Is Morgellons Disease Real or Imagined

Is Morgellons Disease Real or Imagined Basics Print Is Morgellons Disease Real or a Delusional Disorder? By Naveed Saleh, MD, MS twitter linkedin Naveed Saleh, MD, MS, is a medical writer and editor covering new treatments and trending health news. Learn about our editorial policy Naveed Saleh, MD, MS Medically reviewed by Medically reviewed by Richard Fogoros, MD on April 15, 2015 Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. He is Verywells Senior Medical Advisor. Learn about our Medical Review Board Richard Fogoros, MD Updated on February 21, 2020 Science Photo Library / Getty Images More in Psychology Basics Psychotherapy Student Resources History and Biographies Theories Phobias Emotions Sleep and Dreaming In recent years, a very small yet vociferous patient population has complained of skin infestation by either parasites or inanimate matter along with related somatic complaints. People with convictions of such infestation report poor or non-healing skin sores (skin lesions); itchiness (pruritis), and sensations of stinging, biting, and insects crawling on or under the skin (formication). These people also claim that thread-like fibers are excreted from these skin lesions. Despite this condition having neither any established diagnostic criteria and treatment nor any formal institutional recognition, among members of the lay population, this dermopathy has been termed Morgellons disease. Emerging Research and Controversy About Morgellons Disease This condition is controversial. Many dermatologists and psychiatrists believe that Morgellons is, in fact, delusional parasitosis, a psychiatric disease.??  More specifically, such experts point out that delusional parasitosis is a monosymptomatic psychosis, and formication is a common complaint among people with psychiatric disease. Furthermore, cases of Morgellons disease often clump among couples and other family members suggesting shared psychosis. Newer research is exploring whether Morgellons disease is caused by the bodys reaction to an infectious agent, the Borrelia spirochete that causes Lyme disease.?? The filaments may be composed of keratin and collagen, a reaction by the skin cells, and colored due to the presences of melanin. Much of our knowledge is based on case reports, case series, anecdotal accounts and a limited number of retrospective analyses done by catchment health-care institutions including the Mayo Clinic and Kaiser Permanente. Undoubtedly, and as is the case with many  other diseases, more research needs to be done on Morgellons disease. Characteristics of People With Morgellons Typical characteristics of people who complain of Morgellons disease include the following: Middle-aged??Symptoms lasting more than 3 yearsDisability caused by this conditionCo-morbid psychiatric diseaseIllicit drug use??Doctor-hopping with hopes of finding treatmentA steadfast belief that the disease is medical in nature Of note, few people with complaints of Morgellons disease initially present to psychiatrists  and instead are referred to psychiatry only after being seen by a dermatologist or emergency physician. Morgellons disease came to wider attention among health professionals in the early aughts. Because complaints of Morgellons disease increased shortly after Internet use became ubiquitous, many people have called it a disease spread by the Internetâ€"a disease that patients ascribe to only after reading other personal accounts. A common complaint among people with Morgellons disease is that fibers can be pulled from skin lesions. In a 2012 PLoS ONE article titled Clinical, Epidemiological, Histopathologic and Molecular Features of an Unexplained Dermopathy, researchers at Kaiser Permanente examined 115 people with complaints consistent with Morgellons disease and found that on skin biopsy, lesions contained no parasites or mycobacteria.??  Instead, materials procured from skin usually consisted of cotton-like material mixed with pus, and skin changes were most likely caused by excoriation (scratching) or arthropod (insect) bites. These findings seem to suggest that these fibers come from clothing. However, other research has found that fibers more meticulously collected from deeper in the skin are composed of collagen and keratin and may be colored by melatonin.?? They might be produced by the body due to a reaction to the Borrelia spirochetes. It is also notable that people with spirochete infection often develop brain involvement, which can produce psychiatric symptoms. Final Thoughts on Morgellons Disease Without a doubt, people who complain of Morgellons disease suffer. More specifically, a majority of people with this condition complain of chronic fatigue and a host of co-morbid conditions including depression and substance abuse. We still are unsure how to treat people with Morgellons disease. A very limited amount of research has shown that people with Morgellons disease may benefit from antipsychotic medication. However, because many people with Morgellons disease (and some researchers) truly believe that the etiology is infectious, its often difficult to convince these patients that psychiatric treatment is a good idea. Some experts have gone so far as suggesting that clinicians essentially trick patients with Morgellons disease into taking psychiatric medications under the auspices of therapeutic privilege or therapeutic exception.??  A better solution probably involves psychiatrists working with dermatologists as a therapeutic team to provide guidance and treatment. A mere 200 years ago, before the advent of modern medical research and evidence-based practice, physicians believed that four humors â€" yellow bile, black bile, phlegm, and blood â€" struck the balance of health.  Without a doubt, weve come a long way from these early views of physiologic homeostasis; nevertheless, we still have much more to learn about disease and the human body.  In light of our still limited comprehension of the ineffable complexity of health, we must be careful to refrain from outright dismissing possible pathology no matter how unlikely.

