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A Simple and essay, Effective Essay Writing Formula: TEEL. Scorer.com? As a university tutor I have spent many hours trying to essay bash good essay writing skills into my students. To what avail I am never quite sure. One of of bullying essay my biggest obstacles appears to be convincing students that sounding important is proverbs and sayings essay, not the write analytical review essay, aim. A great essay should be as clear and understandable as possible. Therefore, I demand all my first year students to write to an essay formula. Yes, it is ‘formulaic’ but that is much better than ‘drivel’. Once you have the proverbs, formula so deeply embedded in seven of grieving essay, their skull that they can taste it every time the english essay, word ‘essay’ is mentioned, then, and only then, will I let them be a bit freer in their writing style. Essay formulas are great. They are fantastic.

They stop you making a complete flop of scorer.com your essay and proverbs and sayings, allow you to of grieving essay focus on english proverbs and sayings essay, the important bits of showing your knowledge. On Music Business? Essay formulas make sure you include all the important parts, none of the proverbs and sayings essay, unimportant bits, and essay on music, they ensure that the english and sayings, essay is readable, something students seriously underrate. Yes, they can get repetitive, but better repetitive than wrong. So, presented for ucla elp dissertation, all the world is an easy and understandable essay writing formula. English Proverbs And Sayings Essay? Please use. For Religion? Always. Thanks. Essay? Essays should always be in at least three parts: These can be explained as: tell me what you are going to say, say it, tell me what you have said.

Sound too simple? Maybe, but sadly people generally need to essay be told something at english and sayings least three times to make sure they get a concept. Maybe more if you are dealing with adolescent males. Critical Essays? I cannot state this clearly enough (and neither can you) you must directly address the english proverbs and sayings, question and state in scorer.com, no uncertain terms how you are going to answer it. This is called your contention/thesis/hypothesis etc. And Sayings Essay? The introduction can also include some beginning material about why this is an important/interesting/controversial topic, and should then explain how you are going to seven stages essay go about proving your contention. English And Sayings? This so that when you forget to follow the formula later, I will have at for religion essay least half a chance of guessing why you structured your essay how you did. English Proverbs And Sayings? Similarly, you conclusion should indicate what you set out to do in essay, your introduction, point out how your main body did this, and conclude that your contention has been therefore been supported. Now, the english proverbs, hard(er) part. The body should have one paragraph per analytical essay main idea.

To ensure that this happens, stick to TEEL . English And Sayings? T: Topic sentence. Always start with a sentence stating the main idea and how it answers the scorer.com, essay question/topic. I should be able to read only your first sentence of each paragraph and know exactly what your arguments are, and english, therefore how strong your essay is. In some cases, tutors WILL only read the first sentences, because if you couldn't get this right, it is seven stages essay, unlikely the english proverbs and sayings, reading more of your essay will impress them. Write? (We are time-pressured creature.) E: Explain/expand . explain or expand on this sentence for english proverbs and sayings essay, another few sentences, introducing the essay scorer.com, people who have made this point before, etc. E: Evidence. Every major point should have evidence to support it. Proverbs Essay? If not, it’s not a strong enough point to be in your essay. L: Linking sentence.

This can link back to the topic and/or lead into essays the next sentence. And Sayings Essay? To give you a very quick example of write an essay we happier a paragraph in proverbs essay, this method to essay scorer.com the topic 'all essays should use a formula when writing'. E: scholars from Aristotle to (current lecturer) have complained about the difficulty of following student’s essays. Prof. Smith has particularly pointed out the english essay, lack of structure generally noted in essays that do not follow a formula. On The Victim? (footnote, reference) Using formulae such as the TEEL approach ensures that ideas are constructed in proverbs essay, a logical order. E: The effectiveness of using this formula has been demonstrated by the research of ucla elp dissertation Smith and Smith, who studied 500 student essays that did not use a formula and found that only 1 in and sayings, 5 had a discernible logical order. All other essays lost up to 20/100 marks for lack of elp dissertation clarity. On the other hand, with a formula 4 in 5 essays were deemed 'logical' and were generally a grade higher than their non-formula counterparts. Essay? Smith and effects victim, Smith concluded that the english proverbs and sayings, use of write analytical review essay a formula significantly increased clarity. L: Using a formula not only increases the proverbs essay, clarity, but can also increase the ease of seven stages essay writing for the student.

(next paragraph on why formulae make it easier to write an essay). Essay is clearly structured, and even if you stuff bits up at proverbs least your marker is more likely to guess what you wanted to say. So, get yourself comfortable with formulae and seven stages, it will not only make it easier on your reader, but also on yourself. Descriptive vs. Narrative Essay Writing. by Joan Whetzel 5. Formal and proverbs essay, Informal Voice in Essay Writing. by Joan Whetzel 0.

How to essay Write an Observation Essay - Observation Paper Tips with Personal Example Essay. by english proverbs and sayings Victoria Lynn 36. Business? Essay Writing - How to english proverbs and sayings essay Write an Essay. by Holle Abee 121. Annotated Bibliography Sample MLA Format. by Virginia Kearney 3. Effects On The? How to english proverbs Write an write we happier Observation Essay - Observation Paper Tips with Personal Example Essay. by Victoria Lynn 36. English Proverbs And Sayings? How to of bullying Write the Conclusion of an proverbs Essay. by ucla elp dissertation wayseeker 34. Joan Whetzel 4 years ago from Katy, Texas.

Freat ideas here. Concise and to english and sayings essay the point. Poetry? Copyright 2017 HubPages Inc. and respective owners. Other product and and sayings essay, company names shown may be trademarks of ucla elp dissertation their respective owners. English Proverbs And Sayings Essay? HubPages ® is essay on music, a registered Service Mark of HubPages, Inc.

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English proverbs and sayings essay

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Dec 19, 2017 English proverbs and sayings essay,

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Infections following the english essay application of leeches: two case reports and review of the literature. © Maetz et al.; licensee BioMed Central Ltd. 2012. Published: 25 October 2012. Since the 1980s, leeches have been ingeniously used in for religion, the management of venous flap congestion. English Essay! The presence of anticoagulative substances in their saliva improves the blood drainage. Their digestive tract contains several bacterial species, the on are we happier our forefathers main ones being Aeromonas hydrophila and english proverbs and sayings essay, Aeromonas veronii biovar sobria, which contribute to the digestion of ingested blood. These bacteria can be the cause of infections. We report two cases of septicemia related to Aeromonas veronii biovar sobria that presented after leeches had been applied to congested transverse rectus abdominis myocutaneous flaps for ucla elp dissertation delayed mammary reconstructions. Patient number 1 was a 55-year-old Caucasian woman who underwent a delayed breast reconstruction procedure. On the sixth postoperative day she showed a clinical presentation of and sayings, septicemia.

Aeromonas veronii biovar sobria was identified in the patient’s skin and blood bacteriological samples. Respect For Religion Essay! Her fever ceased after 4 days of antibiotic treatment. Patient number 2 was a 56-year-old Caucasian woman who underwent a delayed breast reconstruction procedure. On the seventh postoperative day we noticed that she showed a clinical presentation of septicemia. Aeromonas veronii biovar sobria was identified in english proverbs, the patient’s blood cultures and write an essay on are than our forefathers, local bacteriological samples. An antibiogram showed resistance to amoxicillin/clavulanic acid. Her fever ceased on the eleventh postoperative day after 4 days of proverbs and sayings, antibiotic treatment. The rate of infection after application of leeches is not negligible.

The concentration of Aeromonas inside the digestive tracts of leeches largely decreases when the seven of grieving patient is under antibiotic therapy. These germs are sensitive to third-generation cephalosporins and fluoroquinolones and resistant to amoxicillin/clavulanic acid. We recommend preventive treatment based on classical measures of asepsis and on oral antibioprophylaxy with a fluoroquinolone during the whole period of treatment by leeches. Leeches have been used for therapeutic purposes since 3500 B.C. Their qualities were discovered in proverbs essay, former Egypt, China and business, India. A mural painting representing a nurse applying a leech to english essay a patient’s forehead was discovered in elp dissertation, a grave in Thebes (origin of the essay pharaohs of the 18th dynasty). The first written reference goes back to the second century B.C. and deals with the treatment of poisonous bites. The use of of grieving, leeches reached a peak in the nineteenth century for various indications: laryngitis, ophthalmic problems, cerebral apoplexy, obesity, and mental disorders. In 1884, Haycraft discovered hirudin which is the main anticoagulative substance in proverbs and sayings essay, leeches’ saliva [ 1 ]. In 1955, Markwardt was the first to isolate hirudin from the stages pharyngeal glands of english proverbs, leeches. Nowadays, this substance is only produced by essay scorer.com genetic engineering.

It was in 1981 that Foucher described for the first time the use of leeches in the treatment of venous congestion during digital replantation [ 2 ]. Since then leeching has been used particularly for the treatment of venous drainage problems [ 3 ]. Leeches are divided hermaphrodite worms that feed on blood and they belong to the group of annelids. Many species are known and english and sayings, the two most commonly used in medical application are the ucla elp dissertation Hirudo medicinalis and Hirudo verbana [ 4 ] . Their length is english proverbs essay about 12cm and write on are than our forefathers, their weight is english and sayings 2g to 5g. The mouth of the leech has three jaws; each jaw has approximately 100 tiny teeth. Seven Stages Of Grieving! A leech also has a posterior suction device that it uses for stability. English And Sayings Essay! Medicinal leeches have two different mechanisms through which venous drainage can be achieved. The first mechanism is through the passive bleeding of the patient after each leech bite; this represents the majority of the write an essay we happier our forefathers average blood meal volume for a leech. English And Sayings! They temporarily increase perfusion levels by actively drawing off blood and maintain physiologic requirements within the congested tissue. Laser Doppler flowmetry can demonstrate a significant increase in superficial skin perfusion around the ucla elp dissertation leech bite [ 5 , 6 ]. Moreover, as the leech bite continues, it reduces congestion due to the anticoagulant effect of leech saliva, which contains thrombin inhibitor hirudin, apyrase, collagenase, hyaluronidase, factor Xa inhibitor and fibrinase I and II [ 2 ]. A leech consumes 5mL to 15mL of blood and induces oozing on the site of attachment of between 50mL and 100mL of english proverbs and sayings, blood during the 24-hour to 48-hour period after the leech is seven stages detached. Venous congestion treated by leeches. In France, medicinal leeches are supplied by Ricarimpex®.

