead to worsening of symptoms.
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This document discusses depression in the elderly population. It finds that around 5% of community-dwelling elderly have major depression, while that number rises to 12-30% in institutional settings. Late-life depression is defined as major depressive disorder in adults aged 60 or older. Depression in the elderly often presents atypically with somatic complaints rather than mood changes. The document outlines risk factors, screening tools, differential diagnoses, treatment considerations, and types of depression seen in elderly patients.
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Depression is common in many neurological and medical conditions. It can influence outcomes and prognosis. Treatment requires consideration of issues specific to each condition such as effects on symptoms, cognition, rehabilitation, and mortality. While evidence is limited, antidepressants may benefit conditions like stroke, Parkinson's disease, and multiple sclerosis when used carefully. Future research needs to further evaluate treatments and their impact on overall physical health and quality of life outcomes.
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This document discusses mental illness and chronic mental illness. It defines mental health as a state of well-being where individuals can realize their potential and cope with stress. Chronic mental illness is defined based on diagnosis of conditions like schizophrenia or bipolar disorder for over 5 years with mild to severe social or occupational disability. Common chronic disorders include schizophrenia, addiction, personality disorders and mood disorders. The document outlines statistics on the prevalence of these conditions worldwide and barriers to treatment like stigma and lack of services. It states that people with chronic impairments may need long-term care facilities to support independent living. Ways to help include educating oneself, seeking help if needed, and promoting awareness and acceptance of mental illness.
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This document summarizes a presentation on mental health issues related to MDR-TB treatment. The presentation covers common psychiatric disturbances seen in MDR-TB patients, including borderline disorders like depression and psychotic disorders. Specific anti-TB medications like isoniazid, cycloserine, and fluoroquinolones are linked to psychiatric side effects. Psychological and social stress factors for MDR-TB patients are also discussed. The presentation provides guidance on screening, supporting, and treating psychiatric disorders in MDR-TB patients through a combination of psychotropic medications, psychotherapy, and social work.
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This document discusses post-stroke psychiatric disorders. It describes five frontosubcortical circuits that are involved in cognition, behavior and movement. Common post-stroke psychiatric conditions include depression, anxiety, apathy, psychosis and pathological laughing/crying. Lesion location can impact the type of psychiatric disorder, such as left anterior lesions increasing risk of depression. Treatment involves pharmacotherapy, such as antidepressants, and psychotherapy. Screening and ongoing monitoring of symptoms is important after a stroke to identify and manage post-stroke psychiatric complications.
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The term “psychosomatic disorder” is mainly used to mean “a physical disease that is thought to be caused, or made worse, by mental factors.” ... For example, chest pain may be caused by stress and no physical disease can be found.
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This document discusses co-occurring disorders, where an individual suffers from both a mental health disorder and substance abuse disorder. It notes that co-occurring disorders can be difficult to diagnose as the symptoms can mask one another. Only a small percentage of individuals receive treatment for both conditions. Those with co-occurring disorders face greater challenges including higher rates of issues like relapse and homelessness compared to those with a single disorder. The document advocates for greater understanding and treatment of co-occurring disorders.
Evidence based practices and mental health
This document discusses evidence-based practices for mental health in Finland. It outlines current care guidelines for several mental health conditions and emphasizes prevention, treatment, and promotion of mental health. Common evidence-based approaches are presented, such as using short-term psychotherapy and lifestyle changes before medication for conditions like depression and sleep problems. The document also notes seven common pitfalls in general practice related to identifying and managing mental health issues.
Post stroke depression
This document provides guidance for nurses on post-stroke depression (PSD). It discusses that PSD affects about 1 in 3 stroke patients and can negatively impact recovery if left untreated. It identifies risk factors for PSD and outlines tools to assess for it such as self-report scales and objective data scales. Signs and symptoms of PSD include lack of energy, motivation, and enjoyment. The document recommends that nurses play a key role in screening, educating patients and families on treatment options like antidepressants and behavioral therapy, and providing ongoing support for recovery.
Demography and epidemiology of psychiatric disorders in elderly
This document discusses the demography and epidemiology of psychiatric disorders in elderly populations. It begins with an introduction to geriatric psychiatry and outlines some key statistics on aging populations globally and in India. Specifically:
- The proportion of those aged 60 and older is projected to increase dramatically in India, from 8% currently to over 20% by 2050.
- Psychiatric morbidity is high in elderly populations, with estimates ranging from 17-43% suffering from mental health problems in various Indian studies.
