Your Ideal Reader

Your Ideal Reader Your Ideal Reader Your Ideal Reader By Ali Hale If you’re reading Daily Writing Tips, you’re probably a writer of some description. And being a writer means, in the vast majority of cases, that you have – or at least want to have – readers. So, have you thought about your Ideal Reader? What is an Ideal Reader? Your ideal reader is a construct designed to represent your audience. If you’re writing a blog about frugality and budgeting, your ideal reader might be a single mom in her thirties. Alternatively, your ideal reader could be a high school graduate heading off to college. For a short story writer, an ideal reader might be a woman working in a shop, flicking through short stories in her breaks or during quiet times of the day. Alternatively, a short story writer might envisage a very different ideal reader – perhaps an elderly male professor poring over the story in a hushed library, extracting every nuance. Why do I want an Ideal Reader? You might wonder what the point of creating an â€Å"ideal reader† is. Perhaps you think your audience is too diverse, and that there’s no way you could come up with one imaginary character to represent them. But having an ideal reader is well worth the effort, in terms of boosting your writing productivity: â€Å"Consider how much more quickly words flow when you’re writing an email to a friend versus creating a formal business presentation. When you have a specific recipient in mind, you have a much easier time communicating your ideas.† from Why Create An Ideal Reader? Do you ever find yourself struggling to get started an article, blog post, story or poem? Do you worry that the topic will bore your readers, or that your literary allusions will go over their heads? Having an ideal reader in mind makes it much easier to pitch your writing at the right level. Even if you don’t have an audience yet, you’ll still want to think about your ideal reader. When I was planning my new blog, Alpha Student, I put a good bit of thought into my ideal reader: a keen, intelligent, slightly shy, university student who isn’t really into the wilder aspects of student life. This really helped when focusing the blog and deciding on the tone of the articles (I’ve not written about drunken nights or peppered my advice with swear words, for instance!) Who is My Ideal Reader? If you’re writing for a specific publication, you’re in luck. Many magazines publish profiles for prospective advertisers, detailing the demographics of the magazine’s readership. Here in the UK, I find the IPC Media website very helpful for finding these details. For example, for Horse magazine, I’m told that the â€Å"target readers† are horse enthusiast women aged 20-40 from the ABC1 (middle/upper class) categories. This would be a good starting point for creating an ideal reader. â€Å"At a minimum I keep in mind the age and gender of the reader. For example, I sometimes do news articles for a small, local weekly newspaper. Since I live in the neighborhood, I know that we’re an incredibly diverse area, but that the readership of the paper tends to be older women. So that’s who I write for, keeping in mind the others, and occasionally working in some ethnic bits.† from Write for Your Ideal Reader If you’re writing fiction for a particular magazine, look at the advertisements, the editorial, and the letters from readers. This can give you a lot of clues about the gender, age, interests and social class of the ideal reader for that market. Even copywriters and marketers can create an ideal reader – often called an â€Å"ideal customer†. I took Sonia Simone’s excellent Content Class by email (it’s free), and her first lesson is â€Å"Write for One Customer†. She says: If your ideal customer is a little formal, write to her like youd send an email to your Great Aunt Susie. If hes casual, write like youd write to an old college buddy. (Its probably smart to keep it rated-G, though.) Over to You If you have a blog, novel, short story collection, article or any other writing project underway, stop and ask yourself – who am I writing for? Who’s my ideal reader? You can get as detailed about this as you like: try to make it a fun exercise. Give your ideal reader a name, a personality, interests, worries, a birthday. Then, every time you write, write for that one person. Why not tell us about your ideal reader in the comments? Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Writing Basics category, check our popular posts, or choose a related post below:12 Types of LanguageEmail EtiquetteWords Often Misspelled Because of Double Letters

How to Write a Perfect Physician Assistant Resume (Examples Included)

How to Write a Perfect Physician Assistant Resume (Examples Included) The healthcare industry is one of the hottest career paths around right now. As the baby boomer generation ages and people focus more on health and quality of life, the demand is growing for professionals in all corners of healthcare. If you’re already on that path as a physician assistant or looking for a career change, a great resume can be your best ally in finding the right job. Let’s look at sample resumes from three physician assistants who are at different places in their career. First up is Alex, who’s trying to get started as a physician assistant.download this resume in ms wordAlex doesn’t yet have a lot of experience to fall back on, so he wants to focus on his skills and training. The functional resume format works better for Alex than the traditional reverses)How to Write a Perfect Occupational Therapist ResumeHow to Write a Perfect Physician Assistant Resume (Examples Included)How to Write a Perfect Receptionist Resume (Examples Included)How to Create a Perfect Retail ResumeHow to Write a Perfect Sales Associate Resume (Examples Included)How to Write a Perfect Social Worker Resume (Examples Included)How to Write a Perfect Truck Driver Resume (With Examples)

Healthcare system reform Essay Example | Topics and Well Written Essays - 2000 words

Healthcare system reform - Essay Example The treatment should focus on relieving the symptoms experienced by the individual, and providing emotional and practical support to the family and carers (Abbey, 2006). Workforce, training and integration of services have been major barriers in the provision of quality end of life care. This has been recognized and general practice and specialist palliative care linkages with residential aged care facilities are being developed (Palliative Care Australia, 2008). The quality of life for individuals with life-limiting illness and their families could be improved by a palliative approach. The aim of palliative approach is to reduce suffering by early identification, assessment and treatment of individuals, with needs in areas such as pain, physical, cultural, psychological, social, and spiritual. The approach could be beneficial in reduction of individuals and families potential distress, by the provision of sufficient information to facilitate the decision making process. The approach is most effective when provided by a multidisciplinary team, and could be provided in a surrounding that the individual is familiar and comfortable in. Advance care planning requires systematic implementation, including communication between individuals, family and care givers. Educational programs for care team and individuals on a regular basis increase the probability of plans being completed and implemented. Comprehensive advance care plans should include re gular assessments and responding to changes in resident’s health (The National Palliative Care Program, 2006). Our vision for the provision of quality care at the end of life is to satisfy the needs of individuals, and commitment to necessary action for achievement of quality care. We plan a service delivery based on needs, supporting the individual’s appropriate choice of place for delivery of service, development of workforce including education and training, greater service integration for continuity of care,