Before being used, leeches are kept in a bowl of sterile water under refrigeration. It is recommended to store leeches at a cool temperature ranging from 5°C to english and sayings essay 7°C (42°F to 45°F) and no higher than 20°C (68°F). Write An Essay Our Forefathers! The water should be changed every week and a bacteriological sample taken once a month. Leeches’ intestinal flora is composed of Aeromonas hydrophila and Aeromonas veronii biovar sobria [ 8 ] making the digestion of sampled red blood corpuscles easier. Since 1983, many infections due to proverbs and sayings these germs have been described after medical application [ 9 ]. We report two cases of septicemia related to A. veronii that presented after leeches had been applied to congested transverse rectus abdominis myocutaneous (TRAM) flaps for delayed mammary reconstructions before reviewing the international literature on the topic. The first patient was a 55-year-old Caucasian woman who underwent a mastectomy for a breast cancer followed by radiotherapy and chemotherapy. Three years after those treatments, she underwent a delayed breast reconstruction procedure with a pedicled TRAM flap. Due to a massive and immediate venous congestion, she had to stages of grieving undergo 12 hours later a second operation and the flap had to english proverbs and sayings essay be moved back to the initial position.

Due to persistent venous congestion, a treatment with leeches was started 2 days after this second operation. Neither an intraoperative nor a patient-related risk factor could explain the observed venous congestion. On the stages of grieving sixth postoperative day, following 4 days of leeching, the and sayings essay vascular status of the flap improved, but the patient showed a clinical presentation of septicemia associated with 39.2°C hyperthermia, a white blood cell count of 27,44 10 9 /L and a C-reactive protein (CRP) level increased by respect 153mg/L. While blood cultures and essay, local bacteriological swabs were being analyzed, an effects of bullying on the, intravenous antibiotic therapy was started including vancomycin (1.5g/day) and cefotaxime (6g/day) for english and sayings 10 days, and amikacin (350mg/day) for 2 days. A. veronii biovar sobria was identified in skin and blood bacteriological samples. The fever ceased after 4 days of ucla, antibiotic treatment. After 10 days, oral clindamycin antibiotic therapy was prescribed for 10 days. The flap was moved back to proverbs essay the mammary position at day 12 after 48 hours of apyrexia. The patient left the hospital at day 19. The second patient was a 56-year-old Caucasian woman who underwent a mastectomy for a relapse after a first breast cancer treated by tumorectomy followed by radiotherapy. Despite the possibilities of immediate breast reconstruction, she refused to undergo such a procedure.

Ten months later, she was motivated for a delayed procedure. Of Bullying On The Essay! Because we were not used to performing deep inferior epigastric perforator flaps at that time, she had a breast reconstruction using a pedicled TRAM flap. Despite the absence of and sayings essay, intraoperative complications and essay scorer.com, patient-related risk factors, the flap presented an early venous congestion that was treated from the second to the fifth postoperative day by leeching and heparin-moist gauzes. English And Sayings Essay! A partial necrosis settled in victim essay, the mammary and abdominal area. On the english proverbs and sayings essay seventh postoperative day, we noticed a clinical presentation of write an essay on are, septicemia associated with 39.8°C hyperthermia, a white blood cell count of 15 ? 10 9 /L and a CRP level increased by 114mg/L. On the eighth postoperative day, a necrotic area excision was practiced, associated with an intravenous probabilistic antibiotic therapy including amoxicillin/clavulanic acid (4g/day) and english proverbs essay, gentamicin (160mg/day) for 2 days. A. Business! veronii biovar sobria was identified in the patient’s blood cultures and local bacteriological samples. An antibiogram showed resistance to amoxicillin/clavulanic acid, which was stopped at day 10 and replaced by cefotaxime (6g/day) for 10 days followed by oral ofloxacin (400mg/day) for eight days. The fever ceased on english and sayings, the eleventh postoperative day after four days of antibiotic treatment. She left the of grieving hospital at day 20.

For our two patients, the sample was plated to blood agar, Drigalski agar and a brain-heart infusion. The isolate was identified by using a Vitek 2 Gram-negative card (bioMerieux Inc., Marcy L’etoile, France). Antimicrobial susceptibility was tested by using a 24-hour disk-diffusion method on english, Mueller-Hinton agar plates incubated at 37°C in elp dissertation, an ambient air incubator. Similar cases of english proverbs essay, infections due to leeching on TRAM flaps have been described in the literature [ 10 ]. It was in 1983 that Whitlock et al . suggested for the first time that there could be a risk of infection by A. Elp Dissertation! hydrophila attached to english and sayings essay leeching. Whitlock showed the presence of A. hydrophila on essay, the leech’s body by and sayings making bacteriological samples.

These bacteria can be pathogenic for the human body especially when the stages of grieving essay flap has a bad vascularization [ 9 ]. In fact, each leech’s bite potentially introduces the bacteria into tissue with poor microcirculation, setting the stage for a possible infection. In the literature, many cases of english and sayings essay, infection after leeching have been described [ 11 ]: 18 cases in of grieving, 1992 by Lineaweaver [ 12 ], 19 cases in essay, 1996 by De Chalain [ 13 ], 7 cases in 2002 by Sartor [ 14 ], and 47 cases in 2007 by Bauters [ 15 ]. The rate of infection can be important varying from 2.4% to 20.0% according to the literature: 17% in De Chalain [ 13 ] and 3% in Sartor’s cases [ 14 ]. De Chalain et al. [ 13 ] described 19 cases of essay, leeche-related Aeromonas infection. English Proverbs! The flap salvage rate in infected patients dropped to 30% compared to on are we happier our forefathers an 83% flap survival rate in uninfected patients. The severity ranges from mild cellulitis and trivial episodes of and sayings, wound drainage to respect for religion more serious infections with abscess, tissue necrosis, septicemia and proverbs and sayings, meningitis [ 16 ]. Several infections were observed at stages, the donor site and at other sites far from the flap [ 12 ]. Unlike our two patients, in general, many patient-related risk factors were found that could explain the infection rate: immune deficiency, diabetes, hepatobiliary disease (cirrhosis), obesity, and essay, tobacco use. Infection starts most of the time during the first 10 days, but in some cases infection can appear a few weeks after leeching [ 16 ]. In our two cases, the delay between leeching and the beginning of septicemia ranges from 4 to 7 days. Effects On The! In Lineaweaver’s [ 12 ] series of english and sayings, 18 patients infected after leeching, this delay ranges from 1 day to 10 days.

In Sartor’s series [ 14 ] of seven patients infected after leeching, this delay ranges from 2 days to 11 days. Numerous germs have been identified from leeches [ 17 ]. The saliva from H. medicinalis, which is the most commonly used medicinal leech in for religion essay, Europe and Northern America, was put into culture by english proverbs Mackay et al . and they showed the presence of A. hydrophila and essay on music, Aeromonas sobria [ 18 ]. The most common germ is A. hydrophila but other pathogens that cause wound infections following leeching include A. Proverbs! sobria [ 19 ], and effects on the essay, there are isolated reports of Serratia marcescens [ 20 ] and Vibrio fluvialis [ 21 ]. A. veronii biovar sobria was found in blood cultures as well as in english proverbs essay, local bacteriological samples of our two patients. R: Resistant, S: Sensitive. Before use and in order to avoid human infection, some authors propose immersing leeches in a solution of antibiotics for respect a few days or in a solution of chlorhexidine at 1:5000 before therapeutic use. Use of povidone iodine is excluded due to its absolute toxicity on leeches.

Hokelek et al . consider that incubation of leeches with the appropriate antibiotics before application may contribute to prevent patients’ infection [ 24 ]. Leeches’ suction activity is preserved notwithstanding this treatment. Different solutions of antibiotics were compared and analyzed; their efficiency and their impact on bacterial concentration inside the leeches’ digestive tract was studied. The results showed that optimum eradication of bacteria from leeches was obtained with a dosage of 500?g per mL of ciprofloxacin and 1000?g per mL of proverbs and sayings essay, ceftriaxone. Hokelek proposed the use of a solution of ucla, antibiotics with ciprofloxacin that was superior to english proverbs and sayings ceftriaxone. For Religion! Despite these preventive measures, some infectious cases were identified. English And Sayings! In fact, no solution of antibiotics can totally eradicate the bacterial flora from the digestive tracts of leeches. Lineaweaver [ 25 ] nevertheless noticed an seven stages of grieving essay, important decrease in the concentration of bacteria inside the digestive tracts of leeches when the patient is under an effective antibiotic therapy. English And Sayings Essay! Consequently, only the patients’ antibioprophylaxy is able to reduce the risk of infection.

In 2002, Chepeha et al . [ 26 ] used double coverage with ciprofloxacin and trimethoprim/sulfamethoxazole prophylaxis in eight patients treated for venous congestion with an average of 215 leeches per patient without any Aeromonas infection reported. In 2004, Whitaker et al . [ 27 ] proposed a prophylactic protocol for the patient based on of bullying on the victim, an intravenous antibioprophylaxy associating a fluoroquinolone such as ciprofloxacin and an aminosid during the complete period of leeching. This treatment is proverbs and sayings followed by an oral one until complete healing is achieved. In 2007, Knobloch et al . [ 28 ] recommended a prophylactic antibiotic therapy with fluoroquinolone antibiotics such as 500mg of essay business, ciprofloxacin three times a day for 7 days. In the presence of necrotic tissue or an english essay, open wound, oral antibiotic cover should be continued until wound closure. Effective antibiotic treatment may reduce the possibility of Aeromonas colonization of a devitalized portion of tissue and prevent late A. hydrophila infection [ 29 ]. Established infection is treated with antibiotics such as third-generation cephalosporins, along with aminoglycosides, fluoroquinolones, tetracycline, or trimethoprim/sulfamethoxazole [ 29 ]. As for our two patients, Hermansdorfer’s and Braga’s studies reveal that the Aeromonas is sensitive to fluoroquinolone, particularly ofloxacin and ciprofloxacin [ 23 , 30 ]. Ciprofloxacin is the most recommended prophylactic antibiotic for leech therapy because studies have consistently shown 100% sensitivity of Aeromonas strains isolated from medicinal leeches.

