Watership Down Essay Research Paper Richard Adams free essay sample

Watership Down Essay, Research Paper Richard Adams # 8217 ; book was a favourite of mine turning up, likely because it had all the thaumaturgy and exhilaration of the best faery narratives, but it besides portrayed the natural universe good of course. I believed in the coneies and the brainsick sea gull that helped them, and I learned to appreciate the value and beauty of creative activity by concentrating on the predicament and hazard of these hapless animals in a huge and unsafe universe. These were non # 8220 ; bunnies # 8221 ; , sentimentalized furballs frolicing about and cantabile vocals. These were characters with the weight of Arthur and his Knights of the Round Table. Hazel is a troubled and loath leader, drawn to a despairing pursuit by his friend, the doormat called Fiver, who suffers hideous visions that shortly the coneies # 8217 ; community will be destroyed by world. With the aid of a brusque and burly soldier coney named Bigwig, they round up a group who of coneies who believe in them and fly their Warrens, go forthing behind them most of the community disbelieving and express joying at them. We will write a custom essay sample on Watership Down Essay Research Paper Richard Adams or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page On the route, they encounter a universe of dangers, possibly none more awful than other coneies who have different imposts. One peculiar Warren seems to be happy on the borders of a farm, fed by a husbandman. This spooks a few of Hazel # 8217 ; s pack, and when their intuitions prove true, it is a terrorizing disclosure so. And that # 8217 ; s merely the first half of the journey. The 2nd half becomes a tense, cliff-hanging quest to add females to their group, so they can get down a new place when they settle into their finish. The lone manner available to them, it seems, is to steal them from another Warren. And fortuitously ( or possibly unluckily ) for them, there are some females enduring in a cruel, military province Warrens non far off. This leads them out into the unsafe universe once more, opposing their marbless against the strength and barbarous tactics of General Woundwort, a scoundrel as memorable and fierce as Darth Vader. As a kid, I identified with the vulnerable heroes as they sought to happen their topographic point in the universe. As a adult, I am drawn into the mythology that Adams has chromium eated here, the compelling play that echo historical struggles in fascist provinces, and the eldritch bent he has for suspense. A batch of this is efficaciously preserved in the movie, as our heroes try to liberate the enslaved, laden females from the regimented society called Efrafa. And so, like C.S. Lewis # 8217 ; s The Chronicles of Narnia, Watership Down is a narrative I love to portion with friends of any age. The movie is exceeding in that it stays comparatively true to the strengths of the novel. It merely tells a narrative, and tells it attractively, winsomely, and creatively, without oversimplifying or redacting things to do it more of a traditional crowdpleaser. That gives it the advantage over Disney # 8217 ; s full alive catalogue, in my book. The life is strikingly realistic and elaborate ; I don # 8217 ; t intend realistic in the manner digital life can be realistic. It # 8217 ; s jittery in topographic points, much like Nipponese life. But that # 8217 ; s because it # 8217 ; s handpainted. And in its regard for the grace, colour, and natural behaviour of the countryside and of coneies, it is clear the energizers knew their topic. This is wholly appropriate. Adams himself was fascinated by the animals, and wrote an debut to a book called # 8220 ; The Private Life of the Rabbit. # 8221 ; Angela Morley # 8217 ; s music is a little-known hoarded wealth, a compelling escapade soundtrack with memorable subjects and a melodious quality that makes it an outstanding work in its ain right, more elegant even than the romantic subjects of John Williams. And the voices are good chosen. From John Hurt to Zero Mostel, they suit the characters absolutely. Mostel is particularly good, conveying attitude and energy to the important character of the injured chump, Keehar, who helps the coneies navigate. The film suffers merely from its ain ambitious project. Watership Down is a drawn-out novel, and to include everything would do for a cumbersome movie. The authors have adapted the book laudably, paring here and at that place while keeping the unity of the narrative. As a consequence, there are some disconnected passages between chapters, but merely fans of the book will detect the bumps. 324

How to Build a Modern PR Plan That Works With Marketing (Template)

How to Build a Modern PR Plan That Works With Marketing (Template) If youre at all like me, then one of your most recent experiences working on a standard press release might be that media relations class you took in college. Think about it. When was the last time your team sent a press release to a reporter, received some valuable coverage, and saw your site traffic boom? Or, on the other hand, when was the last time a cold email landed in your inbox that truly excited you about the possibilities within that strangers pitch? Public relations has undergone some major transitions. In fact, you could go so far as to say that todays PR doesnt look much at all like the PR of yesterday. Media and communications has always been an industry that moves quickly, and advances in technology and social media have escalated those moves. Add to that audiences increased expectations of trust, authenticity, and the rise of practices like content marketing, and its clear PR really had no choice but to evolve or become largely obsolete. Now, if you havent already, take a moment to lament all the hours you spent in your PR classes, drafting press releases and debating whether majoring in communications was a good idea. I feel for you - but not all is lost. A Word About : Did you know makes it possible to manage content, social, email, and more, all on one integrated marketing management calendar? Start your free trial or schedule a demo with an expert. Start With Your Free Modern Public Relations Plan Template This post offers tons of advice on creating a PR strategy that actually works concurrently with content marketing. But, did you know that marketers who document processes are 466% more likely to report success? Its true.  Ã‚  Thats why this post also includes a free PowerPoint template you can use to put this advice into practice, and document a plan you can execute. Get it free now, then read on.How to Build a Modern PR Plan That Works With Your Marketing by @natalieslyman via @What Modern PR Looks Like While PR looks different today than it did in the past, it still achieves similar goals. It's still press your company earns  in a third-party outlet, and it still helps you establish credibility, boost brand awareness, and extend your brand positioning. The biggest difference is in its execution. Modern PR is much less transactional and more relational than ever before. In the past, marketing and PR teams could trade templated press releases to reporters in hopes of some self-promotional writeup published by whoever would pick up the story. The new PR  is focused on your relationships with journalists, influencers, editors, and contributors at online publications and with the audiences you share with them. Trust is key, and it's earned by delivering valuable content to media contacts who can use it to provide value to their readers - the audience you're ultimately trying to reach. Audiences want engaging content from outlets they trust. When you pitch media contacts at those outlets truly valuable content and sources they can use to publish that engaging content (rather than stuffy, self-promotional releases), everyone wins. If some of this talk of "value" and "audience engagement" is ringing a bell to you, it's probably because content marketing focuses a lot on these things, too. Modern PR and content marketing are not one in the same, but content marketing has proven too effective for PR to ignore. That's why it's evolved beyond overt self-promotion en masse to offer more value - to audiences, media contacts, and the brands using modern PR alike. Below are seven essential steps to building and implementing a modern PR strategy for your company: Table of Contents: Building a PR Plan in 7 Steps Lay Out Your Brand Positioning Goals Identify the Outlets That Reach Your Audience Create Strategic, High-Quality Content Carefully Craft Your Pitches Develop (And Use) a Distribution Plan Keep Your Network Organized Don't Neglect Your Content Marketing1. Lay Out Your Brand Positioning Goals Most people understand PR as a tool to really supercharge buzz around a one-time event or product launch. It's something that can quickly get a lot of people excited for a short time before fizzling out after that event or launch concluded. It is absolutely still a good tool for that - but how many events, launches, or other truly newsworthy events do you expect to happen in a year's time? Your company is doing important work for clients every day. How are your PR efforts elevating that work and, therefore, your brand overall? PR can also be used to help generate and sustain brand awareness, interest, and credibility that don't have an expiration date. PR can help generate brand awareness, interest, and credibility that don't have an expiration dateTo do this, start considering the bigger picture of how you want your audience to see your brand. How do you want your brand to be seen? What do you want to be known as an expert in? What feelings do you want your brand to inspire in your audience? Look beyond short-term goals for event registrants or demo sign-ups, and think about how you want to position yourself in front of your target audience. When you know how you want to be seen, you can better identify the outlets, writers, and editors that can help reinforce that brand image. Action Item: Develop an effective branding strategy and understand where you fit in the marketplace. Start with this detailed guide from Jordan Loftis. 2. Identify the Outlets That Reach Your Audience Your audience is looking for content that's informative, engaging, and published on sites it trusts - like reputable online publications in their industry. Historically, publications were managed by journalists and traditional reporters and staff writers. But audience demand for that informative, engaging content has risen, and those outlets have grown their networks to include content from other sources, too, like industry leaders, experts, and individual contributors. To position your brand in front of the right audience, identify where they're getting their content. Which industry influencers, thought leaders, journalists, and editors do they trust? What outlets do they love? Start compiling a list of potential publications and contacts to pitch that align with your brand positioning goals and reach your audience. Action Item: Use Buzzsumo to identify influential media outlets and journalists. 3. Create Strategic, High-Quality Content Now, if you're not sending out press releases to those contacts you've listed, what exactly are you pitching? Content. This content is part of your PR efforts, so you might think it has to be really self-promotional to make the impact you're looking for. But that's not what modern PR is about. It's about value to your audience and your media contacts - which translates into value for your brand. When our team surveyed publication editors about the biggest problems they have with the content they're pitched, 79 percent  said content is too promotional and 56 percent said it isn't a fit for their readership. So, as you're creating content to pitch editors and other contacts, ask yourself: Does this content align with my company’s goals? Does it add value to readers? Does it align with the tone, topics, and opinions expressed in the publication I'm pitching? A good way to test whether the content you've created is as beneficial to your contact and your audience as it is to your PR goals is to remove your company completely from the content. If a quote or link or mention you've included about yourself can be removed without really affecting the piece, then it probably doesn't add much value. If the piece loses value when you do this, then you know that whatever you've included about your company enhances the quality of the content, which is good news for everyone involved. It's important here to note that not every media contact is going to want to receive a pitch with a full article attached. The content you're creating here can be a full article for the publication of one of the contacts you're reaching out to. It can also be the outline of an article, or it can be a summary and key points. Regardless of the content formatting your contact prefers to receive, remember to avoid overt self-promotion, and keep it relevant to the outlet's tone and topics. Action Item: Develop a full understanding of how guest blogging works with this excellent interview with Jeff Ostroff of Don't Panic Management. Then, follow this guide on developing high-quality content. 4. Carefully Craft Your Pitches Your pitches should be created with as much care as the actual content you create - because if your pitches get deleted, your content goes with it. Take the time to research your points of contact, customize your emails to demonstrate your message is worth reading, and remember the following points as you pitch your media contacts: Get Specific These people likely receive plenty of pitches - why does it make sense for them to accept yours? To make your case, include a few key points from your content, in addition to an overall angle, article summary, and title suggestions. You should also provide an explanation of your company and any subject matter experts and sources included in your content. This helps your contact understand who you are, why you're a valuable, trustworthy source, and why your inclusion in this content is an important addition that can enhance audience engagement. Respect Their Schedules and Expectations Your contacts aren't just watching their inboxes, waiting for a pitch from you. They are incredibly busy. They're creating their own content, collaborating with other writers and brands, and they're working on tight deadlines. Their time is valuable, and when you're asking them to fork over even a little bit of it, you must respect it by proving to them you care about more than just what's in it for you. Lay the Groundwork for a Relationship Modern PR isn't about quick, one-time wins; it's more relational than transactional. Be friendly, personable, and patient in your communication, and offer to revise or refine any content if needed. A good relationship benefits you both (and the audiences you share), and it's up to you to lay that foundation in your outreach. Action Item: Follow this guide and template to make every pitch perfect. 5. Develop (and Use) a Distribution Plan Let's say your pitch goes well. This journalist or editor or influencer loves your idea and decides to use you as a source in an article he or she publishes. This is typically the exciting part, but it doesn't mean your work is done. You can't rely on these contacts to distribute this content for you. You have to do your part in maximizing press and getting this content to as many people as possible. Thankfully, there are so many ways to distribute content. Consider: sending an email to your team with a request for them to share it on social media. sharing this content on your company's social media accounts. encouraging your sales team to send it to leads and in other outreach. putting some paid promotion behind it. adding it to your email signature. including an "As Seen On" badge on your site. including it in your newsletters or drip campaigns. These are just some  suggestions. You know your audience best, so use every avenue you have to deliver this content to them. The important thing is that you don't just sit on any content or press once it goes live. Sharing it with your audience helps you, as well as the contact who helped secure it. Action Item: Two places to start sharing your content include social media and your email list. 6. Keep Your Network Organized This approach to modern PR isn't a one-and-done tactic. Obviously, pitching the same content to the same contacts isn't the idea here, but maintaining your relationships is critical. You don't want to work with a contact of yours to place content and then ghost them as soon as you've gotten your press. When you're implementing this plan, you'll want to organize and manage your own network. I recommend starting small with a simple spreadsheet that you and other members of your marketing and PR teams can contribute to. This gives you a centralized place to store information about your media contacts, including: Names Email addresses Twitter handles Publication names Tone Topic And other content guidelines, and pitch preferences. This will help you easily identify who you should reach out to with different kinds of content, which is key to maintaining good relationships. It can also serve as a place to record your outreach and keep your relationship status updated, so you know how often you're connecting with various people in your network and if any contact information changes. Once you have a way of seeing what everyone's wants, needs, and goals are, it's much easier to meet them - or to make strategic introductions to other sources you know could potentially help out these journalists and editors. Bottom line:  If you want to secure mentions of your brand and deliver quality content to your audience, then you need to build and manage of a robust network of contacts. A spreadsheet is as good a place to start as any. Action Item: You can find a free Google Sheets template to create your spreadsheet here. 7. Don't Neglect Your Content Marketing Remember previously when I addressed how similar some aspects of this modern PR are to content marketing? Well, modern PR and content marketing may share some ideas, but that doesn't mean either can act as a substitute for the other. The honest truth is that an effective PR plan today is one that works alongside a robust content marketing strategy. Public relations and content marketing  work so well together because they fuel one another. Your content marketing can generate press coverage, which can fuel your content marketing, which can ... you see where this goes. Your content can be your foot in the door to PR opportunities. It helps you build your brand as a leader in your space, which can help you grab the attention and interest of journalists, influencers, and other members of the press. Your content can be your foot in the door to PR opportunities.Think about it: Would a journalist or influencer be more willing to accept a pitch from someone who's been consistently creating content in their industry and building their brand, or someone who's never created any content? Plus, surrounding your brand with expert content can even lead to press opportunities you don't pitch yourself - ones that emerge organically, that come as a result of your industry expertise. And on the other side of the spectrum PR can amplify your on-site content because it directs more people to it. More people in your audience who see your company mentioned in the press can find their way to your site where they can explore even more content and continue engaging with your brand. These two work too well together to skimp on either. Maximize your modern PR strategy by continuing to invest in your content marketing. Action Item: Read these resources to do better content marketing: How to Build a Content Marketing Strategy You'll Actually Use (Free Template) The Best Way to Get Organized With a Content Marketing Editorial Calendar (Free Template) How to Choose the Best Content Marketing Platform Ready to Master Modern PR? You may not have learned about this evolution of public relations in college, but I'd say if you've made it all the way through this post, you've kind of taken a master class in modern PR. Your PR practices don't have to continue down an outdated and old-fashioned path that shortchanges your brand, your media contacts, and your audience members. It's time to get on board with modern PR, and these steps will help ensure it's an easy transition.