History of islamic spreading worldwide PowerPoint Presentation

History of islamic spreading worldwide - PowerPoint Presentation Example Founded by Prophet Muhammad, the religion has spread over the centuries to cut across every society around the world. Historic Age Role of Politics in Spreading Islamic Religion By examining the Arab conquest in the early centuries, one is able to trace the history and the trends in spreading the Islamic faith around the globe. History shows that by 15th century Islamic religion had started spreading across the globe (Lockard 295). In these early days, political systems were instrumental in influencing religious activities. The Ottoman Empire was a regional power during this period. It had established as a multiethnic nation attracting traders from Africa, Europe, and other parts of Asia. When Muhammad conquered this city, the religion of the nation became Islamic. With the politics of the day bending towards the Islamic religion, Islam spread very fast. Moreover, every trader that visited the Ottoman Empire learned of the religion and subsequently spread the religion to their land. Political empires spearheaded the spread on the Islamic religion across the world. For instance, the Ottoman Empire expanded rapidly, conquering European countries such as Hungary. The political goodwill provided space for spreading Islamic religion to spaces where the Muslim pilgrims landed. As indicated, trade was an important factor that influenced the distribution or migration of people in the early times. Historians attribute the migration patterns to accommodative political dominions. Such dominions would enable the Muslim pilgrims to settle in a given region and spread the Islamic religion. The conquest of Arab in the 14 and 15th century did not only expand political interest into the conquered land, but also religious practices (Lockard 295). For instance, when the Ottoman Empire conquered some parts of Europe, this government allowed the Muslims to spread their religion to the conquered world. Notable, when the Muslim Empire Spain fell 15th century, some Muslim thought it w ould be the end of the Islamic religion in the western countries. The powerful Islamic state relied on their economic and political power to advance the spread of Islamic religion. Some of these states included Persia, Ottoman Empire, among others. The resurgence of Muslim states in India other parts of the world in 1500 was as result of the so-called social renewal. Largely, the social renewal is a term that describes the change in tact of spreading Islamic religion after the fall of the Ottoman Empire in Spain. The Muslim pilgrims detected the dangers associated with the fall of this empire, consequently developing new trends of spreading the Islamic religion to other parts of the world. Role of trade in spreading Islamic Religion Historians link cultural exchanges, language, ideas, and religion to the early Arabs trading activities with their neighbors Africa, European, and East. As the Arab merchants travelled to these destinations, they influenced the practices of the people th ey met in these continents, consequently leading to the establishment of the Islamic religion. Muslim traders alongside other traders could intermingle and share their religious practices freely. Historians attribute the spread of Islam beyond Mecca and the Arab countries to the trade. Traders could journey from southern Asia, Africa, Europe, and other parts of the world to buy merchandise from the Istanbul, the capital of the Ottoman E