- Common disorders discussed include dementia, depression, anxiety, bipolar disorder, and others. Dementia prevalence is estimated to be around 3.5 million people currently in India, and this number is expected to rise dramatically with
The physical nature of addiction
Addiction was traditionally viewed as a mental ailment rather than a physical disease. However, recent research has discovered physical changes in the brain of people prone to addiction. This has led the medical community to increasingly view addiction as a physical disease rather than just a mental condition. Treating addiction as a physical disease allows for management through a combination of medication and therapy, similar to other chronic diseases, enabling people with addiction to live productive lives.
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This document discusses psychological factors that can affect various medical conditions. It begins with an introduction on mind-body interactions and how psychological and social factors can influence medical illnesses. It then provides several examples of how psychological factors like depression, anxiety, stress, and maladaptive behaviors can negatively impact conditions like cardiovascular disease, diabetes, pulmonary disease, and end-stage renal disease. The document emphasizes that considering psychological influences is important for understanding disease mechanisms, improving health outcomes, and the physician-patient relationship. It also notes the complexity of differentiating psychological versus medical causes.
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Depression-in-Medical-Settings-2019.pptx
This document discusses depression in medical settings. It begins by classifying different types of depressive disorders and then discusses the prevalence of depression across various medical conditions such as heart disease, cancer, diabetes, and neurological diseases. It notes the difficulties in diagnosing depression in medically ill patients, as medical symptoms can overlap with depressive symptoms. The document then covers evaluating depression in both inpatient and outpatient medical settings. It discusses differential diagnoses and conditions that can mimic depression. Finally, it briefly touches on the impact depression can have for those with chronic medical illnesses.
Harniess 01
1. Physical examination is important in mental health assessment to identify any underlying organic causes for psychiatric presentations such as infections, metabolic disorders, endocrine abnormalities, and neurological conditions.
2. The physical examination should be tailored to the particular mental health presentation and may include systems like cardiovascular, respiratory, abdominal, neurological, and endocrine examinations.
3. Good documentation of physical findings, assessment, and management plan is important for continuity of care, medical-legal purposes, and showing thorough clinical reasoning.
Harniess 01
The document discusses the importance of conducting a physical examination for patients presenting with mental health issues. It provides rationales for why organic causes should be considered, such as many past patients having underlying physical problems. It also lists potential organic causes for common mental health presentations like depression, anxiety, and psychosis. The document emphasizes tailoring the physical exam to the presentation and importance of thorough documentation.
Cbt for anxiety2
1. CBT Based Anxiety Management discusses the use of Cognitive Behavioural Therapy (CBT) to treat anxiety disorders. It outlines the basics of CBT including the link between thoughts, emotions and behaviors.
2. The document provides information on assessing and managing anxiety using CBT techniques such as cognitive restructuring, relaxation exercises, challenging irrational thoughts, and activity scheduling.
3. Barriers to implementing CBT in Pakistan are discussed, as well as initial findings from qualitative interviews with psychologists on using CBT to treat anxiety and depression.
Parmentier 02
(1) Generalized anxiety disorder (GAD) is one of the most common mental disorders seen in primary care. (2) Effective treatments for GAD exist, including SSRIs, SNRIs, pregabalin, benzodiazepines, and cognitive behavioral therapy. (3) Guidelines recommend SSRIs, SNRIs, pregabalin, and benzodiazepines as first-line treatment options for GAD, with tricyclic antidepressants and other options as second-line treatments if first-line options are not effective or tolerated.
Elderly Depression and Suicide Risk
This document discusses elderly depression, suicide risk, and treatment options. It notes that depression is a leading cause of disability worldwide. Late life depression prevalence is estimated at 1-3% of those aged 65 and older. Risk factors for late life depression include chronic illness, cognitive impairment, and lack of social support. Screening tools like the PHQ-9 and GDS can help assess depression severity. Treatment may include psychotherapy, pharmacotherapy, partial hospitalization, or inpatient care depending on symptom severity and suicide risk. Managing elderly depression requires considering medical comorbidities and choosing appropriate treatment.
BIPOLAR DISORDER
Bipolar disorder is a mood disorder characterized by episodes of mania and depression. It can cause shifts in mood, energy levels, and ability to function. The document discusses the diagnostic criteria for bipolar disorder according to the DSM-V, including symptoms of mania, hypomania, psychosis and depression. It also covers the prevalence of bipolar disorder, potential causes, evaluation process, treatment options including mood stabilizers, psychotherapy and alternatives if monotherapy fails. Treatment trends are discussed for children, adolescents, and the elderly population.