America s War On Drugs - 1539 Words

On June 17th, 1971, President Richard Nixon declared drug abuse to be â€Å"America’s Public Enemy #1† in a press conference in which he called for an â€Å"all out offensive† against this enemy, an initiative that would later be known as America’s War on Drugs. By giving this speech, thus starting â€Å"The War on Drugs,† President Nixon created what would eventually become one of the most catastrophic failures in United States political history. Analysis of the historical events surrounding Nixon’s declaration reveal ulterior motives behind the initiative, providing context to the reasons for its failure, which were based short term in its moral failure, and long term in its failure of efficiency and results. The War on Drugs has lasted for generations and continues to be responsible for policies that criminalize non-violent drug offenders at the expense of taxpayers, contributing to a devastating mass incarceration dilemma in the United States that perpetuates a disproportionate marginalization of low-class, particularly African American citizens. The declaration of a â€Å"War on Drugs,† upon surface inspection, addressed the American public in its entirety. The issue that the speech and the coinciding initiative sought to resolve was drug use in American society, which was becoming an increasing problem, particularly in African American communities and among Vietnam War protesters. The speech occurred in 1971 during the Vietnam War, and just after the resolution of the Civil RightsShow MoreRelatedAmerica s War On Drugs1306 Words   |  6 Pagesas eugenics. One of the primary focuses of America s War on Drugs has always been the controversial drug Marijuana. In the early twentieth century, Henry Anslinger became the first commissioner of the Federal Bureau of Narcotics where he remained between 1930-62. Anslinger’s campaign was driven primarily by racism. He convinced the public to believe Blacks were negative influences in society and negatively associated African Americans with the drug. Anslinger made heavily racist remarks such asRead MoreAmerica s War On Drugs Essay1299 Words   |  6 Pagesserved time in prison for his connection in the Watergate scandal, the Drug War was â€Å"intended to disempower the anti-war and black rights movements in the 1970s.† It’s no secret that drug use in the United States has been a problem. Many Americans have struggled with addiction to some of the worse drugs. Many lives have been affected in some of the most terrible ways. 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Sharon Curry-Robinson, Duval County Court Bailiff Florida Gulf Coast University â€Æ' America’s War on Drugs 3 Abstract It was surprising to learn that, while the United States makes up just five percent of the world population, over twenty-five percent of the world’s detainees are from the United States. Yes, at a projected figure of moreRead MoreAmerica s War On Drugs3748 Words   |  15 PagesThe term â€Å"War on drugs† was first announced when President Richard Nixon created a volume of programs intended to suppress the consumption of certain recreational drugs in 1972. It marked the beginning for the era of mandatory minimum sentencing, privatized prisons, racism, and constituency that profits as a result of the illegal drugs. The â€Å"Just Say No† and the D.A.R.E. campaign were created to help youths from starting to use drugs but they were not effective. Treatment programs have directed theirRead MoreAmerica s War On Drugs2355 Words   |  10 PagesOne of the primary focuses of America s War on Drugs is the controversial drug Marijuana. Marijuana remains the most widely used illegal drug and stirs up constant debate everywhere. According to the United Nations Office on Drugs and Crime from the World Drug Report 2004 an estimation of about 4 percent of the world’s adult population (162 million) consume marijuana annually (156). For thousands of years human beings have attempted to find ways to get passed the struggles of everyday life. WithRead MoreThe War On Drugs And America s Drug Problem1878 Words   |  8 PagesSpitz D Block 5/19/2016 The War on Drugs Based on the success and failures of the drug policies of the past, what is the best strategy for the United States to implement to help America’s drug problem? Throughout time, United States drug policy has shifted dramatically. From all drugs being legal to Prohibition and the War on Drugs, the US has had conflicting ideas about what is best for society and American citizens when it comes to drugs. The current War on Drugs has resulted in countless arrestsRead MoreAmerica s War On Drugs1754 Words   |  8 Pagesplan was afoot for them: the war on drugs. The war on drugs is unequivocally the biggest and most durable war this country has ever fought against its own citizens. Like any other wars the United-States has engaged in, the war on drugs is remarkably different; it was fought internally, and intended to target a specific group, people of color. Their communities, houses and churches were flooded with law enforcements, constantly checking for illegal possession of drugs. They were branded criminalsRead More Bad Neighbor Policy: Washington?s futile war on drugs in Latin America?3153 Words   |  13 PagesBook review: â€Å"Bad Neighbor Policy: Washington’s futile war on drugs in Latin America† Edited by Ted Galen Carpenter Overview Introductionnbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;3 Read MoreThe Impacts of the War on Drugs1075 Words   |  4 Pages The War On Drugs has lasted many years, including before it was officially called â€Å"War On Drugs.† The prohibition of drugs first got its start in the late 1800’s with anti-opium laws, focusing on chinese immigrants. This was common with the first anti-drug laws. It entirely about scientific based facts on what the effects or risks of the drugs, rather who was associated with the use of the specific drugs. For example, the anti-cocaine laws in the early 1900’s were directed at black men, and the

