Kiss The Hype Essays - Kiss, Wicked Lester, Peter Criss,

Kiss The Hype What is publicity? Publicity is characterized as special exposure of an excessive or imagined kind. It is utilized to draw the buyer to a specific item or an occasion or something to that affect. The opposition for the purchaser's consideration is serious and even edgy on occasion. All through the 1970's, there was an immense hardware of promotion encompassing the music business. Some of what came out of it was unique and creative, yet a few was misleading and incredible. Whatever it was, it was completely focused on the customer. The stone gathering Kiss has been performing for more than twenty-six years. In that time, they have sold more than ninety million collections, amassed armies of fans, and sold out arenas around the globe. There is a purpose behind the phenomenal accomplishment of Kiss. It has something to do with their music, yet it has more to do with the manner in which they are advertised and bundled. So lets open up that bundle. In 1972, Gene Simmons was a 6th grade teacher in New York City. With guitarist Paul Stanley, he shaped a band called Wicked Lester that played in little clubs and bars around New York. That band immediately fizzled. Insidious Lester simply wasn't the lethal jammin' attack crew they had consistently needed (Kitts 12). Be that as it may, Simmons and Stanley felt they could and would become stars. They put resources into some enormous gear and chose to begin a significant musical gang. From the swarms of drummers, they picked Peter Criss, who had been publicizing himself in New York papers. They tried out more than thirty guitarists and picked Ace Frehley, who had been conveying alcohol professionally. The band was shaped and now came an opportunity to sell it. The key advance was to convince Bill Aucoin, executive of the network show Flipside, to assume control over the administration of the band. Kiss accentuated style over substance and went substantial on trappings. Cosmetics started things out. It set them apart from every other person and gave them an atmosphere of puzzle. Every part built up his own modify self image. It was the first of many Kiss tricks that worked. The ensembles came straightaway, complete with dark calfskin, aluminum studs, and seven-inch stage heels. They never permitted themselves to be captured bizarre. The publicity was self-sustaining. The more Kiss' characters were protected, the more enthusiasm there was in attempting to photo them (Lendt 40). By 1978, Kiss was the most noteworthy netting live act on the planet. Their shows became primary attractions for many individuals. Kiss' equation for progress was straightforward: hit the crowd so hard, with a blast of tricks, stunts, and showy behavior, that they won't have the option to overlook you. Everything was planned to extend power. The twofold s' toward the finish of the Kiss logo were intended to look like helping jolts. The stage was furnished with drum risers, stages, and a transcending electric sign with a colossal lit up Kiss logo. A high point, or promotion point, in the show came when Gene Simmons, the evil presence, would inhale fire. Another publicity point would come when Simmons spewed blood. For Kiss, their shows were the best ads for their collections. Kiss needed to advance in the 1970's without the assistance of radio. There were basically no stations in the nation that would play their music. Rather, they advanced themselves in different ways. They allowed no limited time probability to sneak away. Kiss sold shirts, caps, belt clasps, puzzles, dolls, coats, pictures, banners, comic books, and for all intents and purposes any and all that they could put their logo on. Here and there it encapsulated exactly how huge and distinctive we were that a great deal of different groups (Stanley, Kiss Extreme Close-up). They utilized the entirety of this advancement to sell records. In the music business, this kind of thing is called, not without reason, misuse. Kiss is probably the best case of publicity in the music business. Without their picture, alongside the bundle, they probably won't have ever constructed it out of the clubs and bars. Not many imitators have endeavored to duplicate or adjust the Kiss equation's undeniable intrigue, and unquestionably none have outperformed Kiss' prosperity at gaining by that recipe. In time, Kiss may one day be for all time

10 Fiery Muhammad Ali Quotes

10 Fiery Muhammad Ali Quotes In 1964, when Cassius Clay took on the relentless Sonny Liston, no one understood that a star was conceived. Cassius Clay had quite recently stirred up the world with his battling soul. Not that he was agonizingly bashful about his ability. His declaration to the press not long before his triumphant session with Sonny Liston that he was the best neglected to inspire an emotional response from manyâ skeptics. Indeed, his over-the-top presumption tinged with narcissism made the world careful about this new wannabe. The Megalomania of Muhammad Ali: The Worlds Greatest Sports Star Not long before the battle, Cassius Clay pointed a few insults at the prepared and ruling Liston, maybe to scare his adversary. He yelled at Liston saying, Somebody is going to bite the dust at ringside today around evening time. That night would presumably be the most exceptional occasion for some boxing lovers for two reasons. One, they saw a dominant heavyweight boxing champion go down. Two, a 22-year-old longshot with a motormouth and an interest for garbage talking had quite recently impacted the world forever. Cassius Clay, who got known as Muhammad Ali after he changed his religion, surprised the world. Each time Muhammad Ali won, he reminded the world that he was the best. He didnt state that he was the best, most grounded, best, or most extravagant. He pronounced, I am the best! He articulated it withâ ã ©lan. He could stir up a free for all in the ring and report his significance to the world. At no other time had anybody seen a games figure so audacious, so in-your-face, thus fiercely legitimate. At the point when Muhammad Ali Went Against the US Government Most avid supporter respect Muhammad Ali as the best fighter that at any point lived. He took on numerous battles inside the ring and outside the ring. Those that he battled inside the ring were simple matches. He truly gave orders there. In any case, the ones he battled outside the ring were the hardest battles he at any point had. The greater part of them were against the foundation. The man who could skim like a butterfly and sting like a honey bee frequently jumped on an inappropriate side of the decision class. His nasty proclamations sent the press into a tantrum. His clever rebounds and mockery pressed catches of numerous a legislator. At the point when gotten some information about whether he would serve in the military for the Vietnam War, he presumptuously replied,â Man, I aint got no fight with them Viet Cong. No Vietcong at any point called me n****r. He had an uncanny comical inclination, a brisk temper, a major mouth, and a delicate heart. One of his evil remarks that regularly snatch features is: I am America. I am the part you wont perceive, however become acclimated to me. Dark, certain, presumptuous. My name, not yours. My religion, not yours. My objectives, my own. Become acclimated to me.  Ali once stated, Allah is the best. Im simply the best fighter. Furthermore, in reality, he was. As multiple times victor of the direct world heavyweight title, a title held by no other fighter, Muhammad Ali was a bad dream for his rivals. He was granted the Sportsman of the Century by the BBC and Sports Illustrated magazine in 1999. Muhammad Ali Never Minced His Words: 10 Quotes Prove His Indomitable Spirit Muhammad Ali was not only one of the best wearing symbols that at any point lived, he was likewise an incredible speaker. A portion of his statements are legendary. These 10 uncover the stuff to have a triumphant disposition. Buoy like a butterfly, sting like a honey bee. His hands cannot hit what his eyes cannot see. Presently you see me, presently you dont. George figures he will, however I realize he wont. These words made perhaps the best statement in brandishing history. Ali expressed these words justâ before his battle with George Foreman in 1974. These words launch Muhammad Ali to moment fame.â Its absence of confidence that makes individuals scared of meeting difficulties, and I have confidence in myself. You think I was stunned when Nixon surrendered? Hold up till I whup George Foremans behind. I explored new territory for this battle, I done tassled with a croc! Believe it or not. I have tassled with a croc! I done tussled with a whale! I done bound lightning, throwed roar in prison! Just a week ago I killed a stone, harmed a stone. Hospitalized a block. I’m so mean I make medication wiped out. Champions arent made in the rec centers. Champions are produced using something they have somewhere inside them: a longing, a fantasy, a dream. On the off chance that they can make penicillin out of rotten bread, they can sure make something out of you. In the event that you ever fantasy about beating me... you better wake up and apologize. Joes going to be smokin an I aint even jokin however Ill be peckin and a pokin and Ill pour water on that smokin. Presently this may flabbergast and astound ya yet I will wreck Jo Frazier. There are two things that are difficult to hit and see, that is a creepy apparition and Muhammed Ali. Like The Beatles, there will be nothing similar to them. Like my man, Elvis Presley. I was the Elvis of boxing. Im not the best, Im the twofold most prominent. In addition to the fact that I knock em out, I pick the round. Im the boldest, the prettiest, the most predominant, generally logical, most skilfullest warrior in the ring today.

8 Effective Tools for Common Meeting Management Tasks - Focus

8 Effective Tools for Common Meeting Management Tasks - Focus We’ve all been there. You turn up to a meeting and the table is full, but an eerie silence ensues. Everyone’s waiting for someone else to kick things off. Without a clear facilitator to go through the necessary meeting management steps,  meetings like these are doomed. To make your meetings productive, there are a number of essential meeting management tasks each facilitator should go through. How these tasks are managed can make or break a meeting. Fortunately, there are a bunch of great online meeting management tools to assist. In this article, we’ll walk you through the 5 common meeting management tasks that should be covered for a productive meeting and recommend 8 effective meeting management tools to help you complete these tasks. Common Meeting Management Tasks and the  Meeting Management Tools to Assist The premise of a productive meeting is to effectively come to a solution and decide upon the onward action needed to achieve that solution. Here are the five tasks that most meetings will need to cover in order to reach this aim, and a selection of meeting management tools to help you on your way: 1. Decide Whether the Meeting Is Truly Necessary As shared in the Harvard Business Review: “A great many important matters are quite satisfactorily conducted by a single individual who consults nobody. A great many more are resolved by a letter, a memo, a phone call, or a simple conversation between two people. Sometimes five minutes spent with six people separately is more effective and productive than a half-hour meeting with them all together.” We’ve all attended meetings that should have never been held, so to prevent this, the first task is to decipher whether the meeting is necessary and useful. This involves establishing whether there’s a practical alternative, and if not, who should be invited for providing real value and decision-making authority to the meeting. To help with this, first try using a product that could reach the same collaborative outcome, without such a significant draw on resources. Here are two of our favorites: Slack As argued in HBR, many discussions can be answered far more quickly via a brief one-on-one discussion or via email, without needing to get everyone together in person. What’s even faster than email is if you can solve the discussion via an internal communication tool, like Slack. Already trusted by millions of people around the globe for collaborative working, Slack might just be your answer to unnecessary meetings. Microsoft Teams In a similar vein, Microsoft Teams is the chat-based workspace from Microsoft. As part of Office 365, Microsoft Teams was created with the needs of modern teams in mind, enabling teams to work on documents and plans from directly inside the app, via team and private chats. With the ability to turn plans into action via the MeisterTask Tab, teams can host productive co-working sessions from within the app, removing the need for in-person meetings. 2. Get Everyone Together, On Time The next task is to ensure that everyone is able to join the meeting on time. Whether you’re organizing a meeting in-person or online, you need to ensure that everyone is aware of the time and have instructions on how to attend. This begins with a thorough meeting agenda, including the time, time zone, date and instructions to join, so either the physical location or how to join online, e.g. via a link to join the call. This agenda should be sent out alongside a calendar invite with plenty of time before the meeting, to ensure attendees are available and have sufficient time to prepare. Google Meet To get all attendees together, try using Meet â€" the online meeting software from Google.   Meet provides real-time meetings, available via the browser, and enables attendees to share audio and video, as well as share screens and presentations via their ‘Present your screen’ feature. Through generating a shareable link to join the call, attendees can join the call in seconds. Jitsi Meet Jitsi Meet provides secure, flexible and completely free video conferencing. There’s no need to sign up, you can simply generate a unique call link, named whatever you like, to share with meeting attendees, meaning everyone can join at a click of the link, with no need to sign in. Jitsi Meet is fully encrypted, 100% open source and free all day, every day, with no account needed. 3. Facilitate the Meeting to Cover its Aims Within the Allocated Time Next, someone needs to effectively facilitate the meeting. This requires one or more attendees to take ownership over ensuring that the meeting will cover all agenda items within the designated time period. Meeting facilitation might also mean managing attendees to some extent, ensuring all attendees stick to the meeting ground rules and that all attendees get a chance to express their opinion, without having the session run by just a small handful of ‘meeting tyrants’. Google Drive To ensure all attendees are sufficiently prepared for the meeting, share all the necessary documents in advance via Google Drive. Hosted via secure cloud storage, files stored on Google Drive can be accessed from anywhere with a secure internet connection â€" perfect for attendees who’d like to review the files on route to the meeting. Toggl To ensure everything runs to schedule, a time tracking tool can help hugely. Toggl is a time tracking product featuring a simple online timer and a powerful timesheet calculator.   Available via the desktop, as well as via iOS and Android apps, Toggl offers a free plan and a number of paid plans. 4. Take Clear Meeting Notes, Ready to Share Another important task is for one attendee to take clear, accountable meeting notes, throughout the session. This involves noting key decisions made and ensuring that all actionable items are assigned to the correct person. Depending on your workflow this could also involve turning those actionable items into assigned tasks within your team’s task management tool. After the meeting, these meeting notes should be shared with all attendees, via email. It’s important that the key decisions and a list of tasks, including who is accountable for what, are all included. MindMeister Used by over 9 million people globally, MindMeister is the leading online mind mapping product, specifically designed for collaborative teamwork. Available via the desktop and on mobile apps for iOS and Android, users can try out MindMeister for free, with a Basic plan limited to 3 free mind maps and a selection of paid plans available, too. With MindMeister, teams can create collaborative meeting agendas to share online in advance, via email or shareable link. Then, during the meeting, attendees can open the mind map and add meeting notes and ideas in real-time. Plus, with all plans displayed in a mind map form, concepts and plans are easier to understand and more visually appealing. Following the meeting, the map remains accessible for all participants so they can refer back to it as needed and potentially add comments or information to it later on. Tip: You can use MindMeister right inside Microsoft Teams to get the combined power of mind mapping plus live chatting! 5. Delegate Outstanding Tasks and Ensure Task Accountability As mentioned previously, it’s vital that all decisions made during the meeting are followed up with actionable, assigned tasks. Therefore, if there was no one who raised their hand to take on a task, it is down to the team manager or meeting facilitator to delegate all outstanding tasks. Note: Effective task delegation requires you to sufficiently prepare the employee who is being delegated to. Read our guide on effective delegation to learn more. MeisterTask Finally, it’s vital to ensure decisions are turned into action, so this is where a collaborative task management product will come into action. Integrating directly with online meeting tool, MindMeister, MeisterTask is an agile task management solution, designed to make teamwork more productive. Via the MindMeister integration, tasks decided during the meeting can be turned into assigned tasks, without even leaving the collaborative mind map. From there, tasks can be embellished, for example by adding task due dates, checklist items, or attachments. MeisterTask is available as a web app and offers desktop apps for Mac and Windows, as well as mobile apps for iOS and Android. It’s free to get started via the MeisterTask Basic plan, with a number of paid plans available too, offering heightened productivity features. So those are our tips for effective virtual meeting management. If you have any of your own, we’d love to hear them in the comments below! Manage Meetings Effectively with Mind Maps Try It Now! Its free! Try It Now! 8 Effective Tools for Common Meeting Management Tasks - Focus We’ve all been there. You turn up to a meeting and the table is full, but an eerie silence ensues. Everyone’s waiting for someone else to kick things off. Without a clear facilitator to go through the necessary meeting management steps,  meetings like these are doomed. To make your meetings productive, there are a number of essential meeting management tasks each facilitator should go through. How these tasks are managed can make or break a meeting. Fortunately, there are a bunch of great online meeting management tools to assist. In this article, we’ll walk you through the 5 common meeting management tasks that should be covered for a productive meeting and recommend 8 effective meeting management tools to help you complete these tasks. Common Meeting Management Tasks and the  Meeting Management Tools to Assist The premise of a productive meeting is to effectively come to a solution and decide upon the onward action needed to achieve that solution. Here are the five tasks that most meetings will need to cover in order to reach this aim, and a selection of meeting management tools to help you on your way: 1. Decide Whether the Meeting Is Truly Necessary As shared in the Harvard Business Review: “A great many important matters are quite satisfactorily conducted by a single individual who consults nobody. A great many more are resolved by a letter, a memo, a phone call, or a simple conversation between two people. Sometimes five minutes spent with six people separately is more effective and productive than a half-hour meeting with them all together.” We’ve all attended meetings that should have never been held, so to prevent this, the first task is to decipher whether the meeting is necessary and useful. This involves establishing whether there’s a practical alternative, and if not, who should be invited for providing real value and decision-making authority to the meeting. To help with this, first try using a product that could reach the same collaborative outcome, without such a significant draw on resources. Here are two of our favorites: Slack As argued in HBR, many discussions can be answered far more quickly via a brief one-on-one discussion or via email, without needing to get everyone together in person. What’s even faster than email is if you can solve the discussion via an internal communication tool, like Slack. Already trusted by millions of people around the globe for collaborative working, Slack might just be your answer to unnecessary meetings. Microsoft Teams In a similar vein, Microsoft Teams is the chat-based workspace from Microsoft. As part of Office 365, Microsoft Teams was created with the needs of modern teams in mind, enabling teams to work on documents and plans from directly inside the app, via team and private chats. With the ability to turn plans into action via the MeisterTask Tab, teams can host productive co-working sessions from within the app, removing the need for in-person meetings. 2. Get Everyone Together, On Time The next task is to ensure that everyone is able to join the meeting on time. Whether you’re organizing a meeting in-person or online, you need to ensure that everyone is aware of the time and have instructions on how to attend. This begins with a thorough meeting agenda, including the time, time zone, date and instructions to join, so either the physical location or how to join online, e.g. via a link to join the call. This agenda should be sent out alongside a calendar invite with plenty of time before the meeting, to ensure attendees are available and have sufficient time to prepare. Google Meet To get all attendees together, try using Meet â€" the online meeting software from Google.   Meet provides real-time meetings, available via the browser, and enables attendees to share audio and video, as well as share screens and presentations via their ‘Present your screen’ feature. Through generating a shareable link to join the call, attendees can join the call in seconds. Jitsi Meet Jitsi Meet provides secure, flexible and completely free video conferencing. There’s no need to sign up, you can simply generate a unique call link, named whatever you like, to share with meeting attendees, meaning everyone can join at a click of the link, with no need to sign in. Jitsi Meet is fully encrypted, 100% open source and free all day, every day, with no account needed. 3. Facilitate the Meeting to Cover its Aims Within the Allocated Time Next, someone needs to effectively facilitate the meeting. This requires one or more attendees to take ownership over ensuring that the meeting will cover all agenda items within the designated time period. Meeting facilitation might also mean managing attendees to some extent, ensuring all attendees stick to the meeting ground rules and that all attendees get a chance to express their opinion, without having the session run by just a small handful of ‘meeting tyrants’. Google Drive To ensure all attendees are sufficiently prepared for the meeting, share all the necessary documents in advance via Google Drive. Hosted via secure cloud storage, files stored on Google Drive can be accessed from anywhere with a secure internet connection â€" perfect for attendees who’d like to review the files on route to the meeting. Toggl To ensure everything runs to schedule, a time tracking tool can help hugely. Toggl is a time tracking product featuring a simple online timer and a powerful timesheet calculator.   Available via the desktop, as well as via iOS and Android apps, Toggl offers a free plan and a number of paid plans. 4. Take Clear Meeting Notes, Ready to Share Another important task is for one attendee to take clear, accountable meeting notes, throughout the session. This involves noting key decisions made and ensuring that all actionable items are assigned to the correct person. Depending on your workflow this could also involve turning those actionable items into assigned tasks within your team’s task management tool. After the meeting, these meeting notes should be shared with all attendees, via email. It’s important that the key decisions and a list of tasks, including who is accountable for what, are all included. MindMeister Used by over 9 million people globally, MindMeister is the leading online mind mapping product, specifically designed for collaborative teamwork. Available via the desktop and on mobile apps for iOS and Android, users can try out MindMeister for free, with a Basic plan limited to 3 free mind maps and a selection of paid plans available, too. With MindMeister, teams can create collaborative meeting agendas to share online in advance, via email or shareable link. Then, during the meeting, attendees can open the mind map and add meeting notes and ideas in real-time. Plus, with all plans displayed in a mind map form, concepts and plans are easier to understand and more visually appealing. Following the meeting, the map remains accessible for all participants so they can refer back to it as needed and potentially add comments or information to it later on. Tip: You can use MindMeister right inside Microsoft Teams to get the combined power of mind mapping plus live chatting! 5. Delegate Outstanding Tasks and Ensure Task Accountability As mentioned previously, it’s vital that all decisions made during the meeting are followed up with actionable, assigned tasks. Therefore, if there was no one who raised their hand to take on a task, it is down to the team manager or meeting facilitator to delegate all outstanding tasks. Note: Effective task delegation requires you to sufficiently prepare the employee who is being delegated to. Read our guide on effective delegation to learn more. MeisterTask Finally, it’s vital to ensure decisions are turned into action, so this is where a collaborative task management product will come into action. Integrating directly with online meeting tool, MindMeister, MeisterTask is an agile task management solution, designed to make teamwork more productive. Via the MindMeister integration, tasks decided during the meeting can be turned into assigned tasks, without even leaving the collaborative mind map. From there, tasks can be embellished, for example by adding task due dates, checklist items, or attachments. MeisterTask is available as a web app and offers desktop apps for Mac and Windows, as well as mobile apps for iOS and Android. It’s free to get started via the MeisterTask Basic plan, with a number of paid plans available too, offering heightened productivity features. So those are our tips for effective virtual meeting management. If you have any of your own, we’d love to hear them in the comments below! Manage Meetings Effectively with Mind Maps Try It Now! Its free! Try It Now!

