Planning and Design of Behavioral Healthcare Facilities

July 6, 2017

Behavioral Healthcare Facilities: The Current State of Design

In keeping with most districts of healthcare, the marketplace has seen a boom in the construction of Behavioral Healthcare facilities. Contributing to this increase is the paradigm shift in the way society views mental illness. Society is placing a heavier value on the need to treat people with serious addictions such as alcohol, prescription and elicit drugs. A large percentage of people suffering from behavioral disorders are afflicted with both mental and addictive behaviors, and most will re-enter communities and either become contributors or violators.

These very specialized facilities do not typically yield the attention from today’s top healthcare designers and their quantity accounts for a small fraction of healthcare construction. However, Behavioral Healthcare projects are increasing in number and are being designed by some very prominent architectural firms such as Cannon Design and Architecture Plus. Many are creating state-of-the-art, award-winning contemporary facilities that defy what most of us believe Behavioral Healthcare design to be.

Changing the Way We Design Behavioral Healthcare Facilities

As with all good planners and designers, A+D (along with facility experts) are reviewing the direct needs of patient and staff while reflecting on how new medicine and modern design can foster patient healing rates, reduce environmental stress, and increase safety. This is changing the face of treatment and outcome by giving the practitioner more time to treat because they require less time and resources to “manage” disruptive patient populations.

The face of Behavioral Healthcare is quickly changing. No longer are these facilities designed to warehouse patients indefinitely. And society’s expectations have changed. Patients are often treated with the belief that they can return to their community and be a contributor to society. According to the National Association of Psychiatric Health Systems (NAPHS), depending on the severity of illness, the average length of stay in a Behavioral Healthcare facility is only 9.6 days.

What has changed?

Jaques Laurence Black, AIA, president and principal of New York City-based daSILVA Architects, states that there are two primary reasons for the shortened admission period:

1. Introduction of modern psychotropic drugs that greatly speed recovery

2. Pressures from insurance companies to get patients out of expensive modes of care

To meet these challenges, healthcare professionals are finding it very difficult to effectively treat patients within the walls of antiquated, rapidly deteriorating mental facilities. A great percentage of these facilities were built between 1908 and 1928 and were designed for psychiatric needs that were principled in the belief to “store” not to “rehabilitate.”

Also impacting the need for Behavioral Healthcare construction is the reluctance of acute-care facilities to provide mental health level services for psychiatric or addiction patients. They recognize that patient groups suffering from behavioral disorders have unique health needs, all of which need to be handled and treated only by very experienced healthcare professionals. This patient population also requires a heightened level of security. Self-harm and injuring staff and other patients are major concerns.

The Report of the Surgeon General: “Epidemiology of Mental Illness” also reports that within a given year about 20% of Americans suffer from a diagnosable mental disorder and 5.4% suffer from a serious mental illness (SMI ) – defined as bipolar, panic, obsessive-compulsive, personality, and depression disorders and schizophrenia. It is also believed 6% of Americans suffer from addiction disorders, a statistic that is separate from individuals who suffer from both mental and addiction disorders. Within a given year it is believed that over one-quarter of America’s population warrants levels of mental clinical care. Even if these statistics were cut in half, it cannot be denied as a serious societal issue.

With a growing population, effectively designing in accordance with such measures is at the heart of public health.

Understanding the Complexity of Behavioral Healthcare Design

Therefore, like Corrections, leading planners and designers specializing in Behavioral Healthcare are delving deeper to better understand the complexity of issues and to be the activist to design facilities that promote treatment and healing – and a safer community.

The following is a list of key design variables that are being studied and implemented:

1. Right Sizing

2. Humanizing Materials and Color

3. Staff-Focused Amneties and Happiness

4. Security and Safety

5. Therapeutic Design Tenants

Right-sizing

Today’s Behavioral Healthcare facilities are often one-story single buildings within a campus size. Often debated by Clients due to costs, this design preference is driven by the demand for Uncategorized light, window views to nature for all patient areas, and outdoor open-air gardens “wrapped” within. All of this provides soothing qualities to the patient, reduces their anxieties, counteracts disruptive conduct and helps to reduce staff stress.