Why Althetes Use Ste Roids Essay Example for Free

Why Althetes Use Ste Roids Essay There are two stories that we read that talked about Performance Enhancing Drugs. One was â€Å"Cheating and Cheating † by Joe Posnanski, the other was â€Å"We, the Public the Best Athletes on Pedestals† by William Moller. Both of these stories explain in great detail on how using these drugs are wrong and change any game you play but mostly baseball. Joe Posnanski talks about how in baseball around Babe Ruth’s era nobody had used steroids and they are now called the greatest players of all time including Babe, Ted Williams, Honus Wagner, and Mickey Mantle. Three of these players we on the Yankees. He explains how they didn’t need to use drugs to make their stats better. They worked day in and day out on becoming a better ball player. William Moller explains how A-rod used them because he taught he needed to be the best player in the game from the contract by the New York Yankees. He also explains how there are other was of cheating such as when he was in a school he used Ritalin to stay up and study for a test when he was already beginning his third straight all nighter. There are other drugs then this though. Such as what kids use in college called Adderall. This is the same goal as Ritalin. Except doesn’t have much side effects. This drug makes you focus more then you have ever done before. This is prescribed to people who have add. This can help people get a paper done is under an hour if they can type fast enough. Another side effect is that it is very addictive. You may want to use it the next day because of all the work you’ve done. This is not a drug but it can be counted from what it does. This is called Niacin, and its included into Vitamin B. This helps clear an athlete’s body from drugs. It doesn’t help as prescribed drugs, but it can still do the job. This makes it so athletes cannot be caught if they do take drugs. People need to realize that things like this are available for an athlete. Even though there is no possible way to take this out they need to find a way to see if they have taken this to help them pass the test. â€Å"The Mitchell Report† made a significant impact on the MLB. This report stated that when released in 07’ eighty-nine players were convicted in using steroids or drugs. Bud Selig came to George Mitchell in 06’ asking him to see who used illegal substances. In this report there were many very famous players including Barry Bonds, Jose Conseco, and Roger Clemens. He changed baseball for the better by doing this even though there is still illegal activity in this sport. A way Bud Selig the commissioner for the MLB has stopped this from happening is make players have a 50 game suspension. Well-known names are Manny Ramirez, Ryan Braun (who appealed later and was reversed), and also Melky Cabrera from the San Francisco Giants. He at that time was leading the league in Batting Average, and was a great player who brought the team down after what had happened. Some fans believe that players should use steroids so they can hit those 500-foot bombs, or steal as many bases they can get. They think that it shouldn’t matter because of how much they get paid for. But what they don’t know is what these drugs do to their body. Some athletes still want to have a family and live a normal life once they retire. But these drugs can affect them by not being able to produce for a family. Other fans believe that if players do these drugs then that hurts the sport, and doesn’t show how athletes really play. Records would be broken repeatedly, and the sport would lose fans left and right. They think they can get stronger and stay healthy like any other person does like eating well and lifting weights. A great question to ask is should athletes who used performance-enhancing drugs be allowed in the Hall of Fame? Jim Bunning states this in the us news article, â€Å"Major League Baseball must set an example so that children and young athletes dont see steroids as a way to get ahead of the competition. If a player is caught using banned substances in an effort to break records set by players who achieved them through honest hard work, I think those numbers should be expunged from the record books. There is no place for cheaters in the Hall of Fame.† This is a great statement because in a couple of years the â€Å"steroids era† is going to become eligible for voting. This year Mark McGuire was elected when he was an athlete who used steroids, and while Jeff Bagwell leads in careers HBP (Hit By Pitches) didn’t get accused once. People who had to vote on this ballot had to think about weather someone accused should be inducted. Another view of athletes who use steroids and other drugs could be gamblers. They could argue that a game was not fair because an athlete cheated. Which could cause a massive eruption due to so many athletes being accused. Think of how much an average bet is, could be around $100. So if there was 20 bets placed on one game that totals to $2000 on one game, and if someone cheats why should someone lose their money over it? Some athletes must use steroids though. Lance Armstrong battled cancer for multiple years. Without this drug he might of died and nobody would say he was the best cyclist in the world. They wouldn’t on been able to watch him over these years. But why should he be stripped of his accomplishments? In the Washington Post his attorney Robert Luskin says, â€Å"They don’t unilaterally have the authority because they didn’t award them,† also â€Å"an endless game of whack-a-mole.† why would someone want to take away something an athletes been working for their whole life while battling cancer? How does steroids even affect your body? Some male athletes might not be able to start a family after taking this drug. Also they can enlarge breasts and shrink testicles. It cant stunt your growth, loss of hair, and have oily skin and very bad acne. You can get a stroke or a heart attack at a very young age; have high blood pressure and also very high levels of bad cholesterol. My opinion is that if an athlete has a serious illness or injury there can take steroids to bring them back into action, or use any other drug that could help. But not when they are playing. Why would you want to risk what that does to your body to get an extra base or a hit? They need to learn that some things need to be achieved by doing hard work, and not by cheating yourself and getting ahead of many other players. There is to much risk of side effects then to help raise your chance at an extra salary. Play the game right and play it safe!

percolating paranoia :: essays research papers

Percolating Paranoia Fritz Lang's The Big Heat Fritz Lang brings the terrors of noir into the bright kitchens of America. Watch that coffee pot! BY H In Bright Lights 12 devoted to film noir, Gary Morris locates the malaise giving rise to the noir sensibility in the "mechanized, immoral, soul-destroying city."1 He defines the urban noir setting as attacking its characters’ chances for "hope, happiness, peace, complacency, and romance" (Morris 16). Although the attack may be related to the loss of a pastoral setting as Morris suggests, many film noir narratives locate those happy possibilities in the seemingly stable institution of the family, and can be read as ironic, hopeless searches for a humanized, moral, soul-restoring home. According to Sylvia Harvey, "the loss of those satisfactions normally obtained through the possession of a wife and the presence of a family" is one of the recurrent themes of film noir.2 Of course, the archetypal array of characters in film noir are not family members, but the hard-boiled, trench-coated detective; the beautiful, duplicitous, and greedy femme fatale w ith a revolver shoved deep into the pocket of her fur coat; and a fascinating complement of criminals ranging from sleazy and violent hoodlums to their glib and urbane bosses. The film noir narrative, with its aura of paranoia accentuated by nontraditional lighting and mise en scene, usually plays out not in the brightly lit kitchen or living room of a comfortable home but at night in dimly lit back streets glistening with rain or shadowy stairwells filled with looming shadows. Through a careful reading of a noir text that presents both the typical film noir mise en scene and various familial images, a sense of film noir’s complicated relationship to the family develops. The Big Heat (1953), directed by Fritz Lang, represents family life as a sham, as a relationship of convenience, as perverse, and finally as so fragile and threatened that even an icon of domesticity becomes a weapon. In The Big Heat, violence and criminality contaminate a small city, controlling elections and the police, as well as threatening familial institutions. The cast of characters I have identified as archetypal of film noir narratives is present, but, in keeping with many such films of the ‘50s, they have moved out of the shadowy stairwells and back alleys to occupy well-furnished homes and luxurious estates. Much of the violence occurs offscreen — in the diegesis of the film, occurring no doubt in the old haunts of film noir.