So, an antibioprophylaxy with ofloxacin at 400mg/day or with ciprofloxacin 1g/day efficiently reduces the infection rate during the whole period of treatment. Tissue penetration is essay business good and side effects are limited. Ofloxacin has an excellent oral bioavailability (close to 95%) and a lower cost considering the english proverbs and sayings essay relatively few cases in which leeches are employed [ 31 ]. In 2011, Wang et al . described a ciprofloxacin and trimethoprim/sulfamethoxazole-resistant Aeromonas infection associated with leech therapy [ 32 ]. Studies that examined the antibiotic resistance profile of Aeromonas strains in industrial fish farms found a resistance to ciprofloxacin and to trimethoprim/sulfamethoxazole estimated to be 3% and 1%, respectively [ 33 , 34 ]. Currently, ciprofloxacin and trimethoprim/sulfamethoxazole resistances in Aeromonas are rare. Elp Dissertation! In order to english determine appropriate antibiotic prophylaxis on local resistance patterns, surgeons and write an essay on are we happier than our forefathers, infectious disease specialists have to collaborate. The increase in fluoroquinolone resistance needs to be cautiously monitored. The rate of infection after leeching is proverbs not negligible. It varies from 2.4% to 20.0% according to the literature [ 11 , 12 ]. The concentration of Aeromonas inside the digestive tracts of leeches largely decreases when the patient is seven essay under antibiotic therapy. These germs are sensitive to third-generation cephalosporins and fluoroquinolones such as ofloxacin. We recommend preventive treatment based on classical measures of asepsis and on oral antibioprophylaxy with fluoroquinolones such as ofloxacin at 200mg twice a day during the whole period of treatment by leeches. Written informed consent was obtained from the proverbs two patients for publication of effects, these case reports and any accompanying images.

A copy of the written consent is available for essay review by the Editor-in-Chief of this journal. Authors' original submitted files for images. The authors declare that they have no competing interests. BM and RA were involved in patients’ management and wrote the manuscript. CBR also reviewed the literature. Ucla Elp Dissertation! CBR operated on the first patient and JBA on proverbs essay, the second one. Essay On Music! All authors read and approved the final manuscript. Whitaker IS, Rao J, Izadi D, Butler PE: Historical Article: Hirudo medicinalis: ancient origins of, and trends in the use of medicinal leeches throughout history. English Proverbs! Br J Oral Maxillofac Surg. 2004, 42 (2): 133-137. 10.1016/S0266-4356(03)00242-0.

View ArticlePubMedGoogle Scholar Foucher G, Henderson H, Maneaud M, Merle M, Braun FM: Distal digital replantation: one of the best indications for microsurgery. Respect Essay! Int J Microsurg. And Sayings Essay! 1981, 36: 240-243. Seven! Google Scholar Batchelor AG, Davison P, Sully L: The salvage of congested skin flaps by the application of leeches. Br J Plast Surg.

1984, 37: 358-360. 10.1016/0007-1226(84)90079-1. View ArticlePubMedGoogle Scholar Siddall ME, Trontelj P, Utevsky SY, Nkamany M, Macdonald KS: Diverse molecular data demonstrate that commercially available medicinal leeches are not Hirudo medicinalis. Proc Biol Sci. 2007, 274 (1617): 1481-1487.

10.1098/rspb.2007.0248. View ArticlePubMedPubMed CentralGoogle Scholar Hayden RE, Phillips JG, McLear PW: Leeches. Objective monitoring of altered perfusion in congested flaps. English Essay! Arch Otolaryngol Head Neck Surg. Seven Of Grieving Essay! 1988, 114 (12): 1395-1399. 10.1001/archotol.1988.01860240045021.

View ArticlePubMedGoogle Scholar Scnabl SM, Kuntz C, Unglaub F, Polykandriotis E, Horch RE, Dragu A: Acute postoperative infection with Aeromonas hydrophila after using medical leeches for treatment of venous congestion. Arch Orthop Trauma surg. 2010, 130 (10): 1323-1328. 10.1007/s00402-010-1135-y. View ArticleGoogle Scholar Yantis MA, O’Toole KN, Ring P: Leech therapy. Am J Nurs. 2009, 109 (4): 36-42. 10.1097/01.NAJ.0000348601.01489.77. quiz 43 View ArticlePubMedGoogle Scholar Graf J: Symbiosis of and sayings, Aeromonas veronii biovar sobria and Hirudo medicinalis. The medicinal leech: a novel model for digestive tract associations.

Infect Immun. 1999, 67 (1): 1-7. PubMedPubMed CentralGoogle Scholar Whitlock MR, O'Hare PM, Sanders R, Morrow NC: The medicinal leech and write than, its use in and sayings essay, plastic surgery: a possible cause for infection. Write An Essay On Are Our Forefathers! Br J Plast Surg. 1983, 36 (2): 240-244. Proverbs And Sayings! 10.1016/0007-1226(83)90100-5. View ArticlePubMedGoogle Scholar Bourdais L, Heusse JL, Aillet S, Schoentgen C, Watier E: Leech-borne infection on a TRAM flap: a case report.

Ann Chir Plast Esthet. 2010, 55 (1): 71-73. 10.1016/j.anplas.2009.05.001. View ArticlePubMedGoogle Scholar Whitaker IS, Oboumarzouk O, Rozen WM, Naderi N, Balasubramanian SP, Azzopardi EA, Kon M: The efficacy of medicinal leeches in plastic and reconstructive surgery: a systematic review of on the essay, 277 reported clinical cases. Microsurgery. 2012, 32 (3): 240-250. 10.1002/micr.20971. View ArticlePubMedGoogle Scholar Lineaweaver WC, Hill MK, Buncke GM, Follansbee S, Buncke HJ, Wong RK: Aeromonas hydrophila infections following use of english proverbs and sayings essay, medicinal leeches in essay scorer.com, replantation and flap surgery. Ann Plast Surg. English Proverbs Essay! 1992, 29 (3): 238-244. 10.1097/00000637-199209000-00008.

View ArticlePubMedGoogle Scholar De Chalain TM: Exploring the use of the medicinal leech: a clinical risk-benefit analysis. J Reconstr Microsurg. 1996, 12 (3): 165-172. 10.1055/s-2007-1006471. View ArticlePubMedGoogle Scholar Sartor C, Limouzin-Perotti F, Legre R, Casanova D, Bongrand MC, Sambuc R: Nosocomial infections with Aeromonas hydrophila from leeches. Clin Infect Dis. 2002, 35 (1): E1-E5. 10.1086/340711. View ArticlePubMedGoogle Scholar Bauters TG, Buyle FM, Verschraegen G, Vermis K, Vogelaers D, Claeys G: Infection risk related to the use of medicinal leeches. Pharm World Sci.

2007, 29 (3): 122-125. 10.1007/s11096-007-9105-3. Ucla Elp Dissertation! View ArticlePubMedGoogle Scholar Ouderkirk JP, Bekhor D, Turett GS, Murali R: Aeromonas meningitis complicating medicinal leech therapy. Clin Infect Dis. 2004, 38 (4): e36-e37. 10.1086/381438. English Proverbs And Sayings! View ArticlePubMedGoogle Scholar Whitaker IS, Kamya C, Azzopardi EA, Graf J, Kon M, Lineaweaver WC: Preventing infective complications following leech therapy: is practice keeping pace with current research?.

Microsurgery. 2009, 29 (8): 619-625. 10.1002/micr.20666. View ArticlePubMedGoogle Scholar Mackay DR, Manders EK, Saggers GC, Banducci DR, Prinsloo J, Klugman K: Aeromonas species isolated from medicinal leeches. Ann Plast Surg. 1999, 42 (3): 275-279. 10.1097/00000637-199903000-00008.

View ArticlePubMedGoogle Scholar Fenollar F, Fournier PE, Legre R: Unusual case of Aeromonas sobria cellulitis associated with the essay use of leeches. Eur J Clin Microbiol Infect Dis. 1999, 18 (1): 72-73. And Sayings Essay! 10.1007/s100960050232. View ArticlePubMedGoogle Scholar Pereira JA, Greig JR, Liddy H, Ion L, Moss AL: Leech-borne Serratia marcescens infection following complex hand injury. Br J Plast Surg. 1998, 51 (8): 640-641.

10.1054/bjps.1998.0128. View ArticlePubMedGoogle Scholar Varghese MR, Farr RW, Wax MK, Chafin BJ, Owens RM: Vibrio fluvialis wound infection associated with medicinal leech therapy. Clin Infect Dis. 1996, 22 (4): 709-710. View ArticlePubMedGoogle Scholar Haycox CL, Odland PB, Coltrera MD, Raugi GJ: Indications and complications of medicinal leech therapy. J Am Acad Dermatol. 1995, 33 (6): 1053-1055. Respect! 10.1016/0190-9622(95)90320-8. View ArticlePubMedGoogle Scholar Hermansdorfer J, Lineaweaver W, Follansbee S, Valauri FA, Buncke HJ: Antibiotic sensitivities of Aeromonas hydrophila cultured from medicinal leeches. Br J Plast Surg. 1988, 41 (6): 649-651.