Three Little Words The Compelling Autobiography of Ashley...

â€Å"Sunshine, you’re my baby and I’m your only mother. You must listen to the one taking care of you, but she’s not your mama. Never forget, I’m the only mama who will love you forever and ever.† Ashley Rhodes Courter’s mom had told her. Ashley Rhodes-Courter was only three years old when she was separated from her mother. She spent the next nine years bouncing from one foster family to another. Her mother, Lorraine, was only twenty years old, and she was also too young to take responsibilities for her two children. However, Ashley grew up earning straight â€Å"A’s† in her classes; she won a world-wide Harry Potter essay contest in New York, as well as many others. She was born in South Carolina, and later was taken to her first foster family in Florida. The closest family member she was kept with was her step-brother Luke, who didn’t share the same father. Later on, when Ashley was eleven years old, she got a new step-sister, who did not share the same father as she and Luke. The book grew from an essay that Ashley wrote for a competition in which students were asked to write a moment in their lives which they learned something about themselves The most noteworthy achievement of the subject in the book, Three Little Words is when Ashley got a home after being in foster homes for a long period of time. She has spent at least ten years in foster care; which includes moving from one school to another, moving foster homes, she had seventy-three different

Thoughts on Characteristics of Race and Gender Du Bois...

Du Bois versus De Beauvoir: Essential characteristics of race and gender In the debate over equality for both African-Americans and women, the question of nature versus nurture inevitably arises. Although most authors acknowledge that there are differences between these historically discriminated-against groups and members of the hegemonic culture, the origin of those differences has been hotly debated. While the African-American intellectual W.E.B Du Bois was inclined to conceptualize African-Americans as a race, feminists of the 1950s like Simone De Beauvoir were more inclined to see the values ascribed to the genders as mainly rooted in cultural norms established by men, not as essential attributes of women. The turn-of-the-century W.E.B Du Bois wrote his seminal text The Souls of Black Folk in response to what was then called the Negro Problem. The Negro Problem was the question of whether African-Americans should be treated as equal within the firmament of American society and whether integration or separate but equal were more viable doctrines. Du Bois wrote against such advocates of acceptance like Booker T. Washington, and instead demanded parity for his people in terms of opportunities. In the first essay of Du Bois book entitled Our Spiritual Strivings, Du Bois writes of his frustrations as a young, African-American child who was intelligent and thoughtful yet all too well aware of how his race would limit his ability to pursue his studies although he

Factors That Affect Enzyme Reaction Rate Free Essays

Lab Report Factors That Affect Enzymes Reaction Rate Name of lab: Effects of temperature, pH, Enzyme Concentration, and Substrate Concentration on Enzymatic Activity Introduction: Enzymes are the most important types of proteins, they act as catalysis (speed up chemical reactions). If enzymes didn’t exist, biochemical reactions would act to slowly and they couldn’t keep up with the metabolic functions. Enzymes have a three-dimensional structure that is really complex. We will write a custom essay sample on Factors That Affect Enzyme Reaction Rate or any similar topic only for you Order Now This structure consists of one or more polypeptide chains, they form an active site, which is an area in which the substrate eventually will fit. The four factors that affect the activity and reaction rate of an enzyme are temperature, pH, enzyme concentration and substrate concentration. Research Question/Hypothesis: The hypothesis is that when the temperature is higher than 40? C, the enzyme catalysis will increase. That the enzyme activity with the pH effect is that if it isn’t at the optimum pH value there will be a total loss of the enzyme activity. As the change in enzyme concentration increases the activity rate will increase if there is a proportional amount of enzyme concentration and substrate. Variables: Independent: pH, enzyme concentration, substrate concentration and enzymatic activity. Dependent: the reaction rate Control variable: temperature and amount of substrates and enzymes added. Materials: Phosphate Buffers Beaker Catechol Potato Juice Parafilm Test Tubes Procedure: To study the effect of temperature: 1. Three different test tubes where filled with 3mL of phosphate. 2. They were set in three different temperature settings. First tube was placed in an ice-water bath for ten minutes, the second in a room temperature until 21? C was reached, and the third tube was placed in a beaker of warm water. To study the effect of pH: 1. The pH values of pH 4, pH 6, pH 7, pH 8, and pH 10 was used to fill five separate test tubes with 3 mL each. 2. To each test tube, ten drops of catechol and potato juice were added, each tube was covered with Parafilm, and inverted several times to mix the contents. After letting each tube stand for three to five minutes the tubes were inverted at one minute intervals. To study the effect of enzyme concentration: 1. The steps include four test tubes that were labeled A, B, C, and D. 2. The contents added to tube A are 3mL plus 20 drops of pH 7 phosphate buffer, but no potato juice. To tube B, 3 mL plus 15 drops of pH 7 phosphate buffer and 15 drops of potato juice. The amount of pH 7 phosphate buffer added to test tube C are 3 mL plus 10 drops of potato juice. To test tube D, 3 mL of pH 7 phosphate buffer and 20 drops of potato juice were added. 3. Then, each tube was covered in Parafilm and inverted several times to mix the contents. After doing so, 10 drops of catechol were added to each tube and covered with Parafilm and inverted several times to mix the contents. 4. After allowing each tube to stand for three to four minutes the tubes were mixed at one-minute intervals. To study the effects of substrate concentration: 1. Eight test tubes that were involved. 2. These test tubes were labeled 1, 2, 4, 8, 16, 24, 32, and 48. Next, each test tube had a certain amount of phosphate buffer and catechol was added to each. 3. To test tube #1: 5 mL plus 47 drops of pH 7 phosphate buffer and 1 drop of catechol; test tube #2: 5 mL plus 46 drops of pH 7 phosphate buffer and 3 drops of catechol; test tube #4: 5 mL plus 44 drops of pH 7 phosphate buffer and 4 drops of catechol; test tube #8: 5 mL plus 40 drops of pH 7 phosphate buffer and 8 drops of catechol; test tube #16: 5 mL plus 32 drops of pH 7 phosphate buffer and 16 drops of catechol; test tube #24: 5 mL plus 24 drops of pH 7 phosphate buffer and 24 drops of catechol; test tube #32: 5 Ml plus 16 drops of pH 7 phosphate buffer and 32 drops of catechol; and test tube #48: 5 mL of pH 7 phosphate buffer and 48 drops of catechol. 4. Then, each tube was covered with Parafilm and inverted several times to mix the contents. Also, to each of the tubes, 30 drops of potato juice were added and covered with Parafilm and inverted several times to mix the contents. The test tubes set at room temperature for five minutes and were mixed at one minute intervals. How to cite Factors That Affect Enzyme Reaction Rate, Papers

Agoraphobia Essay Research Paper My report is free essay sample

Agoraphobia Essay, Research Paper My study is on Agoraphobia. Agoraphobia typically consequences from the fright of holding a panic onslaught in specific state of affairss # 8220 ; from which flight might be hard ( or abashing ) or in which aid may non be available in the event of holding an unexpected or situational predisposed Panic Attack or panic-like symptoms. Peoples with this phobic disorder worry that they will non be able to acquire someplace safe. They frequently worry about holding a panic onslaught or terror symptoms like giddiness, purging, loss of control, or trouble external respiration. Peoples with Agoraphobia normally fear big topographic points like promenades, theatres, food market shops, or Parkss. They besides fear big crowds or topographic points where they feel trapped like going on a plane, driving in first-come-first-serve hr traffic, being on a span, or sing the physician. Normally, a individual with agoraphobia can joint what they fear or where they fear it. We will write a custom essay sample on Agoraphobia Essay Research Paper My report is or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Although, sometimes they merely know that they have a sense of apprehension. The individual will get down to avoid the state of affairss where he or she feels uncomfortable. Agoraphobia can decline without intervention ; in some utmost instances, that individual can go trapped in his or her ain place because he or she is excessively fearful to leave. Sometimes, the individual can take part in activities or travel if a sure comrade goes with him or her. The chief intervention for agoraphobia is a certain type of Cognitive Therapy called exposure therapy. The end of this therapy is to acquire the individual to face the fright straight. With success they learn that they have nil to fear. The first measure of this therapy is to handle Panic Disorder because most people with agoraphobia besides have panic upset. As the terror onslaughts disappear, the individual becomes more confident about-facing the state of affairss they fear. Then the individual begins exposure to the topographic points or state of affairss that they fear. Most therapies will get down with the least feared and travel up to the most feared. The exposure Sessionss normally last about 2 hours and happen twice a hebdomad. Daily patterns without the healer is critical. About 75 % of those treated with exposure therapy study less anxiousness, improved morale, a better quality of life at place and work, expanded involvements and activities, and more sweet relationships. De pending on the state of affairs, some people besides find that cognitive therapy, assertiveness preparation, biofeedback, hypnosis, speculation, relaxation, or twosomes therapy is helpful.