Joseph Heller

In his 1961 piece, Joseph Heller in a subtle way brings an exclusive attention of the readers to the experiences of the world wars to the soldiers. Heller uses the Second World War and John Yossarian, the protagonist as case studies in this milieu. The story transmitted in a third person narrative illuminates the experiences that make Yossarian afraid to continue serving as a soldier. It remains an enlightening piece that divulges the inner spirit of a soldier when masked with fear, more so having seen his or her colleagues die dreadfully. As the narration commences, the story is told within the hospital buildings where Yossarian is hospitalized. The doctors examining him are puzzled with his condition, which means that he would be pretending. They make a determination that if he would be jaundiced, they would treat him, but if not, they discharge him. Explicitly, Yossarian is faking sickness, but in an intelligent manner. It seems that in his mind, the hospital is safe to take solace since liver problems take time to treat. Nurse Duckett signs a note to give him some pills, but interestingly, the liver pain had healed, yet no doctor realized it. Yossarian is the center of the story and everything is deflected from his perspective. Innately, he is determined to remain safe at all times. However, the story is not told in a chronological order, and therefore, the readers must collect all the jaunts together to comprehend what it all implies. It uses flashbacks and presages to depict what happens. For instance, Yossarian is troubled with the memories of Snowden case where a soldier was killed awfully, and as a result, he has lost the aspiration to continue participating in the war. He is more perturbed and feels weak, something that happens with many soldiers on the battlefield. The same applies to other characters such as Dunbar who similarly stay with him in the ward. He wants to stay longer in the hospital by engaging in various boring activities to pass time. Indeed, the hospital setting has become a better place for them. Yossarian has made up his mind to remain in the hospital for the remaining time of the war, and writes a letter to different people known to him, but never tells them the reasons. Having realized that being insane can work for him, he pretends to be insane in order to be discharged from the military service. He is surprised that by claiming that he is insane is a proof that he is actually sane. The readers can see the way a soldier suffers emotionally in the military camp, even if expected to be strong.In conclusion, the story portrays the diverse points of views that the readers can relate to. It gives a pointer to the minds of the characters that depict the inner world of a soldier. It carries the audience with mixed reactions while interacting with the events. Certain events are funny, while others elicit pity. Yossarian is shaken by the storms of the experiences of the war and uses numerous tactics to get himself out of the military service. For instance, he fakes his prolonged stay in the hospital. When he also tries to pretend to be insane, he is openly caught. Rightly, the story compels the readers to see much inside a soldier's heart than just what is seen from outside.

Favorite Restuarant

My Favorite Restaurant Every year for my birthday we go out as a family to my favorite restaurant, Benihana! For those of you that are ready to have a good time with family or friends this place is definitely the place to go, but it is best to book a reservation ahead of time it isn’t a secret to society. Benihana is an all-time favorite restaurant of mine, with great location, unforgettable entertainment and an excellent menu choice. Benihana is an all-time favorite restaurant of mine because it is located in the heart of downtown, in the midst of all the city lights and city life.When we go to Benihana we park around the block and get a horse & carriage to take us to the door. Parking is free the carriage is extra. This is an excellent idea for any special occasion or just a date night on the town. The location is convenient to any of the major freeways (I-45, I-10 and 59). Aside from the location, Benihana is an excellent place to go for a fun filled night of entertainment. I can assure anyone that after an experience at the original Benihana it will be easy to see why I am declaring it to be my favorite restaurant.Benihana has unforgettable entertainment from the moment you walk in. Walking into the restaurant the guest will be greeted by the amazing aroma of some of the best food, laughter and fun for all! The server will take drink orders from each guest and when they come to bring the drink orders, the fun decorated souvenir glass starts out as a unique conversational piece, as the cook prepares the table for even more unforgettable entertainment. At Benihana the food is not only cooked it's choreographed.The chefs will have you craving for more as they slice and dice and chop your meal before your eyes, very skilled and trained, in the art of entertainment or â€Å"eater-tainment† as they call it themselves. Each table’s personal chef will perform a uniquely amazing presentation as they cook each guest personal favorites. Everything is cooked right in front of the guest on a Japanese style on a hibachi table. The best entertainment is the entertainment your taste buds get from the outstanding menu.The menu has anything from sushi to steak. Everything is fresh no frozen, no canned, no additives! Each guest will be brought a hot towel to clean their hands. Then served a hot onion soup, as well a huge favorite to many; the salad with the Benihana dressing over the top! You can use chop sticks or the regular silver ware, it’s fun to learn how to use chop sticks, and in case you may not know how to use them, the server will be glad to give quick, fun lessons!One of my personal favorite items from the menu is the â€Å"Sea and Meadow† or better known as steak and shrimp, is served to perfection with vegies, fried rice and sauteed bean sprouts over extra more shrimp. Anything from the menu is to die for and all ranges in price from $10. 75-19. 95 not bad for steak, chicken, and shrimp, or lobster and sc allops. Don’t forget to order dessert from the menu, maybe a tempura banana or rainbow sherbet. After dessert the guest have had the most memorable night in a while entertained and full to the brim.For those looking for a new favorite restaurant I would recommend Benihana or even if you are just looking for something outside the norm, or maybe a special someone is having a birthday or anniversary, this is definitely a restaurant that will leave the guest wanting to come back time and time again. Benihana is conveniently located in the heart of downtown, it’s full of surprises, and extreme diner entertainment and everything on the menu is delicious and healthy! Book your reservations and enjoy the experience that will leave a lasting memory and bring home some uniquely designed souvenir cups.