A Befriended Brother in Mansfield Park by Jane Austen

William Price is well regarded in â€Å"Mansfield Park† by Jane Austen. He is the brother of Fanny Price, whom is the main character of the novel. Fanny is taken in by her uncle, Sir Thomas Bertram and leaves her biological family, which is both unfortunate as well as fortunate for Fanny. By living with the Bertrams, she is allowed a better education and to be raised in a higher form of etiquette due to the fact that her family did not have as much money as the Bertrams did. The ill-fated part of her story is that she must leave her brother, William who, in the result, gains access into the navy because of his connections with Fanny’s adopted family. Jane Austen writes a novel that both pushes at the romantic standards that women had to obey to while also focusing on a great deal of love within the family. The love that Fanny has for her brother right until the end of the novel is striking and heart-warming. William is the older brother that every little sister wants to look up to, he is not only an idol to Fanny but a role model to the readers of the narrative. Austen creates characters to dislike and characters that convey emotion. Lady Bertram is one character of which the reader’s dislike does not stop for due to her mean attitude towards Fanny and the fact that she is almost constantly sitting on the couch with her pug, which she treats as if she loves more than her own children. Other characters, such as William, allow for the novel to not be one of complete hate amongstShow MoreRelated The Importance of Home and Family in Jane Austens Mansfield Park1450 Words   |  6 PagesThe Importance of Home and Family in Jane Austens Mansfield Park         They were a remarkably fine family...and all of them well-grown and forward of their age, which produced as striking a difference between the cousins in person, as education had given to their address. (Austen, 49)   Within the first few pages of Mansfield Park, Jane Austen implants in the minds of her readers the idea that contrasting and conflicting environments are the forces that will

Pre Revolutionary War Attitudes Free Essays

By the 1750’s, Americans began to query their involvement with the British Empire by establishing their own identity and unity as Americans. The colonist began to see a strong display of British oppression. Taxes and the different Acts, such as the Intolerable Acts caused the colonists to believe that it would be better if they were separated from their mother country. We will write a custom essay sample on Pre Revolutionary War Attitudes or any similar topic only for you Order Now Colonists also felt that some of their rights and liberties were being taken away by the British Empire. By the eve of the revolution colonist had a sense of identity of an American. America became the melting pot of the world. Colonist began to think of themselves as a new race of men (Document H). Colonist slowly dismissed their ancient dispositions and demeanor and accommodated new ones (Document H). With a natural barrier (the ocean) between Great Britain and America, colonist started to think of the colonies as a separate nation (Document B). The ocean caused the colonist to believe that they were separated from the mother land for a reason (Document B). They believed that the ocean was there to prevent the colonies from blending with Great Britain (Document B). Since colonists were separated from Great Britain they considered having their own congress (Document D). The colonist would rather have three thousand people who is living near them and who can see the problems they are facing govern them rather than have one person govern them that isn’t there and doesn’t know what’s going on in the area the colonist are located at (Document D). Another act of identity is show in 1774 and 1775 (Document G). During those years Boston wasn’t relying on Great Britain to provide them with donations of goods, such as food, animals, or money (Document G). This illustrates that the colonies don’t need to confide on Great Britain and they can depend on the other colonies alternatively. Throughout these events it is evident that the colonists are displaying a sense of identity. Before the revolution, the colonist displayed many acts of unity. In 1754, a picture of a cut up snake was posted in the Pennsylvania Gazette (Document A). Benjamin Franklin once said, â€Å"If not united to form a whole snake, then the snake cannot survive†. The picture displayed that if the colonies do not come together as one united nation, it is possible that the different colonies could perish (Document A). This picture could have motivated the colonies to act as one nation. In 1774, it was said that a very small