Athesim Is The New Fundamentalism Religion Essays

Athesim Is The New Fundamentalism Religion Essays Athesim Is The New Fundamentalism Religion Essay Athesim Is The New Fundamentalism Religion Essay Merely what is all the dither about? Well, I suppose that depends on who you talk to. Some people say the existent inquiry is whether god exists or non. Other folks will state that it is an statement about fundamentalism ( with its built-in dangers ) and that both sides accuse each other of being merely that. Even more province that it is about holding creationism and the ( alleged ) thought of intelligent design being allowed back into the schoolroom. For me, I have already stated my ain personal beliefs. This is NOT a complicated issue for me. No God exists and the universe can make merely ticket WITHOUT my believing that one DOES be. The Earth will go on to revolve on it s ain axis ; will go on to revolve in an oval around the Sun each twelvemonth. We will go on to love household and friends, flowers will blossom in the spring and the future consequences of planetary warming-good OR bad- will go on without my belief in a super-natural being. For the benefit of those that have non seen the arguments, nor had an disposition to read tonss of books on the topic, possibly I can cast some visible radiation on at least some of the more major subjects being debated between theists and atheists today. Another chapter or 2 will be devoted to existent claims by theists and the sensible rebuttals of those places. One recent argument was about whether athesim is the new fundamentalism . A cardinal statement from the theistic side was that atheists normally did non understand the committedness one makes sing being close to god, etc.. It was felt that atheists by and large dismiss that every bit merely another one of faiths idiosyncrasies. Again the unbelieving point of view trades with the statement straight and merely provinces that the great bulk of non-religious people USED TO BE, and have become, non-religious because they ve given up the committedness that they were led into as kids, taught in school, taught by their community, church, mosque, temple, etc.. Sometimes, even, they have given it up with changing grades of uncomfortableness and hurting, but they understand really good what is involved and what the narrative is that their oppositions, in the treatment, are committed to . We all know that virtually every faith in the universe has their holy book , or original manuscript of the compacts, regulations, narratives, and fables that combine to organize the footing FOR that faith. In Judaism you have the TORAH and Hinduism has the BHAVAGA GITA. Islam has the QURAN, the Bahai religion has the KITAB-i-IQAN and Christianity has the NEW TESTAMENT. Atheists have been accused of holding a philosophy, some common base to which all anti-theists subscribe. There is no holy book of godlessness and neer COULD be , states Professor Richard Dawkins in a recent argument. Atheism is non a belief system , there is merely publically-verified grounds . This goes against the very definition of fundamentalisms rigorous attachment to a holy book, and instead provinces that godlessness contains a committedness to alter, every bit shortly as new grounds comes in . Along with the accusals of godlessness being fundamentalist , there is besides the misconception that we know all there is to cognize, that we know the truth . In fact, any intelligent atheist runs pretty-much along the same lines as the idea processes of scientists. That is to state that we glorification in what we yet DO NT cognize . We are non bored with the yesteryear ( as theists would impeach us, associating to our comparative neutrality in the history of the bible, for case ) but instead we are excited by what it leads on toaˆÂ ¦ . What we DO NT knowaˆÂ ¦.. It can be, once more, compared to the scientific sphere where the spreads in our cognition ( the dodo record, as we have already talked about, for illustration ) are the beginning of derision from the theistic side. They maintain that, because of big spreads in our grounds or cognition, that no more inquiries have to be askedaˆÂ ¦ the reply is that god did it . On the contrary, scientists and atheists li kewise take pride in the fact that they are ready to roll up their arms and acquire down to working out things , trying to FILL IN those spreads. Any effort to de-rail unbelieving, rational, critical idea by claiming a holy book written by antediluvian, desert nomads is the reply, is foolish so. Dawkins concludes, Science may non cognize what happened before the Big Bang , scientific discipline may non cognize yet how life began, but if SCIENCE does nt cognize the replies to those inquiries, so there s perfectly no ground to say the reply is to be found in an ancient sanctum book, or ANY spiritual textaˆÂ ¦.. To believe THAT would be True FUNDAMENTALISM aˆÂ ¦aˆÂ ¦ Another muddying-the-water theist technique is to seek to hold long, intellectually-formed articles, trying to depict what an atheist truly stands for. What type of atheist ARE you , one might state. Materialism, pantheism, agnosticism, negative theoretic godlessness, practical godlessness. These are some of the categories of godlessness defined. They tell of philosophical differences, and changing degrees of committedness towards anti-theism. Suffice-it-to-say that each of these have their footing in history, but you will happen that most modern-day atheists are of the normal type, merely basking life without the demand to believe in an omniscient super-natural creatoraˆÂ ¦ . terminal of narrative. A 2nd point to see sing accusals of being fundamentalist, are the charges that we are extremists , that we are similar to the people involved in abortion-clinic bombardments or the ill-famed events of Sept. 11th, 2001. These, possibly, are accusals of the highly despairing or ill-informed, nevertheless I feel the demand to compose on this a spot. There have been many atrocious things in our history done in the name of faith, but when have you of all time heard of something atrocious being done in the name of Atheism? It is easy to take out and depict atrocious things like the extinction of 1000s of intellectuals and more by the despotic leader POL POT, for illustration, and state he did these atrocious things BECAUSE he was an atheist. In his early beginnings, because of hapless classs in school, he was considered to be a premier campaigner for inclusion into the philistine PCF group but that was 20 old ages before he came to power. I suppose that being an anti-intellectual organisation histories for their targeting of atheists, as a big per centum of true atheists do so hold ( or possess in some manner ) an rational mentality. POL POT evidently did non. Furthermore, POL POT was into many things, and if you take a sound expression into his life, he was more about killing people indiscriminately and doing problem in the name of groups within his state instead than killing people BECAUSE he was an atheist. If he WAS an atheist, he was surely NOT killing people based on that minor personal belief. He was nuts, pure-and-simple! ! ! The same can be said of STALIN, another individual frequently lumped in with the few tyrants the universe has had to postulate with who happened to be atheists ( in changing grades, I might add ) , but did NOT perpetrate their offenses BECAUSE they were atheists. He was an evil adult male who had a place of power and was a marionette of LENIN. He was a totalitarian dictator and if he had killed spiritual people, it would be because they would certainly be against the province and thereby him every bit good. Further research into Stalins life reveals that possibly he was non so anti-theist as people think. In the documental Mysteries of the Century: Kremlin Kids ( having Stalins girl, Svetlana Alliluyeva Stalin ) she recalled the followingaˆÂ ¦ . In male parent s library, between other books, were few tomes of Christ . It was history of Christ written by vox democrat Morozov. I said to my male parent: But Christ did nt be! and he answered Oh no, Christ, certainly exist ed. She goes on to speak about a few Acts of the Apostless that would look to propose Stalin was instead soft on covering with the religious-mindedaˆÂ ¦ . Under Stalins insistingaˆÂ ¦ . The Politburo of the Central Committee has admitted prosecutions of trusters inexpedient . Stalin besides canceled Lenin s direction from May, 1st, 1919 for N 13666-2 About battle against priests and faith and gave orders to People s Commissariat of Internal Affairs ( NKVD ) to let go of from detention already arrested priests if activity of these citizens did nt harm the Soviet authorization . The 9/11 calamity was committed by 19 highjackers who did all in the name of faith . They candidly and unfeignedly believed they were acting in a good and righteous manner , explains Richard Dawkins. They believed they were making what their God wanted them to make, they believed they were traveling to a martyrs wages . There is a logical patterned advance towards extreme spiritual indoctrination and these types of tragic events. Atheists beliefs have no such sort of logical, awful effects. These Muslim extremist folks have been taught these sorts of things since childhood in their religion schools. If there WERE a school of religion for godlessness there most surely would Not be any instructions which would demand a violent onslaught on people. If there WERE such schools they would be taught critical-thinking and how to do up their ain heads . Another accusal placed upon atheists ( more so on the more vocal 1s like the people I refer to in this book ) is the manner in which they use words to explicate their instance. Theists will state that they are utilizing the linguistic communication of extremism in seeking to acquire their facts across. In fact, this alleged new godlessness is the current phrase being bandied about on the argument circuit. Some of the more vocal of the unbelieving supporters, Richard Dawkins and Christopher Hitchens, as illustrations, are accused by assorted and assorted as being militant , dogmatic , radical , or extremist in their positions. The amusing thing about all this ( if you can name it funny ) is the immense spread in the existent extremism practiced, when comparing other societal motions like ISLAM, CHRISTIANITY and the BLACK PANTHERS. From saintgasoline.com you get What is being branded as extremism, combativeness, and fundamentalism in the New Atheist motion is barely correspondent to the extremism found in most other societal motions. In Islam, for case, the extremists talk of destroying heathens and western society, strap bombs to themselves, and wing planes into edifices. In Christianity, extremists and fundamentalists vilify homophiles and the generative picks of adult females, frequently trying to restrict their rights through statute law. In the civil rights motion, groups like the Black Panthers advocated and even practiced force. Meanwhile, in the New Atheist motion at worst you might happen Hitchens doing a self-satisfied comment, and that is what constitutes atheist fundamentalism and ext remism to so many critics of this motion. Passion for the attempt and work, plus the energy and enthusiasm observed with these two atheists is frequently mistaken for an utmost point of view, but is misguided as you can see. Another argument subject is the idea, by some theists, that atheists are truly agnostics-in-disguise. They go on to impeach atheists of being close-minded in their beliefs and that agnosticism is a more acceptable point of view. It is, nevertheless, false to accept the position that being agnostic is the middle-ground between theism and godlessness. Agnostics merely province that they can non claim to cognize for certain if any Gods exist or non. Atheists merely have an absence of belief in any God. In this manner, agnosticism is wholly compatible with both theism and godlessness. A individual can believe in a God ( theism ) without claiming to cognize for certain if that God exists ; the consequence is agnostic theism. On the other manus, a individual can discredit in Gods ( godlessness ) without claiming to cognize for certain that no Gods can or make exist ; the consequence is agnostic godlessness. The fact is that it is wholly possible for a individual to be agnostic AND atheist at the same clip. The averment by theists that atheists are more close-minded than doubters barely is a point in their favour. If atheists are close-minded for their rejection of Gods so, by really definition, so are the theists for their positions on the existent being of Gods! ! Far be it for atheists to really Be close-minded to the being of God though. It is apparent that some theists WANT their unbelieving oppositions to acknowledge that they are agnostic, as they can so impeach them of non being perfectly certain that God exists and of holding a faith place and hence have the upper manus in arguments, as that averment would do the theists feel more comfy. There are truly two definitions of godlessness that are considered in this subject. The THEIST version of an atheist is one who is certain there is no God, whereas the Agnostic is non certain. The ATHEIST version is one who BELIEVES there is no God, whereas an Agnostic merely does non cognize. I realize the two sound similar, but the ground most atheists say they do nt Believe in a God indicates something less than an absolute certainty of a Gods non-existance. In my sentiment, any moderately intelligent atheist would acknowledge that he/she would let 2 or 3 per centum points in favour of the possibil ty that there may be a God. It is non a sitting-on-the-fence scenario, instead it is an intelligent, reasoned position based on their apprehension of the work scientific discipline contributes to the universe. It is the truth brought about by the balance of grounds ( instead than a faith-based place ) that motivates atheists. They are cognizant that some piece of grounds might demo itself in the hereafter, and they respect that possibility ( againaˆÂ ¦ evidenceaˆÂ ¦ ) At any rate, theists are ever seeking to happen that angle to do the unbelieving side more vulnerable, but nil seems to be making the fast one so faraˆÂ ¦ . One of the chief implicit in subjects of argument certainly would hold to include the manner both scientific discipline and faith view the universe. In a spiritual world-view it s the supernatural construct of being that is the starting-point for peoples ethical motives and mentality on life, whereas that is non present in a non-religioius world-view. That is the basic premiss, nevertheless theologists are frequently excessively speedy to indicate out, harmonizing to www.teachingaboutreligion.org ( in the opportunism of their debating place ) that a worldview is acquired on an on-going footing, and many an person s worldview model blends spiritual impressions and patterns he or she acquires from a battalion of experiences over clip. A individual with exposure to several spiritual traditions is likely to hold a life mentality that is cobbled from the varied experiences and apprehensions to which they have been exposed. Although that statement might be true plenty, it does non take into history the absolute bulk of people who lazily go by the one-and-only faith in which they have been brought up. To propose that most have such an nonsubjective position of their ain faith is to propose that most use REASON to their spiritual beliefs and that does non look to be justifiable. The quotation mark says a individual with exposure to several spiritual traditions aˆÂ ¦aˆÂ ¦ . Where ARE these people? Surely non in the bible-belt of the United States. Surely non in North Korea. Freedom of faith does non be in Saudi Arabia, and a batch of other Muslim provinces. Harmonizing to www.pewforum.org, mentioning to the Pentecostal arm of Christianity..aˆÂ ¦ at least a one-fourth of the universe s 2 billion Christians are thought to be members of these lively, extremely personal religions, which emphasize such spiritually regenerating gifts of the Holy Spirit as speech production in linguas, Godhead healing and prophesying. Even more than other Christians, Pentecostals and other renewalists believe that God, moving through the Holy Spirit, continues to play a direct, active function in mundane life. I think this quotation mark goes a long manner to explicating the real-life position of the truster in our contemporary society. Add the fact that ( from www.religioustolerance.org ) over 33 % of the universe is Christian, Muslims history for about 20 % , Hindus 13 % and 21 % of the universes population patterns all the other signifiers of faith, and one gets a pretty clear image of the sheer Numberss. I would Love to cognize what per centum of these people are free-thinkers when it comes to embracing other peoples world-views ? Some of the arguments and treatments are nonreversible. These theists are at that place non to larn anything, but are at that place to make the sermon they know all excessively good. Arguments are a bipartisan street and one should ever hold a small spot of an unfastened head when come ining into such a argument. Preparation should be compulsory, but so should a willingness to larn niceties of the other sides place that, perchance, you were before of unaware. At a recent argument at a local auditorium, I had the good luck of being able to present a inquiry ( spoken as a remark because I did non desire to come across TOO harsh ) to the theists on the phase. I merely asked whether their statements on their existent belief in the being of God were echt, or did they merely reflect the fact that they had much to derive from holding dedicated a life to faith and spiritual surveies and holding written books and profited greatly by their publication etc.. I besides stated that would look a normal and baronial thing, to support oneself against an onslaught of unfavorable judgment over positions tightly held, but that all statements made SHOULD be done with a nod to common-sense and ground, things NOT apparently high on the docket of the theistic side. In fact, a sound self-look into 1s ain spiritual beliefs may problem many a truster, so of course we do nt anticipate their statements to incorporate much critical-thinking. I neer truly did acquire a satisfactory response to my inquiry that afternoon.

Presidential Election of 1888 essays

Presidential Election of 1888 essays In the year 2000, the presidential campaign between George W. Bush and Al Gore proved to be an inconclusive test of the most popular candidate, with Bush winning the electoral vote and Gore winning the popular vote. The last time a close election produced a split decision in the popular vote and the Electoral College was 1888. The 1888 presidential campaign is known as the most corrupt campaign in U. S. history. The current President, Stephen Grover Cleveland, won more popular votes than his opponent, but somehow Benjamin Harrison wound up with the larger share of electoral votes. Cleveland, the current Democratic President, had been through a close campaign once before. The Democratic Party unanimously nominated President Cleveland at the Democratic convention in New York. At the Republican convention, Benjamin Harrison was nominated and placed on the eighth ballot. The election campaign itself was very controlled with neither side actively campaigning. The major issue in the campaign was concerning tariffs. Benjamin Harrison supported a strong tariff policy and Grover Cleveland's policy was to reduce tariff's. The election itself was very close with President Cleveland winning the popular vote, but losing the electoral votes to Benjamin Harrison. When a reporter asked President Cleveland to talk about his defeat, Cleveland smiled and said, "It was mainly because the other party had the most votes." He never complained that he had more votes than Benjamin Harrison. President Cleveland dealt with his defeat with a lot of dignity. There were no recounts or lawsuits. His grace in defeat was even more amazing considering that the loss meant he had to surrender power he already possessed, not merely accept failure to reach it. One of the reasons that people did not challenge the election was that during this time, the government didnt matter as much in their lives as it does today. In 1888, Washington only collect...