Critically analyse and apply the theory underpinning one intervention with a dually diagnosed client. Contrasting this intervention with other techniques. The WritePass Journal

Critically analyse and apply the theory underpinning one intervention with a dually diagnosed client. Contrasting this intervention with other techniques. Conclusion Critically analyse and apply the theory underpinning one intervention with a dually diagnosed client. Contrasting this intervention with other techniques. IntroductionAn introduction to C-Bit Achievable Goal setting Behavioural ExperimentsEstablishing supportive social networksLimitations of its useAlternative approachesMotivational interviewingConclusionRelated Introduction Dual diagnosis has been described as one of the most significant problems facing the health services (Phillips et al 2010). The term was first used in America in the 1980s and in its most basic elements describes someone who has a combination of a mental illness and substance misuse problem.   Dually diagnosed patients are often frequent users of emergency services and of in-patient care (Bartels et al 1993). There is also a much higher rate of offending and imprisonment amongst this group (Yesavage and Zarcone 1983 cited in Menezes et al (1996). Yesvage and Zarcone cited in Menezes (1996) believe that alcohol and drug misuse interact with the symptoms of psychotic illness to produce a more severe acute illness.   Due to the complication of treatment approach recovery is often slower than a psychotic episode uncomplicated by substance abuse.   This places a great burden on resources and staff (Drake et al 1993), which is corroborated by the London survey   (Menezes et al 1996 ) discovering on average that this group of patients spends almost twice as much time in hospital than those without a substance misuse problem. Clients with the most severe psychiatric disorders tend to have the highest rates of co-occurring substance use disorders (Drake 2007). It has been well documented that the co-existence of severe mental health and substance misuse problems are common (Regier et al 1990; Krausz et al 1996; Menezes et al 1996 cited in Graham 2003). Prevalence figures vary across studies however the latest study by Weldon and Ritchie (2010) estimate the lifetime prevalence rate of substance abuse amongst persons with severe mental illness at 50%, which is 4.6 times higher than that of the general population (Blanchard et al 2000). One of the challenges of mental health providers is how best to meet the needs of this group of clients (Graham 2003). The most recent government guidance is one of integrated treatment whereby the treatment for drug and alcohol problems are provided primarily within mental health services, integrating this with the treatment of mental health problems   (DoH 2002). This is to be provided by one team and involves a flexible combination of treatments targeting the specific needs of those diagnosed with co-morbid severe mental illness and substance misuse (Horsfall 2009). Researchers and clinicians have developed a number of interventions that combine, or integrate mental health and substance abuse interventions (Drake et al 2007). An example of one element of   integrated treatment is Cognitive- Behavioural Integrated Treatment (Graham and Carnwath 2004). C-bit incorporates an integrated approach with personalised formulation to deliver improved treatment outcomes to dual diagnosis patients. The focus of this essay will be on the use of C-bit (Graham and Carnwath 2004) and its application with a client who has been has been diagnosed with schizophrenia and alcohol problems. For the purpose of this essay and confidentiality his name has been changed to David. C-bit can be split into 4 distinct phases, Engagement and Building motivation, Negotiating some behaviour change, Early relapse prevention Relapse management. The essay will concentrate on negotiating behavioural change and what this entails. The author will then compare its effectiveness with an alternative approach. An introduction to C-Bit Hermine Graham (2004) describes C-bit as a psychological multi-purpose tool designed specifically for people with both a mental illness and a problematic substance misuse.   It was developed from CBT which had a strong evidence base for mental health (Grant et al 2004) and substance use problems (Conrod and Stewart 2005).   The evidence base of CBIT in dual diagnosis remains poor as studies have tended to focus on engagement and building motivation as appose to the maintenance of change that CBIT encompasses (Callaghan and Jones 2010). However early studies would suggest that the skilful use of analysis, disputing cognitions and homework assignments improve the skills required to promote abstinence including self-efficacy in finding, establishing and maintaining appropriate support networks (Rassool 2002). CBIT follows the cognitive model and treatment approach (Graham 1998, 2003). A clients beliefs about substance misuse are often linked to their own experience of mental health problems. David would often say in therapy that the side effects of his anti-psychotic medication made him feel over sedated and this had a knock on effect in social situations. He found that alcohol improved this and allowed him to integrate better in social situations. By continuing to use alcohol it was maintaining a negative maintenance cycle. Graham (2004) identifies three key aims of CBIT with dual diagnosis patients. The first concentrates on client and therapist identifying and challenging unrealistic beliefs about substance misuse and substituting them with alternatives that aim to break negative maintenance cycles. The second facilitates an understanding of the link between substance misuse and mental health problems and thirdly CBIT aims to give the client the ability to self-manage substance misuse and recognise the early signs of relapse.   Although there are 4 distinct steps in treatment approach the flexibility of the treatment means a client does not need to progress through them all. The harm reduction philosophy that underpins the intervention (Heather et al 1993) puts more emphasis on a client setting more realistic goals and achieving these. Although flexibility is a key asset of CBIT it would be wrong to assume there was no structure to therapy sessions. In later sessions especially, before commencing a session client and therapist must set an agenda to discuss which ensures key areas are discussed (Graham 2004). In practice, teams trained in the use of CBIT tend to use the general principle of the approach rather than the distinct components or techniques (Graham et al 2006). The author believes this shows the flexibility of the therapy and therapists and clients find what proves useful to them . Graham et al (2006) also discovered that when trained members of the team used various assets of CBIT, engagement increased, alcohol intake was reduced and a reduction in alcohol-related beliefs. The study however noticed similar findings when the client had been seen by teams that had not yet received CBIT training suggesting that CBIT alone was not responsible for the change in behaviour