“When you look at the program mix in these buildings, there’s a high demand for perimeter because there are a lot of rooms that need Uncategorized light. Offices, classrooms, dining areas, community rooms, and patient rooms all demand Uncategorized light, so you end up with a tremendous amount of exterior wall, and it forces the building to have a very large footprint.” – James Kent Muirhead, AIA, associate principal at Cannon Design in Baltimore

These design principles are also believed to improve staff work conditions. Unlike a multi-story complex, at any moment staff can walk outdoors and access nature, free from visual barriers, and within a building that more accurately reflects building types that both patients and staff would encounter in their communities.

In addition to right-sizing for the overall building footprint, is right-sizing for internal patient and staff support area. Similar to the move we have seen in Corrections to de-centralize support spaces, Behavioral Healthcare is moving to decentralized nursing/patient units called “neighborhoods.” With mental health facilities there is a large concern with distances and space adjacencies in relation to the patient room and patient support areas such as treatment and social spaces. Frank Pitts, AIA, FACHA, OAA president of Architecture Plus, Troy, NY, advocates neighborhoods that average 24-30 beds arranged in sub-clusters, called “houses”, of 8-10 beds. Thus, each neighborhood consists of three houses. Often these layouts will include a common area where patients congregate and socialize, with a separate quiet room so patients can elect to avoid active, crowded areas. In addition Pitts states, “There’s a move away from central dining facilities. So, while facilities will still have a central kitchen, it’s a whole lot easier moving food than it is patients.” However, it is important for the facility to mimic normal outside daily life routines, so patients are encouraged to frequently leave their neighborhoods to attend treatment sessions, and outdoor courtyards.

Humanizing Materials & Color

In all facilities that play a role in rehabilitation, design strives to create spaces that humanize, calm, and relax. Behavioral Healthcare patients need to feel that they are in familiar surroundings; therefore, the architectural vocabulary should feel comfortable and normal. Since these facilities are about rehabilitation (when possible) and encouraging patients to merge back into society, the facility should feel like an extension of the community. Their spaces should reflect the nature and architecture of the surrounding region and thus so, no two facilities should look too much alike.

“Our a
pproach to designing these facilities is to view the facility as an extension of the community where patients will end up when they’re released. Interior finishes also depend on geography because you want to replicate the environment patients are used to. You want to de-stigmatize the facility as much as possible.” – Tim Rommel, AIA, ACHA, OAA, principal with Cannon Design in Buffalo, NY.

Therefore, materials and colors within these spaces want to feel familiar to one’s region and everyday life. To soothe the psyche and rehabilitate, they want to feel soft and comfortable, yet visually stimulating. An interior that is overly neutral or hard in appearance is not appropriate. Materials should reduce noise, and colors should lift the spirit. This can help to create an environment in which the patient can learn, socialize, and be productive while easing anxieties, delivering dignity, and modifying behavior. As stated previously, behavioral studies advise the use of softer interior materials-like carpeting, wood doors and tile. Doing so translates directly to both patient and staff well-being, particularly staff safety, and makes for a nicer place to work. In addition, staff have more resources to “treat” instead of manage heated situations. When staff experiences are eased and satisfied, morale is boosted and life-saving rules and policies are more likely to be enforced.

Staff-Focused Amenities & Happiness

While reducing staff stress and fatigue through a healing supportive environment seems like an obvious goal, there are relatively few studies that have dealt with this issue in any detail. More attention has been given to patient outcomes. However, many leading hospitals that have adopted therapeutic tenants into their newly built environments have seen vast improvement through their “business matrixes” and financial reporting.

In one example, the Mayo Clinic, a national leader in implementing healing design in its facilities, has reported a reduction of nursing turnover from a national annual average of 20% to an annual 3%-4%. In another example, when Bronson Methodist Hospital incorporated evidence-based design into its new 343-bed hospital, they cited their 19%-20% nurse turnover rate dramatically dropped to 5%.