corrupted Junto, a self appointed committee in New York acknowledged the idea that all of North America was united (Document C). The Junto also acknowledged that North America was determined to defend their rights and liberties endlessly against Great Britain (Document C). On July 6, 1775, the representatives of the United Colonies of North America met in Congress at Philadelphia to talk about going to war (Document E). Colonists were daring to start rebellions and resist their authority to preserve their liberties (Document E). The representatives were under the impression that all the colonist had the same state of mind. They thought that they would rather die as freemen rather than like slaves (Document E). Another unifying act of the colonies was when many of the colonies donated food, animals, money, and etc to Boston in 1774 and 1775 (Document G). The colonies donated goods due to the Intolerable Acts, when the British closed the Boston ports. This illustrates that the colonist were willing to come and work together to help other colonies in need. Throughout these events it is evident that the colonists are displaying a sense of unity. Throughout history there has been many acts of Americans developing a sense of identity and unifying as one nation. Americans were very devoted to making sure they were not taken advantage of by Great Britain. Although Americans had to fight for their independence and their liberties they were able to push and break free from the British Empire. How to cite Pre Revolutionary War Attitudes, Essay examples

Cultural Identity Essay Research Paper free essay sample

Cultural Identity Essay, Research Paper # 8216 ; Cultural individuality # 8217 ; , harmonizing to Stuart Hall can be viewed through two different ways. The first place positions # 8216 ; cultural individuality # 8217 ; in footings of one shared civilization, reflecting typical historical experiences and shared cultural codifications. Further, these cultural codifications and common historical experiences # 8216 ; supply us, as # 8216 ; one people # 8217 ; , with stable, unchanging and uninterrupted frames of mention and significance # 8217 ; ( Hall, p.393 ) . The 2nd position relies to a great extent on the single # 8217 ; s experience of their civilization. Through this position, civilization is ever altering, it is non inactive as claimed by the first definition. # 8216 ; Far from being everlastingly fixed in some essentialised yesteryear, they are capable to the uninterrupted # 8216 ; play # 8217 ; of history, civilization and power # 8217 ; ( Hall, p.394 ) . We all write and speak from a peculiar topograph ic point and clip, from a history and a civilization that is specific to us, in other words from a # 8216 ; place of diction # 8217 ; . The # 8216 ; black experience # 8217 ; which Hall refers to as a normally shared history and political orientation, pendent on coloring material, is in world something which relies to a great extent on single experience, and each experience in this instance is context positioned. We will write a custom essay sample on Cultural Identity Essay Research Paper or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page For illustration, the black experience of a Jamaican and an African life in Britain will be different even though they are both black. Hall talks about the synthesis of civilizations, of holding an original civilization that is dominated by a colonising civilization and the consequence being an integrating of the two into something wholly new. This # 8216 ; mixture # 8217 ; or # 8216 ; hybridity # 8217 ; is the kernel of what makes Jamaica what it is today. Peoples can’t return to the mystical beginnings of an idealized clip in history and disregard the influences of the colonial invasion. His decision is that the intent of the modern black film is to let us to recognize and research the different parts that go into building our # 8216 ; cultural individualities # 8217 ; . # 8216 ; This is the career of modern black film: by leting us to see and recognize the different parts and histories of ourselves, to build those points of designation, those positionalities we call in retrospect our # 8216 ; cultural individualities # 8221 ; ( Hall, p.402 ) . Culture is socially transmitted and if non passed on, will be forgotten, and therefore will discontinue to be. Through the media, civilization is constructed and by analyzing these cultural individualities we attempt to explicate ourselves and our yesteryear, hence go oning our being. # 8216 ; A national civilization is the whole organic structure of attempts made by a people in the domain of idea to depict, justify and praise the action through which that people has created itself and maintain itself in being # 8217 ; ( Fanon, p.188 ) . During the British business of Malta, the Maltese adopted many of the British imposts but modified them to suit their ain cultural norms, hence making a hybridity of the two. For illustration, the linguistic communication usage of the upper # 8211 ; category in Malta. It is English, but it has been altered plenty, through the speech pattern, to do it distinguishable and recognizable as a Maltese idiom of the English linguistic communication. This shows the synthesis of the two civilizations, uniting to make a new signifier particular to the Maltese civilization after British regulation.