and belief. However, qualitative information recorded from the teams’ staff suggested that treatment integration increased over the course of the study, and that CBIT was a useful tool for integrating planning substance misuse treatment. Qualitative information from the team managers suggested that CBIT tr aining improved the ability of teams to address substance use by themselves, rather than avoiding substance issues referring clients to specialists. Achievable Goal setting Following treatment phase one the client will be able to identify some of the negative effects of substance misuse. David could recognise the negative effect that alcohol use had on his ability to find any form of employment and how he had no real supportive social network besides ‘drinking companions’. Graham (2004) highlights that in treatment phase two it is probably too early for a client to consider complete abstinence. David was beginning to make links with the amount he drank and the negative effects he was having. Due to this he negotiated with the therapist that he would reduce his alcohol input by stopping all spirits but remaining on his strong lager. This follows the harm reduction philosophy that there are several levels in which change can occur that would reduce the negative impact it causes to the client. David identified his long-term goal as eventually getting some form of employment. Following treatment phase one David was able to see the impact excess ive impact alcohol was having on his ability to make appointments on time (if at all), and how this would have a negative effect on any chance of employment. Graham (2004) suggests that for a client to get to this long-term goal a series of short term harm reducing steps need to be identified by the client in therapy that will in-turn have a positive impact upon his life. David had already agreed to stop drinking spirits but further steps included reducing contact with fellow drinkers, attending all appointments on time, getting his body back into a work routine. These steps would move David closer to the eventual long term goal and give him the belief that this was achievable. The therapist found that the use of the recovery star was a useful tool with aiding the client identify and plan how to achieve these goals. The recovery star helps both client and therapist measure change and visually see progress made. At times when David struggled to achieve goals it provided an opportunit y for discussion on how to change the approach. David found the tool useful in between sessions where he could refer back to past successes to give him the confidence to continue.   On reflective sessions what proved important for David was to identify and discuss possible obstacles that he may experience in trying to achieve his goals and to recognise that if things do not go as planned it should not be automatically assumed to be a failure. Simmons and Griffith (2009) believe that there is never a failure but an opportunity to learn and do things differently. Behavioural Experiments By treatment phase two of CBIT the client will have identified an unhelpful thought, the nature of which will be maintaining a negative maintenance cycle. David had begun to plan harm reduction goals to reduce the negative aspects of his substance misuse however there was clearly some situations he was avoiding, and some underlying maladaptive thoughts there were perpetuating his problems. To address this the therapist and David discussed and designed a Behavioural Experiment. Beck (1995) believes that BEs   strengthen an intellectual belief by helping the client test out alternative beliefs and thoughts in practice in order to gain evidence to discover the validity of a belief . Beck (1979) believed through altering behaviour a cognitive change occurs. BEs are significant as a means of explicitly targeting belief change through experience and as such offer prime opportunities for sustained therapeutic change (Padesky 2004). David held the belief that if he did not drink alcohol he would appear boring and no-one would have any time for him. For this reason when David was going to be in the company of anyone he would drink excessively, therefore getting intoxicated became a safety behaviour.   By allowing a client to see what will happen if they drop safety behaviour and then testing out what actually happens in that situation proves to be a powerful challenge to unhelpful assumptions (Whitfield and Davidson 2007).   Sloan and Telch (2002) support this view adding that experiments target safety behaviours result in significantly greater changes than exposure alone. Safety behaviour may seem helpful and protective to a client but can lead to maintenance cycles of maladaptive processes perpetuating the initial belief. If a threat is not disconfirmed the maladaptive cognition continues (Salkovskis 1991, Sloan and Telch 2000, Clark 1989, Salkovski et al 1998). The notion of experimentation, derived from scientific principles, can be applied to the patient†™s experience of the therapeutic process and it is this active experience which can be so meaningful; the validity of a new cognition being generally more memorable when followed through from conceptualisation to active experience (Westbrook 2007). Once the evidence contradicts the initial belief it allows the client and therapist to explore the validity of new more adaptive beliefs (Westbrook et al 2007). David and the therapist designed an experiment in which he would limit his alcohol approach and would then engage in general conversation in his local pub. Initial experiments gave David the confidence to build on further experiment supporting the work of Bennett-levy (2004) who believe early experiments increase confidence and independence BEs can be active, where the patient takes the lead role in either real or simulated situations to test the validity of thoughts, or observational, where data is gathered. Lewin and Kolb propose a learning cycle in which it suggests that for learning and retention to be enhanced the client must build upon knowledge and understanding gained through the experiment which in turn forms a foundation for the next step of the experiment. (Lewin 1946; Kolb 1984). The five key aspects of this learning cycle, Experience, Observation, Reflection, Planning and then further experiment underpins BE work. Establishing supportive social networks In the field of substance misuse social factors are seen as important in the onset, aetiology and maintenance of substance misuse (Graham 2004). David recognised that as his alcohol intake increased the friends he associated with were also using alcohol regularly. This supports the work of Drake (2004) who identified that clients with both severe mental health problems and substance misuse problems would have social networks of solely fellow substance users. David felt increasingly isolated from anyone outside of this network as his behaviour would draw attention towards himself. Trumbetta et al (1999) suggest that for anyone to make changes in substance misuse they need to reduce contact with such peers. Healthier networks need to be formed which provide positive support where there is