All That You Ever Wanted To Know About Depression
The document discusses clinical depression and its treatment. It defines clinical depression as a decrease in neurotransmitters that affects mood, sleep, appetite, and other functions. Depression affects 20% of the population and is the most common mental health issue. It has biological, social, and psychological causes. Treatment aims to restore neurotransmitter balance through medication, psychotherapy, and behavioral changes.
mental health(1).pdf good quality content
This document discusses mental health issues in India. It notes that over 20 million Indians suffer from serious mental disorders, but only 29,000 hospital beds are available to treat the 30 lakh people in need. Mental health is defined as a state of well-being and balance that allows individuals to realize their abilities and cope with stress. Determinants of mental illness include social, economic, demographic factors as well as conflicts, disasters and physical illness. Both the National Mental Health Program and new District Mental Health Program aim to integrate mental healthcare into primary health services, but have been limited by a lack of resources and slow implementation. The WHO's new global mental health action plan also takes a community-based approach focused on low-income countries
Fitness and Mental Health
NBCC, NAADAC, CAADAC, and California Board of Behavioral Sciences approved Mental Health continuing education and addictions counselor training series. Narrated versions and CEUs available at http://www.allceus.com
Depression journey contnues
This document discusses various topics related to depression and mental health. It addresses the somatic presentations of depression, factors associated with suicide, protective factors against suicide, the relationship between anxiety and suicide risk, and the need for treatment of depression. It also discusses antidepressant groups and factors to consider in selection, as well as strategies for managing treatment-resistant depression, such as augmenting antidepressants or changing medication classes. Finally, it notes some indications for the antidepressant venlafaxine.
Anxiety
This document provides an overview of anxiety, including its epidemiology, types, signs and symptoms, diagnosis, complications, treatments, exercise recommendations, and conclusions. Some key points:
- 18.1% of US adults and 25.1% of US 13-18 year olds experience anxiety, with women being twice as likely as men. It costs over $42 billion per year.
- Common types of anxiety include generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, and social phobia.
- Signs and symptoms include feelings of panic, fear, obsessive thoughts, nightmares, rituals, sleep problems, physical sensations like sweating or shortness
Classification-of-Psychiatric-Disorders11
Mental health is conceptualized as a state of well-being where one can cope with stress, be productive, and contribute to their community. Mental illness refers to clinically recognizable symptoms or behaviors associated with distress or impaired functioning. Presentations can include thoughts, emotions, behaviors, and abnormalities may be short-lived responses to life stresses or clinically significant conditions like depression or anxiety. Diagnosis is done using the ICD-10 which classifies disorders into categories like organic disorders, substance use, psychotic disorders, mood disorders, and more. Treatment approaches consider biological, psychological, and social factors as well as predisposing, precipitating, and perpetuating influences.
Current concept of depression management
This document discusses depression, including its definition, signs, prevalence among various medical illnesses, drugs that can cause it, and treatment options. Regarding treatment, it describes both pharmacological (antidepressant medications) and nonpharmacological (psychotherapy like CBT, IPT, PDT) approaches. It notes that current antidepressant therapy has limitations like slow onset of action and inadequate response for many patients. Psychotherapy techniques aim to help patients identify and change inaccurate perceptions as well as improve communication skills and self-esteem. The overall message is that depression management requires comprehensive assessment, formulation of an individualized treatment plan including medications and therapy, and proactive follow-up to prevent relapse.
Screening for psychosocial problems in occupational health
Presentation on why it is nescessery to screen for mental health problems in occupational health, what to screen for and an overview of a short, self-administered, screening instrument, the Patient Health Questionnaire (partially validated, i.e. the PHQ-9 in occupational health), which can be used for the most common and most disabeling mental health disorders, i.e. depression, anxiety and alcohol abuse.
Pain recovery
Pain management is a critical component to patient care. However, it is leading to opioid addiction at an alarming rate in the United States. For many patients, a paradigm shift is needed to go from pain management to pain recovery.
Schizophrenia and Primary Care
A lecture by Dr Imran Waheed, Consultant Psychiatrist, outlining the approach towards the diagnosis and management of schizophrenia, with particular reference to primary care. Delivered in March 2013 in Birmingham, UK.