Book review Essay Example | Topics and Well Written Essays - 1000 words - 7

Book review - Essay Example He further jots that for them it is nothing more than history: not all that diverse from the Peloponnesian War. He has channeled this insight into publishing this book that gives a valuable overview, in spite of an individual’s proximity to the Cold War. He outlines three vital lessons of the cold war. First, it was in period of cold war that the military strength stopped to be defining attribute of power itself, which it had been for the past 500 years. Gaddis’ clearest explanation of this phenomenon is the fact: even after the USSR collapsed, it still had its nuclear power and military into place (Gaddis, p14). Gaddis illustrates prior to 1945, great countries fought great wars so often that they tended to be permanent features of the transnational landscape: Lenin even relied or depended on them to give the mechanisms by which capitalism would-self destruct. However, after 1945 wars were limited to those between smaller powers and superpowers, as in vitenam, Korea and Afghanistan or to wars among smaller powers. What never occurred, in spite of world fears that it might, was a full force war involving the Soviet Union, United States and their respective allies. For the first time since timely memorial, no one could be assured of triumph, or surviving a big war. Second, the cold war discouraged dictatorship. Gaddis points out that even though china, the USSR and several states in Europe had authoritarian governments back in 1948 when a well-known book about totalitarian world, 1984, by George Orwell got published, the systems did not extend to the other countries. As 20th century was about to elapse, communism fell out of favor since it failed in delivering its promise of making the workers live better. Third, the cold war period, experienced globalization of democracy, explained by the growing number of democracies as the 20th century was elapsing (Gaddis, p82).

Consumer Behavior Assignment Example | Topics and Well Written Essays - 250 words

Consumer Behavior - Assignment Example e side of marketing organizations can be inefficient marketing activities such as high cost promotions, inefficient place selection for marketing the product, and higher prices. Establishing effective marketing strategies is not an easy task; common marketing strategies can lead organizations towards loss, same as bad services and products leads organizations to negative word of mount that has immense impact on consumers buying behavior. Highly stricken governmental and public policies can be disastrous for organizations such as higher taxes, strict advertising, and labeling policies. In order to prevent from costly procedures, the proper marketing plan must be analyzed. In current business arena, online marketing has taken place and revolutionized the marketing world; therefore, internet should be considered as an alternative. Organizations must consider its value while making strategies and should keep public and governmental policies in mind. Countries with lower regulations should be considered as an alternative. Word-of-mouth does not have any alternative but good marketing campaign, and sampling technique can be an alternative. The most important thing that can influence consumer behavior is marketing strategy if the marketing strategy is good then organization can deal with other issues easily. In order to avoid bad marketing strategies proper course of actions must be introduced and to influence customers positively inbound marketing software and technological innovations should be acquired. Organization can choose place where government does not have much impact on producers. For example, U.S has tight policies and regulations and to meet these policies and regulations is not possible for everyone. Technological advancement and use of software will enable organization to avoid bad, time consuming, and costly practices and acquire good strategies. If organization will go global by entering in countries that have not tight rules and regulation, then it

The Effects Of Infrastructural Facilities

The Effects Of Infrastructural Facilities Infrastructure are the basic facilities, services, and installations needed for the functioning of a community or society, such as transportation and communications systems, water and power lines, and public institutions including schools, post offices, and prisons. Large infrastructure projects generally stimulate demand for nearby real estate .these infrastructural projects usually create abundance of jobs as well as follow on demand for goods and services. They also provide a more effective use and connectivity of the available economic resources and the resulting increase in economy activity from new and more disposable income will in turn typically boost. Economic growth, thats why people will want to purchase or rent residential estate in location within close proximity to major works, Major infrastructure project can take many forms and often include transport, infrastructure improvement such as link roads, railway line extension, new bridges and major freeways. Other projects could be new shopping malls and commercial precincts, new power stations, improve communication facilities industrial areas and business parks, new hospital, school and universities. These can all have an impact property values and demand for residential properties. It is also worthy to note that the quality and quantity of infrastructure available in a given place societies is the yardstick for measuring the general level of development of that area and a major determinants of property development and their respective value trends. The provision or not of these facilities can positively development affect the rate of property development in a given area and this in turn can improve the property value due to the corresponding boost on economics activities achieved through the better accessibility (road) or the higher degree of convenience from the use of these infrastructural facilities. 1.2 Statement of Problem The infrastructure of a city is a major determinant on the demand of houses. One of the major problems affecting housing demand in Lokoja. The poor infrastructure provision in the study area affects the rate of housing Demand in the area, this is because people will only buy or rent houses in areas were the infrastructure provision is sustainably available,this will help to enhance the livability in the community. The poor infrastructure provision in Adankolo is a major determinant on the decrease in the rate of housing demands in the study area. Those who are living in the study area have no choice because they cannot afford the rent in other livable towns . Housing is an enclosed component or structure that has services which support the comfort and existence of human living. These services or facilities are numerous some of which include; kitchen, toilet, refuse disposals, good road networks, electricity, telecommunication and others. Ogedengbe and Oyedele, (2006) carried a research on effects of waste disposal on property values, similarly Robet in his work The Effects of Road Infrastructure on Property Values emphasized more on just road as a facility affecting demandvalues, Whereas many other facilities affect values of residential properties. This now poses a gap between these previous empirical studies hence there is need to reconsider many other facilities as they affect housing demand and housing demand of residential properties. 1.3 Aim and Objectives The aim of this study is to ascertain the effects of infrastructural facilities on housing demand in Lokoja metropolis. OBJECTIVES To identify the various infrastructure available in the study area. To examine the adequacy of infrastructural facilities provision on the residential properties in the study area To recommend possible solution to the problems of housing in the study area. 1.4 Scope of the study This research work intends to determine the effects of infrastructural facilities on housing demand in Lokoja. It is limited to Lokoja metropolis alone with particular emphasis on two areas namely; peace community ganaja village and Adankolo for comparative analysis. 1.5 Justification Although challenges surrounding life and human wants are limited and endless, however these study focuses on the effects of infrastructural facilities on housing demand in Lokoja. And this particular studywill serve as a guide to the following. Urban and regional planners and other allied professionals such as builders, architect, engineers, and others in their various field of activities .for example, these study would give the city managers the ideas of important of infrastructural facilities in there different areas. It serves as a tool to all researchers in the field particularly in the study area.(Lokoja) 1.6 The Study Area Lokoja, Nigeria is located at 7.80236 [latitude in decimal degrees], 6.743 [longitude in decimal degrees] at an elevation/altitude of meters. The average elevation of Lokoja, Nigeria is 55 meters.Lokoja is also a Local Government Area of Kogi State with an area of 3180 km ² and a population of 195,261 at the 2006 census. It is bounded by the Niger in the north and east upstream from the capital until the border with Kwara State, and includes the city of Lokoja. The postal code of the area is 260.The original site of Lokoja, is a 1,349-foot- (411-metre-) high mass of oolitic iron ore. The town has a hydroelectric power generating plant. It is situated on the local highway between Kabba and Ayangbe and has ferry service across the Niger River. Formerly the capital of Kabba province, Lokoja was part of Kwara from 1967 to 1991, when it became the capital of the newly formed state of Kogi. CLIMATE Climate: The site has a tropical climate that comprises of two season namely dry and wet seasons. The wet seasons starts from the month of April and ends in October, while the dry season starts from November and continues till March. The two seasons are affected by the south-westerly winds coming from the Atlantic Ocean and north-easterly winds which come from the Sahara Desert. Another weather phenomenon (micro climate) is associated with the presence of inselbergs. This feature exerts an influence on local weather greater than their size. Rainfall: Rainfall data obtained from the Department of Meteorological Services Lokoja for 25 years (1989- 2005) reveals that the maximum daily rainfall figures of Lokoja town are as follows: Humidity and Temperature: The highest temperatures in the study area always tend to occur at the end of the dry season close to the spring equinox. Thus March has the highest temperature of about 34.5 c, while the lowest temperature occur in the middle of the dry season in December/January, when outgoing radiation is encouraged by low humidity, clear skies and longer nights. The temperature at this time falls as low as 22.8 c. In the dry season there is a decrease in relative humidity from south to north in the study area caused by the higher elevation in the north. In the rainy season, this variation disappears and associated with the high relative humidity is an extensive cloud cover over the region. ECONOMY Agriculture is main stay in Lokoja area economy, various crops are widely grown in the area which includes; coffee, cocoa, palm oil, cashews, groundnuts, maize, cassava, yam, rice and melon.The state is home to the largest iron and steel industry in Nigeria known as Ajaokuta Steel Company Limited. One of the largest cement factories in Africa, the Obajana Cement Factory . MAP OF NIGERIA DEPICTING STUDY AREA Limitation of the Study The major problem in the field of study is language barrier and through these, the researcher that did not understand their language (respondents) will find it difficult to express his mind freely to those that did not understand English language which is the general language in Nigeria, among the respondents. Another problem is illiteracy among the respondents; because some of the respondent finds it difficult to fill questionnaire which is the main information needed from them for the completion of the project. Lastly regardless of these limitations, data collected are sufficient enough to reach the research objectives. 1.8 Definition of Terms Infrastructures It can be generally defined as the set of interconnected structural elements that provide framework supporting an entire structure of development The term typically refers to the technical structures that support a society, such as roads, bridges, water supply, sewers, electrical grids, telecommunications, and so forth, and can be defined as the physical components of interrelated systems providing commodities and services essential to enable, sustain, or enhance societal living conditions The terms housing demand and housing needs are often confused. There are Some key differences between housing demand and housing needs that must beclarified. The meaning assigned to both terms is erroneously similar in manydocuments. The following statement is extracted from the study of housing- Demand models published by the Housing Branch in Hong Kong which asserts that: Housing needs Housing needs is defined as the number of existing ornew households requiring adequate housing. Anadequately housed household is one that lives in selfcontained living quarters made of permanent material.(Liu, Wu, et al. 1996) They also proffer a workable definition of housing demand, viz: Housing demand Housing demand is defined as the number of householdsactually seeking accommodation. In the public sector,demand is assumed to be equal to housing needs. In theprivate sector, demand is constrained by affordability. Facility may refer to: An installation, contrivance, or other things which facilitates something; a place for doing something: Literature Review Infrastructure has been variously defined, according to William Merish and Catherine Brown described infrastructure as the systematic framework which underpins a communitys ability to fulfill its mission of providing a basis of its citizen to productive and to nurture social equity.Omuojine(1997) described it as the stock of fixed capital assets in a country for example Road, railways, Airports, Hospitals, Waterway, power stations, water works, and telecommunication network. It serves as slender threads that weaves together human want and value with those of the environment.Literally, it refers to fixed facilities or installation traditionally provided by public sector. Omuojine (1997) classified it as followed. Transportation including road, railway, airports, seaports and water way. Water supply including water works and Dams Electricity including power stations Telecommunication including postal, telephone, telex, fax, mile services. Health including Hospital, maternity home, and health centers. Sanitation and solid waste disposal. Drainage and Embankments. Infrastructures have certain characteristics viz. Requires large lump sum investment. Entails considerable economic of scale which results in monopolies. Has a high level of externalities both positives and negatives. Intermediate input characteristics. Possess important networks effects. Posses difficulties in cost recovery. While these characteristics have generally remained true, the exact character trait will depends on whether it is urban, rural or inter rural. Infrastructure or trunk and feeder type of fixed/ moving facilities, or the operator of the facility i.e. Whether public or private, central/ state, local Government agencies. Infrastructures include the aggregate of all facilities that enables a society to function effectively, by providing the physical facilities, which moves people, goods, commodities, water, waste, Electricity, road, sewerage and information infrastructure provides an enabling environment for growth and enhanced quality of life.PojuOnibokun (1985) infrastructure is therefore; universally regarded as the engine that drives the city. The linkage between the economy activities and infrastructure continue to grow stronger and more critical as an economic activity becomes increasingly more complicated and global in scope. Lawal (1997). Through the provision of urban infrastruct ure is tradition all the presence of government, the growing difficulties and limitation of public finance and the reality of the wide gap between the demand and supply of infrastructures services with all its pervasive effect inevitably compel urban authorities to look to the private sector and community. Based organization (cbos) for partnership. Babawale (2004) infrastructure is generally poor in developing countries. Although it differs widely among countries and sectors. In Nigeria for instance most households and private companies get electricity form private generating sets because of power holding of Nigeria unreliability. This imposed extra cost on companies and environmental effects on neighbors. There is no water supply in most cities and therefore no waste disposal system. HOUSING DEMAND Housing demand is defined as the housing need people backed up with the purchasing power or the ability and willingness to pay. According to You (1993). As quoted in Olufemi(1993), housing demand could be expressed in term of purchasing power, a function of income, family size, location and tradition etc. Housing demand is different from need. It is only when the need (desire) is backed up with price or rent that we talk of effective demand.According to Robinson (1979), there are three main component of housing