Customer Relationship Management Summary Essay Example

Customer Relationship Management: Summary Essay Definition CRM CRM is a core business strategy that integrates internal processes and functions, and external networks, to create and deliver value to targeted customers at a profit grounded on high-quality customer-related data and enabled by information technology (book) Types of CRM Strategic CRM: customer-centric business strategy Dedicated to winning and keeping customers by creating and developing better value than competitors. Reduce oriented: customer choose products with best quality, performance, design destruction oriented: low price products Sales oriented: customers are persuaded by advertisement and sales promotions Customer market oriented: uses customer and competitive information to develop better value propositions. is a learning firm that constantly adapts to customer requirements and competitive conditions. Operational CRM: automation of customer-facing processes Automates and improves customer facing and customer supporting business processes. Market automation: applies technology to marketing purposes. Sales force automation: applies the technology to the management of a companys selling activities (provides a standardized view of the sales cycle and a common language for concussion of sales issues). Service automation: allows companies to manage their service operations: call centers, contact centers, web or face-to-face. Enables efficiency of users Reducing service costs Partner relationship management: Allows partners to communicate with suppliers through a portal to: manage leads, sales orders, information, incentives Analytical CRM: intelligent mining of customer-related data Focuses on the intelligent mining of customer-related data for strategic or tactical purposes. Build on the foundation of customer related information Essential part of CRM implementations Helps makes decisions like: Which customer to target Focus of sales effort Relative priority for customers and what level of service to offer. Collaborative CRM: application of technology across organizational boundaries Strategic and tactical alignment of normally separate enterprises in the supply chain for the more profitable identification of customers. Enables separate organizations to align their effort to service customers more effectively. We will write a custom essay sample on Customer Relationship Management: Summary specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Customer Relationship Management: Summary specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Customer Relationship Management: Summary specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Service: The non-material equivalent of a good Economic activity that does not result in ownership The product is the act of delivery Special attributes that characterize services: Intangible (Services which cannot be seen), variable (mechanically reproduced to exact specifications an tolerances, services cannot), perishable (Services cannot be held in inventory for sale at a later time), inseparable (service are produced at the same time and place ), difficult to evaluate, based on experience and credence Traditional customer service = do to the customer vs.. Modern CRM = done with the customer Ongoing, cooperative and built for the long term 5 phases of CRM implementation CRM models DIG methodologies that companies should take four actions in order to build closer en-to-one relationships with customers. Identify who your customers are and build a deep understanding of them Differentiate your customers to identify which customers have most value now and which offer most for the future. Interact with customers to ensure that you understand customer expectations and their relationships with other suppliers or brands Customize the offer and communications to ensure that the expectations of customers are met. CRM Value Chain by Francis Buttes mode primary stages and 4 conditions which lead to the end goal of enhanced customer profitability. Settlers 8-step Change Model : Create Urgency change to happen, it helps if the whole company really wants it. Develop a sense of urgency around the need for change. This may help you spark the initial motivation to get things moving. : Form a Powerful Coalitionists people that change is necessary. 3: Create a Vision for Changed you first start thinking about change, there will probably be many great ideas and solutions floating around. Link these concepts to an overall vision that people can grasp easily and remember. 4: Communicate the Visitation you do with your vision after you create it will determine your success. Your message will probably have strong competition from other day-to-day communications within the company, so you need to communicate it frequently and powerfully, and embed it within everything that you do. : Remove Obstacles in place the structure for change, and continually check for barriers to it. Removing obstacles can empower the people you need to execute your vision, and it can help the change move forward. 6: Create Short-term Wins Nothing motivates more than success. Give your company a taste of victory early in the change process. Within a short time frame, youll want to have results that your Taft can see. Without this, critics and negative thinkers might hurt your progress. : Build on the Changeover argues that many change projects fail because victory is declared too early. Real change runs deep. Launching one new product using a new system is great. But if you can launch 10 products, that means the new system is working. 