Evaluation of the geriatric patients with behavioural dysfunction
This document provides an overview of evaluating behavioral dysfunction in geriatric patients. It begins with definitions of key terms like geriatrics, gerontology, and behavioral and psychological symptoms of dementia (BPSD). It then discusses common types of behavioral dysfunction seen in older adults like agitation, irritability, delusions and hallucinations. The document outlines the approach to evaluation, including assessing for medical causes, psychiatric illnesses, and environmental stressors. Differential diagnoses like delirium, dementia, and mood disorders are explored. Assessment tools for conditions like BPSD are also mentioned. The "ABCs" model of antecedents, behavior, and consequences is described as a framework for understanding and intervening in problematic behaviors in older
Unipolar Depression .ppt
Unipolar depression, also known as major depressive disorder, is characterized by at least two weeks of depressed mood or loss of interest accompanied by other cognitive and physical symptoms. It is a complex disorder that can manifest through emotional, physical, and cognitive symptoms due to involvement of many brain regions. Treatment goals include reducing symptoms, restoring function, and minimizing relapse risk. While SSRIs effectively treat emotional symptoms, dual-acting antidepressants that increase both serotonin and norepinephrine may better treat the full symptom spectrum due to the roles of these neurotransmitters in both the brain and spinal cord. Achieving full remission is important for improving long-term outcomes, as residual symptoms are associated with higher relapse risk.
Classification_in_Psychiatry.pptx
This document provides an overview of psychiatric classification and diagnosis. It discusses the aims of classification, including facilitating communication between clinicians and standardizing diagnoses. The two main classification systems, ICD-10 and DSM-5, are described. ICD-10 was developed by the WHO and is used globally, while DSM-5 was developed by the APA and is used primarily in the US. The document outlines the history of psychiatric classification and compares features of ICD-10 and DSM-5.
Similar to Aab guidelines overview_06a (20)
Screening for psychosocial problems in occupational health
Screening for psychosocial problems in occupational health
Evaluation of the geriatric patients with behavioural dysfunction
Evaluation of the geriatric patients with behavioural dysfunction
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Tms profile
The Institute of Team Management Studies collects data from around the world to look at work preferences across a variety of samples. The current database contains more than 151,000 people from 162 countries, 76 industries, and 246 professions.
The data for professions is interesting in that it shows significant distribution differences in the way that people like to work. To highlight some of the differences it is worth comparing three profession samples (Bankers, Psychologists, and Electrical Engineers) with the worldwide sample, using the Team Management Wheel.
So when you next facilitate a team development or strategic planning workshop, reflect on whether you are 'shortcutting' the road to high performance. The High-Energy Teams model illustrates well the path that needs to be travelled. It's a difficult but clear route 'through a jungle'. Sometimes it's tempting for a team to take a shortcut, but keep in mind that 'shortcutting creates erosion'.
Copyright © Team Management Systems.
Perjeta
Food and Drug Administration (FDA) approved Perjeta® (pertuzumab)* in combination with Herceptin® (trastuzumab) and docetaxel chemotherapy for people with HER2-positive metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy for metastatic breast cancer.1
The combination of Perjeta, trastuzumab and docetaxel chemotherapy was the only regimen that has been shown to significantly improve the time people with previously untreated HER2-positive metastatic breast cancer lived without their disease getting worse (median progression-free survival, or PFS, 18.5 vs. 12.4 months; 6.1 months improvement) compared to trastuzumab and docetaxel chemotherapy
The breast
The breast is composed of lobes, lobules, and ducts. It receives its blood supply from the internal and external mammary arteries. Lymph drainage is primarily to the axillary lymph nodes.
Breast anatomy and development can vary between individuals. Common benign breast conditions include fibroadenomas, cysts, and fibrocystic changes.
Breast cancer originates in the breast ducts or lobules. HER2-positive breast cancer is a type where cancer cells overexpress the HER2 receptor, causing rapid growth. Physical signs may include a painless breast mass, nipple retraction, and enlarged lymph nodes.
Gazyva
Gazyva is a medicine that works with the body’s own immune system to attack blood cells called B-cells that have a certain marker on their surface (CD20). B-cells are the cause of common blood cancers.1,2
Gazyva is FDA-approved for the treatment of people with previously untreated chronic lymphocytic leukemia (CLL) in combination with chlorambucil chemotherapy.3
Phase III clinical data showed that Gazyva plus chlorambucil chemotherapy helped people with CLL live longer without the disease worsening than chlorambucil chemotherapy alone.3
Listening OR HEARNG
Noise in the background - you are not concentrating on the sounds at all and nothing is registering with you. Ignoring would be another way to describe this type of listening. There is nothing wrong with passive listening if it's truly not important, but passive listening - which we might more aptly call Not Listening - is obviously daft and can be downright dangerous if the communications are important.
Why we no longer need hr departments
The time has come for HR (Human Resources) departments to call it a day. HR departments often portray themselves as a valued business partner for management and staff alike. However, how can anyone take a department seriously that refers to people as ‘resources’? Nothing matters more to companies than the people who work there. Companies are nothing without the right people! And I am sure that not one, single individual wants to be referred to as a ‘human resource’.So, the first point I want to make is that the name is wrong: very wrong. It signals to everyone that this department manages ‘human resources’ in a top-down fashion, i.e. managing humans in a similar way to other resources such as finance, property or machines. If departments can’t see that this is sending out the wrong messages, then they don’t deserve to be there anyway.