demand and these are. From new households, demand from movers between tenure group and demand from existing household within a particular tenure groups. The author also noted that renting is an important feature of demand. This is because the majority of household who could not build or purchase their own home often result to renting. Demand for housing differs from place to place across the socio- economic groups. For instant demand in the city differs from that of the rural areas. Demand also differs among high, medium, and low income groups. Housing demand also changes with time and with social and economic situations. In Nigeria for instance there is a noticeable change in the demand for different type of units. As income and building technology changes. There has been gradually change from the demand for row housing or face to face tenement to more modern housing types such as self contain and flats apartment as well as duplexes. Generally,housing market or sub market of the low income group demonstrates a great diversity of demand, which result from two major factors (UNCHS, 1996) first is there disposal income and the second is how much they are prepared to spend on housing. The amount of money they are willing to spend on housing is in turn determined by the type of accommodation available, the location, s ize, and quality of the houses in terms of infrastructure and services available, and the level of security offered. The demand for housing is a reflection of the ability of household to pay for them. Thus, an examination of households, income and prices of housing unit provides a basis for accessing housing demand, an assessment of the housing demand situation in Nigeria by the UNCHS (1993) reveals that the different income groups are confined to different options. Generally, the poor economic situation in Nigeria during and in the post. Structure adjustment program (SAP) period has affected the purchasing power of the majority. Although household income have risen, in numerical terms, by a factor of about five since 1987, the purchasing power has declined by a factor of about eight(UNCHS,1993). It is therefore observed that the household income of the lowest income group are too low to allow them to exercise any effective demand for formal housing in the open market consequently, majority of the low income household cannot afford any form of formal housing without subsidy. Thus they resort to sur vival outside the formal housing market. For this group the UNCHS (1993) observed that. the present 20% of the household do not earn enough to participate in formal housing market in the urban area. They resort to various informal housing arrangements for themselves. This arrangement includes the setting -up of shanty dwellings of their own on land belonging to them(squatting), renting shanty dwelling, colonization of uncompleted multiples storey buildings, occupation of vacant spaces in public buildings at night,etc. BASIC CONCEPT OF HOUSING. Housing is an empirical word as Salau (1990) has written The confusion of given an exact meaning of definition to housing is perhaps due to the multi-dimensional nature of housing itself Agboola (1998) stated that Housing involves series of processes by which resources such as land, labour, finance and building materials are combine to produce new housing. It involves also the upgrading of existing housing to the demanders .He explained further that housing particular delivery system encompasses the process that allocates housing unit to households in particular country and that housing delivery is stimulated and sustained by the demand and supply mechanism this of course,means that in a free market economy like Nigeria, the forces of demand and supply for housing stock, may determine what stocks come into the housing delivery market and who among the demander get what from the market?. According to Baurue (1981), Housing is the provision of all forms of infrastructures for a conducive living environment whereas habitable and standard houses bythe residential or commercial or any other forms of building properly arranged in a statutorily planned area meeting all the forms of planning rules and ordinances in housings.World health Organization (WHO). Defined housing as a residential environment which includes in addition to the physical structures. The main uses for shelter, all necessary services, facilities, equipment and devices needed or desire for physical or social wellbeing of the family and individuals. Ayeni(1984) defines housing as not only referring to the shelter provided by the structure but also the lot on which the shelter stands and the services provided to the lots such as waterand energy supply, waste disposal, drainage, fire and police protection and kick lighter (1986)defined the term housing in its entire ramification to refer to more than just a dwelling but also included all that is within and surrounds thedwelling. Salau(1990) transcends the physical dimensions of shelter and include the general environment within which the structure is located and the availability of essentialsocial services and infrastructural facilities, which ultimately ensure the satisfaction of the population. National housing policy (1991), housing forms an important part of peoples life and it is rather inseparable from them as it provides the users of occupiers shelters, security, privacy, prestige and a means of self-expression. It is a basic need as everyone requires a shelter, which for most people means a home that, is a permanent base in which the greater part of time is spent. Ozo (1987), asserted that a house must be a home;that is , a resting place in which to try to fulfill the fundamental purpose of human society,namely a secure , rewarding, happy or atleast a reliable life.to the individual family,a house as both a shelter and symbols of physical protection and psychological identity of economic valueand a foundation for security and self respect.Olotuali (1997) stated that housing provides the framework of meeting mans need for shelterand it is all encompassing phenomenon of the creation of the environment, in which man grows and lives and grows.Bourne (1981)summed housing up as a physical entity, a good artifact, an economic good, a capital stockand a statue symbol all at once.Madge(1968) assorted that housing is an important element in all capital formation and the largest single component in total building of any nation. According to Omole(2001), housing is more than a mere shelter in its proper definition , housing can be defined as a residential environment which man uses for shelter and the environment of the structure needed or design for his physical and mental health as well as the social being. Ozo (1987), a house is certainly the bulkiest, the most difficult to move and most durable consumer good. In view of the enormous resources requiredin acquiring housing (since it can hardly be purchase out of ones income in less developed countries). It is true measure of the social- economic statues of a society. Looking at the definitions above .therefore a good housing or shelter development of a group of people and a nation at large. A well determined settlement equally determined the productivity and consumption ration as well as economic, moral and welfare terms of the people or nation. THE NIGERIAN HOUSING MARKET The Nigerian housing market is highly untapped and undeveloped despite lot of opportunities that abound in the sector (Akeju 2007). This is basically due to many reasons amongst which includes. Lack of finance Government policy Lack of infrastructural development High level of poverty. There is continuous increase in the average price of house due to increase in cost of building materials and inflation in the economy. This has highly contributed to the upward trend in the house trend in the house price which has significantly affected the number of unit of houses constructed annually. The Government efforts at addressing the problem have not been successful due to its unsustainable approach of providing houses to the people, the houses are grossly inadequate and unaffordable by the larger proportion of the masses for which they are meant for. There are efforts by the private individuals to help in alleviating these housing problems. The bulk of the housing problems is prevalent in urban cities, but there are lot of un occupied and dilapidated houses in the rural areas to urban centers for greener pastures. Most individual that are involved in property development build for their own uses or are home owners, while the few ones involves in building for commercial purposes, build shops and space to let for offices because if the high rental income accruing from such commercial properties. The residential developments in most cases are illegal, informal and untitled. This is due to long, undue delay to title registration and laxity in enforcing development control regulations by the official of the urban and regional planning department (Fasakin and Ogunmakin 2006). Private sectors contribution toward alleviating this housing problems has been I the form of individual efforts, cooperative societies or association, corporate bodies, estate agents, nongovernmental organization / charity organization and foreign investors, their contributions toward alleviating housing problems in Nigeria are briefly discussed below. INDIVIDUALS This represent the greatest source of contribution from the private sector in most urban centers where the housing problem is very prevalent , a greater proportion of the population dwells in residential houses built by private individuals. These individual financed the project through their personal savings, borrowing from family, friends and lenders or cooperative movements. It can be categorically stated that number of housing unit built by individual have been very substantial when compared with other source of constructing houses. (2) COOPERATIVE BODIES The idea of cooperatives housing have started long time ago when individual planning to own a house seek help from relative, in town, neighbors and friends (Wahab 1988). This concept has been successfully tested and certified in countries like Italy, United Kingdom, Zambia, Sweden and Philippines (Daramola, 2006). It is suited to meet the need of low income earner who constitutes the vast majority of Nigerians. The member of the cooperative are able to enjoy housing loan for the construction of their own housing unit. (3) CORPORATE BODIES. The federal government of Nigeria has realized that they cannot solve the housing problem alone. Has involved the cooperate bodies to contributes their own goals towards the achieving the objectives of housing for all. It was evident that most of the companies have totally neglect for housing needs of their workers. These consequently made the Government come to the rescue of the workers. These consequently made the Government come to the rescue of the workers through the promulgation of employee housing scheme (special provision). Decree 54 of 1979, thus compelling any employer of 500 employees to provide minimum housing of 50 units of which 75% should available for non-executive staff. (4) ESTATE DEVELOPER / AGENTS The private developer or estate agents activities were concentrated in Lagos in 1990 and they play significant roles in the development of the Nigeria housing market (Efin. A and Finmark trust,2010), they ensure adequate shelter is provided to meet the demand of the increasing number of people having housing need. They often employ various finance techniques such as turnkey, pre-letting and joint finance to construct housing unit for the people (Nubi 2000). (5) NON GOVERNMENTAL ORGANISATION AND VOLUNTARY ORGANISATION. In recent year there is increasing trends by non-governmental organization and voluntary organization such as religion bodies to contribute their own effort at addressing the housing problems faced by the people in both rural and urban cities. They assist resetting displaced people having housing problem as a result of natural disaster like war, flood, famine, earthquakes, and etc. (6) FOREIGN PARTNERS / INVESTORS. The government through its various development policies has attempted to encourage foreign investors in the housing market. This is usually in the form of foreign partnership with the local estate developers.These provided more capital base for the estate company, thus making them to be involved in large capital based project. The company are usually handling Government housing project which are capital intensive and required more technical expertise and knowledge. THE ECONOMICS OF HOUSING Housing as a product is regarded as a commodity with an exchange value, according to Angel et.al (1992), housing is viewed as a commodity with an exchange value rather than as goods to be produced and allocated outside the market place. Hence the housing sector is composed as a vast set of exchange relations, driven by supply and demand forces which permit all part of the sector despite the existence of apparently distinctive sub markets. (Agunbiade 1993). The units in the standing stock to be traded in the market have a contribution of attributes and qualities, which determines their selling prices. Such attributes include age and durability of structures, total floor space, structural design and internal layout, location accessibility, ancillary services present, security, aesthetics and the general environmental condition. These attributes distinguish one unit from the other. Thus the structural condition of units and the flow of services they yield determine the value of housing unit in the market. According to Robinson (1979) there are two measure of value in the housing market, these are rent and price. Rent is the payment made for a flow of housing services received over a specific period of time while price is the capital value associated with a particular unit of stockin the ordinary sense, we could argue that the value of housing unit (V) is equalto its price (P) i.e. V = P . However in some cases, the different between the exchange value and the actual value is refers to as subsidy, which is often, paid by Government or corporate bodies to their employees. Thus, subsidy could be regarded as a distortion to the actual market determined price or rent of a housing unit. Housing need, supply and housing price in an economy involved complex processes that are influenced by social and economic force. The understanding of the nature and attributes of the demand and supply of housing is therefore important in any housing study. However, before we address the issue of need, demand, supply and price. It is ideal to consider the characteristics of housing as a product 2.5 ROLE OF INFRASTRUCTURAL FACILITIES ON DEVELOPMENT Ratchiffe (1995) classical rent theory conceptualizes that general improvement in access routes (Roads) have positive effect on the areas land values; Boyce and Allen (1974) in Denver studied the impact of accessibility and amenities on property values. They selected several study areas then applied six (6) criteria encompassing accessibility, amenities and property characteristics and used regression analysis to investigate 24,082 property transactions. They identified a positive impact of infrastructural facilities on property values. Stopper and Meybury (1971) claimed that the relevance of transportations facilities in influencing urban growth and development is reflected in most North. American and Europeans town which shows a growth pattern derived largely from transactional routes. Abouchar (1977) investigated the impact of a subway on property value on Toronto, he studies the metropolitan Toronto subway system through on analysis of the operations of welfare criteria with the basic objective of distinguishing the impact of the subway on property value (demand and price) by looking at year to year relative percentage changes in property values in and out of the subway corridor. However, his analysis concluded that the subway had no effect on the property value in the subway area. The validity of findings and conclusion are questionable as the study did not fulfill the requirement of a before and after approach because the analysis of the property market was concluded in 1992 the date the subway began its operation. Abdulateef (1997) observed a positive impact of road transportation and communication on land use development and property values, the provision of infrastructural facilities in any socio economic unit whether a nation, region or community could have either a positive or negative impact on property value. For instance, the provision of an incinerator in a residential district will have a negative effect on the value of the properties in that area while the provision of infrastructural facilities like good roads network, water and electricity supply, drainage system, good refuse collection treatment and disposal system etc enhances values to unpre cedented level just as the inadequacy or lack or these facilities adversely affect value as a paradox. 2.6 IDENTIFICATION OF PUBLIC UTILITIES MANAGEMENT AGENCIES IN NIGERIA The prominent public agencies for the provision and management of the infrastructural facilities in Nigeria are: Power holding company of Nigeria Plc. In charge of electricity generation, distribution and supply to consumers (PHCN) Nigeria telecommunications limited (NITEL) State water corporation State waste management boards Federal road maintenance agencies (FEMA) Nigerian communications commission (NCC) Federal air