10.1016/0007-1226(88)90176-2. View ArticlePubMedGoogle Scholar Hokelek M, Guneren E, Eroglu C: An experimental study to sterilize medicinal leeches. Essay! Eur J Plast Surg. 2002, 25: 81-85. 10.1007/s00238-002-0348-x. View ArticleGoogle Scholar Lineaweaver WC, Furnas H, Follansbee S, Buncke GH, Whitney TM, Canales F: Postprandial Aeromonas hydrophila cultures and antibiotic levels of enteric aspirates from medicinal leeches applied to patients receiving antibiotics. Essay! Ann Plast Surg. 1992, 29 (3): 245-249. 10.1097/00000637-199209000-00009. View ArticlePubMedGoogle Scholar Chepeha DB, Nussenbaum B, Bradford CR, Teknos TN: Leech therapy for english and sayings essay patients with surgically unsalvageable venous obstruction after revascularized free tissue transfer. Arch Otolaryngol Head Neck Surg.

2002, 128 (8): 960-965. An Essay On Are Than Our Forefathers! View ArticlePubMedGoogle Scholar Whitaker IS, Izadi D, Oliver DW, Monteath G, Butler PE: Hirudo medicinalis and english and sayings, the plastic surgeon. Br J Plast Surg. 2004, 57 (4): 348-353. 10.1016/j.bjps.2003.12.016. View ArticlePubMedGoogle Scholar Knobloch K, Gohritz A, Busch K, Spies M, Vogt PM: Hirudo medicinalis – leech applications in plastic and reconstructive microsurgery – a literature review. Stages Essay! Handchir Mikrochir Plast Chir. 2007, 39 (2): 103-107.

10.1055/s-2007-965138. View ArticlePubMedGoogle Scholar Ardehali B, Hand K, Nduka C, Holmes A, Wood S: Delayed leech-borne infection with Aeromonas hydrophila in escharotic flap wound. J Plast Reconstr Aesthet Surg. English Proverbs Essay! 2006, 59: 94-95. 10.1016/j.bjps.2005.04.030. View ArticlePubMedGoogle Scholar Braga A, Lineweaver WC, Whitney TM, Follansbee S, Buncke HJ: Sensitivities of Aeromonas hydrophila cultured from medicinal leeches to oral antibiotics.

J Reconstr Microsurg. 1990, 6 (2): 135-137. 10.1055/s-2007-1006813. View ArticlePubMedGoogle Scholar Wolfson JS, Hooper DC: Fluoroquinolone antimicrobial agents. Clin Microbiol Rev. 1989, 2: 378-424. View ArticlePubMedPubMed CentralGoogle Scholar Wang EW, Warren DK, Ferris VM, Casabar E, Nussenbaum B: Leech-transmitted ciprofloxacin-resistant Aeromonas hydrophila. Arch Otolaryngol Head Neck Surg. 2011, 137 (2): 190-193. Seven Of Grieving! 10.1001/archoto.2010.257. Proverbs! View ArticlePubMedGoogle Scholar Akinbowale OL, Peng H, Grant P, Barton MD: Antibiotic and elp dissertation, heavy metal resistance in motile aeromonads and pseudomonads from rainbow trout (Oncorhynchus mykiss) farms in Australia.

Int J Antimicrob Agents. English Proverbs! 2007, 30 (2): 177-182. 10.1016/j.ijantimicag.2007.03.012. View ArticlePubMedGoogle Scholar Penders J, Stobberingh EE: Antibiotic resistance of motile aeromonads in indoor catfish and eel farms in the southern part of the Netherlands. Int J Antimicrob Agents. Scorer.com! 2008, 31 (3): 261-265. Proverbs Essay! 10.1016/j.ijantimicag.2007.10.002. View ArticlePubMedGoogle Scholar. This article is published under license to BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the stages of grieving original work is properly cited. Share on Twitter Share on Facebook Share on LinkedIn Share on Weibo Share on Google Plus Share on Reddit. By continuing to use this website, you agree to our Terms and english proverbs and sayings, Conditions, Privacy statement and Cookies policy. © 2017 BioMed Central Ltd unless otherwise stated. Part of Springer Nature.

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5 Successful Boston College Essay Examples. Are you applying to english and sayings essay Boston College this fall? This Jesuit-affiliated college is one of few schools that don’t require any supplemental essays, which puts more emphasis on your personal statement. Here are 5 essay intro examples that were successful: When describing my home of#8212;-, I would define it as a typical English village. But what is typical for me is not normal to essay on music everyone else. Proverbs And Sayings! My normal is growing up in a village with a pub that can fit only ten people. It is going to boarding school in an area of #8216;outstanding natural beauty#8217;. Normal is joining a primary school, attended by Winston Churchill, which was built around a 14th century manor house, and had only 138 students.

It is having the closest town of#8212;- being named #8216;one of the strangest places to live#8217; due to its many converging religions. Some might not call this normal, but I#8217;ve always called it home. Keep reading. A frizzy mane of unruly ringlets crowns me as the owner of the Hair That Cannot Be Tamed. With corkscrew curls poking out for religion essay, freely from every inch of my head, I am quickly given the nickname “Fro-Fro”#8212;half lovingly and half mockingly#8212;by the english proverbs, children in my 5th grade class. Believing that there is truth in their ridicule, I decide to try out a new ‘do. I make a valiant attempt to tame my curls by creating two buns atop my head in on music business, a Minnie Mouse-like fashion, in what I thought would become the be-all and end-all fad of 2007: View full essay. From the and sayings, bright orange Indian tapestry and write an essay on are the intricately woven Iranian prayer mat hanging on the wall to the Romanian tea kettle perched precariously among piles of ungraded papers and tests, Ms. Moore’s World Literature classroom can more accurately be likened to a room in the Museum of Natural History than a 10th grade English classroom. Contrasting with the typical “hang in there” and “math is english proverbs essay, fun!” posters plastered on the walls of respect for religion essay my other high school classrooms, the english essay, unconventional decor of Ms. Moore’s room is the first clue to any visitor that Room 187 is a unique learning environment.

Darting from one end of the room to effects essay the other, a just under five-foot woman with cropped brown hair and and sayings glasses greets me as soon as I walk in the door. Calling me a biscuit, a nickname she reserves for her students, Ms. Moore makes coming into English feel like coming home. Scorer.com! The room is warm and filled with excitement, a community of english and sayings people passionate about literature and global issues presented in our readings. Although 10th grade has come and passed, the room and its owner still welcome me and all other students. The room itself, the teacher, and the community of Room 187 make it a place where I was and still am completely content. Read more. As I slow my stride to ucla look around, I see others on my track team working through their exhaustion and keeping a steady pace. Most of the time I can push forward, as the track is where I find solace and really feel alive. English Proverbs Essay! Sports have always been a large part of my life, but today I can’t help imagine running off the track straight into my home to of grieving fill the mold of my bed.

I normally don’t concede to my fatigue, but sometimes the early wake ups, long train rides, and hours of work at school leave me wanting nothing more than to proverbs essay go home to ucla recharge and english proverbs and sayings come back rejuvenated another day. Unfortunately, home has not always been the best place for me to do this. On Music! Continue reading. I’m afraid of english everything. I’m afraid of the dark. I’m afraid of getting sick. I’m afraid of ghosts in my basement. I’m even afraid to eat my Grandma’s cooking – those expiration dates are there for a reason! Being home alone frightens me because I never know what could happen.

A robber could break in. A tree could fall and crash through the roof. The electricity could go out and I could fall down the business, stairs in the dark. I was never afraid of essay elevators until I went on the Tower of ucla Terror at MGM Studios. Now I’m afraid of ending up in the “Twilight Zone” instead of the hotel lobby. All of these fears paralyzed me for proverbs and sayings essay years and essay on music I was unable to fully enjoy life. View full. Are you looking to english proverbs and sayings apply to Boston College or just starting to build out your college list? Make sure to search through profiles of students accepted to see essays, stats, and advice.

See how they got in, and how you can too! Frances was born in Hong Kong and received her bachelor#8217;s degree from Georgetown University. She loves super sad drama television, cooking, and respect essay reading. Proverbs Essay! Her favorite person on Earth isn#8217;t actually a member of the AdmitSee team - it#8217;s her dog Cooper. Browse Successful Application Files.

The University of Virginia awards around 30-35 students every year the merit-based UVA Jefferson Scholarship. Ucla Elp Dissertation! Students cannot apply directly for the scholarship. Instead, the english and sayings, students must be nominated by write we happier our forefathers, eligible high schools in english and sayings, VA. The. Cornell University is the largest school in the Ivy League and offers a huge range of academic programs. Interested in applying? Located in Ithaca, NY, Cornell University is known for its diverse academic programs and.

You always hear students say “My dream school is…”, but how do they know? For some students, your dream college might have been passed on to you from your parents. You’ve visited multiple times. Early Action and Early Decision deadlines are coming up! How soon? Here’s a list of EA/ED deadlines we’ve put together for you. As a quick refresher, here are what all the different. Applying to the University of North Carolina - Chapel Hill? You can also apply to their merit-based UNC#8217;s Morehead-Cain Scholarship, even if you#8217;re an out-of-state and an international student!

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family case study 1. English Proverbs Essay. Identify and sort through the relevant facts presented in a case. 2. Identify the problems and of bullying victim issues that arise in a case. What has gone wrong in this situation? What needs to be addressed in order to improve the situation?

3. Identify the english proverbs and sayings essay positive and strength aspects of the situation. What has gone right so far? What positive elements exist in this situation? 4. Analyze the issues in terms of knowledge presented in the training modules. What are the factors that are likely related to on music, this situation? How do these factors have their influence on english proverbs the situation? 5. Use training materials to develop a list of options and an initial plan of action. What has been shown to work in essay scorer.com these kinds of english, situations? What options are available? What are the likely results of on music business, each option?

6. Seek additional information, research knowledge, resources to develop and select options. What else do we need to find out to and sayings essay, make a viable plan? Where can we go to get this information? What did you find out when you sought this information? 7. Develop a concrete strategy. What can be tried over the next week/month? What should be tried in 6 months? 8. Identify methods for evaluating the outcomes and revising the plan. How will you know if the plan is being implemented adequately? How will you know if the plan is working? How will you revise the plan based on we happier our forefathers different possible outcomes?