Complete Study Guide SAT US History Subject Test

Complete Study Guide SAT US History Subject Test SAT / ACT Prep Online Guides and Tips Alexander Hamilton, Lucretia Mott, Frederick Douglass, and Rosa Parks- these are a few of the important historical figures you might encounter on the SAT US History Subject Test. This complete study guide will tell you everything you need to know for SAT US History, how you can prepare, and where to find the best practice questions to start prepping. To help you find the exact info on the US History Subject Test that you're looking for, here's a table of contents so you can easily jump to the section you want: Format of US History Subject Test Types of Questions on US History Subject Test Concepts Tested on US History Subject Test Where to Find Practice Questions and Tests How to Study for the US History Subject Test Test-Taking Tips When to Take the US History Subject Test What Is the Format of the US History Subject Test? Like all Subject Tests, SAT US History is 60 minutes. Within that hour, it asks you 90 multiple-choice questions. Clearly, you'll have to develop your skills in answering questions quickly and efficiently! There are five answer choices per question, and the questions generally fall into three main types. What Types of Questions Are On the Test? The three main types of questions on the SAT US History are Recall questions, Analysis questions, and Using Data questions. Recall Questions Recall questions are relatively straightforward. They test your knowledge of specific facts, terms, and concepts. The following is a typical example of a "recall" question: One purpose of the Marshall Plan of 1948 was to A) rebuild European economies to make communism less appealing. B) aid the depressed agricultural economies of Latin American nations. C) aid communist nations that would agree to embrace democracy. D) give military aid to those nations resisting communist subversion. E) help the peoples of Asia establish heavy industries. This question doesn't ask you to analyze or use data- either you have knowledge about the Marshall Plan of 1948 or you're out of luck (though you might be able to use the year, 1948, to make an educated guess). The correct answer is A) rebuild European economies. Analysis Questions Analysis questions also require your knowledge of a time period, important figures, or notable events, but they go one step further by asking you to apply that knowledge to analyze or interpret presented information, such as a quotation, map, graph, or cartoon. For instance, the following question gives a quote from the 1840's and asks you what idea it expresses, rather than simply asking for a description of the idea itself. "If the Creator had separated Texas from the Union by mountain barriers, the Alps or the Andes, there might be plausible objections; but He has planned down the whole [Mississippi] Valley including Texas, and united every atom of the soil and every drop of the water of the mighty whole. He has linked their rivers with the great Mississippi, and marked and united the whole for the dominion of one government, the residence of one people." This quotation from the 1840s can be viewed as an expression of A) The New Nationalism B) popular sovereignty C) Manifest Destiny D) the Good Neighbor policy E) the frontier thesis You can see how this question requires you to interpret a quotation and place it in context of a historical trend. The correct answer for this (wildly outdated) quotation is C) Manifest Destiny. Using Data Questions The third type of question asks you to relate given data to history or to evaluate it. Data can be anything from a chart to a graph to a picture, like this famous image: Rosie the Riveter is, of course, referring to A) the contribution of women to the defense industry. Answering these recall, analysis, and data questions on the SAT US History calls upon the following skills. Anticipated Skills on the SAT US History These anticipated skills go along with the three types of questions. They are Historical concepts, cause-effect relationships, geography, and other data that you need for understanding major historical developments Concepts of historical analysis Ability to use knowledge to interpret data in maps, graphs, charts, and cartoons You can probably see how these skills will be applied to recall, analysis, and using data questions. Now that you're familiar with the types of questions you'll see and the skills you need to answer them, what about the content on the test? Just how much US history do you need to know? What Does the US History Test Cover? The US History Subject Test ranges over several hundred years, from pre-Columbian history to the American Revolution to the Industrial Revolution to the present. Most of the focus is on the years after 1790, though there is a small portion that has to do with earlier history. The exam includes political, economic, social, and cultural history, as well as foreign policy. Political and social history are emphasized more than the others. The College Board gives the following breakdown of material and time periods: Political history 31–35% Economic history 13–17% Social history 20–24% Intellectual and cultural history 13–17% Foreign policy 13–17% Periods % of Test Pre-Columbian history to 1789 20% 1790 to 1898 40% 1899 to the present 40% US History Subject Test Prep Materials Now that you're familiar with the content and format of the test, let's talk about where you can find high-quality practice questions. Then we'll discuss the best ways to study effectively and strategies for succeeding on the test. Test Prep Books Official practice questions are always the gold standard when it comes to books for SAT test prep, so you can immediately look to the College Board. Their book includes two previously administered full-length practice tests, along with detailed answer explanations. While this book is a good review, it's definitely not a replacement for staying focused throughout US History class. You'll need a solid foundation of historical knowledge in order to use this book effectively. Books that offer a more detailed review of US History are Barron's and Princeton Review. Barron's has three full-length tests and a diagnostic test at the beginning to gauge your starting point. Its 40 or so chapters are divided by historical era. Two cons about Barron's: it gives so much information that you might be studying needless facts and figures, and a lot of students say its questions are unnecessarily complex. Since you probably don't have a ton of time for Subject Test prep, you want to make sure you're getting the best results from your study time. Princeton Review also gives a solid comprehensive overview, along with two full-length SAT US History practice tests in the book and an additional one online. It's a good resource in conjunction with your history class- just watch out for any questions that seem outdated. Starting out with official practice questions might help you develop your eye for this. Kaplan is another option, but it's not your best resource. A lot of the questions are just too easy, so you'll probably get an unrealistic idea of your score from using its practice tests. I would recommend Kaplan the least for truly preparing for the US History Subject Test. Finally, if you're taking AP US History around the same time as the SAT US History, you might want to check out No Bull Review: For Use with the AP US History Exam and SAT Subject Test. Keep in mind this book is not specific to the SAT Subject Test, but offers you strategies for combining your test prep, along with a review of history that will show up on both tests. To sum up, if you're studying with books, check out College Board first, then Barron's and/or Princeton Review. Kaplan is not that helpful. For those of you also taking AP US History, No Bull Review can be a good supplemental resource. What about online practice questions? Online Practice Questions Again, your first go-to should be College Board. Here it has 29 official practice questions and answer explanations. It also gives you some more practice questions and general advice in this PDF, though you'll have to self-correct and self-score them. This site, 4tests.com, has 34 decent practice questions. They are a good, quick review that you can do and see them scored automatically. Another site with a lot of online practice questions can be found here. It also has some helpful PDF downloads with key term glossaries and general review study guides. Finally, you can check out US history practice questions at Varsity Tutors which consists of several diagnostic tests for the US History Subject Test. Study Tips and Techniques for the US History Subject Test Whether you're using test prep books, online practice questions, or a combination, you want to make sure you're studying in the way that's most effective for you and your learning style. The following are some study techniques that will help you be truly ready for the SAT US History. #1: Keep Up in Class SAT US History covers a huge time period. It requires knowledge that spans several hundred years, and this knowledge takes time to learn, an entire year or more of studying US history in class. Keeping up in class is essential to building a strong foundation of knowledge, as well as the skills of analysis and data interpretation that will be called upon in the Subject Test. One way to keep yourself accountable would be to get an SAT US History test prep book in the beginning of the year, and use it for review as you go along through the course. This way you can reinforce the information and ensure that you can recall or apply it when answering Subject Test practice questions. Gradual review over the year will be hugely helpful, and then you can do some more focused studying a couple months before the test, and really ramp up your studying two to three weeks before. #2: Befriend the Practice Test Practice tests are the best way to get ready. They don't just help keep you sharp and able to recall content and apply your skills, but they'll also help you develop your time management and pacing. Remember, the test asks 90 questions in only 60 minutes! The Subject Tests don't change a huge deal from year to year, so any and all practice questions you can find will be helpful in some way (keeping in mind the recommendations I gave above). There's a huge difference between passive studying and active test-taking. Taking practice tests will put your knowledge into action, as well as help you