excessive substance misuse is not the norm (Drake 1993a). David identified his sister as someone who was willing to and who he would like as a supportive person away from mental health services. In cr isis David could contact his sister who could give him some level of support. Graham (2004) emphasises the importance of working closely with family members as they often know very little about dual diagnosis problems. David was only close with his sister. The rest of his family had isolated him due to his substance misuse. Ideally psycho-education information is often given in the group setting as family members may benefit from the experience and support of fellow members (Graham 2004). David’s sister became a key figure in David’s recovery and was encouraged to attend sessions on psycoeducation so she could best understand the problems associated with dual diagnosis clients and how best she could support David. Limitations of its use Prochaska and DiClemente (1992) recognised certain barriers to treatment for dual diagnosis patients in regards to therapeutic engagement, treatment continuance and goal setting. In the case of CBIT it makes assumptions of a certain level of coping skills and ability to facilitate cognitive change. Symptoms of schizophrenia can inhibit a client’s impetus to change behaviour (Horsfall et al 2009). Negative symptoms which have a negative effect on motivation and energy affects individuals internal drive to initiate the complex behavioural routines needed for abstinence (Ballack and DiClemente 1999). An integrated treatment approach incorporating CBIT does not make dramatic changes in the short term, it is a long term therapy. Evidence based studies are always plagued by attrition rates as clients relapse or do not return to the study. This may suggest that CBIT may suffer from the same poor treatment compliance/attendance. For clients who complete a full programme of treatment 1 0-20 per cent achieves a stable remission of their substance use problems per year (Graham 2004). This seems a low figure for the intensive input required on the part of the therapist and client. Bellack and Gearon (1998) believe the therapist must become tolerant of this client group dropping in and out of therapy and abstaining then relapsing. David’s attendance was at times sporadic but the therapist never criticised him for this but used it as a platform for discussing problems experienced through the week. Drake et al (2001) suggests the importance of assertive outreach teams in retaining clients within programmes. Hellerstein et al (1995) cited in Philips et al (2010) highlight that without this input dropout rates may be high, especially amongst those identified as having difficulties participating in treatment. Alternative approaches The evidence base for dual diagnosis is still in its infancy.   Those studies completed have limited generalisation due to methodological issues such as heterogeneous samples, equivocal descriptions of treatment components and high attrition rates (Weldon and Richie 2010). Horsfall et al (2009) recognises that due to a lack of longitudinal studies long term outcomes have yet to be determined. It also proves difficult to compare C-Bit with alternative interventions as C-Bit is not used in a vacuum it is often used in conjunction with other therapies such as pharmaceuticals of motivational interviewing. Kemp et al (2007) found a significant improvement in substance use in dual diagnosis patients when CBT and MI principle were combined. For the purpose of this essay the author will briefly look at one main alternative approach to dual diagnosis, that of motivational interviewing. Motivational interviewing Treasure (2004) describes MI as a patient centred counselling approach that facilitates the patient in resolve and explore ambivalence about behaviour change. The theory of MI centres on the cycle of change and its six components,   precontemplation, contemplation, decision, action, maintenance of change and relapse. Miller and Rollnick (1994) describes motivation as something that one does as appose to something that one has. Empathy is vital in the therapeutic relationship and the use of MI. If the client believes the therapist has no appreciation of their experience they are likely to dis-engage or not fully commit to therapy. Rassool (2002) believes active listening also has an important role in MI. Reflecting back to the client their thoughts, fears, hopes and doubts give a feeling of genuineness, trust and empathy. In MI it is important not to offer advice , give judgement or attempt to question. The reason for behavioural change should be acknowledged and stated by the clien t. MI proves an effective therapy in dual diagnosis if delivered effectively. The therapist needs to avoid confrontation as this will lead to client denial, the role of the therapist as expert proves counter-productive and structured answer formats will inhibit the client in recognising the effects of their substance misuse. Motivational styles that guide a client in discovering alternative ways of thinking about their problems results in positive change (Miller and Rollnick 1991). By combining elements of style and technique MI has proven successful in dual diagnosis patients and has a developing evidence base. It proves difficult to contrast MI with CBIT as both complement each other so well and have similar approaches. Both are based on a collaborative relationship with clients, both incorporate a non-judgemental approach and both are approaches are built on empathy, warmth, trust and positive regard (Rogers, 1991). Both approaches also incorporate socratic questioning techniques encouraging the client to discover alternative meanings of their experience (Padesky and Greenberger 1995). One of the key differences is when it is best to use either technique. Those following a transtheoretical model of change may use MI when the client remains undecided about change in the precontemplation and contemplation stage whereas CBIT can be adopted when the client is more committed to change (Treasure 2004). This would support the work of Drake et al (2001) who after studying the work of a number of researchers believe that to enhance attendance and utilisation of treatment motivation interventions a re important. Conclusion    The research on the impact of CBIT as a therapeutic intervention is still in its infancy. Some anecdotal evidence would suggest it provides the skills necessary to promote abstinence (Rassool 2002). Qualitative information gained from Grahams (2006) study suggests CBIT proved a useful tool for integrating and planning substance misuse. Due to the complex nature of dual diagnosis it seems unlikely that a single intervention will have the desired effect of meeting all the clients’ needs. Kemp (2007) supports this finding an improvement in substance misuse when MI and CBIT were combined. Due to this there has been a shift towards the integration of interventions delivered by mainstream mental health services (DOH 2002, 2006;Rassool 2002; Ziedonis et al. 2005). Some of the strongest treatment effects have come from combining a number of approaches (Barrowclough et al 2001).