Now, both the Mayo Clinic and Bronson Methodist Hospital have had to initiate a waiting list for nursing staff seeking positions. This converts to better-trained and qualified staff, and a reduced error rate. Therefore, more health facilities are investing in staff support areas such as lounges, changing rooms, and temporary sleep rooms. Within these staff spaces and in the hospital throughout, facilities are also recognizing the need for upgrade materials, better day lighting, and an interesting use of color: One soon realizes that the need of patients and staff are interwoven, each impacting positively or negatively the other.

Security & Safety

Without debate, self harm and harm to staff is one of the biggest concerns mental health facilities manage. Often the biggest safety and security concern is the damage patients can do to themselves. “There are three rules I had drummed in me,” says Mark Hanchar; Director of Preconstruction Services for Gilbane Building Company, Providence, R.I. “First, there can’t be any way for people to hang themselves. Second, there can be no way for them to create weapons. Third, you must eliminate things that can be thrown.” Hanchar says that the typical facility is, “a hospital with medium-security prison construction.” This means shatter proof glass, solid surface countertops (laminate can be peeled apart), stainless steel toilets and sinks (porcelain can shatter), push pull door latches and furniture that cannot be pulled apart and used as a weapon. These are just to name a few.

Additionally, removing barriers between patients and nursing staff is a safety consideration. Frank Pitts, AIA, FACHA, OAA president of Architecture Plus, says what may be counter-intuitive for safety precautions, “Glass walls around nursing stations just aggravate the patients.” Removing glass or lowering it at nursing stations so patients can feel a more human connection to nurses often calms patients. There is also discussion of removing nursing stations altogether; decentralizing and placing these care needs directly into the clinical neighborhoods and community spaces. Pitt says, “The view is that [nursing staff] need to be out there treating their patients.”

Therapeutic Design Tenants

As medicine is increasingly moving towards “evidence-based” medicine, where clinical choices are informed by research, healthcare design is increasingly guided by research linking the physical environment directly to patient and staff outcomes. Research teams from Texas A&M and Georgia Tech sifted through thousands of scientific articles and identified more than 600 – most from top peer-reviewed journals – to quantify how hospital design can play a direct role in clinical outcomes.

The research teams uncovered a large body of evidence that demonstrates design features such as increased day-lighting, access to nature, reduced noise and increased patient control helped reduce stress, improve sleep, and increase staff effectiveness – all of which promote healing rates and save facilities cost. Therefore, improving physical settings can be a critical tool in making hospitals more safe, more healing, and better places to work.

Today’s therapeutic spaces have been defined to excel in 3 categories:

1. Provide clinical excellence in the treatment of the body

2. Meet the psycho-social needs of patients, families, and staff

3. Produce measurable positive patient outcomes and staff effectiveness

Considering the cost of treating mental illness, which is exceedingly high, and wanting facilities to have effective outcomes, a further practice of incorporating therapeutic design is increasing. The National Institute of Mental Health (NIM H) approximated in 2008 that serious mental illnesses (SMI ), costs the nation $193 billion annually in lost wages. The indirect costs are impossible to estimate.

The estimated direct cost to clinically treat is approximately $70 billion annually and another $12 billion spent towards substance abuse disorders. In addition to the increased need of care and the boom in Behavioral Healthcare construction, it becomes an obligation to make certain that we as facility managers, architects, designers and manufacturers therapeutically plan and design these facilities.

Notably, in 2004, “The Role of the Physical Environment in the Hospital for the 21st Century: A Once-in-a-Lifetime Opportunity,” published by Roger Ulrich P.H.D., of Texas A&M University, was released. In a culmination of evidence-based research, research teams found five design principles that contributed significantly to achieving therapeutic design goals.

The report indicates five key factors that are essential for the psychological well-being of patients, families and staff, including:

1. Access to Nature

2. Provide Positive Distractions

3. Provide Social Support Spaces

4. Give a Sense of Control

5. Reduce or eliminate environmental stress

Access to Nature

Studies indicate that nature might have the most powerful impact to help patient outcomes and staff effectiveness. Nature can be literal or figurative – Uncategorized light, water walls, views to nature, large prints of botanicals and geography, materials that indicate nature and most importantly, stimulating color that evokes nature. Several studies strongly support that access to nature such as day-lighting and appropriate colorations can improve health outcomes such as depression, agitation, sleep, circadian rest-activity rhythms, as well as length of stay in demented patients and persons with seasonal affective disorders (SAD).