8: Anchor the Changes in Corporate Calculatingly, to make any change stick, it should become part of the core of your organization. Identify critical success factors (SF) for CRM projects CIFS are attributes and variables that can significantly impact business outcomes. SF most strongly association with CRM is an accurate and well developed knowledge management system. Critical success factor People Process Technology 1. Senior management commitment X 2. Creation off multi-disciplinary team XX 3. Objectives definition X 4. Interdepartmental integration XX 5. Communication of the CRM strategy to staff X X 6. Staff commitment X 7. Customer information management X 8. Customer service XX 9. Sales automation XX 10. Marketing automation XX 11. Support for operational management XX 12. Customer contact management X X 13. Information systems integration X Strategic: encountered at the beginning of the project (clear CRM vision, top management commitment and management expertise) Tactical: becomes important later on (trouble shooting skills, good communication, software configurations) Customer portfolio Management Market segmentation: dividing up the market in homogeneous subleases forecasting: 3 techniques = qualitative methods, time series methods, casual methodically based costing: see which customer are or will be profitabilitys value estimation: present day value of all net margins earned from a relationship tit a customer; enables to estimate companys valued mining: find pattern or relationships in large volumes of data (SEEMS, SPAS) Customer experience Formal: Customer experience is the cognitive and affective outcome of the customers exposure to, or interaction with, a companys people, processes, technologies, products, services and other outputs Informal: If you were to ask your customers, What is it like doing business with us? Their answers would be descriptions of their customer experience. Methods to understand customer experience Mystery shopping: paid shoppers report their superintendences mapping: focus groups, ace-to-face and telephone interviews with sample streptococcuss mapping: using blueprint (graphical representation of business processes)customer activity cycle: describes the processes customers go through in making and reviewing buying processes. Participant observation: senior management at front line customer service Sources of customer value (3 value disciplines) A value proposition is the explicit or implicit promise made by a company to its customers that it will deliver a particular bundle of value-creating benefits. (page 191, table 7. ) Operational excellence: A philosophy of the workplace where problem-solving, marrow, and leadership results in the ongoing improvement in an organization. The process involves focusing on the customers needs, keeping the employees positive and empowered, and continually improving the current activities in the workpla ce. Product leadership: Product leaders are companies that dominate their markets because they continuously offer the best and most innovative products or services in their industry. These companies display the ability and determination to make products that customers consider superior, products that deliver more benefits than others. Customer intimacy: A marketing strategy where a service supplier or product retailer gets close to their clients. The benefits of greater customer intimacy for a business might include improved highly tailored problem solving capabilities and greater adaptation of products to customer needs, as well as higher customer loyalty levels. Value from Service SURVIVAL model of service quality 5 core components of service qualitatively offers managers a systematic approach to measuring and managing service quality. It emphasizes the importance of understanding customer expectations, and of developing internal procedures that align company processes to customer expectations. Reliability Ability to perform the promised service dependably and accurately Assurance Knowledge and courtesy of employees and their ability to convey trust and confidence Tangibles Appearance of physical facilities, equipment, personnel and communication materials Empathy Provision of caring, individualized attention to customers Responsiveness Willingness to help customers and to provide prompt service 3 stages of customer life cycle ; Key customer acquisition Acquiring new customers New customers: new-to-category (identified a new need or found new category of elution for existing need ; new-to-company (are won from competitors) Conversion model by Jan Hypertrophied customers Entrenched customers unlikely to switch in future Average customers unlikely to change in short but maybe in medium Uncommitted customers Shallow customers lower commitment than average; some already consider alternatives Convertible customers most likely to defect Prospecting Searching for opportunities tha t might generate additional value for the company. BOB Satisfied customers (Referrals from satisfied customers), Networking (Personal contacts with well-connected and co-operative people), Promotional activities (Exhibitions, seminars, trademarks and conferences, Delegate and attendee lists, Advertising response inquiries, Publicity), Web-sites, Lists and directories (SIC listings, telephone directories), Canvassing, Tell-marketing, E-mail BBC Advertising, Message, Media, Sales promotion, buzz or WOMB, Merchandising Retaining existing customers Keeping your customers to buy your productive measures of customer retention Raw customer retention rate: This is the number of customers doing business with a firm at the end of a training period expressed as percentage of those who were active customers a the beginning of the period Sales-adjustment retention rate: this is the value of sales achieved from the retained customer, expressed as a percentage of the sales achieved from all customers who were active at the beginning of the period P rofit-adjusted retention rate: This is the profit earned from the retained customers, expresses as a percentage of the profit earned from all customers who were active at the beginning of the period. Retention issues Not beneficial to maintain all relationships -; some are too costly to serve, others are strategic switchers in search of a better deal. Which customer to retain (strategic significant customers)? L . High future lifetime value: These customers will contribute significantly to the companys profitability in the future. 2. High volume: These customers might not generate much profit, but they are strategically significant because of their absorption of fixed costs, and the economies of scale they generate to keep unit cost low. 3. Benchmark customers: These are customers that other customers follow. 