Cognitive Impairment And Alzheimers Disease Health And Social Care Essay

Apathy is one of the commonest symptoms in Alzheimers disease and is associated with frontal lobe disfunction. Apathy is associated with high health professional load and has several negative effects.Purposes:The primary purpose of this survey is to analyze an association between apathy and frontal lobe disfunction in patients with memory jobs. We besides aimed to look into the association between apathy badness and health professional load along with the relationship between apathy and practiceMethods:This was a retrospective cross sectional survey. We selected 162 back-to-back patients diagnosed with Alzheimer ‘s dementedness and Amnestic Mild Cognitive Impairment who had comprehensive battery of neuropsychological trials and a behavior evaluation graduated table of involvement for this survey recorded in the database. Correlation between apathy with and without depression were tested against frontal lobe trial including Trail doing A, Trial doing B, Letter Fluency, Ideationa l Fluency, Category eloquence, Abstract Thinking and Executive working subtest of CAMGOG-R. Similarly correlativity analysis was besides done to look into association between apathy and caregiver load every bit good as practice.Consequences:Statistically important relationship were found between apathy and executive map tonss, conceptional eloquence tonss, abstract thought and class eloquence tonss. Relationship between apathy and health professional load were extremely important. Further bomber analysis, found apathy to be significantly associated with health professional load in both AD and aMCI patients.DecisionsApathy is associated with frontal lobe disfunction particularly impaired executive map and conceptional eloquence even when controlled for depression. It is extremely associated with health professional load both in AD & A ; aMCI.Hence early acknowledgment and direction of apathy is of import bettering the forecast of patients with AD & A ; aMCI.Table OF CONTENTSABSTRACT 3Chapter 1: Overview OF APATHY 5- 18Chapter 2: Introduction 19 – 20Chapter 3: AIMS & A ; OBJECTIVES 21Chapter 4: Methodology 21 – 28Chapter 5: RESULTS 28- 40Chapter 6: DISCUSSION & A ; CONCLUSIONS 40 – 44REFERENCES 45 -48APPENDIX A: Clinical RESEARCH PROTOCOLAPPENDIX B: ETHIC APPROVAL LETTERAPPENDIX C: NHS R & A ; D APPROVAL LETTEROVERVIEW OF APATHYDefinitionApathy is derived from the Grecian term apatheia intending deficiency of poignancy, or passions, and is normally referred as absence of feeling, emotions, involvement, or concern. ( Marin, 1990 ) Marin was the first to gestate apathy at both symptomatological and syndromal degrees and defined apathy as â€Å" deficiency of motive non attributable to decrease degree of consciousness, cognitive damage, or emotional hurt † ( Marin, 1990 ) .Motivation is a psychological construct and therefore it hard to quantify and measure up it.Hence to do it more clinically qualifiable and quantifiable, Apathy was proposed as a behavioral alteration from the person ‘s baseline and measured as a decrease in spontaneous and purposeful activity. ( Levy and Dubois, 2006 ) . A Starkstein and co-workers have developed a set of diagnostic standards for apathyA these standards specify the undermentioned as nucleus characteristics of apathy: lessened motive, inaugural and involvement, and blunting of emotions ( Starkstein and Leentjens, 2008 ) . In malice of assorted definitions of apathy being proposed, confusion continue to reign sing the nosological place of apathy.Nevertheless progressively apathy is being recognised as an of import constituent of neuropsychiatric research and that ‘s why dependable instance description and designation is necessary, to help communicating, research and intervention. This led to the development of consensus diagnostic standards for apathy in Alzheimer ‘s disease and other neuropsychiatric upsets ( Robert et al. , 2009 ) .DIAGNOSTIC CRITERIAThe revised consensus standards for apathy follow the same general construction as the standards proposed by Starkstein et Al in 2001 ( Robert et al. , 2009 ) . For a diagnosing of Apathy the patient should carry through the standards A, B, C and DStandards ALoss of or diminished motive in comparing to the patient ‘s old degree of operation and which is non consistent with his age or civilization. These alterations in motive may be reported by the patient himself or by the observations of others.Criteria BPresence of at least one symptom in at least two of the three following spheres for a period of at least four hebdomads and present most of the clipDomain B1: Loss of, or diminished, purposive behavior as evidenced by at least one of the followers: Loss of self-initiated behavior ( for illustration: starting conversation, making basic undertakings of daily life, seeking societal activities, pass oning picks ) Loss of environment-stimulated behavior ( for illustration: responding to conversation, take parting in societal activities )Domain B2: Loss of, or diminished, purposive cognitive activity as evidenced by at least one of the followers: Loss of self-generated thoughts and wonder for modus operandi and new events ( i.e. , disputing undertakings, recent intelligence, societal chances, personal/family and societal personal businesss ) . Loss of environment-stimulated thoughts and wonder for modus operandi and new events ( i.e. , in the individuals abode, vicinity or community )Domain B3: Loss of, or diminished, emotion as evidenced by at least one of the followers: Loss of self-generated emotion, observed or self-reported ( for illustration, subjective feeling of weak or absent emotions, or observation by others of a dulled affect ) Loss of emotional reactivity to positive or negative stimulations or events ( for illustration, observer-reports of unchanging affect, or of small emotional reaction to exciting events, personal loss, serious unwellness, emotional-laden intelligence )Criteria CThese symptoms ( A-B ) cause clinically important damage in personal, societal, occupational, or other of import countries of operation.Criteria DThe symptoms ( A-B ) are non entirely explained or due to physical disablements ( e.g. sightlessness and loss of hearing ) , to drive disablements, to decrease degree of consciousness or to the direct physiological effects of a substance ( e.g. drug of maltreatment, a medicine ) .PrevalenceApathy is an of import and often happening symptom in a assortment of neuropsychiatric upsets. Dementia and schizophrenic disorders are among the common causes of apathy ( ref ) . The prevalence for apathy in Alzheimer ‘s disease ranged between 32.1 % ( Holthoff et al. , 2005 ) and 93.2 % ( Sr ikanth et al. , 2005 ) . Point prevalence for apathy in Alzheimer ‘s disease ranged from 32.1 % 19A to 58.7 % ( Aharon-Peretz et al. , 2000, Holthoff et al. , 2005 ) . Table 1: Prevalence of Apathy Across Disorders ( Ishii et al. , 2009 )DisordersPrevalenceMild Cognitive Impairment 14.7 % a?’39.8 % Parkinson ‘s disease 17.0 % a?’45.7 % Progressive supranuclear paralysis 22 % a?’91 % Huntington ‘s disease 59 % a?’82 % Corticobasal devolution 40 % A Frontotemporal dementedness 89 % a?’100 % Dementia with Lewy organic structure 52 % Multiple induration 20 % a?’31 % Stroke 15.2 % a?’42 % Vascular dementedness 22.6 % a?’93.6 % Traumatic encephalon hurt 20 % a?’70 % Amyotrophic sidelong induration 55.6 % Hiv 12 % Cardiovascular disease 29 %CONDITIONS ASSOCIATED WITH APATHYApathy can be a symptom in a figure of neurological or psychiatric syndromes. Neurological Disorders include Traumatic encephalon hurt, Stroke affecting the frontal-subcortical circuit, Alzheimer ‘s disease ( AD ) , Dementia with Lewy organic structure ( DLB ) , Creutzfeldt-Jakob disease, Frontotemporal dementedness ( FTD ) , HIV dementedness, Parkinson ‘s disease ( PD ) , Progressive supranuclear paralysis, Anoxic brain disorder, Cerebral tumor, Chronic subdural haematoma, Huntington ‘s disease, Limbic phrenitis, Multiple induration, Bingwanger ‘s encephalopathy, Wernicke-Korsakoff syndrome, Kluver Bucy syndrome, Hydrocephalus, Delirium Psychiatric Disorders such as Depression, Schizophrenia, Psychoses and Adjustment upset Psychotropic drugs: . Dopamine adversaries are by and large associated with lessened motive, whilst agonists can increase it. Cannabis dependance, pep pill and cocaine backdown have all been implicated as a causative factor. An amotivational, or apathy, syndrome has been reported in a figure of patients having selective 5-hydroxytryptamines reuptake inhibitor ( SSRI ) intervention over the last decennary. This inauspicious consequence has been noted to be dose-dependent and reversible, but is frequently unrecognised ( Garland and Baerg, 2001 ) . Medical Disorders such as Apathetic thyrotoxicosis, Drug intoxications/withdrawal, Hypothyroidism, Lyme disease, Pseudoparahypothyroidism, Chronic weariness syndrome, Testosterone lack, Vitamin B12 lack, Other enfeebling conditions ( eg, malignance, CCF, nephritic or hepatic failure ) .IS APATHY AND DEPRESSION THE SAME?Apathy has frequently been treated as a portion of depression and it can frequently be diagnostically disputing to distinguish between the two due to frequent carbon monoxide morbidities and a considerable convergence in cardinal symptoms. However they are different concepts and it is of import to distinguish them because of predictive and intervention deductions. Apathy can besides ensue from the intervention for depression. There are theoretical concern that serotonergic re-uptake inhibitors ( SSRIs ) may impact the counterweight of 5-hydroxytryptamine and Dopastat, which can take to apathy, and SSRI-induced apathy has been progressively reported.Table 2: Differences and convergences in the clinical symptoms of apathy and depression ( table adapted from Landes et al. , 2005 )Apathy SymptomsDepressive SymptomsShared SymptomsLack of emotional response Indifference Diminished motive Lack of productiveness Poor Persistence Low societal & amp ; occupational battle Person is by and large satisfied Low temper Feelingss of guilt, Suicidal ideations Insomnia Reduced appetency Pessimism Self-criticism Hopelessness Worthlessness Loss of involvement Psychomotor deceleration Fatigue/hypersomnia Lack of penetrationEffectss of ApathyApathy has important negative effects and therefore early designation and diagnose is critical. In Alzheimer ‘s Disease ( AD ) patients, apathy is associated with hapless penetration into cognitive and behavioral alterations ( Derouesne et al. , 1999 ) along with greater cognitive every bit good as functional diminution ( Holtta et al. , 2012 ) . Apathetic patients are frequently misperceived as lazy by the household taking to increasing resentfulness. Apathy may impact patient perceptual experience of quality of life ( Gerritsen et al. , 2005 ) and is significantly associated with activities of day-to-day life ( ADLs ) damage ensuing in increased patient and health professional distress.. It is besides significantly associated with older age and a higher incidence of depression and craze ( Holtta et al. , 2012 ) . Apathy has been shown to be associated with frontal lobe disfunction particularly executive map in dementedness ( Ready et al. , 2003 ) and these frontal lobe maps are indispensable to a individual ‘s ability to transport out mundane planning and determination devising along with health-promoting behaviors, such as medicine direction, dietetic and lifestyle alterations, self-monitoring of responses, and follow-up with wellness attention professionals ( Kuo and Lipsitz, 2004 ) . Apathy affects the quality and degree of familiarity in a relationship and hence enjoyment of each other ‘s company. This leads to impairment of the relationship, increased health professional load and an increased the hazard of institutionalisation ( Spruytte et al. , 2001 ) ( de Vugt et al. , 2003 ) . Apathy besides has of import diagnostic and intervention deductions.It may forestall patients from seeking an early formal appraisal and may interfere with attachment to pharmacologic intervention for memory loss and engagement in compensatory schemes, such as keeping an accurate and up-to-date memory notebook ( Ready et al. , 2003 ) . Apathy may hold important predictive value.Apathy has been described to increase the hazard of patterned advance from MCI to dementia. In nursing place patients with Alzheimer ‘s dementedness, apathy has been associated with physical damage, dependence, hapless nutritionary position and significantly increased 2-year mortality rates ( Holtta et al. , 2012 ) .PATHO-PHYSIOLOGY OF APATHYApathy has been shown to be associated with a break of the frontal-subcortical neural circuit. Assorted surveies have concluded that the neural circuit that originates from the anterior cingulate cerebral mantle, so proceeds to the ventral striate body, globus pallidus, and thalamus, with a concluding cringle back to the anterior cingulate cerebral mantle is related to apathy ( Bonelli and Cummings, 2007 ) .Autopsy surveies have shown that neurofibrillary tangles load were significantly higher in the anterior cingulate cerebral mantle in apathy ( Marshall et al. , 2006 ) .Similarly structural magne tic resonance imagination ( MRI ) surveies have shown that apathy badness correlated with wasting of bilateral anterior cingulate and left auxiliary motor country ( Apostolova et al. , 2007 ) .Studies with Single photon emanation imaging have besides shown that apathetic AD patients had significantly decreased perfusion in the anterior cingulate, the inferior and median convolution frontalis and the orbito frontal convolution ( Robert et al. , 2006 )FigureA 1.A Behavioural and cognitive alterations associated with break of specific frontal-subcortical circuits ( Ball et al. , 2010 ) .Dopamine is the principle neurotransmitter of purposive behaviour, modulating motive, rousing, motor response, and sensorimotor integrating. There is a strong relationship between D2 receptor stimulation and anterior cingulated cortex metamorphosis. The anterior cingulate cerebral mantle appears to be of importance in motive and wages ( Devinsky et al. , 1995 ) and receives exceptionally heavy dopaminer gic ( DA ) excitation originating from ventral tegmental country ( VTA ) nerve cells ( Williams and Goldman-Rakic, 1998 ) . Cholinergic and serotonergic tracts besides play a neuromodulatory function in the motivational circuitry. Acetylcholine ( ACh ) and DA systems appear to organize striatal wages map in a feed-forward, complementary mode ( Williams and Adinoff, 2008, Zhou et al. , 2003 ) . Serotonin is chiefly an repressive neurotransmitter can straight impact frontal lobe activities and they can indirectly modulate frontal lobe activity by suppressing the release of Dopastat ( Daw et al. , 2002 ) . Positron Emission Tomography surveies have important decreases of 5-HT2AA receptor densitiesA in the frontal lobe in patients with apathy ( Franceschi et al. , 2005 ) .ASSESSMENT OF APATHYThere are assorted graduated tables available to determine and quantify apathy. A recent literature reappraisal has identified around 14 graduated tables of which seven were full apathy graduated ta bles and eight were apathy subscales embedded in larger graduated tables ( Clarke et al. , 2011 ) . The most widely used graduated table were the Apathy Evaluation Scale AES ) and the Neuropsychiatric Inventory ( NPI ) .Neuropsychiatric Inventory ( NPI )The NPI is a graduated table that assesses and quantifies neurobehavioral perturbations in dementedness patients and besides quantify health professional hurt caused by such behaviors ( Clarke et al. , 2011, Cummings et al. , 1994 ) . The NPI has an apathy subscale, which consists of a general screen point rated on a yes-versus-no footing. If the symptom is found to be present, seven extra apathy inquiries are administered and scored on a yes-versus-no footing. The overall frequence ( rated as 1-4 ) and badness ( rated as 1-3 ) of apathy is so rated. Tonss on the NPI apathy subscale scope from 0 to 12 with higher tonss bespeaking more terrible apathy ( Cummings et al. , 1994 ) . The NPI, and therefore the NPI-apathy subscale, is depe ndable, widely used, and has been validated in many different scenes.Apathy rating graduated table ( AES )The AES is an Eighteen-item graduated table capturing symptomatology over last 4 hebdomads. This scale buttockss and quantifies the affectional, behavioural, and cognitive spheres of apathy. It specifically assesses apathy and discriminates it from depression. Each point can be rated on the 4 point likert Scale. It takes around 10-20 min to be completed by a trained interviewer. This trial has a good interrater dependability and is widely usedPOTENTIAL TREATMENT OPTIONS FOR APATHYNonpharmacologic Treatment of ApathyThere are many non pharmacological intercessions that have anecdotal and qualitative grounds of effectivity in the apathy but merely a few of them has quality research confirmation in footings of effectivity ( Brodaty and Burns, 2011 ) . Open-label surveies have shown that multisensory behavior therapy and music therapy have positive consequence in cut downing apathy and could hike the consequence of anti dementedness drugs ( Ferrero-Arias et al. , 2011, Staal et al. , 2007 ) . Cognitive stimulation therapy that provides activities affecting cognitive processing, within a societal context, with an accent on enjoyment has been shown to be effectual in cut downing apathy in early Alzheimer ‘s Disease ( Buettner et al. , 2011 ) . Treatment of apathy requires multidisciplinary attack along with health professional psycho instruction about the pathological nature of apathetic province. The health professionals should besides be encouraged to present new beginnings of pleasances, involvements and stimulation along with increasing chance for socialization. It is besides of import that the patient ‘s general medical conditions are assertively treated and centripetal shortages corrected along with environmental alterations such as usage of adaptative devices such as wheelchair, seeable Clocks, calendars and equal lighting to increase the reward potency of the environment and thereby enhance motive. Although there is presently lack of research grounds, it is possible the other non pharmacological intercessions such as originative activities, cookery, Montessori methods, and behavioural elements, frequently separately tailored, exercising, multisensory stimulation, favored therapy, and particular attention unit s have the possible to cut down apathy ( Brodaty and Burns, 2011 ) .Pharmacologic Treatment of ApathyAcetylcholinesterase InhibitorsAChIs are chiefly used for handling cognitive symptoms in dementedness but recent surveies have shown positive effects on noncognitive symptoms such as apathy, depression, anxiousness, and purposeless motor behaviours. Consequences from randomized controlled tests have shown that AChIs including donepezil, galantamine and rivastigmine are clearly good in the intervention of apathy. There is no clear indicant that any one AChI is superior.NDMA Receptor AntagonistMemantine