These and related studies continue to affirm the powerful impact of Uncategorized elements on patient recovery and stress reduction. Thus, it is clea
r that interior designs which integrate Uncategorized elements can create a more relaxing, therapeutic environment that benefits both patients and staff.

Positive Distractions

These are a small set of environmental features that provide the patient and family a positive diversion from “the difficult” and, in doing so, also negate an institutional feel. These can be views to nature, water walls, artwork, super imposed graphics, sculpture, music – and ideally all of these want to be focused on nature and, when applicable, an interesting use of color. Therapeutic environments that provide such patient-centered features can empower patients and families, but also increase their confidence in the facility and staff. This helps with open lines of communication between patient and caregiver.

Social Support Spaces

These are spaces designed partially for the patient but mainly for the comfort and socialization of family members and friends of the patient; therefore, family lounges, resource libraries, chapels, sleep rooms and consult rooms all play a role. When family and friends play a key role in a patient’s healing, these spaces encourage families to play an active role in the rehabilitation process.

Sense of Control

In times when patients and family feel out of control, it is very healing for the facility design and staff to provide it back when appropriate. Although, this cannot always be done suitably in mental healthcare facilities. However, when applicable, these design features include optional lighting choices, architectural way-finding, resource libraries, enhanced food menus, private patient rooms and

optional areas to reside in. A few well-appointed studies in psychiatric wards and nursing homes have found that optional choices of moveable seating in dining areas enhanced social interaction and improved eating disorders. When patients feel partially in control of their healing program and that the building features are focused to them, an increased confidence of the quality of care enters and tensions lower.

As with all therapeutic design, this allows the caregiver to use their resources healing in lieu of “managing” patient populations.

Reduce or Eliminate Environmental Stress

Noise level measurements show that hospital wards can be excessively noisy places resulting in negative effects on patient outcomes. The continuous background noise produced by medical equipment and staff voices often exceeds the level of a busy restaurant. Peak noise periods (shift changes, equipment alarms, paging systems, telephones, bedrails, trolleys, and certain medical equipment like portable xray machines are comparable to walking next to a busy highway when a motorcycle or large truck passes.

Several studies have focused on infants in NIC Us, finding that higher noise levels, for example, decrease oxygen saturation (increasing need for oxygen support therapy), elevate blood pressure, increase heart and respiration rate, and worsen sleep. Research on adults and children show that noise is a major cause of awakening and sleep loss.

In addition to worsening sleep, there is strong evidence that noise increases stress in adult patients, for example, heightening blood pressure and heart rate. Environmental surfaces in hospitals are usually hard and sound-reflecting, not sound-absorbing causing noise to travel down corridors and into patient rooms. Sounds tend to echo, overlap and linger longer.

Interventions that reduce noise have been found to improve sleep and reduce patient stress. Of these, the environmental or design interventions such as changing to sound-absorbing ceiling tiles, are more successful than organizational interventions like establishing “quiet hours.”

Conclusion and Additional Information

The information contained in this excerpted report is intended as a guide for architects, specifiers, designers, facility planners, medical directors, procurers, psychologists and social workers which have a stake in providing improved facilities for behavioral healthcare patients. It is a portion of a report entitled “The Contributions of Color” authored by Tara Hill, of Little Fish Think Tank. Ms. Hill was commissioned by Norix Group Inc., in 2010 to research the role color plays in the safe operation of correctional facilities and behavioral health centers. More in-depth information specifically about the psychological influence of color and behavioral healthcare facility design can be found by reading the full report.

Laparoscopic Surgical Instruments

June 11, 2017

Pacing the Trocar in its correct spot is one of the most crucial procedures of laparoscopic surgery for your medical instrument. Many crucial problems have been reported as a result of incorrect placement of laparoscopic instruments. You need to make positively sure that you are placing the trocar correctly.