Definition and Examples of Narration

Definition and Examples of Narration In writing or speech, narration is the process of recounting a sequence of events, real or imagined. Its also called  storytelling. Aristotles term for  narration was  prothesis. The person who recounts the events is called a narrator. Stories can have reliable or unreliable narrators. For example, if a story is being told by someone insane, lying, or deluded, such as in Edgar Allen Poes The Tell-Tale Heart, that narrator would be deemed unreliable. The account itself is called a narrative.  The perspective from which a speaker or writer recounts a narrative is called a point of view. Types of point of view include first person, which uses I and follows the thoughts of one person or just one at a time, and third person, which can be limited to one person or can show the thoughts of all the characters, called the omniscient third person. Narration is the base of the story, the text thats not dialogue or quoted material. Uses in Types of Prose Writing Its used in fiction and nonfiction alike. There are two forms:  simple narrative, which recites events  chronologically, as in a newspaper account; note William Harmon and Hugh Holman in A Handbook to Literature, and  narrative with  plot, which is less often chronological and more often arranged according to a principle determined by the nature of the plot and the type of story intended. It is conventionally said that  narration  deals with time,  description  with space. Cicero, however, finds three forms in De Inventione, as explained by Joseph Colavito in Narratio: The first type focuses on the case and...the reason for dispute (1.19.27). A second type contains a  digression...for the purpose of attacking somebody,...making a  comparison,...amusing the  audience,...or for  amplification (1.19.27). The last type of narrative serves a different end- amusement  and training- and it can concern either events or persons (1.19.27). (In Encyclopedia of Rhetoric and Composition: Communication from Ancient Times to the Information Age, ed. by Theresa Enos. Taylor Francis, 1996) Narration isnt just in literature, literary nonfiction, or academic studies, though. It also comes into play in writing in the workplace, as Barbara Fine Clouse wrote in Patterns for a Purpose: Police officers write crime reports, and insurance investigators write accident reports, both of which narrate sequences of events. Physical therapists and nurses write narrative accounts of their patients progress, and teachers narrate events for disciplinary reports. Supervisors write narrative accounts of employees actions for individual personnel files, and company officials use narration to report on the companys performance during the fiscal year for its stockholders. Even  jokes, fables, fairy tales, short stories, plays, novels, and other forms of literature are narrative if they tell a story, notes  Lynn Z. Bloom in The Essay Connection. Examples of Narration For examples of different styles of narration, check out the following: ​The Battle of the Ants  by Henry David Thoreau  (first person, nonfiction)The Holy Night by Selma Lagerlà ¶f  (first person and third person, fiction)Street Haunting  by Virginia Woolf  (first person plural and third person, omniscient narrator, nonfiction)

Lloyds Bank Building and the Northern Rock Building Essay

Lloyds Bank Building and the Northern Rock Building - Essay Example The pillars have connotations of classical antiquity, while the carvings are reminiscent of an age when craftsmanship was valued and used as a demonstration of wealth and success. Ordinary buildings like homes and shops did not have these features, and they were reserved for the aristocracy and for civic buildings, imparting an air of authority and â€Å"establishment†. This is the origin of the rather conservative cultural meaning that the building conveys (Rotenberg, 1993).   Quite apart from these historic features of the Lloyds bank building, there are also distinctive visual elements which convey meanings to the observer. The building is taller than it is broad, which suggests a towering presence that dwarfs the viewer. The implication is that the bank is both strong and dominant, providing a stable, if somewhat stern, or even forbidding presence on the high street. The rather narrow door is brought slightly forward of the main building and set to the left, with a series of steps leading up to it. This suggests that entry to the bank is a privilege granted only to those who are worthy to climb the steps and enter its narrow frame. The entrance is dark and reveals nothing of the interior. This increases the mystery of the institution for the uninitiated, and the feeling of privilege for insiders, and this illustrates the contested nature of meaning when it comes to architectural spaces (Gieryn, 2000).   The bank’s name is positioned in modestly proportioned uppercase letters above the door as if to emphasize the act of entering this special portal. There is no distraction or adornment to the name, which is allowed to stand as the main advertising feature of the whole building.

The management of change in Hampton Roads Sanitation District Essay

The management of change in Hampton Roads Sanitation District - Essay Example Organization Development (OD) is one of the chief concepts that relates to the organizational change management. It can come under definition as â€Å"Organization development is a system-wide application of behavioral science knowledge to the planned development and reinforcement of organizational strategies, structures, and processes for improving an organization's effectiveness† (Boonstra, 2004). In other words, enterprises implement the process of organization development through proper and careful planning in order to improve and benefit their business processes, functions, employees and other stakeholders (Cummings & Worley, 2008). The process of improvement through organization development can be for either the entire organization and its processes or a smaller portion of the enterprise. This process starts from collecting the information and identification of the problems/concerns in order to create an understanding about the existing state of affairs of the organization. An appropriate solution, strategy, or guiding principle comes under establishment based on the recognized opportunities for change (McLean, 2005). The organizations focus and give emphasis to productivity, profitability, and quality of work since the company’s accomplishments and success lies behind these factors. Due to this reason, organizations are now investing maximally on their employees, as this has become an escalating trend in the contemporary business environment. (Jones  & Brazzel &  NTL Institute for Applied Behavioral Science, 2006). Likewise, the attitudes of the employees have also changed as they work to get a feeling of accomplishment and recognition. In the same way, the customers are also demanding quality products or services, fast delivery, competitive prices and other attributes compatible to innovation and complex environment that add the worth of the product. With all these aspects of organization, employees, and the customers, the importance of organization development or an organization has augmented, as the efficient organization wants to meet the current and future challenges in order to s urvive and sustain (Kondalkar, 2009). Several organizations have already experienced and still in the process of undergoing the organization development and change process. Amongst numerous enterprises, Hampton Roads Sanitation District (HRSD) is one of the organizations that have undergone the process of organization development. Company Background Hampton Roads Sanitation District (HRSD) is an organization with more than 650 employees at the wastewater utility with a huge customer base where the billing system is direct to the customers without involving any third party. HRSD is a regionally based organization in Virginia that supplies to several cities, counties and military facilities in the region of southeast of Virginia. Moreover, HRSD supplies the facility to an area that comes under the population of more than 1.5 million natives. The utility operates on a system with various major and few smaller treatment plants where it treats and transports