Designing and managing services
The document discusses the nature and characteristics of services. It notes that services are intangible, inseparable, variable, and perishable. It also discusses the distinctive characteristics of services like intangibility where services cannot be seen before purchase. It discusses how marketers can address these characteristics through strategies like standardizing service delivery to reduce variability. The document also discusses marketing strategies for services, noting people, physical evidence, and process must be considered in addition to the traditional 4Ps. It emphasizes the importance of internal marketing to train employees.
Attributtes of power point presentation
PowerPoint provides numerous features that offers flexibility and the ability to create a professional presentation. One of the features provides the ability to create a presentation that includes music which plays throughout the entire presentation or sound effects for particular slides. In addition to the ability to add sound files, the presentation can be designed to run, like a movie, on its own. PowerPoint allows the user to record the slide show with narration and a laser pointer. You may customize slide shows to show the slides in different order than originally design and to have slides appear multiple times
Developing pricing strategies
pricing involves the customer demand schedule, the cost function, and competitors’ prices. The question is how should a company integrate cost-, demand-, and competition-based pricing considerations? In setting a price the firm, for example Kodak, will have to consider the following cost-, demand-, and competition-based pricing decisions:
The 8 attribute of great start up internship
An internship is a method of on-the-job training for white-collar and professional careers. Internships for professional careers are similar to apprenticeships for trade and vocational jobs. Although interns are typically college or university students, they can also be high school students or post-graduate adults. On occasion, they are middle school or even elementary students. In some countries, internships for school children are called work experience. Internships may be paid or unpaid, and are usually understood to be temporary positions.
Disciplined team
Discipline Teams can be more quickly assembled, deployed, refocused and disbanded, without disrupting more permanent structures and processes
Wining
Winning isn't everything--but wanting to win is. Winning is a state of mind that embraces everything you do. Winning isn't everything, but the will to win is everything. “A winner is someone who recognizes his God-given talents, works his tail off to develop them into skills, and uses these skills to accomplish his goals. Winning is not everything, but the effort to win is. Winning isn't everything, it's the only thing
Know your-colleague
here are different characteristics in human beings which are seeked 16 personality traits from which one can judge th unknown person
Laws of-motivation
We will look at the laws of motivation. One could argue that they are principles rather than laws, but I prefer to use the word ‘laws’ because it implies that if you break them, you will receive a penalty.
Selling skills
I love the art of selling. LOVE IT. When I first entered the field of sales, the one thing I quickly grew to appreciate was the fact that anything I did to increase my ability in selling also increased my ability in life. Sales skills are life skills
Design and size of sales territories
A sales territory is composed of a group of customers or a geographic area assigned to a salesperson.
Sales person
A sales person is a tool to get your offering out to prospects and/or customers. It’s true we can control the offering and we can shape the message presented. But it’s the Sales person’s style, presentation and skills that will determine how the customer or prospect will feel about usIT’S NOT WHAT YOU SAY IT IS. IT’S HOW THEY SAY IT
Epilepsy
A group of chronic CNS disorders characterized by recurrent seizures.
Seizures are sudden, transitory, and uncontrolled episodes of brain dysfunction resulting from abnormal discharge of neuronal cells with associated motor, sensory or behavioral changes.
Euglucon
Diabetes Mellitus Is Due To A Disorder Of Carbohydrate, protein And Lipid Metabolism As A Result Of An Absolute Or Deficiency In Metabolically Active Insulin.
Ulcer
An ulcer is a sore in the lining of the stomach or duodenum (the first part of the small intestine). People of any age can acquire an ulcer. Women are affected just as often as men.
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Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
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Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
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7. Explain the role of peripheral chemoreceptors in regulation of respiration
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1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
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Aab guidelines overview_06a
- 1. An Overview By
- 4. Anxiety Awareness Board – When ?
- 5. Anxiety Awareness Board – the logo ? AABP The Drop and ripples represent the concept of “ increasing awareness”
- 7. Red Color depicts the alarming situation of the anxiety disorders in the country Green Color represents the National Color December 2005 Anxiety Management Guidelines – the Concept White color represents relief from Anxiety
- 8. Anxiety Awareness Board – Core Members
- 9. Anxiety Awareness Board – Members
- 11. AAB Guidelines Highlights
- 12. AAB Guidelines Contents - highlights
- 17. Please do not let them become patients… Lets fight Anxiety together