Their is so many different types of trocars on the marketplace, some of the most easiest to use are the trocars with the safety mechanisms with robust blades. While basic handling is the same for most trocars, it is important to understand the different functions of the different types.

Laparoscopy approach, When pressing to see if the space can be entered you should view the area through another trocar to be positive that the space can be entered safely. Make sure the patient is free from abdominal wall vessels, darkened the room and view the area under transmitted light. Hold the trocar perpendicular to the abdominal wall. Stretch your finger along the length of the trocar while using your other hand to provide support and prevent accidentally going in to deep. twist and trun the trocar, while maintaining even force until the tip passes through the wall. When using your medical equipment try not to press to hard. Hard pressure may shrink the internal space, increasing the risk of hitting an organ and causing damage. Once the tip is passed through adjust its direction so that it points to an area of open space and press it in further. Locking the safety mechanism will help decrease the risk. However some trocars do not have a lock mechanism safety. You need to be especially careful when inserting this sort of device. A malacar trocar is the best for this operation. It has a self-securing lock you can use during the procedure.

Internet Marketing Strategy

July 25, 2017

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Protecting your elderly loves ones at home

July 21, 2017

Are you a senior citizen that desires to protect your house and family from doable burglary and intruders? Perhaps you might have a beloved one that’s typically at dwelling alone and you want to provide them the most effective protection doable when you are away? A senior alarm system is a superb safety monitoring system that provides a solution to all of your problems and insures loved ones and relations are kept from harm’s way.

A few years house alarm techniques of any type required a specialist to return to the house in question and carry out the installation of the unit which was time consuming and expensive. As of late instances have changed and you may either purchase a safety package that may take as little as half-hour to install or contact one in all many security corporations that provide affordable systems which embody installation as part of the price.

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Shopping For the Latest Trends

August 4, 2017

Shopping is one thing almost every girl loves. The thrill of the smell of new clothes on the rack and the latest trend in America with all the teenagers. Some girls love the smell of new shoes, new scarfs, new pants, new shirts, and yes new underwear and when the moment come to try stuff on to see how you will look in an outfit for the first day of school, work, or just plain ole soccer practice. When people go shopping they first try and find a basket to put all of their back-to-school apparel in. When a poor family goes to go shopping it feels weird to them because they want the latest trend and all of the latest fashions but they know they can not afford it so they wind up getting the hand me downs from the rich cousin three times re-married four times removed.

When I see an under privileged family on the streets with not much it makes me want to have all of the money in the world so I can take them on a shopping spree and buy them whatever they want. I would make their day and ask for nothing in return, I know the feeling of wanting something would be there but when you get to heaven and see Jesus it is all worth it. The biggest thing I would ask for would be a big hug from the family and that would be it. So many other people would ask for so much more even though the family does not have much.

Commercial Real Estate – Listing Tools and Tactics

August 11, 2017

Attracting new property listings is an ongoing task that requires constant focus for the commercial real estate agent. Whether they are new or old to the industry, prospecting for new listings is (or should be) ongoing. Clear tactics are required if you want to dominate your market and the other real estate agents around you.

Without new listings you cannot generate the commissions and quality of enquiry you require. What I will give you here is a well proven base plan and set of tactics for generating listing opportunity.

Understand this, the more enquiries you generate from the people you know, the better your real estate business. You have to know a lot of people to be successful in the real estate business.

With the advances in technology today you would think that this is prospecting process is easier than ever before, although some people still struggle with it.