is a specificA N-methyl-D-aspartate receptor adversary and is the lone drug approved for handling terrible AD.A It appears to work by modulating the activity of glutamate, leting a controlled sum of Ca to flux into nerve cells ( enabling information processing, storage, and retrievalA 98 ) protecting nerve cells against glutamatergic excitotoxicity and, potentially, holding a neuroprote ctive consequence by cut downing toxic Ca inflow. There is grounds from randomized, double-blind, placebo-controlled tests, which indicated important betterments in apathy degrees for patients treated with MemantineMajor tranquilizersTypical Consequences from Randomized, double-blind, placebo-controlled test in nondepressed inmates with dementedness found no alteration in apathy degrees Atypical Surveies look intoing the effects of untypical major tranquilizers on apathy have reported important betterments in symptomsA farther 12-week open-label survey 130 of risperidone in 135 patients with AD showed increasing and important betterment in apathy. An RCT of 652 nursing place occupants with terrible AD reported betterment in apathy for occupants treated with olanzapine 5 mg/day but non with 1, 2.5, or 7.5 mg/day, and there was no accommodation for multiple comparingsAntidepressantsBupropion is aA dopamineA andA norepinephrine re-uptake inhibitorA and releaser. It is approximately twice as potent an inhibitor of Dopastat re-uptake than of norepinephrine reuptake.A Besides reuptake suppression of Dopastat and noradrenaline, bupropion besides causes the release of Dopastat and noradrenaline. Hence theoretically should profit apathy but there have been no good quality tests with Bupropion. There is grounds signifier clinical instance series that bupropion may profit apathy ( Corc oran et al. , 2004 ) Assorted tests of antidepressants in the interventions of apathy have mostly been negative, supplying extra support that depression and apathy are different concepts. There is good quality grounds from assorted randomised controlled trails that antidepressants do no alteration in apathy degrees. Interestingly apathy syndrome has been reported in a figure of patients having selective 5-hydroxytryptamines reuptake inhibitor ( SSRI ) intervention over the last decennary and hence SSRI must be used with cautiousnesss clinicians need to be proactive in supervising for this inauspicious consequence ( Barnhart et al. , 2004 )PsychostimulantsEvidence from instance studies and little open-label surveies in non demented populations suggests that psychostimulants such as dextroamphetamine and Ritalin may be effectual in the intervention of apathy.Results from a recent double-blind, randomized, placebo-controlled crossing over test of Ritalin for the intervention of apathy suggest modest benefit s in a subset of AD patients, but that tolerability may be a concern in this population ( Herrmann et al. , 2008 ) .A There are instance studies that have reported that Modai ¬?nil may profit apathy syndrome in the older patients and is more tolerable ( Camargos and Quintas, 2011 )Dopaminergic agentsThere are merely few surveies on the effectivity of dopaminergic agents as a intervention for apathy and such surveies have been chiefly focussed on Parkinson ‘s disease and station shot conditions.Bromocriptine, aA Dopastat agonist, in case-series studiesA have been found to be effectual in cut downing apathy symptoms in shot and hypoxic encephalon hurt patients ( Barrett, 1991, Debette et al. , 2002, Krishnamoorthy and Craufurd, 2011 ) . There is nevertheless no good quality research grounds of their effectivity in handling apathy in Alzheimer ‘s disease ( van Reekum et al. , 2005 ) .Amantadine is aA N-methyl-D-aspartic acid receptor adversary, which may indirectly height en dopaminergic transmittal and confer neuroprotective effects, similar to its parallel, memantine has been shown to be effectual in bettering executive map and apathy symptoms in chronic encephalon hurt, dementedness and Parkinson ‘s disease ( Drayton et al. , 2004, Wu and Garmel, 2005 ) . Levodopa/carbidopa besides appears to better motive in assorted neurological and psychiatric upsets harmonizing to instance surveies of patients ( Bakheit et al. , 2011, Drubach et al. , 1995 ) Pramipexole, another Dopastat agonist with D3-preferring receptor adhering profile, is used in the early-stage Parkinson ‘s disease ( PD ) .A meta-analysis of placebo-controlled surveies have shown good consequence on temper and motivational symptoms in PD patients ( Leentjens et al. , 2009 ) . Similarly Ropinirole, Dopastat D2/D3 receptor agonist been reported to better apathy and temper in patients with Parkinson disease ( Czernecki et al. , 2008 )IntroductionApathy is a neurobehavioral syndrome which is defined as quantitative decrease of voluntary, purposive behavior ( Levy and Dubois, 2006 ) .It extremely prevailing across a big assortment of neurological, psychiatric, and medical conditions and is the most common neuropsychiatric symptom of Alzheimer ‘s disease with an mean point prevalence of 60 % in outpatients with Alzheimers Disease. ( Clarke et al. , 2011, Robert et al. , 2004 ) Apathy is a major hazard factor for transition to dementia in MCI topics and follow up surveies have shown that rates of transition to dementia in MCI with apathetic symptoms were up to 60 % as compared to 24 % for MCI without apathy and depression ( Vicini Chilovi et al. , 2009 ) . Apathy was thought to be upset of sub cortical encephalon construction but interestingly it appears to be really commoner in cortical encephalon upsets with averaged point prevalence of about 60 % as compared to 40 % in upsets of sub cortical constructions ( van Reekum et al. , 2005 ) . The frontal lobes play an of import function in back uping higher-level cognitive map, dwelling of executive accomplishments and working memory. Executive maps are higher-order cognitive procedures that orchestrate simple thoughts, motions and actions into complex purposive behaviors. They include be aftering, induction, coincident information processing, ordinance, judgement, abstraction, and job resolution. Damage of executive working consequences in disinhibition, concrete thought, perseveration, deficiency of enterprise, apathy, and loss of cognitive i ¬Ã¢â‚¬Å¡exibility ( Tsoi et al. , 2008a ) . A significant organic structure of grounds suggests that apathy typically occur following harm to prefrontal cortical-striatal circuits in the encephalon, and are seen in many neurological and psychiatric upsets, including all of the common signifiers of dementedness: Alzheimer disease ( AD ) , vascular dementedness ( VaD ) , and Frontotemporal dementedness. ( Craig et al. , 1996 ) .Studies have shown that Apathy in AD patients was associated with more terrible hypoperfusion in frontal parts on functional imagination ( Craig et al. , 1996 ) . A few surveies have tried to look into the relationship between apathy in dementedness and frontal lobe disfunction. Apathy in AD has been shown to be significantly associated with hapless public presentation on executive map trials, such as the Trail-Making Test and the Stroop colour intervention trial ( McPherson et al. , 2002 ) . Executive disfunction, particularly shortages impacting verbal eloquence and conceptional eloquence, was a important forecaster of apathy in dementedness ( Tsoi et al. , 2008a ) . There has been really small literature about relationship between practice and apathy in Alzheimer ‘s disease. It is known that frontal systems behavioral jobs are associated with higher health professional load after commanding for dementedness badness and health professional depression. There has been conflicting studies about part of apathy towards caregiver burden. Few surveies have shown that apathy was associated with greater grade of health professional load ( Chow et al. , 2009 ) ( Leroi et al. , 2012 ) while another survey showed that it was the behaviors associated with executive disfunction and disinhibition that were prognostic of load and apathy was considered less troublesome to health professionals ( Davis and Tremont, 2007 )AIMS & A ; OBJECTIVES:The primary purpose of this survey is to analyze the association between apathy with or without depression and frontal lobe disfunction in patients with memory jobs. The secondary purpose is to look into association between apathy badness and the health professional load In add-on, this survey will look into the association between apathy and practice in AD and MCI as there are presently limited surveies that have looked into association between them.DESIGN/ METHODOLOGY:Ethical motives Approval: A The survey was approved by The National ResearchA EthicsA Service ( NRES ) Committee for East of England, King College London every bit good as the NEPFT NHS R & A ; D officePutingThe survey was done at the West Essex Neurocognitive Clinic which is third referral Centre and is based at three locations viz. St Margaret ‘s Hospital, Epping, Princess Alexandra Hospital, Harlow and Rectory Lane Health Centre, Loughton. The catchment country serves population of aged people of greater London and Essex, UK. The Clinic provides a specialised, multidisciplinary, hospital-based appraisal for people with cognitive jobs Majority of the patient ‘s referred are those with mild cognitive damages or patients hard to name due to combination of medical, neurolog ical, societal and neuropsychological factors. The clinic is focused on research and preparation and is involved in assorted imagination, cognitive and intervention surveies, every bit good as encephalon contribution programme. Referral standards are based on a history of cognitive damage, which is likely to be caused by degenerative alterations of the encephalon with the MMSE mark of at least 20/30, complex presentations due to interplay of varying degrees medical, neurological and neuropsychological factors and hard to name instances. Patients must be aged in surplus of 40 old ages ( reflecting appropriate referral of people with possible immature onset dementedness ) and must be able to give informed consent. The appraisal is done by a trained and experient clinician along with a psychologist/assistant psychologist. Assessment encompasses a assortment of trials aimed at set uping diagnosing and badness of unwellness. The appraisals of involvement for this survey includes A standard psychiatric interview Behavioural Pathology in Alzheimer ‘s Disease Scale ( BEHAVE-AD ) sum 75 where higher mark indicates more disturbed behavior ; Apathy/Indifference sub-scale ( NPI ) total/12 – higher mark indicates greater apathy ; Hospital Anxiety and Depression Scale ( HADS ) -total on each scale/21 -score of 7 or less indicates no important symptoms, mark of 8 – 10 indicates mild symptoms, mark of 11 + indicates moderate symptoms ; Instrumental Activities of Daily Living Scale ( IADL ) total/31 -higher tonss indicates increased dependence upon the source or ‘carer ‘ ; Clinical Dementia Rating ( CDR ) total/5 -higher mark indicates more badly affected cognitive and occupational/social operation ; Screen for Caregiver Burden ( SCB ) total/100 – higher mark indicates client is perceived to be a greater load by the source or ‘carer ‘ ; Neuropsychometric Assessment is done by the Psychologist/Assistant psychologist. The battery of neuropsychometric trials done of involvement to this survey includes: Estimated pre-morbid rational operation ( National Adult Reading Test – NART ) , Cambridge Cognitive Examination-Revised ( CAMCOG-R ) Trail doing A & A ; Trial devising B Letter Fluency, Category eloquence, Ideational Fluency Abstract Thinking, Executive working subtest of CAMGOG-R ( eloquence + Similarities+ Ideational eloquence + Visual logical thinking ) Subjects: This was a retrospective Cross-sectional survey. The survey population comprised 160 back-to-back patients with newly-diagnosed Alzheimer ‘s disease and amnestic-MCI, All the patients at the clip of their initial neurocognitive clinic appraisal had a thorough neurological and psychiatric scrutiny by a trained and experiences clinician along with extended neuropsychometric appraisal by a psychologist. Health professionals and next-of-kin were besides interviewed.At the clip of the appraisal all patients had capacity to give an informed consent to undergo the appraisal. Their capacity was assessed by a member of clinical squad familiar with, and trained in usage of the Mental Capacity Act. In add-on, patients have either agreed or disagreed to hold their informations entered into unafraid database maintained by North Essex Mental Health Partnership NHS Trust, for the intent of supplying wellness attention and set abouting medical research and statistical analysis. Eligibility standards: All patients diagnosed with Alzheimer ‘s disease and amnesic Mild Cognitive Impairment who had the undermentioned probes recorded on database: NPI apathy mark, frontal lobe map trial i.e Trail doing A, Trial doing B, Letter Fluency, Ideational Fluency, Category eloquence, Abstract Thinking, Executive working subtest of CAMGOG-R ( eloquence + Similarities+ Ideational eloquence + Visual logical thinking, CAMCOG-R, age, gender, HAD Depression mark, Care giver load and Praxis. All these patients would be eligible to take a portion in the survey. Inclusion standards: Eligible patients who gave an informed consent to hold their informations entered into unafraid database maintained by North Essex Mental Health Partnership NHS Trust, for the intent of supplying wellness attention and set abouting medical research and statistical analysis. This is considered to be patients presumed wants. Exclusion standards: Patients who did non consent to hold their informations entered into unafraid database maintained by North Essex Mental Health Partnership NHS Trust, for the intent of supplying wellness attention and set abouting medical research and statistical analysis. This is considered to be patients presumed wants. Patients whose depression scores on HAD were more than 8 were besides excluded.MeasuresApathy will be measured as the apathy sub-score on the NPI. The NPI was developed to measure and quantify neurobehavioral perturbations in dementedness patients and to quantify health professional hurt caused by such behaviours. The NPI has an apathy subscale, which consists of a general screen point rated on a yes-versus-no footing. If the symptom is found to be present, seven extra apathy inquiries are administered and scored on a yes-versus-no footing. The overall frequence ( rated as 1-4 ) and badness ( rated as 1-3 ) of apathy is so rated. Tonss on the NPI apathy subscale scope from 0 to 12 with higher tonss bespeaking more terrible apathy. The NPI, and therefore the NPI-apathy subscale, is widely used and has been validated in many different samples such as ambulatory patients with dementedness, outpatients with AD, multicultural samples, and nursing place occupants. Cognitive damage will be measured by the mark on Cambridge Cognitive Examination-Revised ( CAMCOG-R ) . This neuropsychological battery steps cognitive shortage in a figure of cognitive spheres – mark & lt ; 80/105 suggests the presence of a dementedness, mark of 80-90/105 is fringy. Frontal Lobe disfunction will be measured by the tonss obtained from the undermentioned frontal lobe map trial i.e. Trail doing A, Trial doing B, Letter Fluency, Ideational Fluency, Category eloquence, Abstract Thinking, Executive working subtest of CAMGOG-R ( eloquence + Similarities+ Ideational eloquence + Visual logical thinking ) . The Trail Making Tests ( TMTs ) are popular neuropsychological instruments used either entirely as a showing instrument for observing neurological disease and neuropsychological damage or as portion of a larger battery of trials. The trials are believed to mensurate the cognitive spheres of treating velocity, sequencing, mental flexibleness and visual-motor accomplishments Part A is by and large presumed to be a trial of ocular hunt and motor velocity accomplishments, whereas portion B is considered besides to be a trial of higher degree cognitive accomplishments such as mental flexibleness. TMT-A requires chiefly visuoperceptual abilities, TMT-B chiefly reflects working memory and secondarily task-switching ability, while B-A minimizes visuoperceptual and working memory demands, supplying a comparatively pure index of executive control abilities.Average DeficientDrag A 29 seconds 78 seconds Trail B 75 seconds 273 seconds Letter Fluency undertakings require coevals of words get downing with specific letters within a limited clip it has been. Letters F, A, and S ( FAS ) version of the The Controlled Oral Word Association Test is used in this survey. The trial disposal takes about five proceedingss. The mark is the amount of all admissible words for the three letters ( Loonstra et al. , 2001 ) . Category Fluency undertaking require persons to bring forth examples of specific semantic classs such as the names of animate beings or fruits. CF trial is a really speedy ( normally taking 1 min ) , easy to administrate trial that proved to be utile in the diagnosing of mild AD. The most common version involves the semantic class of animate beings. Surveies have shown that tonss below 15 in the CF ( animals/min ) had a sensitiveness of 88 % and a specificity of 96 % , in distinguishing AD patients from normal controls, bespeaking that a 1-minute trial can be helpful to clinicians to place persons in the early phases of the disease ( Caning et al. , 2004 ) . Category Fluency and Letter Fluency require frontally mediated executive retrieval mechanisms. Both besides require entree to phonological/lexical shops. But, merely class eloquence besides requires entree to more widely distributed semantic shops as the topic searches for examples suiting the mark class ( Cerhan et al. , 2002 ) .Datas AnalysisDependent variable is Apathy mark. Independent variables are CAMCOG-R tonss, tonss of the undermentioned frontal lobe testsTrail doing A, Trial doing B, Letter Fluency, Ideational Fluency, Category eloquence, Abstract Thinking, Executive working subtest of CAMGOG-R ( eloquence + Similarities+ Ideational eloquence + Visual concluding ) every bit good as tonss of health professional load and practice. All these variables will be analysed as uninterrupted informations. The consequences will be graphed to look into if the distribution is about normal and the spread secret plan used to measure the one-dimensionality of the association. Correlation analysis, measured as a correlativity coefficient R, will be used to look into for the presence, the strength and way of a relationship between these variables. Cut-off point of 0.4 will be considered to be important. Depending on the one-dimensionality one of the two correlativity coefficients will be calculated. Ranked correlativity will be used in the statistical analysis if the relationship between the two variables in non-linear. Rank correlativity coefficients, such as Spearman ‘s rank correlativity coefficient measures the extent to which, as one variable additions, the other variable tends to increase, without necessitating that