gauge your progress and identify which areas you need to focus more on. #3: Score Your Practice Tests Make sure to score your tests and understand the answer explanations. If you make a mistake or don't know a question, you should write that one down in a notebook so you can go back to it and fill in the gaps in your knowledge. By periodically checking in throughout the year with SAT US History practice tests, you can gauge your progress and see your improvement over the year. Then you can really ramp it up in the weeks before the test. #4: Analyze Your Wrong Answers To repeat the point, you don't want to just score your test and move on. This score is a signal to you and what you know and what you need to learn. You should figure out why you missed the question. Was it lack of knowledge, a wrong guess, or carelessness? If the first, you should brush up on your understanding. Reread that section of history and take notes on it. If the second, work on refining your process of elimination skills. If you find yourself overly rationalizing or justifying an answer, it's probably a "distractor"- there's only one 100% correct answer choice. Figure out what was distracting you and get to the core of what the answer choices are communicating. Finally, if the error was due to carelessness, continued practicing will help you improve your ability to read and comprehend a question and answer it quickly and efficiently. That's why timing yourself is such a good idea when taking practice tests. Which leads me to my next suggestion... #5: Simulate Testing Conditions Practice tests will give you the best "real test" experience if you simulate the testing conditions you'll encounter on test day. Give yourself exactly 60 minutes, no more, no less, and sit in a quiet space with few distractions. After all your studying, you want to make sure you'll be able to get to all the questions and answer them thoroughly in the hour you'll be given. Apart from practice tests and class materials, are there any other approaches you can take to learning the material? #6: Get Creative In Your Studying History involves a ton of reading and note-taking. If you find yourself feeling disengaged, you might want to try other approaches to make history come to life and engage with it in ways that are interesting to you. Reading aloud or watching documentaries, like on American Experience, could be a good way to supplement your understanding throughout the year. Of course, these shouldn't be your main focus in the weeks leading up to the test, but try to find creative ways that will keep you interested in the people, places, and events of American history. Test-Taking Strategies for the US History Subject Test Beyond these study techniques, let's talk about some other important strategies you need to know to master the US History Subject Test. #1: Note the Chronological Order of Questions Questions on the US History Subject Test are grouped into 8 to 12 questions that go in chronological order. When a new grouping starts, you'll see a sharp change in the time period. Understanding the time frame will help you comprehend the question, so pay attention to these groupings to make sure your head is in the right era. #2: Use Process of Elimination The US History SAT Subject Test deducts 1/4 of a point for every wrong answer, so you want to be strategic in how you answer the questions. If you can eliminate even one answer as incorrect, then I would recommend making your best educated guess. Even if your mind goes blank after reading a question, you can generally apply your knowledge to eliminate wrong answers. While they are designed to all sound plausible, keep a sharp eye and look for "distractors" or answer choices that are irrelevant to the time period or content at hand. #3: Take Time to Comprehend the Question On a similar note, you want to make sure you really comprehend what the question is asking. Look for key words like EXCEPT or NOT, as well as superlatives like best, worst, all, none, always, or never. As you get better with time management, you'll be able to quickly get to the root of a question and its accompanying answer choices. Finally, now that you know where to find practice materials, how to use them, and these test-taking strategies, when exactly should you take the US History Subject Test? When to Take the US History Subject Test The SAT US History Subject test is offered in August, October, November, December, May, and June, and the College Board recommends that you have at least a year of a college prep US History class before taking the exam. If you're taking AP US History, then you should be well prepared to take the test at the end of the year, and can combine your studying for both the AP test and the SAT. However, you can definitely do well even if you haven't taken AP. It's best to take the test at the end of the school year. Remember, you can't take the Subject Tests on the same day as the SAT, but you can take up to three Subject Tests on one test date. My recommendation for US History would be the June test date. You can read more about out other considerations for when to take the SAT Subject Tests and the full list of test dates here. By keeping up in class, identifying and filling in your knowledge gaps, and prepping with practice questions, you'll be well prepared to conquer the US History Subject Test. What's Next? What's a good score for an SAT Subject Test? Actually, that depends on the Subject Test. Read about the good scores for each one here, along with what you need to know to get ahead of the curve. Want to learn more about specific US History topics? We have discussions of Ida Lewis, the Platt Amendment, checks and balances, and how the executive branch checks the judicial branch. For some quirkier topics, check out our articles about the histories of the 3-hole punch and hip hop and the story of the Loomis Fargo heist. Are you also prepping for the SAT? Use these free official SAT practice tests as you get ready for the test. Need a little extra help prepping for your Subject Tests? We have the industry's leading SAT Subject Test prep programs (for all non-language Subject Tests). Built by Harvard grads and SAT Subject Test full or 99th %ile scorers, the program learns your strengths and weaknesses through advanced statistics, then customizes your prep program to you so that you get the most effective prep possible. Learn more about our Subject Test products below:

Environmental and global health issues Essay Example | Topics and Well Written Essays - 1500 words

Environmental and global health issues - Essay Example Health care centers and nurses became very active and strict precautionary measures were taken for the controlling of the disease. Severe Acute Respiratory Syndrome is a viral lung disease which is caused by coronavirus often referred to as SARS –CoV. It is serious or an extreme case of pneumonia. A person suffering from SARS will have to face severe difficulty in breathing and sometimes may even face death. The first case of SARS was found in Asia in 2003 and within a few months it spread in numerous countries all over the world. It is a well-studied example of a communicable disease and a disease that can spread easily due to the travelling of people to other countries. The breakout of SARS in 2003 was a very serious one and it took almost all the countries of the world and a total of 8,098 people were affected and out of these 774 people died. But now SARS have become totally under control but the virus still exists in the hosts which are animals and there are always chances that the virus can again return to the humans. The severity of SARS is greater in people of older age as compared to younger and middle aged people (Serradell, 2005). The symptoms of SARS are similar to that of common cold but those symptoms are much more severe as compared to those that of cold. SARS has no definite cure or medicine but it can be prevented by taking precautionary measures like avoiding communication with the patient, frequent hand washing, eating food rich in vitamin C, and other such measures. The epidemiological indicators of the SARS rife and the ways for the prevention, control, and complete eradication of SARS include gestation period, time period of communicability, mode of transference of the epidemic agent, risk factors involved in the transmission of the virus, environment, ways of reserving animals and the prevention of SARS (Stewart, 2004). The various countries in which the outbreak of SARS occurred

Principal direction Essay Example | Topics and Well Written Essays - 1000 words

Principal direction - Essay Example Individuals will then follow a principal direction giving them a sense of power. So, we can see the link between goal, meanings and the direction. That is, achievement or actualization of goal will provide meaning to one’s life and thereby paving the life in a new principal direction. So, this paper will analyze the theme, what is our goal, our meaning, our principal direction?, in relation to the activities of the central characters in E.T.A. Hoffmanns novel The Sandman, Fritz Langs silent film Metropolis and Terry Gilliams film Brazil. â€Å"The Sandman†, English translation of a German short story, â€Å"Der Sandmann†, was written by E.T.A Hoffmann and forms a part of the collection of stories titled, The Night Pieces. The story is about the central character, Nathanael and how his presumed horrors and nightmares in his childhood, continued to haunt him even in his adult life pushing him to go in search of an ‘undefined’ goal. That is, Nathanael forms a presumed fear about an imaginary character Sandman, who he thinks will steal the children’s eyes, if they don’t go to their bed early. Even though this story about Sandman is just a traditional bringer, Nathanael fully believes it. "My mothers answer did not satisfy me; indeed my childish mind formed the conviction that our mother was only denying The Sandmans existence so that we should not be afraid of him; after all, I could always hear him coming upstairs." (Robertson). He even ‘thinks’ and ‘sees†™ his father’s lawyer friend, Coppelius as the actual Sandman. And, when Coppelius disappears he feels little secured, but after passage of many years, in his adult life, that fear for Sandman reappears, when he sees a person named Coppola, who has striking resemblance to Coppelius. To ease his fearful mindset, Nathanael falls for Olimpia, daughter of Physics professor, Spalanzani, and sets a new goal of getting her.