So where can you generate the property enquiry that you need? Here is a list that will help you on the way:

  • Old real estate sales and leasing activity over the last few years will give you the names and dates of transactions that will soon potentially come back in the market. That means you should use the old property sales and leasing records from your region as a base of fresh prospecting and cold calling. Most investment property will change hands every 5 to 7 years. It is a cycle that allows you to target properties that have been held for some time by the same owners. They are likely to need your help soon.
  • Business owners may lease or own their premises. Make the call to these people or drop in at their offices to find out what they need and want in the way of property.
  • Walk the streets that contain the good properties and the good businesses. Leave your business card and pick up the business card of all the managers or proprietors.
  • Ask the people you meet in the local businesses about the local properties around them and any changes that they know about. This is a great source of market intelligence. They know the market around them better than you do.
  • Vacant land should always be researched as to the owner and what they are doing about the property. You can put your sign on vacant land if the owner lists their property with you. The more signs you get up the better for your market image and market share.
  • Old property listings that other agents have failed to sell or lease should be monitored in case the listing can be reactivated. As part of this keep a tally on the time on market for the listings. This will tell you when the market is changing with certain listing types.
  • Make cold calls on developers, solicitors, accountants, and architects. They all have an interest in commercial property and will have clients that need help from time to time.
  • Rent rolls and other property managements held by other agents are prime targets for new business. By their very nature, the owners of these properties are investors, and many investors own more than one property.

You and your daily activities are at the center of this prospecting process. Prospecting is hard for some people given that the level of self-discipline required is high. Many salespeople will find something else to do that is easier. Any excuse will do to avoid prospecting. Many salespeople will take the easy prospecting process of dropping flyers and sending generic mail to hundreds of local businesses where they do not follow up. Does this really work? Yes but only to a minor degree and the road to success is slow.

You have to talk to people if you want to fast track your listings and opportunity.

If you take on this challenge and practice your prospecting processes until they are second nature, then you will create better results. As you improve, the more meetings and presentations you can do, and this leads to listings.

It pays to keep a running tally of your calls, meetings, and conversions to listings. This helps you understand when you are getting better at the prospecting process. So who are you going to call? This is the research part of the prospecting model and every day you do a bit more research into the properties and the areas that you are interested in. This also helps you understand what is going on in your area.

New property listings help you build your database. It is the database that will bring you so much market share and qualified enquiry. The bigger and more accurate your database, the more people you can call when some enquiry or opportunity arises. Your database is a very personal thing and should be maintained by you personally. This helps you take ownership of the process.

Electric Cigarettes (cigarros electronicos)? An initial Line Reaction to Giving up Smoking

August 9, 2017

Electric cigarettes(cigarros electronicos) really are a first line reaction to giving up the demon tobacco weed and preventing the consumption of poisonous chemicals and pesticides that are by items from burning tobacco in cigarette(cigarette), pipes and cigars.

Electric cigarette(cigarro electronico) are determined by nicotine being breathed in in the small atomizer included in the electric cigarettes(elektronines cigaretes) however that’s in which the resemblance finishes when evaluating electric cigarettes(elektroniskas cigaretes) to regular tobacco filled cigarettes.

Preventing the deadly practice of smoking cigarette or tobacco items do not need to function as the agony it’s been for decades of people who smoke previously electric cigarettes(elektroniske cigaretter) enable people who smoke to create the difficult and somewhat harrowing transition from smoking regular tobacco items and also the debilitating unwanted effects and withdrawal signs and symptoms to some creation that brings about all of the pleasures of smoking with no Uncategorized dangers.

Traditional tobacco items are statistically accountable for over 400,000 deaths in the usa each year and never surprising really once the content of tobacco is analysed and also the results show some 5,000 chemicals and compounds are contained therein, including numerous chemicals for example arsenic, chemicals, ammonia & benzopyrene simply to title a couple of.

Electronic cigarettes(sigarette elettroniche) really are a socially acceptable option to smoking regular tobacco items because there’s no smoke produced therefore there’s no smoke smell hanging in mid-air, neither are non people who smoke around the immediate vicinity contaminated using the foul smell and acrid burning sensation to them, nor it is possible to danger from what’s generally known to as ?passive smoking.
Overall, electronic cigarettes(cigarette) really are a safe option to regular tobacco items in just as much that no deadly chemicals or compounds are made available to your body.

Electronic cigarettes(sigaretta elettronica) work by vaporizing a tiny bit of liquid nicotine which provides the enjoyable feeling acquired from smoking, but no hideous unwanted effects connected with smoking real tobacco items for example stained teeth, foul-smelling breath, emphysema, cancer from the lung area, throat and mouth and also at worst, a lengthy and agonized slow dying.