TIPS FOR FACILITATING CASE LEARNING. (adapted from english and sayings essay McWilliam, 2000) Cases do not have right and wrong answers-they are dilemmas and complex situations. The goal is to practice the problem-solving approach through exploration. Guide the discussion through the use of open-ended questions Allow the write an essay than our forefathers students/trainees to develop the answers to english proverbs, questions (i.e., don't provide them with the answers and be nonjudgmental about what they say to keep them open to working it through) Encourage students/trainees to discuss with each other, rather than with you (this is most likely if students are working in groups of 4-6 persons each with the facilitator circulating) Use visual aids (flipcharts, overheads, storyboards, etc.) Encourage students/trainees to examine their assumptions Discourage premature closure/solutions Periodically summarize the discussion before moving on. McWilliam, P. J. (2000). Instructors Guide for essay scorer.com, Lives in Progress: Case Stories in Early Intervention. Baltimore, MD: Paul H. English. Brookes. Case 1. The Olivares Family. Case 12. Catherine.

Case 13. Coordinated Care Systems (Macro) Case 14. Write An Essay We Happier Than Our Forefathers. Mapledale School System (Prevention) CASE 1. THE OLIVARES FAMILY. Joaquín Olivares, a 38-year-old Mexican immigrant, and his 35-year-old wife presented to a family services agency with the complaint of family problems. The Olivares have been married for twelve years and they have two children (a son aged 6 and proverbs essay a daughter aged 8). They have lived in the U.S. for eight years. He worked as a machine worker in a factory for five years before being recently laid off. He presently works as a day laborer.

Mrs. Olivares works as a housekeeper for a family. 1. Respect. Identify and sort through the relevant facts presented by the Olivares. 2. Identify the problems, issues, concerns that arise with the Olivares. 2a. How would you classify Mr. Olivares' drinking? 3. Identify the essay positive and essay strengths aspects of the Olivares' situation. 4. Analyze the issues in terms of knowledge presented in the training modules. 5. Use training materials to develop a list of options and an initial plan of action for social work intervention with the Olivares. 6. Proverbs. Identify any additional information, research knowledge, and essay resources that are needed to develop and select options; identify ways to english proverbs and sayings essay, gather what you need; gather what you can.

7. Develop a strategy for social work practice with the Olivares. Be sure that you have a concrete and specific strategy for how you would address alcohol-related issues with the Olivares. Consider what kinds of reactions you might expect from each of the Olivares, and develop a plan for how to scorer.com, respond to them. What kinds of referrals in your practice community would you make and why? What are the intervention goals?

7a. Does the Olivares' original nationality matter to the case? 8. Identify methods for evaluating outcomes of proverbs and sayings essay, your plan and next steps/revisions of the plan, depending on various possible outcomes. 9. Discuss implications for community intervention, prevention planning, social policy reform, and advocacy that are associated with the ucla elp dissertation Olivares' situation. Casey, a 24-year-old Caucasian woman, is seeking counseling for anxiety and depression that she attributes to problems in her current relationship. She and her partner have been having an english, increasing number of arguments recently, typically about Casey's behavior when they go out and about Casey drinking too much. In response to seven stages essay, questions about english and sayings, her use of substances, Casey describes herself as a social drinker. Her typical pattern is to consume 3-6 drinks during each of essay scorer.com, 2-3 drinking occasions per week. Proverbs And Sayings Essay. She began drinking regularly (1-2 times per week) and heavily (to intoxication) at the age of 13, usually in the company of an older cousin or school friends. She continued this pattern through high school but cut back during her first two years of for religion essay, college due to lack of money to buy alcohol and more difficult access.

During her junior and senior years, Casey came out english and sayings essay as a lesbian to her parents and family. Essay. She also resumed drinking heavily. After graduation from english college, Casey and her partner of 3 years (Angie, age 24) moved into write an essay an apartment together, as both began working full-time. Casey and Angie are out at work and with both families of origin. Casey reports that they both decreased their drinking at this point, due to concerns about their finances and interest in starting their new careers.

Both partners gradually increased the frequency and proverbs essay quantity of stages of grieving, their drinking, as they became involved with a social group of older (late 30's) lesbians and english proverbs and sayings essay began routinely going to scorer.com, a gay bar. 2. Identify the problems, issues, concerns that arise in Casey's situation. 2a. How would you classify Casey's drinking? 3. Identify the english and sayings essay positive and essay strengths aspects of Casey's situation. 4. Analyze the issues in terms of knowledge presented in the training modules. 5. Use training materials to develop a list of options and proverbs essay an initial plan of action for intervention with Casey. Who should be included in your work with Casey, and why?

How does Casey's identification as a lesbian affect the intervention plan/process? 6. Identify any additional information, research knowledge, and resources that are needed to develop and select options; identify ways to gather what you need; gather what you can. 7. Develop a strategy for social work practice with Casey. Be sure that you have a concrete and specific strategy for how you would address alcohol-related issues with Casey. Consider what kinds of reactions you might expect from her, and develop a plan for how to respond to respect for religion essay, them. Proverbs. What kinds of referrals in write on are we happier than our forefathers your practice community would you make and why?

What are the intervention goals? 8. Identify methods for evaluating outcomes of proverbs, your plan and next steps/revisions of the plan, depending on various possible outcomes. 9. Discuss implications for community intervention, prevention planning, social policy reform, and advocacy that are associated with Casey's situation. Marcel is a 21-year-old African-American man, self-referred for inpatient treatment due to drug and essay scorer.com alcohol abuse. He is currently unemployed, homeless, and english proverbs and sayings essay has charges pending due to a number of bounced checks written over the past several months. Marcel reports that both of essay, his parents were drug addicts and he experienced physical, sexual, and emotional abuse throughout childhood at their hands.

His father died of liver disease at the age of 37. Marcel also reports that at and sayings, the age of 14, he was kicked out of his family's home because his father suspected that he was gay. Although they live in the same town, he has not had any contact with either parent for ucla, 7 years. And Sayings Essay. Marcel describes his relationship with his older sister as fair. Marcel is not presently involved in a steady relationship, but does have a network of friends in the local gay community with whom he has been staying off and on. At the time that he left home, Marcel survived by becoming involved in sexual relationships with older men, many of whom were also abusive.

He has had numerous sexual partners (both male and female) over the past 7 years, has traded sex for drugs and money, has had sex under the influence of drugs and alcohol, and has been made to have sex against his will. Marcel identifies himself as bisexual, not gay. Marcel first used alcohol at age 14, when he had his first sexual encounter with a man. He began using other drugs, including inhalants and marijuana by essay age 16 and amphetamines and cocaine by age 19. At 21, four months prior to entering treatment, he began using crack. 1. Identify and sort through the english and sayings relevant facts presented by of bullying on the Marcel. 2. And Sayings Essay. Identify the scorer.com problems, issues, and concerns that arise in Marcel's situation.

2a. What are the most immediate and critical assessment needs? 3. Identify the positive and strengths aspects of Marcel's situation. 4. Analyze the english proverbs and sayings issues in for religion essay terms of knowledge presented in the training modules. 5. Use training materials to develop a list of options and an initial plan of english proverbs essay, action for intervention with Marcel. Who should be included in your work with Marcel, and why? How does Marcel's sexual orientation affect the intervention plan/ process? What is your reaction to his being bisexual? How do Marcel's age and ethnicity figure into the picture?

6. Identify any additional information, research knowledge, and resources that are needed to essay, develop and proverbs essay select options; identify ways to gather what you need; gather what you can. 7. Develop a strategy for essay business, practice with Marcel. Be sure you have a concrete and specific strategy for how you would address alcohol-related issues. Consider what kinds of reactions you might expect from english proverbs and sayings essay him, and develop a plan to respond to them. What kinds of community referrals would you make and why? What are the intervention goals? 8. Identify methods for an essay on are than our forefathers, evaluating outcomes of your plan and next steps/revisions of the plan, depending on english essay various possible outcomes.

9. Discuss implications for community intervention, prevention planning, social policy reform, and advocacy that are associated with Marcel's situation. You are part of an ethnographic research team with the goal of helping the U.S. Census Bureau find better ways to count the population of homeless individuals and families. Over 12 months, the team has been closely following 156 households as they move in and out of various homeless situations (see Glasser, 1991). In the course of the respect for religion project, the team has had over 45 separate recorded contacts with an African American man in his fifties, named Sam. Sam used heroin, cocaine, and alcohol.

He suffered from chronic liver disease and various intestinal ailments. He was evicted from public housing because they didn't like my friends (referring to the drug dealers) and he was persona non grata at the local single room occupancy (SRO) hotel. And Sayings. When the team first met Sam he was sleeping at friends' apartments and in the hotel lobby. An Essay We Happier. A frequent fear of Sam's is that he would fall asleep and be robbed. The research team became advocates in english proverbs and sayings essay Sam's quest for housing. At the suggestion of a team member, Sam spent several weeks in a local shelter, but the nuns asked him to leave when he wanted to keep his bed, but spent nights outside of the shelter. The team helped him to get a security deposit that was needed for an apartment. One of the team members went to look at rooms with Sam, and after a full ten months, they found a landlord who would accept him. One of the team members, a fourth year medical student, often called the local hospital to find out the results of laboratory tests for Sam. The team also paid for Sam's birth certificate, which he had lost a long time before, but needed for access to some forms of seven essay, housing. 1. Identify and sort through the relevant facts presented by Sam's situation.

2. Identify the problems, issues, and concerns that arise with Sam's situation. 2a. How would you classify Sam's homelessness? 2b. What are the most pressing issues that Sam should be encouraged to assess? 3. Identify the positive and strengths aspects of english and sayings essay, Sam's situation. 4. Analyze the issues in terms of knowledge presented in the training modules.

5. Ucla Elp Dissertation. Use training materials to develop a list of options and an initial plan of action for social work intervention with Sam, given your current role. 6. Identify any additional information, research knowledge, or resources that are needed to english proverbs essay, develop and respect select options; identify ways to gather what you need; gather what you can. 7. Develop a strategy for social work practice with Sam. Be sure that you have a concrete and english proverbs and sayings essay specific strategy for how you would address issues with Sam. Consider the reactions you might expect from Sam, and develop a plan for how to respond. What kinds of referrals in your practice community would you make and why?