Last Product Purchased Essay Example for Free

Last Product Purchased Essay Think for a moment about the last product you purchased. What was the product? What is the brand name of the product? How would you describe the customer for this product? What is the product’s closest brand competitor? Explain why you chose this brand rather than the competitor’s brand. How did the marketing for the product influence your purchase? The last product I purchased was my new car. It is a 2012 Chevrolet Malibu. The customer for this product would be a young adult to middle aged adult. The customer for this car wants a car that is smaller in size but one that also has plenty of room for at least 4 people. The closest brand to this car would be, in my opinion, the Pontiac G8. When I purchased my Malibu I went to test drive the G8. It was a 2011 and had only a few miles on it. It was traded in for a different car because the car was too small for the current owner. I loved the G8 and it was everything I wanted. It was only a couple thousand dollars less than the Malibu and the Malibu was brand new with only 20 miles on it. My husband is the one who really liked the Malibu and talked me into test driving it. Needless to say that is the car I choose. I chose this particular car because with the FREE extended warranty and the rebates on this car it turned out to be a cheaper car than the G8 but also a better car. Honestly the marketing on this car did not influence my opinion at all. I never thought about this specific car until at the dealership that day. When I purchased this car Chevrolet has awesome rebates and interest on their new vehicles. After my purchase I stared seeing, or paying attention, to the commercials on this car and I am positive I made the right decision. If I would have paid attention to the commercials on this car it would have been the car I chose anyway.

Deaf Culture Essay -- Hearing Loss Essays

Deaf Culture I may not be considered part of the hearing culture due to my severe to profound hearing loss, but some people might be surprised to hear that I am not considered a part of the Deaf culture. A majority of the Deaf culture is very critical of those who assimilate with hearing people and accept hearing culture as their majority culture. I believe that every hearing impaired and deaf person is an individual and needs to do what is best for them instead of being worried about following the rules of the Deaf culture. The members of Deaf culture have many different levels of hearing that range from profoundly deaf to slightly hard of hearing (Halpern). However, none of the members of the Deaf culture consider themselves hearing-impaired. Deaf culture has its own jokes, language and theatre. People who can suddenly hear find that they are the one with the handicap when they walk into the Deaf culture. The Deaf community takes pride in their identity and does not have any desire to become part of the hearing culture. This community also displays its pride by capitalizing their culture with a capital D (Halpern). "Thou shalt honor thy mother and father, diverse Deaf role models and hearing allies" (Weinstock), is one of the Ten Commandments of the culturally Deaf . This gives an idea of how Deaf culture considers hearing people as allies and not necessary as a part of their culture. The Deaf community's all or nothing philosophy can be shown in the Deaf culture's many jokes and narratives. There are the Ten Commandments of the culturally Deaf which state some rules and beliefs that the Deaf culture hold. Pride is shown in this statement, "I am a proud Deaf Being who brought you out of pure oralism, out of oppressi... ...eturn, I should get some respect for the lifestyle that I have chosen. Feel free to email me with your imput and comments! Works Cited Halpern, Carla. "Listening in on Deaf Culture." 1996: n pag. Online. Internet. 20 April 1998. Available: http://stripe.colorado.edu/~standard/V5N2/AWARD/halpern.html. Matlin, Marlee. Letter. TIME Domestic 24 October 1994: n pag. Online. Internet. 20 April 1998. Available: http://pathfinder.com. Van Biema, David. "Beyond the Sound Barrier Deaf Americans are proud that one of their own is Miss America. But can her example apply to them?" TIME Domestic 3 October 1994: n pag. Online. Internet. 20 April 1998. Available: http://pathfinder.com. Weinstock, Janet. "The Ten Commandments of the Culturally Deaf." May 1993: n pag. Online. Internet. 20 April 1998. Available: http://www.weizmann.ac.il/deaf-info/commandments.html.

Border Security

Security our border is essential to securing the homeland. The country faces a different set of challenges with non-Mexicans who are caught crossing the border illegally. Mexican illegal immigrants are initially detained when they are apprehended. The problem is that the detention facilities do not have enough room for accommodation. As a result, about four of every five non-Mexican illegal immigrants that are caught are released in society and asked to return for a court date. When the date arrives, about 75 percent of those released do not show up at the court.In 2004, only 30,000 of the 160,000 non-Mexicans were sent home for being caught coming across the southwest. (http://www. whitehouse. gov/news/releases/2005/11/20051128-7. html) The practice of catch and release had been the government’s policy for decades. It was an unwise policy and the government has plans to end it. To help end catch and release, there is need to increase the capacity in the detention facilities. The president signed a legislation supported by members of the Arizona delegation in 2005 to increase the number of beds in detention facilities.One of the most effective tools the government has in this effort is a process called expedited removal. Under expedited removal, non-Mexicans are detailed and placed into streamlined proceedings. It allows the government to deport them at an average of 32 days, almost three times faster than usual. In other words, the government is cutting through bureaucracy. The program was so successful that the defense secretary expanded it al up and down the border. (http://www. whitehouse. gov/news/releases/2005/11/20051128-7. html)Since 2001, the government has hired 1900 new Border patrol agents. The agents are being helped by deployment of technologies. Technology helps an individual have broader reach and more effectiveness. When agents can take advantage of cutting edge equipment like overhead surveillance drones and infrared cameras, they can d o a better job for everyone. In Tucson agents on the ground are directing unmanned aerial technology in the sky, and they are acting rapidly on illegal immigration or illegal activities they may see from the drones.Since these unmanned flights began, agents have intercepted a lot of drugs on the border that otherwise and people that otherwise have made it through. (http://www. whitehouse. gov/news/releases/2005/11/20051128-7. html) US spending on military and police aid to Mexico has more than tripled to $57. 8 million with the hope that it will help protect America’s southern flank. The draw down of National Guard troops along the US-Mexican border should be stopped or alternative border security improvements provided because of problems with a high-tech â€Å"virtual fence† project.â€Å"Project 28† project, a 28-mile array of radars and surveillance cameras near sasabo, indicate that broad implementation of a â€Å"virtual fence† along the nationâ€⠄¢s southern border won’t happen soon. Project 28 is part of a national plan to secure the US Mexico border with physical barriers and high-tech detention capabilities. (Carl B, 2007) Curbing illegal immigration and security the nearly 2,000 mile, (3,200-kilometer) south western border are hot topics in this US election year. Washington has pledged to complete 67 miles (1,070 kilometers) of new barriers by the close of 2008, despite resistance from landowners and environmentalists.Based on along standing relationship of cooperation and mutual assistance, US customs and Border Protection (CBP) and the General Customs Administration of Mexico (GCAM) have begun the implementation of those action items designed to guarantee the secure and efficient flow of trade between the two nations. (Carl B, 2007) For purposes of developing and implementing initiative identified in the US/Mexico Border Partnership Plan, CBP and GCAM have created special working groups: the Border working Grou p, the Enforcement Working Group and the Technology and Customs Procedures Working Group.These groups have been working on a broad range of initiatives namely; 1. Extending and harmonizing the service hours in coordination with the trade communities, at the entry ports located at the common border. 2. Ensuring the Advanced Passenger Information System in Mexico is implemented. This will help collect and share data concerning air passengers arriving to and departing from United States and Mexico. 3. Deploying gamma ray machines at our railroad crossings. 4. Exchanging core data on every transaction occurring through the common border in an electronic environment.5. testing and implementing new technologies for instance electronic seals 6. Fraudulent trade investigations should be conducted jointly. This has led to significant seizures of undervalued and illegally transshipped goods. 7. Devolving systems to monitor in-transit shipments through our territories. 8. Seizing illegal cash transported by air passengers. (http://www. dhs. gov/xnews/releases/press_release_0137. shtm. ) The Mexican border fence that was approved by President Bush in October 2006 is now complete, but accolades for the project are few and far between.The secure fence Act, which was touted by Republicans as a major border security initiative in the weeks leading up to the 2006, mid-term elections is now viewed by many as a fiasco of the first order. The fence is only two and a half feet high and people argue that it cannot stop illegal immigrants. The Mexican border fence as completed is a roughly 30 inch high barrier built primarily of wooden stakes and chicken wire. Chicken wire could not be provided for the entire length of the fence due to budget constraints.These portions therefore consist only of wooden fence posts driven into the ground roughly every twelve feet with small-hand written in between bearing the words â€Å"security fence). (Carl B, 2007) Governor Janet Napolitano on We dnesday March 08 ordered more National Guardsmen posted at the Mexican border to help stop illegal immigrants and curb related crimes. National Guard troops have worked at the border since 1988, but Napolitano signed and order authorizing commanders to station an unspecified number of additional soldiers there to help federal agents.Once the funding is approved, the troops will monitor crossing points, assist with cargo inspection and operate surveillance cameras, according to the order. About 170 national Guardsmen are already posted at the nation’s busiest illegal entry point, where they assist with communications, fence construction and antidrug efforts. (Carl B, 2007) For the last four years, the crisis at the southern border has not improved. Today, approximately the same number of illegal crossings occurs on the southern border as occurred four years ago.That averages about 5,000 illegal crossing per day and approximately 5 million illegal crossings. In a post 9/11 worl d this is unacceptable. (http://www. lenmunsil. com/BorderMunsil. pdf. ) The government should immediately deploy the Arizona National Guard and assign it the mission of security Arizona’s southern border working cooperatively with US Border Patrol and ongoing operation Jump start. The Governor is authorized under A. R. S Sec-26-172 to â€Å"mobilize all or any part† of the National Guard when the Governor proclaims an emergency or â€Å"deems it necessary to protect lives or property.It should also seek funding to create the â€Å"Arizona Border Patrol† as a division of the Department of Public Safety-Law enforcement will play a significant role in safeguarding Arizona from ongoing effects of illegal immigration. (http://www. lenmunsil. com/BorderMunsil. pdf. ) It should also seek funding to deploy radar technology to the entire length of Arizona’s southern border, complementing current Border Patrol efforts and covering those areas that are currently u nprotected.Additional resources should also be provided to law enforcement, the courts and all necessary components for the criminal justice system to process illegal aliens quickly and move them out of the state system. (http://www. lenmunsil. com/BorderMunsil. pdf. ) Reference: Carl Braun. 2007. Above all Else. The Minute man Struggle to Secure America’s Borders. http://www. whitehouse. gov/news/releases/2005/11/20051128-7. html. Retrieved on13th March 2008 http://www. dhs. gov/xnews/releases/press_release_0137. shtm. Retrieved on 13th March 2008 http://www. lenmunsil. com/BorderMunsil. pdf. Retrieved on 13th March 2008.