E-cigarette have numerous, several benefits for private wellness and health, but additionally they provide an excellent wealth advantage too.

The Government does not tax them out of the box the situation with real tobacco items, plus they are cheaper professional rata without ?no tax? benefit.

To learn more and also to discover which non tobacco electronic cigarettes (cigarro)or electric cigarettes is worth considering and also to break the deadly habit a person can have, start smelling more gratifying and restore your wellbeing.

How to Shop For a Woman

July 28, 2017

There’s a saying that goes, “Women are from Venus, men are from Mars;” this saying does hold true when shopping for a woman. It can get quite difficult and intimidating to buy gifts for a woman, like an anniversary present or a gift for Valentine’s Day. Many men get intimidated when shopping for women, because it’s quite difficult to know and understand what a woman really wants. There are times that even the most heartfelt and well-intentioned gifts can spark fits of the wrong emotions in a woman. Shopping for women doesn’t have to be a roller coaster of confusion; here’s a quick guide to help.

Think Like a Woman

To shop for a woman, you have to get in touch with your feminine side. Whether you’re shopping for your mother, your sister, your wife, or your girlfriend, you need to have a good idea of what she likes. Don’t go for obvious things like jewelry or flowers or teddy bears. Every woman has a unique personality, which means that what she really wants may fall under a stereotype or an idea you have of what women want.

Go for the Sale

Many women love sales. Sales are that time of the year where everything good comes cheap. The mall may be crowded during mall-wide promo sales, but the extra time and effort you spend looking for a gift is well worth the savings you get if you buy shop on a sale. Sales can be difficult to come by, and can get a bit stressful especially with a crowd of shoppers. Here are some tips to keep in mind when shopping at a sale.

* Holiday and clearance sales. The most expensive items usually have up to a 50% markdown during special sales, when stores and boutiques need to clear out inventory. Make sure that you’re not buying old stock, and that you’re getting the best value for money.

* Discounts. Shopping for women can get a bit expensive. Store owners know this, and try to offer discounts for gift items for women as much as they can. Discount goods need not be cheap; as long as the gift is of a good quality and has a reasonable price, then you can buy it.

* Follow the leader.

Duplicates and One-of-a-Kind Items

If you think that shopping for women won’t get any more difficult, think again. Some women prefer to have two or more items of the same variety, and some prefer to have a one-of-a-kind item that only they own. What makes it even more confusing is that many women have certain preferences on what items should be bought in duplicates, and what items should be one-of-a-kind. To make things easier for your shopping day, here’s a quick list of what can be duplicated, and what should be extra-special:

* Duplicates: perfumes, shoes, jewelry, make-up kits, skin care products

* One-of-a-kind items: clothes, bags, purses, watches, bracelets

Keep Up With Trends

While reading a fashion or women’s lifestyle magazine may sound unappealing and completely beneath your manhood, it’s always a good idea to do research before shopping. You don’t have to completely and thoroughly read the articles as much as you would a hotrod magazine or the latest video games; the least you could do is to look at pictures, memorize them, and look for similar items at the boutique or the department store. That way, you can keep your friend or significant other trendy and happy with the way she looks.

Shop, and Get It Over With

One of the reasons why men find it so difficult to shop for gifts is the very idea of shopping. For some men, a boutique or a store that specializes in women’s apparel and accessories is like a punishment for some unknown sin. While the place may seem a bit too feminine and fluffy for your own tastes, the only way you’re going to get a good gift for that special woman in your life is if you enter the store, have a good idea of what you’re going to buy, make shopping quick, and high-tail it out. Chances are, though, that you may enjoy the shopping experience more than you’re willing to admit to yourself.

Internet Marketing – New Trends in an Evolving Industry

July 18, 2017

Over the years internet marketing has been evolving from the
Efforts of the first marketers. Trends in the past have seen
marketers placed ads on talk forums, classified sites, in emails
and where ever they could find potential customers.

Some of these actions led to the introduction of changes from
Within the internet marketing community and from without.
An example of a change from within the community is the banning
Of ads on all forums and relegating them to only the signature file.