4. Inspirations: These are customers who bring about improvement in the business. They may identify new applications for a product, product improvement, or opportunities for cost reduction. They may complain loudly and make unreasonable demands, but in doing so, force change for the better 5. Door openers: These are customers that allow the business to gain access to a new market. This may be done for no initial profit, but with a view to proving credentials for further expansion. This may be particularly important for crossing cultural boundaries. Strategies for Customer Retention Positive: delight customers, create customer-perceived added value, create social and structural bonds, create customer engagement Negative: create exit barriers, enforce the contract, extract switching penalties Development customer value 3 ways to create customer-perceived added value loyalty schemes: rewarding customers for their potentiometers clubs: offers value-adding benefits exclusively to embarrasses promotions: in-pack or on-pack voucher, rebate or cash back, patronage awards, free premium for continuous purchase, collection schemes, Self-liquidation premium Two main strategies for customer developments-selling is selling additional products and services to an existing customer. Up-selling is selling higher priced or higher margin products and arrives to an existing customer. Of CRM technologies that are useful for customer development overcompensating management, Event-based marketing, Data mining, Customization, Channel integration, Integ rated customer communications, Marketing optimization Customer related database Is not Just a customer database and consists of all kinds of data related to the customer Secondary data: data have already been collected for other purpose than Criminal data: collected for the first time for CRM or other purpose 6 major steps in developing a customer-related database Define the database functions Databases support the four forms of CRM: Collaborative, Analytical, Operational, Strategic Define the information requirements A direct marketer might need general customer info, a senior manager might need bigger picture data like who are our customers, what do they buy, etc. Indemnify the information sources Internal data: acquired from marketing (market size, segmentation etc. ) sales (purchasing history, buyers names etc. ) Customer service (service histories and requirements, satisfaction levels, etc. ) finance (credit ratings, accounts receivable, etc) and the webmaster may have click-st ream data. Eternal data: from the outside world (market research companies) Select the database technology and hardware platform Customer-related data can be stored in a hierarchical, network or relational way. Relational databases are common nowadays Populate the database CRM databases need data that are appropriately accurate: the accuracy level depends on the databases function. Operational CRM applications need more accurate data than analytical ones. Maintain the database Make sure your database stays up to date . 2 major challenges of multinational CRM Multiple communication technology channels: all the devices that help an organization as well as customers to communicate with each other. Customers expect consistent dialogue. CRM technology lets you create and track a consistent dialogue that reflects the value of the customer. Multiple organizational touch points: not only the different technology channels of an organization, but also the different people within the organization. (Marketing sends out customer offers, sales reps call to negotiate terms and the customer calls the service desk for assistance. The marketing offer should be visible in order for the customer service agent to treat the customer correctly. Channel partners must be included in the communication loop if channel conflict over pricing, leads, and commissions is to be avoided. A customer portfolio is the collection of mutually customer groups that comprise a businesss entire customer base. It is used because not all customers can or should be managed in the same way. Customers have different needs, preferences and expectations. Customers have different revenue and cost profiles. The Customer Journey Stage 1 : Suspect Does the potential customer fit your target market profile? Stage 2: Prospect The potential customer does fit your profile and is being approached for the iris time Stage 3: First-time customer The customer made his first purchase Stage 4: Repeat customer Made additional purchases, your offer plays a minor role in the customer portfolio Stage 5: Majority customer Selects your company as supplier of choice Stage 6: Loyal customer Resistant to switching suppliers, shows positive attitude to your company Stage 7: Advocate The customer generates additional referral dollars through positive word-of-mouth. A company wants to have a relationship with its customers because companies that manage their customer base n order to identify, satisfy and retain profitable customers, enjoy better business performance. Value = Benefits/Sacrifices Sacrifices: Money (price, hidden cost) Search cost (time, effort) Psychic cost (stress, frustration, risk) Perceived risk is a psychic cost. How customers reduce perceived cost: Delay purchase Seek word-of-mouth endorsements Buy with credit-card Negotiate discounts Lifetime Value (L TV) or Customer Lifetime Value (CLC) = The lifetime value is the present day value of all net margins earned from a relationship with a customer, customer segment or cohort. Its also the measure of profit-generation for a company. Calculated by computing the present day value of all net margins (gross margins less cost to serve) earned from a relationship with a customer. The positive customer experience describes customer experience as it is. The normative customer experience describes customer experience as management or customers believe it ought to be. Touch point Touch points exist wherever customers come into virtual or concrete contact with a companys products, services, communications, places, people, processes or technologies. Moment-of-truth Moments of truth occur during customer interactions at touch-points. These are the endorsement customers form evaluative Judgments, positive or negative, about their experience. Engagement A customers emotional and rational response to an experience. Closing the Gaps: Examples Gap 1 Conduct primary research, learn from front-line staff Gap 2 Develop a standard documentation process; assess the feasibility of meeting customer expectations Gap 3 Invest in people, invest in technology, redesign workflow Gap 4 Train employees not to over-promise, excel at service recovery Gap 5 If gaps 1-4 are closed, gap 5 will also close! A successful complaints handling recess enables companies to capture customer complaints before customers start spreading negative word-of-mouth or take their business elsewhere. Why dont unhappy customers complain? They feel the company doesnt care. Perhaps the company or the industry has a reputation for treating customers poorly It takes too much time and effort They fear retribution. Many people are reluctant to complain about the police, for example They dont know how to complain. Three Stages of the Customer Lifestyle 1 . Customer acquisition 2. Customer retention aims to keep a high proportion of current customers by educing customer defections. 