Dementia to Elderly in Uk

Abstract Dementia is characterized by evidence of short term and long term memory impairment with impaired abstract thinking, impaired judgment, disturbances of higher cortical thinking, and personality changes. It is basically a progressive decline of cerebral utility such as logic, remembrance, language, problem solving, or concentration. This disease greatly harms the day by day performance of a person and is seen more in older people, however, is not a normal part of aging. . INTRODUCTION 1. 1. Aim The aim of this dissertation is to analyze the effects of dementia in older people and to suggest possible solutions for its prevention and treatment. 1. 2. Objectives Primary objective of this research is to see how effective the health care management systems are for the diagnosis, treatment and prevention of dementia syndrome specially keeping in view the population of UK. 1. 3. Dementia defined The International Dictionary of Psychology (Sutherland, 1989) defines it as â€Å"an impairment or loss of mental ability, particularly of the capacity to remember, but also including impaired thought, speech, judgment, and personality. It occurs in senile dementia and in conditions involving widespread damage to the brain or narrowing of the blood vessels†. In the preceding definition, Sutherland introduced a different term, senile dementia. Senile is derived from the Latin adverb senex pertaining to age or growing old. This shows that some dementias occur at later or older ages for reasons not known. Definition of senile dementia as per The International Dictionary of Psychology is that it is â€Å"a progressive syndrome starting in old age with no clear cause, in which intellect, memory, and judgment are impaired; it is often accompanied by apathy or irritability† (Sutherland, 1989, p. 397). 1. 4. How common is dementia? In England only, there are approximately 570,000 people living with dementia. It is expected that this number would double in the coming 30 years (Barberger-Gateau, 2007). Generally dementia arises in people who are 65 years of age above. The chances of developing it are more as one gets old as compare to young people. Roughly, it is anticipated that dementia occurs in: †¢1. 4% of men and 1. 5% of women aged between 65 and 69, †¢3. 1% of men and 2. 2% of women aged between 70 and 74, †¢5. 6% of men and 7. 1% of women aged between 75 and 79, †¢10. 2 % of men and 14. 1% of women aged between 80 and 84, and †¢19. 6% of men and 27. 5% of women aged 85 or over. 2. LITERATURE REVIEW In the preceding paragraphs, we will discuss in detail the different kinds of dementia that occur to people at older age along with a number of causes that lead towards this syndrome. . 1. Types of dementia Following are the different types of dementia recognized so far (Davidson, 2005): †¢Alzheimer's disease, where tiny clusters of protein, known as plaques, start to build up around brain cells. This upsets the regular workings of the brain. †¢Vascular dementia, where troubles with blood distribution result in uneven supply of blood and oxygen to certain parts of the brain. †¢Dementia with Lewy bodies, where irregular structures, known as Lewy bodies, grow inside the brain. †¢Frontotemporal dementia, where the two parts of the brain, frontal and temporal lobes, start to shrink. Not like other types of dementia, frontotemporal dementia typically grows in people who are below 65 years of age and is very rare than other types of dementia. 2. 2. Different Kinds of Dementia Different kinds of dementing disorders exist. One way of classification is according to parts of the brain being affected. Some frequently used classifications are as follows: †¢Cortical dementia: This type of dementia damages the brain particularly affecting the brain's cortex, or outer layer. Problems such as memory, language, thinking, and social behavior results due to this disoder. Sub cortical dementia: It affects parts of the brain below the cortex and causes changes in emotions and movements along with damaging memory. †¢Progressive dementia: It gets worse with the passage of time, thus interfering more and more with cognitive abilities. †¢Primary dementia: This denotes to that form that does not result from any other disease such as AD. †¢Secondary dementia: This type of dementia occurs due to some physical disease or injury. †¢Treatable Dementia: About 10 percent of conditions that cause dementia are treatable. With treatment, the dementia can either be upturned or at least halted. Instances of conditions that cause treatable cases of dementia comprise of the following: ?Normal pressure hydrocephalus ?A brain tumor or brain cancer ?Hypothyroidism ?Vitamin B12 deficiency ?Neurosyphilis ?Reactions to medications ?Poisoning. †¢Non-Treatable Dementia: Types of dementia that currently have no cure include: †¢Lewy body dementia †¢Binswanger's disease †¢Frontotemporal dementia †¢Corticobasal degeneration †¢Certain conditions that can cause childhood dementia †¢HIV-associated dementia Other infections within the brain, such as Creutzfeldt-Jakob disease †¢Huntington's disease and other rare hereditary dementias †¢Head trauma, such as dementia pugilistica (also known as boxer's syndrome). Several types of dementia fit into more than one of these classifications. For instance, AD is considered both a cortical as well as progressive dementia. 2. 3Causes 2. 3 . 1Alzheimer's disease It is the most common cause of dementia, affecting around 417,000 people in the UK. German neurologist Alois Alzheimer first described Alzheimer's disease. According to him, it is a physical disease affecting the brain. All through the course of the disease, plaques and tangles develop in the brain, thus leading to the loss of brain cells. Shortage of some important chemicals in the brain also results due to this disease. These chemicals are concerned with the spread of messages within the brain. 2. 3. 2Vascular dementia Vascular dementia is the second most common form of dementia after Alzheimer's disease. It is caused by problems in the supply of blood to the brain. There are a number of conditions that can cause or increase damage to the vascular system. These include high blood pressure, heart problems, high cholesterol and diabetes. This means it is important that these conditions are identified and treated at the earliest opportunity. 2. 3. 3Dementia with Lewy bodies Dementia with Lewy bodies (DLB) is a form of dementia that has characteristics similar to both Alzheimer's and Parkinson's diseases. It makes around four per cent of all cases of dementia in older people. Lewy bodies, named after the doctor who first identified them in 1912, are tiny, spherical protein deposits found in nerve cells. Their presence in the brain disrupts the brain's normal functioning, interrupting the action of important chemical messengers, including acetylcholine and dopamine. Researchers have yet to understand fully why Lewy bodies occur in the brain and how they cause damage. 2. 3. 4Fronto-temporal dementia The term ‘fronto-temporal dementia' includes conditions such as Pick's disease, frontal lobe degeneration, and dementia associated with motor neurone disease. All these are due to damage to the frontal lobe and/or the temporal parts of the brain. These areas are responsible for our behaviour, emotional responses and language skills. . 3. 5Korsakoff's syndrome Korsakoff's syndrome is a brain disorder usually linked with heavy alcohol utilization over a long period. Sometimes it is referred to as ‘alcohol amnestic syndrome' ? ‘amnestic' meaning loss of memory ? although in rare cases alcohol is not the cause. Although Korsakoff's syndrome is not strictly speaking a dementia , people with the condition suffer loss of short-term memory. 2. 3. 6Creutzfeldt-Jakob disease Prions are contagious agents that onslaught the central nervous system and then occupy the brain, causing dementia. Known prion disease is Creutzfeldt-Jakob disease, or CJD. It was first reported by two German doctors (Creutzfeldt and Jakob) in 1920. 2. 3. 7Aids-related cognitive impairment Individuals with HIV and AIDS occasionally develop cognitive impairment – particularly in the later stages of their sickness. AIDS (acquired immune deficiency syndrome) is caused by the presence of the human immunodeficiency virus (HIV) in the body. HIV attacks the body's immune system, making the person affected more susceptible to infection. HIV-related cognitive impairment can be caused by: ? The direct impact of HIV on the brain Infections (called ‘opportunistic infections') that take advantage of the weakened immune system. 2. 3. 8Binswanger's disease Binswanger's disease is a unusual form of vascular dementia in which harm occurs to the blood vessels in the deep white matter of the brain. Symptoms of Binswanger's mostly occur in people over the age of 60 and it is usually linked with long-ter m hypertension. The disease chiefly affects memory and mental abilities such as thinking and learning. The individual may also experience mood swings, tremors, seizures and problems with walking. 2. 3. 9Huntington's disease Huntington's disease is a progressive inherited disease. It typically becomes obvious in adults in their 30s, even though it can occur earlier or later. There is also a puerile type of Huntington's, which affects children. The route of the disease varies for each person, and dementia can occur at any stage of the illness. 2. 4Diagnosis Diagnosis of dementia is based on the following: †¢History †¢Physical exam †¢Tests The process of identifying dementia is made only if two or more brain functions such as memory and language skills are extensively damaged without loss of consciousness. An early and precise dementia diagnosis can help in early treatment of dementia symptoms and maybe reversing the dementia or stopping its development, if the cause of dementia is reversible (such as normal pressure hydrocephalus, a brain tumor, or B12 deficiency). †¢Patient History History taking is a very important step in identifying dementia. It is important to know how and when symptoms developed and about the patient's overall medical condition. Is there any risk factor involved or there is any family history of similar symptoms along with any medication the person is taking. Physician also try to evaluate the patient's emotional state and the degree of day to day actions being affected in spite of of the fact that patients with dementia frequently are ignorant of or in denial about how their disease is affecting them. Typically the family members also deny the reality of the disease because they take this in the beginning as a usual procedure of aging. Therefore, additional steps are necessary to confirm or rule out a dementia diagnosis. †¢Physical Exam: A physical examination can help in the following: ?Rule out treatable causes of dementia Classify signs of stroke or other disorders that can add to dementia ? Identify indications of other illnesses, such as heart disease or kidney failure that can be related with dementia. A thorough neurological assessment is performed to evaluate the balance, sensory function, reflexes, and other functions of the patient and to spot signs of conditions that may have an effect on the diagnosis of dementia. †¢Tests Used in Diagnosing Dementia Tests that are used to diagnosis dementia include the following: ?Cognitive and neuropsychological tests (Mini-Mental State Examination (MMSE) ? Brain scans (MRI or CT scan) Laboratory tests ?Psychiatric evaluations ?Pre-symptomatic testing. †¢Cognitive and Neuropsychological Tests for Dementia Tests are done to measure memory, language skills, math skills, and other abilities associated to mental functioning to help them analyze a patient's condition precisely. A test called the Mini-Mental ® State Examination (MMSEâ„ ¢) is used to judge cognitive skills in people with assumed dementia. This test examines: ? Orientation ?Memory ?Attention Doctors also use a diversity of other tests and rating scales to categorize explicit types of cognitive problems and abilities. †¢Brain Scan Tests for Dementia Brain scans are carried out to recognize strokes, tumors, or other problems that can result dementia. A brain scan may also demonstrate cortical atrophy (the progressive loss of neurons causes the ridges to become thinner and the sulci to grow wider), which is the deterioration of the brain's cortex (outer layer) and is frequent in many forms of dementia. Brain scans can also spot changes in the brain's organization and function that would propose Alzheimer's disease. †¢Computed Tomography Scan or Magnetic Resonance Imaging The most general types of brain scans are computed tomography (CT) scans and magnetic resonance imaging (MRI). A CT scan of the brain frequently suggested in a patient with suspected dementia. These scans, which use x-rays to detect brain structures, can show evidence of: ?Brain atrophy ?Strokes and transient ischemic attacks (TIAs) ?Changes to the blood vessels ?Other problems (such as hydrocephalus and subdural hematomas). MRI scans use magnetic fields and focused radio waves to detect hydrogen atoms in tissues within the body. They can detect the same problems as CT scans but they are better for identifying certain conditions, such as brain atrophy and damage from small TIAs. †¢Electroencephalograms (EEGs) Electroencephalograms (EEGs) are another tool to assist in inspecting people with suspected dementia. In an EEG, electrodes are placed on the scalp over several parts of the brain in order to detect and record patterns of electrical activity and to check for abnormalities. This electrical activity can indicate cognitive dysfunction in part or all of the brain. Many patients with moderately severe to severe Alzheimer's disease have abnormal EEGs. An EEG may also be used to detect seizures, which occur in about 10 percent of people with Alzheimer's disease. It can also help diagnose Creutzfeldt-Jakob disease. †¢Other Brain Scan Tests Several other types of brain scans allow researchers to watch the brain as it functions. These scans, called functional brain imaging, are not often used as diagnostic tools, but they are important in research and they may ultimately help identify people with dementia earlier than is currently possible. Types of functional brain scans include: ?Functional MRI (fMRI): It uses radio waves and a strong magnetic field to measure the metabolic changes that take place in active parts of the brain. ?Single photon-emission computed tomography (SPECT): It shows the distribution of blood in the brain, which generally increases with brain activity. Positron emission tomography (PET): This scans can detect changes in glucose metabolism, oxygen metabolism, and blood flow, all of which can reveal abnormalities of brain function. ?Magneto encephalography (MEG): This can show the electromagnetic fields produced by the brain's neuronal activity. †¢Laboratory Tests for Dementia Doctors may use a variety of laboratory tests to help diagnose dementia or rule out other conditions, such as kidney failure, which can contribute to symptoms. A partial list of these tests includes: ?A complete blood count (CBC) Blood glucose test, which measures sugar levels in the blood ? Urinalysis ?Drug and alcohol tests (toxicology screen) ?Cerebrospinal fluid analysis (to rule out specific infections that can affect the brain) ? Analysis of thyroid and thyroid-stimulating hormone levels. ?A doctor will order only the tests that he or she feels are necessary to improve the accuracy of a diagnosis. †¢Psychiatric Evaluation The healthcare provider may recommend a psychiatric evaluation to determine if depression or another psychiatric disorder may be causing or contributing to a person's symptoms. Pre-Symptomatic Testing In most cases, testing people before symptoms begin in order to determine if they will develop dementia is not possible. However, in cases involving disorders such as Huntin gton's where a known gene defect is clearly linked to the risk of the disease, a genetic test can help identify people who are likely to develop the disease. Since this type of genetic information can be devastating, people should carefully consider whether they want to undergo such testing. 2. 5Treatment For about 10 percent of conditions that cause dementia, treatment is available that can help reverse or at least slow down its progression. Some examples of these treatable causes of dementia include: †¢A brain tumor †¢Normal pressure hydrocephalus †¢Hypothyroidism. For most cases, treatment does not exist to reverse or halt the disease's progression; however, this does not mean that nothing should be done. People with dementia can benefit to some extent from such things as medications and cognitive training. There are also options for the family to help them cope. 2. 6Risk Factors Scientists have found a number of risk factors for dementia that affect the likelihood of developing one or more kinds of dementia. While these are not causes of dementia, they may increase a person's chances of developing the symptoms referred to collectively as dementia. Some dementia risk factors can be treated or controlled and some cannot Some of these risk factors for dementia are modifiable, while others are not.. Also, certain risk factors are more likely to increase the risk for certain types of dementia. For example, the risk of vascular dementia is strongly correlated with risk factors for stroke. Finally, the more dementia risk factors you have, the greater your chances of having dementia. An example of risk factors for dementia that you cannot change involves getting older (the risk of dementia tends to increase with age). Other dementia risk factors you cannot control include having: †¢Age †¢A family history of dementia †¢Down syndrome †¢Mild cognitive impairment †¢History of a stroke. Dementia risk factors that you can control include: †¢Hypertension †¢hypercholesterolemia †¢Diabetes †¢Atherosclerosis †¢Smoking †¢Heavy alcohol use. †¢Homocysteine levels in the blood. There are also things that can be controlled that increase your risk for developing diabetes, atherosclerosis, and other conditions that may increase your risk of developing dementia. These include: †¢Being overweight or obese †¢Lack of physical activity †¢Unhealthy diet. ?Age Age is the utmost risk aspect for dementia. Dementia influences one in 14 people over the age of 65 and one in six over the age of 80. However, Alzheimer's is not limited to aged people: in the UK, there are 15,000 people under the age of 65 with dementia, although this figure is likely to be an underrated. ?Genetic inheritance Several people fear that they may become heir to Alzheimer's disease, and scientists are presently exploring the hereditary background to Alzheimer's. In most of the cases, the effect of inheritance appears to be minute. If a parent or other family member has Alzheimer's disease, probability of developing the disease is only a slight elevated than if there were no cases of Alzheimer's in the direct family. ?Environmental factors The ecological factors that may add to the onset of Alzheimer's disease have yet to be discovered. Not many years ago, there were concerns that revelation to aluminum might cause Alzheimer's disease. Nevertheless, these fears have largely been discounted. ?Other factors Because of the dissimilarity in their chromosomal structure, people with Down's disorder who live into their 50s and 60s may develop Alzheimer's disease. People who have had stern skull or whiplash wounds also come out to be at increased risk of developing dementia. Boxers who get frequent blows to the head are at risk too. Study has also revealed that people who smoke, and those who have elevated blood pressure or sky-scraping cholesterol levels, augment their risk of developing Alzheimer's. 2. 7 Care of people with dementia People with moderate and advanced dementia typically need round-the-clock care and supervision to prevent them from harming themselves or others. They may also need assistance with daily activities such as eating, bathing, and dressing. Meeting these needs requires patience, understanding, and careful thought from the person's caregivers. For people involved with dementia care, there are some important things to consider. These include such things as: †¢Making the home safe †¢Helping to reduce stressors †¢Providing mental stimulation. Good dementia care always involves the issue of driving. One of the hardest things to do is to take away a person's independence that comes with driving. However, for a number of reasons that we will explain later, people with dementia should not drive. 2. 7. 1Dementia Care and the Home A typical home environment can present many dangers and obstacles to people with dementia, but simple changes can overcome many of these problems. For example, sharp knives, dangerous chemicals, tools, and other hazards should be removed or locked away. Other safety precautions include: †¢Installing bed and bathroom safety rails †¢Removing locks from bedroom and bathroom doors Lowering the hot water temperature to 120 °F (48. 9 °C) or less to reduce the risk of accidental scalding. People with dementia should also wear some form of identification at all times in case they wander away or become lost. Caregivers can help prevent unsupervised wandering by adding locks or alarms to outside doors. 2. 7. 2Reducing Stressors People with dementia ofte n develop behavioral problems because of frustration with specific situations. Understanding and modifying or preventing the situations that trigger these behaviors may help to make life more pleasant for the person with dementia as well as his or her caregivers. For instance, the person may be confused or frustrated by the level of activity or noise in the surrounding environment. Reducing unnecessary activity and noise (such as by limiting the number of visitors and turning off the television when it's not in use) may make it easier for the person to understand requests and perform simple tasks. Caregivers may also reduce confusion in people with dementia by: †¢Simplifying home decorations †¢Removing clutter †¢Keeping familiar objects nearby †¢Following a predictable routine throughout the day. Calendars and clocks also may help patients orient themselves. . 7. 3Mental Stimulation as Part of Dementia Care Caregivers should encourage people with dementia to continue their normal leisure activities as long as they are safe and do not cause frustration. Activities such as crafts, games, and music can provide important mental stimulation and improve mood. Some studies have suggested that participating in exercise and intelle ctually stimulating activities may slow the decline of cognitive function in some people. 2. 7. 4Is Driving Safe? Many studies have found that driving is unsafe for people with dementia. They often get lost and they may have problems remembering or following the rules of the road. They may also have difficulty processing information quickly and dealing with unexpected circumstances. Even a second of confusion while driving can lead to an accident. Driving with impaired cognitive functions can also endanger others. Some experts have suggested that regular screening for changes in cognition might help to reduce the number of driving accidents among elderly people, and some states now require that doctors report people with Alzheimer's disease to their state motor vehicle department. However, in many cases, it is up to the person's family and friends to ensure that the person does not drive. 2. 7. 