An example of a change from outside the community it the Can Spam
Law, which was introduced by the USA government to prevent the sending
Of unsolicited emails. This has done much to reduce the problems of
Spam; further to this from within the community we have seen programs
Which filter emails based on the words used in the headlines and in
The body of the emails.

What all these methods have done is fueled the evolution of internet
Marketing. Now marketers are using double opt-in techniques to
Comply with the Can Spam Law, they are using Tele-seminars to
Reach their target market. They are using SEO, search engine optimization,
To reach clients who are using the search engines to look for products
And services.

As we can see the evolution of internet marketing has been fueled from
Numerous sides, the government, the internet community, the internet
Service providers and the customers themselves.

Well my fellow entrepreneur the internet marketing industry is undergoing
another major evolutionary shift fueled this time by the customers.
October, 2006 was the apex of this change which has been building for awhile.

Over the months subscribers to the various mailing lists have been receiving
Emails on a daily basis promoting one new product launch or another. In
some cases some of us have received 2 or 3 emails promoting the same new
product launch. This activity reached it breaking point in October when there
were several product launches in the same day and we received up to a dozen
duplicate emails for the launch of new products.

The end result is that, there were a large number of un-subscribed requests to
The various mailing lists owners, many gurus saw their profits dropped
Dramatically from previous launches.

Currently we are sitting on the verge of a new era in marketing, an era in which
The consumers are helping to create what they consume. This new direction
Presents many opportunities for consumers and marketers. Download this
Free report at the URL below to learn more about how you can profit from
this new trend in internet marketing. http://5kpermonth.blogspot.com

Is an electronic cigarette the best way to quit smoking?

June 14, 2017

For more than fifty years now, physicians have tried to raise people’s awareness regarding tobacco related illness and death, but even with all the anti-smoking ads and the increased excises, a lot of people continue their nicotine addiction. Trying to quit is not an easy process and there have been many ways suggested and praised, from nicotine patches to the newest electronic cigarette. However, giving up smoking is just about strength of character and will, as it is about finding the right method for you. Determination is certainly a factor here, but one should also keep in mind that every body is different and what worked just fine for your friend or relative, may not work for you. The recent invention of the electronic cigarette, however, seems to be enjoying a lot of popularity, although lately, the e-cigarette industry was hit by an FDA report, calling them dangerous.

Taking first things first, supporters of the elektronisk cigaret are claiming that it is the best tool in one’s efforts of giving up smoking. It has the feel and look of the real thing, but without any of the harmful substances. The e cigaret does contain nicotine, but none of the other chemicals, such as tar or carcinogens. So basically, it has three main components: the cartridge, which is the part you put in your mouth, an atomizer, being the heating element, through which the liquid is being vaporized and a battery, which works as a power supply. The elektronisk cigaret also makes use of a flavouring component, which, believe it or not, was one of the aspects for which it has been criticized. The FDA report stated that young people, who are not yet smokers, can be attracted by the different flavours of the e cigaret and thus tempted to try the real thing.

However, the electronic cigarettes industry has a lot to bet on, considering the benefits that opting for an e cigaret brings. Apart from the fact that it has none of the dangerous and extremely harmful substances of real tobacco, such as carcinogens or cancer causing agents, tar and second-hand smoke, the innovative product also eliminates other disturbing elements like smell, the bad breath or the discolouration of teeth. Furthermore, they had such a good start-off and were so well received by people, as a healthy alternative to smoking, that a couple of airlines even allowed their use during flights.

Health campaigners on the other side have argued that going from a tobacco cigarette to an elektronisk cigaret is not a solution. The only solution is giving up smoking in all of its forms, otherwise, sooner or later, people will go back to tobacco or just alternate between the two. Others stated their concerns with propylene glycol, which is a main ingredient in an electronic cigarette as it helps create the illusion of smoke, and how it had not been tested thorough enough.

All things considered, one can try many ways to quit smoking, such as a nicotine patch or gum or even the application of medication, but if the invention of such a device as an electronic cigarette was needed and it works, then it may as well be regarded as a very good, if not best, method.

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