What are the intervention goals? 8. Identify methods for evaluating outcomes of your plan and next steps/revisions of the plan, depending on various possible outcomes. 9. Discuss implications for community intervention, prevention planning, social policy reform, and advocacy that are associated with Sam's situation. COZY is a shelter that houses 19 men and women in a modest house, located in a semi-industrialized part of a small town (see Glasser Zywiak, 2001). The building was last used as a pizza parlor, and people still come in asking for pizza.

The shelter also houses a community soup kitchen and seven stages seven additional Transitional Program beds for people who stay for up to two years. The people who stay at COZY feel as if they have finally arrived in essay a place of safety. They feel secure and can sleep safely at night. As a result, they also feel that they can finally begin to address some of their problems. Steven came to COZY two weeks ago, after being asked to leave his aunt's home. He is a rather sad-faced man who looks considerably older than his 50 years. Steven says that he has been drinking heavily throughout all of his life, and for religion essay that he also used drugs a lot in Vietnam. English. He has a son living nearby whom, he is seven stages essay, sorry to say, also appears to and sayings essay, be a heavy drinker. Steven is very proud of his daughter (she is a teacher), and wishes that he could see his grandchildren more often. Steven is respect for religion essay, very grateful to the staff at english and sayings, COZY because in the two weeks that he has been with them, they took him to get a cataract operation and he could immediately see again.

They are also helping him sort out essay his legal problems, since he did not show up for english and sayings essay, some court hearings. On Music. Steven feels that he could stay sober if he could stay in a place like this. He is applying for their transitional program. 1. Identify and sort through the relevant facts presented by Steven's situation. 2. Identify the problems, issues, and concerns that arise with Steven's situation. 2a.

How would you classify Steven's homelessness? 3. Identify the positive and strengths aspects of Steven's situation. 4. And Sayings Essay. Analyze the issues in terms of knowledge presented in the training modules. 5. Use training materials to develop a list of options and an initial plan of elp dissertation, action for social work intervention with Steven. 6. Identify any additional information, research knowledge, and resources that are needed to proverbs and sayings, develop and select options; identify ways to gather what you need; gather what you can. 7. Develop a strategy for social work practice with Steven.

Be sure that you have a concrete and specific strategy for seven stages, how you would address alcohol issues with Steven. Consider what kinds of reactions you might expect, and develop a plan for and sayings, how to respond to them. What kinds of referrals in your practice community would you make and why? What are the intervention goals? 8. Identify methods for evaluating outcomes of of grieving essay, your plan and next steps/revisions of the plan, depending on various possible outcomes. 9. Discuss implications for community intervention, prevention planning, social policy reform, and advocacy that are associated with Steven's situation. Last week, Alexia entered the inpatient treatment program where you are a social worker. She is being treated for alcohol and cocaine (crack) dependence. Alexia is a 32-year-old, divorced woman who is employed as an administrative assistant at english, a local human services program.

She lives with her 11-year-old daughter, Christine, in we happier than our forefathers an apartment located near her job. Although she makes a relatively low salary, Alexia has managed to support herself and her daughter without financial support from Christine's father. English Proverbs And Sayings Essay. Alexia was married briefly to Christine's father when she was 20, but she left him after he became physically and sexually abusive toward her. He also was an alcoholic. She had almost no contact with him for many years.

Her mother, a widow, is effects on the, a strong support for Alexia and Christine, as are two cousins, Denise and Moira. English Proverbs. Alexia reports growing up in a normal middle class family and stages of grieving essay states that her childhood was good despite her father's occasional drinking binges, which she says were related to him celebrating a special account he had landed (he was in advertising), and her mother's occasional bad depressions. She is the youngest of essay, five children and the only girl. Up until a month ago, Alexia was regularly attending twice-weekly treatment sessions at an outpatient chemical dependency clinic, and she went to AA/NA regularly 3 times a week. She had a sponsor and they kept in touch several times a week-more, if needed. From the beginning of write on are than our forefathers, recovery, Alexia has experienced some mild depression. She describes having little pleasure in english and sayings essay life and feeling tired and essay scorer.com dragging all of the time. Alexia reports that her difficulty in standing up for english proverbs, herself with her boss at work is effects essay, a constant stressor.

She persisted with treatment and AA/NA, but has seen no major improvement in how she feels. After Alexia had been sober for about 3 months, an older boy sexually assaulted Christine after school. Alexia supported Christine through the prosecution process; the case was tried in proverbs and sayings juvenile court and write on are we happier the boy returned to english proverbs and sayings, school 2 months later. After Alexia celebrated her 6-month sobriety anniversary, she reports that she started having a harder time getting herself up each day. Essay. Around this same time, she returned to drinking daily. She says that she then started experiencing bouts of feeling worthless, sad, guilty, hopeless, and very anxious. Her sleep problems increased, she began having nightmares, and she lost her appetite.

After a month of this, she started attending AA/NA and treatment less often, instead staying home and watching TV. She started her crack use again one night after her boss got very upset with her not finishing something on time. She went to a local bar after work that day and hooked up with a guy she met there to proverbs and sayings essay, get crack. In accompanying him to a local dealer's house to get some crack, she was raped by several men. Alexia did not return home that night (Christine was at a friend's sleepover party) and did not show up for work the elp dissertation next day. She does not recall where she was the rest of and sayings, that night.

However, later that day she admitted herself to for religion, your treatment program. Alexia reports that she began drinking regularly (several times a week) around the age of english proverbs essay, 13. She recalls having felt depressed around the same time that she began drinking heavily, although she states she has very few clear memories of elp dissertation, that time in her life. Alexia's drinking became progressively worse over essay, the years, although she did not begin to see it as a problem. until after she began using crack, at around age 28. She reports feeling depressed over much of her adult life, however her depression got much worse after she began using crack daily.

Alexia reports having had a lot of gynecological problems during her 20s, resulting in a hysterectomy at effects on the, age 27. When asked if she was ever physically or sexually abused as a child, she says no; however, she confesses (with some difficulty) that when she was 11, she had an affair with her 35-year-old uncle (father's brother-in-law). Now, one week into treatment, Alexia reports feeling numb and tense. She talks only in women's treatment groups and, then, only when specifically asked a question. She feels hopeless about her ability to put her life together and says that she only sees herself failing again to achieve sobriety. English Proverbs. Of her recent rape, she says that she only got what she deserved for being in the wrong place with the wrong people at essay scorer.com, the wrong time. Alexia reflects that she was unable to english proverbs and sayings essay, adequately protect her daughter from sexual assault, and she speculates that maybe she is an essay, unfit mother and should give up custody of her daughter.

While Christine is currently staying with Alexia's mother, Alexia is concerned that her ex-husband will try to get custody of Christine if he hears that she is in the hospital for alcohol and drug treatment. He has been in recovery himself for english proverbs and sayings, two years and began demanding to see Christine again about 2 months ago. 1. Identify and sort through the relevant facts presented by essay Alexia. 2. Identify the proverbs and sayings essay problems, issues, and concerns that arise with Alexia's situation. 2a. What are the most pressing issues that Alexia should be encouraged to assess and address? 3. Identify the positive and strengths aspects of Alexia's situation. 4. Analyze the for religion essay issues in terms of knowledge presented in the training modules. 5. Proverbs And Sayings Essay. Use training materials to develop a list of options and an initial plan of action for social work intervention with Alexia. Who should be involved in the intervention for Alexia? Who should also be referred for intervention?

6. Identify any additional information, research knowledge, and resources that are needed to develop and select options; identify ways to gather what you need; gather what you can. 7. Develop a strategy for social work practice with Alexia. Be sure that you have a concrete and respect for religion specific strategy for and sayings, how you would address alcohol issues. What are the intervention goals? Following inpatient treatment, what kinds of referrals in seven of grieving your practice community would you make and why?

8. Identify methods for evaluating outcomes of your plan and english essay next steps/revisions of the plan, depending on various possible outcomes. 9. Stages Essay. Discuss implications for community intervention, prevention planning, social policy reform, and advocacy that are associated with Alexia's situation. Jaclyn is 23 years old and is four months pregnant. She is visiting a comprehensive wrap around services health clinic for prenatal care for the first time. The medical team advises prenatal nutritional counseling and vitamins, and assesses her pregnancy as progressing normally at and sayings, this stage.

However, she has been referred to you because in the health assessment she responded that she has always consumed one or two drinks, almost every day, when she comes home from work to essay, unwind from the stress of her job. There are also social events on weeknights and weekends with family and friends that typically involve light to moderate drinking. 1. Identify and sort through the relevant facts presented by and sayings Jaclyn's situation. What tools, approaches, or interviewing strategies would you use with a pregnant woman to essay, assess her drinking and its impact? What other issues should be assessed, as well? 2. Identify the and sayings essay problems, issues, and concerns that arise with Jaclyn's situation. 2a. Seven Stages. What information should you be certain is english, shared with Jaclyn? 3. Identify the positive and strengths aspects of Jaclyn's situation. 4. Analyze the scorer.com issues in terms of knowledge presented in the training modules. 5. English Proverbs. Use training materials to develop a list of options and an initial plan of action for social work intervention with Jaclyn.

Who should be involved in the intervention for Jaclyn? 6. Identify any additional information, research knowledge, and resources that are needed to on the victim essay, develop and select options; identify ways to gather what you need; gather what you can. 7. Develop a strategy for social work practice with Jaclyn. Be sure that you have a concrete and specific strategy for how you would address alcohol issues with Jaclyn. And Sayings Essay. What are the intervention goals? What kinds of referrals in your practice community would you make and why? 7a. What alternatives to drinking during pregnancy can you explore with Jaclyn? 8. Essay Business. Identify methods for evaluating outcomes of your plan and next steps/revisions of the english proverbs and sayings essay plan, depending on various possible outcomes.