5How the local authority assesses need Local authority social services departments are the main providers of care and support services. If a person with dementia or their carer is in need of support, they should contact the local social services department to explain. The department will then carry out an assessment of the person's needs and identify what services would be appropriate to meet those needs. This is known as a community care assessment If the department assesses a person as being in need of certain services, it has a duty to provide the services that fall within their eligibility criteria (locally set rules on what type of needs the local authority will meet). The person may have to contribute towards the cost of these services. Local authorities can provide services directly themselves, or may make arrangements for private or voluntary-sector organizations to provide care on their behalf. Services ary from area to area, but range from those that allow someone to remain independent in their own home (such as meals on wheels, day care, equipment and home adaptations) to residential care. The views and preferences of the person receiving the service should always be taken into account. 2. 7. 6Care plans If, after assessing the person's care needs, the social services department agrees that certain services should be provided, it will give the person a written care plan out lining these services. This applies whether the person lives at home or in a care home. Care plans should be reviewed regularly and as needs change. If a review has not been carried out recently, or if one may be necessary, the person or their carer should contact social services and ask for a review. In addition, care homes must provide an individual care plan for each resident. This must be regularly reviewed to take account of changing needs. 2. 7. 7Thinking through the options Once the social services department has confirmed what services the person is eligible to receive, the person and their carer can begin to think through the options. Even if the assessment concludes that the person's needs are not yet urgent enough to receive help from social services, or if some services are not available under the local authority's eligibility criteria, an assessment will give everyone clearer information about the situation and the kinds of help available from other sources. The person or their family or carer could arrange services themselves, or through a voluntary organization or private agency. A key decision is whether the person can remain in their own home, or whether they would prefer to move into sheltered housing or a care home. If they stay in their own home, there are many additional support options available. It is also important to consider the financial implications of the options available. Social services should be able to give an idea of how much the person will have to pay towards the costs of the various services that are arranged through them. Services provided by the NHS, such as community nursing, are free. Anyone who is arranging services themselves, whether through a voluntary organisation or a private agency, will need to make their own enquiries. It is important not to rush into a decision. It might help to also talk to friends and relatives, other carers and your local Alzheimer's Society branch. Local voluntary organisations are a source of further information, advice and practical help. Below is some guidance about what to consider when you are thinking about the kind of care the person in question needs. 2. 7. 8Understanding and respecting the person with dementia It's very important that people with dementia are treated with respect. It is important to remember that a person with dementia is still a unique and valuable human being, despite their illness. If you can understand what the person is going through, it might be easier for you to realise why they behave in certain ways. When a person with dementia finds that their mental abilities are declining, they often feel vulnerable and in need of reassurance and support. The people closest to them – including their carers, health and social care professionals, friends and family – need to do everything they can to help the person to retain their sense of identity and feelings of self-worth. 2. 7. 9Helping the person feel valued The person with dementia needs to feel respected and valued for who they are now, as well as for who they were in the past. There are many things that the people around them can do to help, including: †¢trying to be flexible and tolerant †¢making time to listen, have regular chats, and enjoy being with the person †¢showing affection in a way they both feel comfortable with †¢finding things to do together. Our sense of who we are is closely connected to the names we call ourselves. It's important that people address the person with dementia in a way that the person recognises and prefers. Some people may be happy for anybody to call them by their first name or nickname. †¢Others may prefer younger people, or those who do not know them very well, to address them formally and to use courtesy titles, such as Mr or Mrs. Make sure you explain the person's cultural or religious background, and any rules and customs, to anyone from a different background so that they can behave accordingly. These may include: †¢respectful forms of address †¢what they can eat †¢religious observances, such as prayer and festivals particular clothing or jewellery that the person (or those in their presence) should or should not wear †¢any forms of touch or gestures that are considered disrespectful †¢ways of undressing †¢ways of dressing the hair †¢how the person washes or uses the toilet. Many people with dementia have a fragile sense of self-worth; it's especially important that people continue to treat them with courtesy, however advanced their dementia. †¢Be kind and reassuring to the person you're caring for without talking down to them. †¢Never talk over their head as if they are not there – especially if you're talking about them. Include them in conversations. †¢Avoid scolding or criticising them – this will make them feel small. †¢Look for the meaning behind their words, even if they don't seem to be making much sense. Whatever the detail of what they are saying, the person is usually trying to communicate how they feel. †¢Try to imagine how you would like to be spoken to if you were in their position. †¢Try to make sure that the person's right to privacy is respected. †¢Suggest to other people that they should always knock on the person's bedroom door before entering. If the person needs help with intimate personal activities, such as washing or using the toilet, do this sensitively and make sure the door is kept closed if other people are around. †¢Everyone involved – including the person's friends, family members, carers, and the person with dementia themselves – reacts to the experience of dementia in their own way. Dementia means different things to dif ferent people. There are lots of things you can do to help the person with dementia feel good about themselves. This factsheet offers some suggestions. When you spend time with someone with dementia, it is important to take account of their abilities, interests and preferences. These may change as the dementia progresses. It's not always easy, but try to respond flexibly and sensitively. Dementia affects people's thinking, reasoning and memory, but the person's feelings remain intact. A person with dementia will probably be sad or upset at times. In the earlier stages, the person may want to talk about their anxieties and the problems they are experiencing. †¢Try to understand how the person feels. Make time to offer them support, rather than ignoring them or ‘jollying them along'. †¢Don't brush their worries aside, however painful they may be, or however insignificant they may seem. Listen, and show the person that you are there for them. †¢Make sure that, whenever possible, you inform and consult the person about matters that concern them. Give them every opportunity to make their own choices. †¢Always ex plain what you are doing and why. You may be able to judge the person's reaction from their expression and body language. †¢People with dementia can find choice confusing, so keep it simple. Phrase questions so that they only need a ‘yes' or ‘no' answer, such as ‘Would you like to wear your blue jumper today? ‘ rather than ‘Which jumper would you like to wear today? ‘ †¢Avoid situations in which the person is bound to fail, as this can be humiliating. Look for tasks that they can still manage and activities they enjoy. ive plenty of encouragement. Let them do things at their own pace and in their own way. †¢Do things with the person, rather than for them, to help them retain their independence. †¢Break activities down into small steps so that they feel a sense of achievement, even if they can only manage part of a task. Our self-respect is often bound up with the way we look. Encourage the person to take pride in their appearance, and compliment them on how they look. Make sure that anyone involved in caring for the person has as much background information as possible, as well as information about their present situatio n. This will help them see the person they're caring for as a whole person rather than simply ‘someone with dementia'. It may also help them to feel more confident about finding conversation topics or suggesting activities that the person may enjoy. 2. 8How effective is heath care management? Health care management involves several techniques to cater the needs of the patient. It should be kept in mind that patient is not responsible for the disease and therefore should not be ignored or avoided. With the advancement in technology, different techniques can be used to look after the suffer of this disorder. However, these techniques and ways could only help the victim survive a bit since. Those kinds of dementia which are treatable and such patients have a different perspective and outlook of life as compared to those who are the victims of the untreatable ones. So the care also varies with these two kinds of patients. Effectiveness of the present day health care management system is satisfactory but as said earlier it cannot bring back the life of the victim, however could let him or her survive for few more days with a happy face. 3. DEMENTIA IN UK Following statistics give a clear cut idea about the ratio and proportion of dementia patients in UK: †¢There are currently 700,000 people with dementia in the UK. †¢There are currently 15,000 younger people with dementia in the UK. †¢There are over 11,500 people with dementia from black and minority ethnic groups in the UK. There will be over a million people with dementia by 2025. †¢Two thirds of people with dementia are women. †¢The proportion of people with dementia doubles for every 5 year age group. †¢One third of people over 95 have dementia. †¢60,000 deaths a year are directly attributable to dementia. †¢Delaying the onset of dementia by 5 years wo uld reduce deaths directly attributable to dementia by 30,000 a year. †¢The financial cost of dementia to the UK is over ? 17 billion a year. †¢Family carers of people with dementia save the UK over ? 