addition to be represented by a additive relationship. If, as the one variable addition, the other lessenings, the rank correlativity coefficients will be negative. If the two variables appear to hold additive relationship Spearman correlativity coefficient will be calculated. The closer the coefficient is to either a?’1 or 1, the stronger the correlativity between the variables. Correlation Negative Positive Small a?’0.3 to a?’0.1 0.1 to 0.3 Medium a?’0.5 to a?’0.3 0.3 to 0.5 Large a?’1.0 to a?’0.5 0.5 to 1.0 If the variables are independent so the correlativity is 0. However, the antonym is non true because the correlativity coefficient detects merely additive dependences between two variables.Power computationStatisticalA powerA analysesA wasA doneA byA usingA G*PowerA 3.1 ( Faul et al. , 2009 ) TypeA IA error=0.05A TypeA IA error=0.01A TypeA IA error=0.001 Power=80 % A 34A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 56A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 84 Power=90 % A 47A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 72A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 106 Power=99 % A 85A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 117A A A A A A A A A A A A A A A A A A A A A A A A A A A 159 ThisA indicatesA thatA inA orderA toA determineA aA correlationA ofA magnitudeA 0.4A atA P & lt ; 0.05A atA aA powerA levelA ofA 80 % , A thisA studyA needsA aA minimumA ofA 34A participants.AConsequenceOne hundred and 60 patients with AD or amnesic MCI who met the above-described standards were enrolled in the survey. Of these 68 patients had a diagnosing of Alzheimer ‘s disease and 92 had a diagnosing of amnesic MCI. The demographic information of the topics are summarized in Table 1. No statistically important differences in age, instruction, gender, premorbid intelligence, or old ages in instruction consequences were observed between the two groups. However as expected, there was statistically important difference in footings of the IADL, CAMCOG-R, CDR & A ; MMSETable 1: Demographic and clinical featuresAverage AD ( SD )Average MCI ( SD )P valueNIADL10.34 ( 5.52 ) 8.11 ( 3.42 ) & lt ; .001 160CAMCOG-R76.8 ( 12.66 ) 86.98 ( 8.71 ) & lt ; .001 156MMSE22.19 ( 5.13 ) 25.81 ( 2.55 ) & lt ; .001 158NART105.33 ( 10.00 ) 106.26 ( 12.23 ) .319 124CDR0.82 ( 0.41 ) 0.55 ( 0.17 ) & lt ; .001 159Age74.37 ( 8.61 ) 73.37 ( 8.70 ) .339 160Old ages Ed.11.14 ( 2.91 ) 11.16 ( 2.60 ) .655 154AdMCIChi SquareP valuePercent female51.5 47.8 0.21 .65Percentage with intoxicant history63.2 65.9 1.47 .69Percentage with smoking history42.6 50.0 2.33 .31 The frequence distribution box secret plan suggested that NPI apathy bomber graduated tables are non usually distributed. We did normalcy trials to find whether apathy informations set is well-modelled by a normal distribution or non. We used the Shapiro-Wilk trial as our numerical agencies of measuring normalcy and found that the apathy informations significantly deviate from a normal distribution. Shapiro-Wilk Statistic df NPI Apathy sub graduated table .624 160 As our information ‘s were non parametric, utilizing the Spearman rho correlativity coefficient, correlativities between variables for whole group and subgroups was generated. The Spearman rho correlativity was repeated with depressive subgroups removed. All trials were one-tailed since hypotheses were directional. The exclusion to this was the trial look intoing the relationship between gender and apathy. These hypotheses were non-directional and therefore two-tailed trials were used.Executive map markAbstract believing markCaregiver loadCAMCOG-R markLetter FluencyClass EloquenceTrail Making Test A ( seconds ) Trail Making Test B ( seconds )Conceptional eloquence markPractice Correlation Coefficient-.222**-.180*.477**-.136*-.071-.166*.009 .010-.213**-.102 Sig. ( 1-tailed ).003.012.000.045.189.019.456 . 464.004.103 Nitrogen157157145156155157152 84156156ConsequencesTable 1: Correlations between variables for whole group and subgroupsCorrelations between variables for whole group and subgroups with depression removed.Executive map markAbstract believing markCaregiver loadCAMCOG-R markLetter Fluency Class Eloquence Trail Making Test A ( seconds ) Trail Making Test B ( seconds )Conceptional eloquence markPractice Correlation Coefficient-.169*-.125 .475** -.067 -.041 -.123 -.052 .089-.186*.019 Sig. ( 1-tailed ).027.077 .000 .223 .321 .080 .279 .229.017.417 Nitrogen131131 121 131 130 131 127 72130131Relationship between apathy and executive mapIn the combined sample ( AD and A-MCI ) , informations on executive map was available for 157 patients. In these patients, NPI apathy mark was significantly related to executive operation ( rs = -.222, P = .003 ) .When the group of patients with depressive symptoms were removed, the NPI apathy mark still remained significantly related to executive operation ( n=131, rs =-.169, p=.027 )Relationship between apathy and trail devising trialsIn the combined sample ( AD and A-MCI ) , informations on trail doing trial A was available for 152 patients. In these patients, NPI apathy mark was non significantly related to drag doing tonss ( rs = .009, P = .456 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to drag doing A tonss ( n=127, R -.052, p=.279 ) In the combined sample ( AD and A-MCI ) , informations on trail doing trial B was available for 84 patients. In these patients, NPI apathy mark was non significantly related to drag doing tonss ( rs = .010, P = .464 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to drag doing B tonss ( n=72, R.089, p=.229 )Relationship between apathy and verbal eloquenceIn the combined sample ( AD and A-MCI ) , informations on missive eloquence ( FAS ) was available for 150 patients. In these patients, NPI apathy mark was non significantly related to eloquence ( rs = -.047, P = .284 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to eloquence tonss ( n=130, R -.041, p=.321 )Relationship between apathy and class eloquenceIn the combined sample ( AD and A-MCI ) , informations on class eloquence ( animate beings ) was available for 157 patients. In thes e patients, NPI apathy mark was significantly related to category eloquence ( rs = -.166* , P = .019 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to category eloquence ( n=131, rs -.123, p=.080 )Relationship between apathy and conceptional eloquenceIn the combined sample ( AD and A-MCI ) , informations on conceptional eloquence was available for 156 patients. In these patients, NPI apathy mark was significantly related to conceptional eloquence ( rs = -.213** , P = .004 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained significantly related to on conceptional eloquence ( n=130, rs -.186* , p=.017 ) .Relationship between apathy and cognitive mapIn the combined sample ( AD and A-MCI ) , informations on CAMCOG-R was available for 156 patients. In these patients, NPI apathy mark was significantly related to cognitive operation ( rs = -.136* , P = .045 ) . When the group of patients with depressive symptoms were removed, the NPI apathy mark remained significantly related to on conceptional eloquence ( n=131, rs -.067, p=.223 )Relationship between apathy and abstract thoughtIn the combined sample ( AD and A-MCI ) , informations on abstract thought was available for 152 patients. In these patients, NPI apathy mark was significantly related to abstract thought ( rs = -.180, P = .013 ) .Relationship between apathy and health professional load.In the combined sample ( AD and A-MCI ) , informations on health professional load was available for 145 patients. In these patients, NPI apathy mark was significantly related to caregiver load ( rs = .477** , P = .000 ) . NPI apathy mark remained significantly related to caregiver burden even when the depressive subgroup of patient was removed ( n=121, rs =.475** , P = .000 ) . The correlativity between apathy and caregiver load were so tested in Alzheimer ‘s disease and amnesic MCI individually and in both subgroups NPI apathy mark was significantly related to caregiver loadNonparametric Correlations: NPI Apathy and Caregiver Burden in AD & A ; aMCIaMCIAdNPI Apathy sub graduated table Correlation Coefficient .458** .480** Sig. ( 1-tailed ) .000 .000 Nitrogen 68 53 A arrested development analysis was carried out to understand the relationship between a health professional load and MMSE, Depression Scores, Apathy, Behave -AD Scores, executive map mark, IADL.Arrested development Analysis CoefficientsaModel Unstandardized Coefficients Standardized Coefficients T Bacillus Std. Mistake BetaNPI Apathy sub graduated table1.130.240.3944.703IADL.360.167.1812.155Behave -AD mark .303 .211 .113 1.438 HADS-depression mark .016 .212 .006 .074 Executive map mark -.113 .200 -.047 -.566 MMSE mark .024 .193 .010 .125 a. Dependent Variable: Mark for ‘caregiver load ‘ questionnaire at baseline It is clear from the multiple arrested development analysis that merely NPI apathy tonss and IADL were significantly related to caregiver load. However the other variables which included Behave AD tonss, HADS depression tonss, Executive map tonss and MMSE were non significantly related to the health professional load tonssModel SummaryModel Roentgen R Square Adjusted R Square Std. Mistake of the Estimate Change Statisticss R Square Change F Change df1 df2 1 .542a .293 .288 7.668 .293 59.353 1 143 2 .592b .350 .341 7.377 .057 12.488 1 142 a. Forecasters: ( Constant ) , NPI Apathy sub graduated table b. Forecasters: ( Constant ) , NPI Apathy bomber graduated table, IADL at baseline ANOVAc Model Sum of Squares df Mean Square F 1 Arrested development 3489.675 1 3489.675 59.353 Residual 8407.663 143 58.795 Entire 11897.338 144 2 Arrested development 4169.290 2 2084.645 38.305 Residual 7728.048 142 54.423 Entire 11897.338 144 a. Forecasters: ( Constant ) , NPI Apathy sub graduated table b. Forecasters: ( Constant ) , NPI Apathy bomber graduated table, IADL at baseline c. Dependent Variable: Mark for ‘caregiver load ‘ questionnaire at baseline Further sub analysis suggests that NPI apathy contributes to about 29 % of the health professional load and IADL contributes to around 5 % of the health professional loadRelationship between apathy and practiceIn the combined sample ( AD and A-MCI ) , informations on executive map was available for 156 patients. In these patients, NPI apathy mark was non significantly related to praxis ( rs = -.102, P = .103 ) .When the group of patients with depressive symptoms were removed, the NPI apathy mark still remained non significantly related to praxis ( n=131, rs =.019, p=.417 )Relationship between apathy and genderMann-Whitney TrialRanksgenderNitrogenMean RankNPI Apathy sub graduated table male 81 85.38 female 79 75.50 Entire 160Test StatisticsaNPI Apathy sub graduated tableMann-Whitney U 2804.500 Wilcoxon W 5964.500 Omega -1.621 Asymp. Sig. ( 2-tailed ) .105 a. Grouping Variable: gender From the above saloon graph, with mistake bars, it appears that males have higher apathy tonss as compared to females. We used the Mann-Whitney U trial to look into if the relationship of apathy with gender is statistically important. However this did non accomplish statistically significance ( U = 2804.500, P = 0.105 )DiscussionApathy is one of the commonest symptoms in Alzheimer ‘s disease. Evidence from assorted clinical, radiological and neuropathological surveies suggests that apathy in Alzheimer ‘s disease is frontally mediated and has important negative deduction. Our survey is a realistic survey with moderate power affecting both Alzheimer Disease and Amnestic-MCI. This is the first survey as per our cognition in which the relationship of apathy with and without depression in a combined sample of AD & A ; aMCI were tested against a scope of frontal lobe map trials which included executive map mark, abstract believing mark, Category Fluency, missive Fluency, conceptional eloquence mark and test doing A & A ; B trials. Few surveies have at the same time investigated the relation of apathy with such a big scope of frontal lobe map trials.Relationship between apathy and executive mapWe found statistically important tie ining between apathy and executive map with and without depression corroborating findings from other surveies ( McPherson et al. , 2002 ) . Deficits in frontal lobe map were significantly worse when symptoms of apathy were combined with depression corroborating the determination from a Nipponese survey with a smaller figure of pati ents ( Nakaaki et al. , 2008 ) .This determination has of import clinical significance because hapless tonss in executive map influence memory abilities by forestalling people to use compensatory schemes that can assist them retrieve information and maintain functional abilities. It is besides associated with greater neuropsychiatric perturbations particularly a greater grade of agitated and disinhibited behaviors ( Chen et al. , 1998 ) . Assorted surveies have shown that impaired executive map is associated with increased pace variableness ensuing in higher incidence falls in patient with AD ( Allali et al. , 2010 ) . In Amnestic MCI, executive map damages is associated with early functional diminution in older grownups ( McGough et al. , 2011 ) . Badness of functional damage is good recognized forecasters of institutionalization ( Rozzini et al. , 2006 ) .Relationship between apathy and conceptional eloquenceSuccessful completion of Ideational eloquence undertakings require speede d productiveness every bit good as the accomplishments of self-monitoring, working memory, scheme coevals, and divergent thought ( Vannorsdall et al. , 2012 ) . We found statistically important tie ining between apathy and conceptional eloquence with and without depression.This is similar to the determination from another survey where Ideational Fluency was found to be significantly associated with apathy ( Tsoi et al. , 2008b )Relationship between apathy and Category FluencyWe found that NPI apathy mark was significantly related to category eloquence but when patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to category eloquence. There are conflicting consequences about the relationship between apathy and class eloquence. One survey ( n=72 ) found no important relationship ( McPherson et al. , 2002 ) but another more recent survey ( n=42 ) found statistically important relationship ( Tsoi et al. , 2008b ) .Relationship between ap athy and abstract thoughtWe found that NPI apathy mark was significantly related to abstract believing but when patients with depressive symptoms were removed, the NPI apathy mark remained nonsignificantly related to abstract believingRelationship between apathy and cognitive mapSimilar to consequences from other surveies, NPI apathy mark was significantly related to cognitive working proposing that apathy was related to poorer cognitive map.However when the group of patients with depressive symptoms were removed, the NPI apathy did non stay score significantly related to cognitive map.Relationship between apathy and missive EloquenceNo statistically important relationship was found. This is consistent with current literature grounds ( McPherson et al. , 2002 )Relationship between apathy and test doing A & A ; B trialsNo statistically important relationship was found between apathy and both TMT- A & A ; TMT-B in our survey. However another survey had found a statistically important relationship between TMB trial and apathy tonss in Alzheimer ‘s dementedness ( McPherson et al. , 2002 ) In drumhead among the frontal lobe trial we found that statistically important relationship between apathy and executive map tonss, conceptional eloquence tonss, abstract thought and class eloquence tonss. When the groups were reanalysed after taking patients with depressive symptoms, the relation between apathy and abstract thought every bit good as category eloquence became non important.We think that this may be do the power of the survey has reduced when the depressive subgroups were removed.The 2nd possible ground is that apathy and depression portion many common symptoms and therefore the patients we removed utilizing a rigorous diagnostic standards of HAD depression standards were truly patients with apathy.Relationship between apathy and health professional loadIn our survey, series of explorative Spearman rho correlativity confirmed the important relationship between apathy and health professional load with and without depression. We did farther bomber analysis and found apa thy to be significantly related to caregiver load in both AD and aMCI patients. Our survey is the first as per our cognition that confirms that apathy is significantly related to caregiver load in amnestic MCI reverse to the popular belief. The relation of apathy to caregiver load was confirmed by other surveies ( Chow et al. , 2009, Leroi et al. , 2012 ) nevertheless another survey showed that it was the behaviors associated with executive disfunction and disinhibition that were most prognostic of load instead than apathy itself ( Davis and Tremont, 2007 ) . However we did a arrested development analysis and found that apathy approximately accounted for 30 % of health professional load but found no important relationship with behave AD tonss, HADS depression tonss, Executive map tonss and MMSE tonss We besides found a higher incidence of apathy in females as compared to males but farther statistical testing showed no important relationship. In our sample NPI apathy mark was significantly related to cognitive operation as confirmed by other surveies but when patients with depressive symptoms were removed the relationship with cognitive damage was nonsignificant. Our survey has few restrictions.First of all this was a retrospective cross sectional survey and so has its drawbacks, nevertheless it realistic, cross-sectional survey. Another possible job is that the subjective nature of the information ‘s nevertheless the information ‘s were collected as a portion of comprehensive neurocognitive appraisal in a third Centre by trained and experient clinicians. Prospective surveies would hold been better but would hold needed extended resources and clip. The sample size was moderate and consisted of assorted sample of Alzheimer ‘s disease and Amnestic MCI, nevertheless it was reasonably powered and amnesic MCI is considered as prodromic Alzheimer ‘s disease. We had used merely one graduated table for mensurating apathy.The NPI Apathy subscale is a portion of NPI devised to buttockss and quantifies neurobehavioral perturbations in dementedness and non specifically developed to mensurate apathy.AEP would hold been a better pic k as it is specifically developed to mensurate apathy, nevertheless the trial would necessitate preparation and would take a well longer period which would non hold been practical in a normal clinic scene This survey has shown high association of apathy with health professional load both in AD & A ; aMCI and given our anterior cognition of the significantly inauspicious effect, we would go on screen actively for apathy and utilize more specific apathy graduated table along with the NPI graduated table in future