9. Discuss implications for community intervention, prevention planning, social policy reform, and advocacy that are associated with Jaclyn's situation. Robert is a 32-year-old businessman who was involved in a car accident on his way home after having a couple of drinks at the local bar. He was referred for evaluation and treatment because at the time of the accident, his blood alcohol test showed .09, which was above the legal limit. He is overweight and tends to have high blood pressure. He grew up in the neighborhood where he and his wife now live. They have two children, ages 6 and 4 years. Robert has several childhood friends who come to the bar, almost every day during the week, to have drinks and socialize. His father is also a frequent visitor to the bar, and ucla has been for the past 40 years. Robert's father drinks 4 to and sayings, 5 drinks when he is at essay, the bar, but he does not seem to have any significant problems related to english and sayings, drinking, except for his hypertension.

Robert drinks 3 to 5 beers at effects victim essay, the bar, but he does not feel that he has any drinking problems because he does not drink at home except for wine with his evening meal. 1. Proverbs Essay. Identify and sort through the of grieving relevant facts presented by Robert's situation. What tools or interviewing strategies would you use to assess his drinking and its impact? What do you assess his drinking risk to be? Why?

2. Identify the problems, issues, and english essay concerns that arise with Robert's situation. 2a. What information should you be certain is shared with Robert? Why? 2b. What is essay, your advice to english proverbs and sayings essay, Robert concerning his drinking? Why? 3. Identify the positive and strengths aspects of Robert's situation. 4. Analyze the issues in terms of on music, knowledge presented in proverbs and sayings the training modules. 5. Use training materials to develop a list of options and an initial plan of action for social work intervention with Robert.

Who should be involved in the intervention for Robert? 6. Identify any additional information, research knowledge, and resources that are needed to scorer.com, develop and english proverbs select options; identify ways to gather what you need; gather what you can. 7. Develop a strategy for scorer.com, social work practice with Robert. Be sure that you have a concrete and specific strategy for english proverbs essay, how you would address alcohol issues with Robert. What are the elp dissertation intervention goals?

What kinds of referrals in your practice community would you make and and sayings essay why? 7a. What alternatives to drinking can you explore with Robert? 8. Identify methods for evaluating outcomes of essay on music business, your plan and proverbs and sayings essay next steps/revisions of the plan, depending on various possible outcomes. 9. Discuss implications for essay scorer.com, community intervention, prevention planning, social policy reform, and advocacy that are associated with Robert's situation. Ms. Essay. Cook is a 28-year-old African American woman who voluntarily approached your primary provider agencies for substance abuse treatment services. She is currently on probation for shoplifting, passing bad checks, vandalism, and parole/probation violations. She has been charged four times with disorderly conduct, once for fishing without a license, and of grieving twice for english proverbs and sayings, driving without a license (she never applied for one). She is currently awaiting trial for battery.

Ms. Cook has been incarcerated twice during her adulthood (once for 10 months and, most recently, for 10 days). The results of an AUDIT-13 screening suggested that she was binge drinking weekly during the stages of grieving essay past year. The screening also determined that, because of drinking/drug use, she had injured herself (2 falls requiring medical care) and someone else (killed the cat by proverbs accidental poisoning), and that others had recommended that she seek help. An Essay On Are We Happier Our Forefathers. Screening for co-occurring problems using the proverbs MPSI-A indicated potential depression and on the essay other psychological distress.

An assessment using the ASI-F was conducted that same day and revealed that Ms. Cook was currently living with her grandmother, who had raised her. She is the english and sayings mother of four children (ages 11, 7, 4, 2 years-she was 17 at the birth of her first child). The older two sons are living in foster care. The younger two daughters have complex health problems and developmental delays; they live with another relative. She is no longer in contact with any of the children's fathers (three men), and was only briefly married to the second man. She reported that both of her parents, several uncles and aunts, and both of seven of grieving, her siblings all have significant drinking and/or drug use problems. She has no close friends and a distant, conflicted relationship with family members other than the grandmother with whom she has almost always lived.

She has great difficulty in getting along with people. Proverbs And Sayings. She was physically abused as a child, which prompted her move to the grandmother's home. Ms. On The Victim Essay. Cook completed all but one year of high school, and received specialized training as a welder, but her most recent job was as a parking attendant. Essay. Her longest period of continuous employment was just over respect for religion essay, one year, and she has worked irregularly throughout her adult life. She describes her present health as good and she has a history of depression, anxiety, hallucinations, cognitive and memory deficits, and violent behavior. She has never received psychiatric care. 1. Identify and sort through the relevant facts presented by english proverbs and sayings Ms.

Cook's situation. 2. Identify the problems, issues, and concerns that arise with Ms. Respect For Religion. Cook's situation. 2a. What are the most pressing issues that Ms. Cook should be encouraged to address? 3. English And Sayings Essay. Identify the positive and respect strengths aspects of Ms. English Proverbs And Sayings Essay. Cook's situation. 4. Analyze the issues in scorer.com terms of knowledge presented in english proverbs and sayings essay the training modules. 5. Use training materials to an essay on are than our forefathers, develop a list of options and english proverbs essay an initial plan of action for social work intervention with Ms. Cook.

6. Identify any additional information, research knowledge, and resources that are needed to develop and select options; identify ways to gather what you need; gather what you can. 7. Essay. Develop a strategy for social work practice with Ms. Cook. Be sure that you have a concrete and specific strategy for how you would address issues with Ms. Cook. What are the intervention goals? How should the service plan be developed and implemented? 7a. What are the various service components with which Ms.

Cook is/should be involved and that must be coordinated? How will they be coordinated? What is the proper forum for english proverbs and sayings essay, interaction amongst these service providers? Who should be involved? 7b. What services are needed but not being received?

How will they be obtained? 7c. What are the appropriate roles of each service component? 8. Identify methods for evaluating outcomes of your plan and next steps/revisions of the plan, depending on various possible outcomes. Who should be responsible for monitoring the service plan?

9. Discuss implications for community intervention, prevention planning, social policy reform, and advocacy that are associated with Ms. Cook's situation. 10. How would the situation be different if Ms. Cook entered the substance abuse treatment system via the child welfare or criminal justice systems? Dave is effects essay, a 38-year-old small-parts factory worker who came into the treatment center after being arrested for drinking and driving (DUI/DWI).

His attorney has suggested that he quit drinking and enter treatment, at least until his trial which is scheduled in two months. Dave does not anticipate serving jail time, but he believes that treatment could strengthen his legal case. After his first arrest for english proverbs and sayings essay, DUI two years ago, he simply paid a fine and attended a special driver's education program for six weeks. Dave found the program to be a waste of time. Dave's work history is very good; he misses less than one day per year. He works the day shift on essay business weekdays, putting in time-and-a-half overtime on most Saturdays. He is well regarded by his supervisors and peers at work. He is fearful that his employer will find out about his treatment (it is english proverbs and sayings, being covered by his HMO), and that people at work will learn about the than our forefathers second DUI arrest.

1. Identify and sort through the relevant facts presented by Dave's situation. What tools or interviewing strategies would you use to assess his drinking and its impact? What do you assess his drinking risk to be? Why? 2. Identify the problems, issues, and concerns that arise with Dave's situation. 2a. What information should you be certain is shared with Dave?

Why? 2b. What is your advice to Dave concerning his drinking? Why? 2c. How would you assess motivational issues prior to english proverbs and sayings essay, and during the course of intervention with Dave?

3. Identify the positive and strengths aspects of Dave's situation. 4. Analyze the issues in terms of knowledge presented in the training modules. 5. Use training materials to develop a list of options and an initial plan of action for social work intervention with Dave. What are reasonable outcomes to be expected with Dave? Who should be involved in the intervention for effects of bullying on the victim, Dave? Why? 6. Identify any additional information, research knowledge, and resources that are needed to develop and select options; identify ways to gather what you need; gather what you can. 7. Develop a strategy for social work practice with Dave. Be sure that you have a concrete and specific strategy for how you would address alcohol issues. What are the intervention goals?

What kinds of referrals in your practice community would you make and why? 7a. What measures and procedures would you employ to english, formulate and negotiate goals with Dave? 7b. How would you apply motivational, cognitive behavioral, and relationship therapy approaches with Dave? 8. Identify methods for evaluating outcomes of your plan and next steps/revisions of the plan, depending on various possible outcomes.

9. Discuss implications for community intervention, prevention planning, social policy reform, and essay scorer.com advocacy that are associated with Dave's situation. 10. What elements would be different in english and sayings essay this case if Dave were, instead: (a) a woman, (b) a white collar professional, (c) elderly, (d) single, (e) divorced, (f) a member of an historically stereotyped, oppressed ethnic group? Sal Franco is of bullying on the, a 74-year old man, living alone in an apartment complex for older adults. You are the Senior Services social worker associated with the housing units. Sal and his wife, Maria, owned and operated a small, local grocery for 44 years (they emigrated from Italy when they were newlyweds at age 19).

They sold the and sayings business to respect for religion, their son Dominic when Sal turned 70. English And Sayings Essay. The plan was to enjoy travel and retired life together. However, shortly after retiring, Maria was diagnosed with an aggressive leukemia, and she died within 4 months. Mr. Franco has been living alone for over 3 years. Because Sal and Maria spent most of their time working and involved with family activities, there are few close friends in his life. For Religion Essay. Dominic's family has Sal to dinner every Sunday, but has little time during the week because of english essay, competing demands.

Sal's other children include a daughter living in another state who calls daily (but seldom visits because of the cost), a daughter oversees in military service, and a son with Down's Syndrome who lives in essay business a group home about an hour away. 1. Identify and sort through the relevant facts presented by proverbs and sayings Sal Franco's situation. What tools would you use to assess his drinking and its impact? What do you assess his drinking risk to be? Why? 2. Identify the problems, issues, and concerns that arise with Sal's situation.

2a. What information should you be certain is on music business, shared with Sal? Why? 2b. What is your advice to Sal concerning his drinking? Why? 2c. What other assessments need to be conducted? Why? 3. Identify the positive and strengths aspects of and sayings essay, Sal's situation.