6 billion a year. †¢64% of people living in care homes have a form of dementia. Two thirds of people with dementia live in the community while one third live in a care home. 4. LIVING WITH DEMENTIA People with dementia have become increasingly involved in the work of the Alzheimer's Society since 2000. Through a national programme called ‘Living with Dementia', people with dementia have been sharing their experiences and knowledge, and raising awareness of dementia at local and national levels. This contribution is crucial to ensure that the Alzheimer's Society develops appropriate information and support for people with dementia. It ensures that people with dementia can influence the work that the Society carries ut on their behalf. On a national level the Living with Dementia programme consults with people with dementia in support of the Alzheimer's Society's work of influencing government policy. †¢People with dementia in action People with dementia are involved in the Alzheimer's Society in a variety of ways: ? Giving presentations and raising public awareness. ?Organising the unique UK wide convention of people with dementia. ?Lobbying MPs and commenting on government legislation. ?Being interviewed by national press and television. ?Recruiting and inducting new staff at the Alzheimer's Society. ?Helping to make the website easier to use. Developing information for other people with dementia and their families. ?Participating in the national consultative body, the Living with Dementia Working group. These are just a few examples. There are many opportunities in the Living with Dementia programme †¢Living with Dementia Programme Various initiatives in the Alzheimer's Society have focused on ways of supporting people living with dementia. Many started as two year pilots in 2001 and 2002, but are now established as a core part of the Alzheimer's Society activity. Examples of current initiatives are listed below: †¢West Kent Computer project Started in 2001. It supports people with dementia using computer equipment, to find new ways of communicating, pursuing interests and have fun. †¢Living with Dementia presentation skills training For people with dementia. Everyone affected by dementia has their own unique story to tell. Personal experiences and views are a powerful way of raising awareness about dementia, making issues come alive. Training people with dementia to share their experience on TV, press and at meetings, helps to reduce the misunderstanding that surrounds dementia and offers hope to people facing the same situation. Providing key skills enables people to undertake publicity work with confidence. †¢Helpcard for people with dementia Developed in 2007 by people with dementia and piloted by people with dementia. The helpcard enables people with dementia to feel confident, not alone and able to ask for help at anytime. It is very useful in emergency situations, and is an effective communication tool that informs others of a person's circumstances. There are three different designs, with three different options for describing particular situations. †¢National conference for people with dementia The Alzheimer's Society has hosted three conferences for people with dementia in London, Newcastle and Birmingham (Thompson, Nanni & Schwankovsky, 1990). The latter two involved members from the Living with Dementia Working group and the Scottish Dementia Working Group, making them the only UK wide events for people with dementia. In Newcastle the ‘Improving Our Lives' feedback included: ?Get out and enjoy life ?Laugh! Confidence ?Remaining the same person after diagnosis ?Open positive communication ?Speak up – have your voice listened to ?Speak to your MP Being denied treatment – medication because of a ‘cost cutting' exercise – it's a disgrace ? Set up an email group ?Done more since having dementia – living my life to the full 5. RESEARCHES Currently, scientists are conducting research on many different aspects of dementia. This research promises to improve the lives of people affected by such symptoms and may eventually lead to ways of pre venting or curing the disorders that result in dementia. Some areas of focus for dementia research include: †¢Causes and prevention †¢Diagnosis †¢Treatment. Researching the Causes and Prevention of Dementia Research on the causes of Alzheimer's disease (and other disorders that are causes of dementia) includes studies of: †¢Genetic factors †¢Neurotransmitters †¢Inflammation †¢Factors that influence programmed cell death in the brain †¢The roles of tau, beta amyloid, and the associated neurofibrillary tangles and plaques in Alzheimer's disease. Some other dementia research scientists are trying to determine the possible roles of cholesterol metabolism, oxidative stress (chemical reactions that can damage proteins, DNA, and lipids inside cells), and microglia in the development of Alzheimer's disease. Current research on dementia prevention and causes includes the following: †¢Research to better understand the role of aging-related proteins (such as the enzyme telomerase) in the development of dementia. †¢Studies of abnormal clumps of proteins in cells. Researchers are trying to learn how abnormal clumps of protein in cells develop, how they affect cells, and how the clumping can be prevented. †¢Studies that examine whether changes in white matter — nerve fibers lined with myelin — may play a role in the onset of Alzheimer's disease. Myelin may erode in Alzheimer's disease patients before other changes occur. This may be due to a problem with oligodendrocytes, the cells that produce myelin. †¢Work being done by scientists to search for additional genes that may contribute to Alzheimer's disease. These researchers have identified a number of gene regions that may be involved in the development of Alzheimer's. Some researchers suggest that people will eventually be screened for a number of genes that contribute to Alzheimer's disease and that they will be able to receive treatments that specifically address their individual genetic risks. However, such individualized screening and treatment is still years away. †¢Studies on insulin resistance. Insulin resistance is common in people with Alzheimer's disease, but it is not clear whether the insulin resistance contributes to the development of the disease or if it is merely a side effect. †¢Several dementia research studies have found a reduced risk of dementia in people who take cholesterol-lowering drugs called statins. However, it is not yet clear if the apparent effect is due to the drugs or to other factors. Therefore, more research is being currently being done be better understand this possible relationship between statins and dementia. †¢ A 2003 dementia research study found that people with HIV-associated dementia have different levels of activity for more than 30 different proteins, compared to people who have HIV but no signs of dementia. The study suggests a possible way to screen HIV patients for the first signs of cognitive impairment, and it may lead to ways of intervening to prevent this form of dementia. Research in this area continues. Research Involving Diagnosis of Alzheimer's Disease Improving early diagnosis of Alzheimer's disease and other disorders that may cause dementia is important not only for patients and families, but also for researchers who seek to better understand the causes of dementia and find ways to reverse or halt them at early stages. Improved diagnosis can also reduce the risk that people will receive inappropriate treatments. †¢In some resea rch, scientists are investigating whether three-dimensional computer models of positron emission tomography (PET) and magnetic resonance imaging (MRI) can identify brain changes typical of early Alzheimer's disease, before any symptoms appear. This research may lead to ways of preventing the symptoms of Alzheimer's disease. †¢One study found that levels of beta amyloid and tau in spinal fluid could be used to diagnose Alzheimer's disease with an accuracy of 92 percent. If other studies confirm the validity of this test, it may allow doctors to identify people who are beginning to develop the disorder before they start to show dementia symptoms. †¢This would allow treatment at very early stages of the disorder, and may help in testing new treatments to prevent or delay symptoms of the disease. Other researchers have identified factors in the skin and blood of Alzheimer's disease patients that are different from those in healthy people. They are trying to determine if these factors can be used to diagnose the disease. Treatment Research †¢Researchers are continually working to develop new drugs for Alzheimer's disease and other causes of dementia. Many researchers believe a vaccine that reduces the number of amyloid plaques in the brain might ultimately prove to be the most effective treatment for Alzheimer's disease. In 2001, researchers began one clinical trial of a vaccine called AN-1792. The research study was halted after a number of people developed inflammation of the brain and spinal cord. †¢Despite these problems, one patient appeared to have reduced numbers of amyloid plaques in the brain. Other patients showed little or no cognitive decline during the course of the study, suggesting that the vaccine may slow or halt the disease. Researchers are now tryi ng to find safer and more effective vaccines for Alzheimer's disease. Researchers are also investigating possible methods of gene therapy for Alzheimer's disease. In one case, researchers used cells genetically engineered to produce nerve growth factor and transplanted them into monkeys' forebrains. The transplanted cells boosted the amount of nerve growth factors in the brain and seemed to prevent degeneration of acetylcholine-producing neurons in the animals. †¢This suggests that gene therapy might help to reduce or delay symptoms of the disease. Researchers are now testing a similar therapy in a small number of patients. Other researchers have experimented with gene therapy that adds a gene called neprilysin in a mouse model that produces human beta amyloid. They found that increasing the level of neprilysin greatly reduced the amount of beta amyloid in the mice and halted the amyloid-related brain degeneration. They are now trying to determine whether neprilysin gene therap y can improve cognition in mice. †¢Since many studies have found evidence of brain inflammation in people with Alzheimer's disease, some researchers have proposed that drugs that control inflammation, such as NSAIDs, might prevent the disease or slow its progression. Studies in mice have suggested that these drugs can limit production of amyloid plaques in the brain. Early studies of these drugs in humans have shown promising results. †¢However, a large NIH-funded clinical trial of two NSAIDs (naproxen and celecoxib) to prevent Alzheimer's disease was stopped in late 2004 because of an increase in stroke and heart attack in people taking naproxen (Aleve ®, Naprosyn ®, Anaprox ®, Naprelan ®), and an unrelated study that linked celecoxib (Celebrex ®) to an increased risk of heart attack. Some research studies on dementia have suggested that two drugs, pentoxifylline and propentofylline, may be useful in treating vascular dementia. Pentoxifylline improves blood flow, while propentofylline appears to interfere with some of the processes that cause cell death in the brain. †¢One research study is testing the safety and effectiveness of donepezil (Aricept ®) for treating mild dementia in patients with Parkinson's dementia, while a nother is investigating whether skin patches with the drug selegiline can improve mental function in patients with cognitive problems related to HIV. . CONCLUSION An appropriate cost effective workup of dementia includes a complete history, a complete physical examination (including a neuropsychiatric evaluation), a CBC, blood glucose, serum electrolytes, serum calcium, serum creatinine, and serum thyroid stimulating hormone (Whitlatch, Feinberg & Tucke, 2005). Other tests should be done only if there is a specific indication for e. g. vitamin B12 and folate if macrocytosis is present (Wilkinson & Lennox, 2005). A CT or MRI should be considered if the onset of dementia is before the age of 65 years, symptoms have occurred for less than 2 years, there is evidence of focal or asymmetrical neurological deficits, the clinical picture indicates normal pressure hydrocephalus, or there is a recent history of fall or other head trauma. If a patient has a history of cancer or is on anticoagulation therapy, then neuro imaging should also be considered. Thus to conclude, it is sufficient to say that dementia, though a dangerous disorder, having not much cures, can be prevented by undergoing certain precautionary measures as illustrated above.