3. Customer development aims to increase the value of those retained customers to the company. Difference between customer retention and value retention is customer retention looks at the number of customers that stay with a company whereas value retention looks at the value customers bring and may force the company to look at the buying behavior and manage the value adders. Open non-customers Available non-customers prefer the alternative to their current offer though they have not yet switched, and are ready to switch. Ambivalent non-customers are as attracted to the alternative as they are to their current brand Unavailable non- Weakly unavailable non-customers prefer their current brands Strongly unavailable non-customers have a strong preference for their current brands Cognitive advertising = raising awareness, developing understanding, and generating knowledge. New customers generally need to be made aware of the product and to understand what benefits it can deliver. Affective advertising = developing a liking for the product, and generating preference. Why Focus on Newly Acquired Customers? New customers may have greater future life-time value potential than longer tenure customers. Evidence suggests that retention rates rise over time, so if defections can be prevented in the early stages of a relationship, there will be a pay-off in future revenue streams. Consumer delight: Perception ; Expectation Three Forms of Commitment Instrumental: customers are convinced that no other offer or company could do a better Job of meeting their needs. Relational: customer develops an emotional tie may be with an individual person, a work group or the generalized company as a whole. Values-based: customers values are aligned with those of the company.

Free Essays on Alienation According To Marx

What does one mean by alienation? Alienation is said to be the misperceived separation of essence from the object that it characterizes.1 In 1844 Karl Marx wrote and published The Economic and Philosophic Manuscripts of 1844, better known as The Paris Manuscripts. This was Karl Marx’s first work, where he writes a study about alienation of workers. Alienation manifests itself in many different forms. Marx argues that; â€Å"One must understand, there are three types of alienation. The first type of alienation is alienation from oneself. The second type of alienation is alienation from his fellow human beings. The third type of alienation is alienation from the world as a whole. These three forms of alienation are interconnected.† This is the core of his approach to the problem of alienation. (Monthly Review, 2000, p.35) However, Alienation has also been associated with early theological writings to refer to the estrangement of a person from God as well.2 Therefore it is without question that Alienation can be extremely harmful as its principle action is to cause people to feel isolated and alone. The recognition of man as a â€Å"species† becomes important to the theory of Alienation, which is central to Marx’s work and vital in reiterating the human essence of man.3 Alienation for Marx was a consequence of the conditions within systems of mutual production, which caused man to lose his identity as a species being and fall into an alienated state through the production of capital.4 Subsequently, he became detached from his conscious life activity causing him to be detached from himself, from others and the product of his labor. Essentially man comes to lose all his traits that identify his recognition of himself as human, causing him to become de-humanized. In the Paris Manuscripts Marx identified four specific ways in which alienation pervades capitalist society. The product of labour: The worker is alienate... Free Essays on Alienation According To Marx Free Essays on Alienation According To Marx What does one mean by alienation? Alienation is said to be the misperceived separation of essence from the object that it characterizes.1 In 1844 Karl Marx wrote and published The Economic and Philosophic Manuscripts of 1844, better known as The Paris Manuscripts. This was Karl Marx’s first work, where he writes a study about alienation of workers. Alienation manifests itself in many different forms. Marx argues that; â€Å"One must understand, there are three types of alienation. The first type of alienation is alienation from oneself. The second type of alienation is alienation from his fellow human beings. The third type of alienation is alienation from the world as a whole. These three forms of alienation are interconnected.† This is the core of his approach to the problem of alienation. (Monthly Review, 2000, p.35) However, Alienation has also been associated with early theological writings to refer to the estrangement of a person from God as well.2 Therefore it is without question that Alienation can be extremely harmful as its principle action is to cause people to feel isolated and alone. The recognition of man as a â€Å"species† becomes important to the theory of Alienation, which is central to Marx’s work and vital in reiterating the human essence of man.3 Alienation for Marx was a consequence of the conditions within systems of mutual production, which caused man to lose his identity as a species being and fall into an alienated state through the production of capital.4 Subsequently, he became detached from his conscious life activity causing him to be detached from himself, from others and the product of his labor. Essentially man comes to lose all his traits that identify his recognition of himself as human, causing him to become de-humanized. In the Paris Manuscripts Marx identified four specific ways in which alienation pervades capitalist society. The product of labour: The worker is alienate...