4. Analyze the issues in terms of knowledge presented in respect the training modules. 5. Use training materials to develop a list of options and an initial plan of action for social work intervention with Sal. English And Sayings Essay. Who should be involved in the intervention for Sal? 6. Respect For Religion. Identify any additional information, research knowledge, and resources that are needed to develop and select options; identify ways to gather what you need; gather what you can. 7. Develop a strategy for social work practice with Mr. Franco. Be sure that you have a concrete and specific strategy for how you would address alcohol issues with him. And Sayings. What are the intervention goals? What kinds of referrals in your practice community would you make and why? What additional activities would you help him initiate? 7a.

What alternatives to drinking can you explore with Sal? 7b. What other services or programs should be engaged for Sal? How? 7c.

How should Sal's physical health, mental health, and social services be coordinated? 8. Identify methods for evaluating outcomes of your plan and next steps/revisions of the plan, depending on various possible outcomes. 9. Discuss implications for respect for religion, community intervention, prevention planning, social policy reform, and advocacy that are associated with Mr. And Sayings. Franco's situation. CASE 12. CATHERINE. Catherine Jackson is a 67-year-old woman, living alone in a mixed housing project. For the past month, she has received visiting nurse services from your agency.

These services were assigned to seven essay, her upon discharge from the hospital with a diagnosis of anemia and proverbs and sayings essay uncontrolled adult-onset diabetes. The nursing care will terminate at the end of the essay scorer.com week, as Catherine's foot sores are beginning to heal. During two separate visits, the nurse reports that she smelled alcohol, but Ms. Jackson did not appear to be intoxicated. When the nurse asked about her drinking, Catherine responded, Oh, I don't drink very much, really.

I just seem so tired all the time and a little medicinal drink now and then makes me feel better. 1. Identify and sort through the relevant facts presented by Catherine's situation. What tools or interviewing strategies would you use to assess her drinking and proverbs its impact? What do you assess her drinking risk to be? Why? 2. Than. Identify the problems, issues, concerns that arise with Catherine Jackson's situation.

2a. What other assessments need to be conducted? 2b. What is your advice to Catherine concerning her drinking? Why? 3. Identify the positive and strengths aspects of Catherine's situation. 4. Analyze the issues in english proverbs terms of knowledge presented in the training modules.

5. Stages Of Grieving Essay. Use training materials to develop a list of options and an initial plan of action for social work intervention with Ms. Jackson. Who should be involved in the intervention for her? 6. Identify any additional information, research knowledge, and and sayings essay resources that are needed to essay, develop and select options; identify ways to english proverbs and sayings essay, gather what you need; gather what you can. 7. Develop a strategy for practice with Catherine Jackson.

Be sure that you have a concrete and ucla elp dissertation specific strategy for how you would address alcohol issues with her. What are the english and sayings essay intervention goals? What kinds of community referrals would you make and why? 7a. How would you ensure that Catherine's care and multiple services are appropriately coordinated? Who should be in charge of coordination? 8. Identify methods for for religion essay, evaluating outcomes of your plan and next steps/revisions of the plan, depending on various possible outcomes. 9. Discuss implications for community intervention, prevention planning, social policy reform, and advocacy that are associated with Catherine's situation. CASE 13: COORDINATED CARE SERVICES (MACRO) Your State Chapter of NASW is english essay, hosting a one-day round table session to which members of substance abuse treatment and scorer.com advocacy agencies are invited, and you are the chairperson. The goal is to respond to a grant request that will support the development of a coordinated service system for proverbs and sayings essay, abused women, needing shelter, who have alcohol use problems.

The first set of tasks includes: Identify the necessary participants (service providers) of the coordinated system; Determine who will be responsible for the prescreening, screening, assessment, treatment, and evaluation responsibilities; Determine who will make referrals, to whom they will make them, and under what circumstances; Identify the community service partners that will serve as additional resources, act as supportive adjuncts, and will also serve as entry points by conducting the appropriate prescreening assessments for clients that come to them (e.g., child welfare, corrections, health care, employment services); Identify natural helping systems that should be connected to the system; Identify which service provider(s) will be responsible for seven stages, service coordination. Later tasks will emerge, including developing time lines, budgets, policies, and english proverbs and sayings procedures. The ultimate goal for each client in the system is to be able to ucla, follow through on the guidelines offered by Thompson (1993): 1. List all services that the client receives from each agency involved; 2. Identify key agencies and english proverbs essay services needed but not represented;

3. Establish a contact person within each agency; 4. Agree on a structure for the case planning group; 5. Define the roles and responsibilities of effects of bullying, each agency; 6. Monitor the implementation of the care plan; 7. Periodically evaluate the relevance and effectiveness of the plan. CASE 14. MAPLEDALE SCHOOL SYSTEM (PREVENTION) You have been asked to consult with a group from the and sayings Mapledale School system, comprised of business people, police, social workers, teachers, parents, administrators, and student representatives (Middle School, High School, and Community College).

The group is interested in on the essay selecting and implementing an alcohol abuse prevention program for their community. They want you to english, advise them on how to go about selecting the best program(s) to invest in-they are not interested in essay having you pick their programs, only in advising them as to proverbs, what to look for. Robbie J., a 19-year-old white male and first-year college student, suffered a significant brain injury 6 months ago as a result of a car accident. Robbie had been partying at a friend's house and left about 1:00 a. m. Driving home, he missed a curve in of grieving the road and rolled his car. Robbie's parents knew that their son drank occasionally, but they never thought he had a problem.

They had purchased a car for him and warned him of the dangers of drinking and english proverbs essay driving. Prior to the accident, Robbie had been a gregarious young man. In high school he had been a good student, popular, and played on the football team. Robbie loved skiing, skin diving, and riding dirt bikes. Robbie's rehabilitation has been arduous. His parents are still in disbelief. Robbie's father is a prominent corporate attorney, and Robbie had always expressed a desire to follow the same career path.

Robbie's mother divided her time between caring for her husband and stages son and her volunteer work on behalf of abused and english proverbs neglected children in the community. Since his injury, Robbie's mother has spent most of her time caring for him and participating in scorer.com his rehabilitation. His father is spending longer hours at work and and sayings essay misses the time he spent hunting, fishing, and respect playing golf with his son. Though supportive at first, his friends are calling less and less and rarely come around. Both parents were stunned to learn that Robbie and some of his friends got drunk nearly every weekend. This information surfaced during a family counseling session conducted by a social worker on the rehabilitation team who had recently attended a seminar on screening and brief intervention for alcohol and other drug problems.

Robbie's parents had a hard time believing it was true, but after questioning Robbie's friends, they learned that this was indeed the situation. The brain damage Robert sustained has affected his impulse control and english and sayings essay decreased his short-term memory and stages essay ability to concentrate. Robbie's emotional affect is labile. At times he laughs out loud; the next moment he may be crying. He has limited insight into his own behavior and how he has changed, so it is difficult for him to understand why his friends and family react to him differently now. Very few things sustain Robbie's attention; even watching TV is not pleasurable. The muscle weakness on his right side limits his ability to proverbs and sayings essay, participate in many of the elp dissertation athletic activities he enjoyed previously. Robbie is on an emotional roller coaster. At one level he knows that his plans for the future have to change.

At another level, he cannot accept these limitations. And Sayings. He wants things to be the effects victim way they were. Proverbs Essay. His condition makes it impossible for him to return to a successful college experience. He resents his parents' constant supervision, and feels that they are treating him like a baby. Essay. He says no girl will want to date him with this kind of interference. Most of his friends are back at college, so he has begun to hang out with a younger group and drink again. Robbie is frustrated with the difficulty he has in remembering, expressing himself, and concentrating. He is restless and agitated sometimes, both as a result of his frustration and the organic aspect of his injuries. English And Sayings. Robbie's parents can afford high quality treatment, but Robbie does not always comply with the treatment regimen. What are the relevant facts in Robbie's case (e.g., What is actually happening here)? Identify the problems and issues that are arising in Robbie's case (e.g., What has gone wrong in this situation? and What needs to be addressed in order to improve the respect situation?) Identify the positive and strengths aspects of the situation (e.g., What has gone right so far? and What positive elements exist in english proverbs essay this situation?) Analyze the issues in terms of knowledge presented in the training modules (e.g., What are the factors, such as development stages, that are likely related to the situation? and, How do these factors influence the situation?) Use training materials to essay, develop a list of options and an initial plan of proverbs and sayings, action (e.g., What has been shown to work in these kinds of situations where substance abuse and a traumatic brain injury are involved? and scorer.com What options are available? and What are the likely results of proverbs essay, each option?) Seek additional information, research knowledge, and resources needed to seven stages of grieving, develop and select options (e.g., What else do we need to find out to english and sayings essay, make a viable plan for Robbie and his parents? and Where can we go to get this information? and business What did you find out when out when you sought this information?

Are integrated programs for addressing alcohol abuse and TBI available in the community?) Develop a concrete strategy for Robbie and his parents (e.g., What can be tried over the next weeks/months? How can you help the parents come to and sayings, terms with the situation? How can you help Robbie address his drinking and make realistic plans for the future?) Identify methods for evaluating the elp dissertation outcomes and revising the plan (e.g., How will you know whether or not the english proverbs and sayings plan is scorer.com, being implemented adequately? and How will you know if the plan is working? and and sayings essay How will you revise the plan based on different possible outcomes?) *Instructors may wish to revise this case in terms of the client's gender, age, ethnicity, family socioeconomic status and access to treatment resources, functional area(s) of the brain affected and severity of the brain injury (for information, see the website of the Brain Injury Association of America: http://www.biausa.org/), or other factors. When using the case in the classroom, students may be divided into respect groups. Each group can be given a different set of client characteristics. English Proverbs Essay. When presenting their responses to the class, students can note whether or how the approaches taken would differ depending on seven stages the client's characteristics and circumstances.

Updated: March 2005. NIAAA: Understanding the impact of english and sayings, alcohol on human health and well-being.

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