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Professor, Pacific Northwest University of Health Sciences

Imitative Behaviors Imitative behaviors are an important source of learning in group therapy treatment 2014 generic 10 mg carbimazole fast delivery. The process of modeling can be particularly important as clients learn new ways to handle difficult emotions without resorting to violence or drug use symptoms pancreatitis order carbimazole 20 mg amex. Therapists must be acutely sensitive to the important role they play within this context; clients often look to the therapist to model new behaviors as they encounter new situations within the group context symptoms chlamydia order carbimazole 20mg visa. Group members can also learn by imitating other members who are successfully dealing with difficult relational issues medications are administered to cheap 10mg carbimazole with amex. It is helpful for a new group member to witness an ongoing group where people are confronting their problems appropriately, moving beyond old dysfunctional patterns, and forming new relationships that support change. The group becomes a living demonstration of these new behaviors, which facilitates and supports insight and change. Development of Socializing Techniques Many substance abusers are "field-sensitive" or "field-dependent" individuals who are keenly conscious of the network of specific relationships as opposed to principles or generalizations that apply regardless of context. Group therapy can take advantage of this trait Interpersonal Learning Groups provide an opportunity for members to learn about relationships and intimacy. The group itself is a laboratory where group members can, perhaps for the first time, honestly communicate with individuals who 167 Chapter 9 will support them and provide them with respectful feedback. Existential Factors Existential factors of loss and death are often issues of great discomfort in the substanceabusing population. The brevity of a timelimited group experience forces these issues to the surface and allows members to discuss them openly in a safe environment. Time itself represents loss and also serves as a motivator, as the members face the ending of each group session and of the group treatment experience. Group Cohesiveness Often misunderstood, group cohesion is a sense of belonging that defines the individual not only in relation to herself but also to the group. It is a powerful feeling that one has meaning in relationships and that one is valued. Catharsis Sometimes group participants will gain a sudden insight through interaction with others, which can cause a significant internal shift in the way they respond to life. Such insights may be accompanied by bursts of emotion that release pain or anger associated with old psychological wounds. This process happens more easily in a group where cohesion has been developed and where the therapist can facilitate a safe environment in which emotions can be freely shared. It is important to recognize, however, that although catharsis is a genuine expression, it is not seen as curative in and of itself. High levels of emotional exchange not addressed in the group can become potential relapse triggers, which endanger the success of individual members. The therapist acknowledges the powerful emotions after the member has shared them but asks the group as well as the member to give those emotions meaning and context within the group. Thus, both the experience of the emotion and the understanding of how that emotion either interferes or supports relationships are healing. Using Time-Limited Group Therapy the focus of time-limited therapeutic groups varies a great deal according to the model chosen by the therapist. Yet some generalizations can be made about several dimensions of the manner in which brief group therapy is implemented. Assessment and Preparation Client preparation is particularly important in any time-limited group experience. Clients should be thoroughly assessed before their entry into a group for therapy. In terms of exclusionary issues, persons with severe disorders or those who cannot accept support may need to be given more individual time before a group experience. Also, persons with significant deficits in cognition may not benefit as much from a time-limited group. A brief explanation of a "here and now" encounter is helpful-the group can become a place where feedback takes place in the "here and now," as members learn how they are affected by the others and how they in turn affect other members. This "here and now" focus brings clients into the present and allows them to deal with real issues within the group that they can then apply in their daily lives. If time permits, it is particularly effective for group members as they are being assessed and prepared for group to either watch or participate in a practice group as a trial experience. A variety of group tapes are available; however, any program can videotape one of its own groups, with appropriate releases for client permission, to use for instructional purposes. This enables new clients to see what will happen in the group session and lowers anxiety.

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Increased balancing area size and faster scheduling reduce regulation requirements medications you cant take while breastfeeding buy carbimazole discount. Figure 4-1 demonstrates that requirements for regulation-a relatively expensive balancing service-are reduced substantially as balancing area size is increased and the dispatch interval is decreased 25 medications to know for nclex cheap 20 mg carbimazole with amex. Analysis may be required to quantify benefits in regions that are not already implementing sub-hourly energy scheduling or that operate with small balancing areas treatment with chemicals or drugs buy 20 mg carbimazole with amex. Such techniques and studies should seek to accurately encompass multiple balancing areas and regions as well as help promulgate best practices symptoms women heart attack effective 20 mg carbimazole, such as optimization of flexibility reserve. These advanced methods can be used to address technology neutrality concerns, assuring that all technologies are treated equally in reliability rules and market structures. Allows power system operator access to additional flexibility from wind plants, when it is economical or necessary for reliability. Key Themes: Reduce Wind Costs; Expand Developable Areas Markets Addressed: Land; Offshore Action 5. The Wind Vision Study Scenario includes the construction and integration of multiple offshore wind plants. Each project is individually responsible for the interconnection that brings power to shore. These power delivery systems will be built on public waterways and connected to the on-shore grid infrastructure. Under this activity, aggregating the power export systems for multiple offshore facilities is expected to lower the cost of offshore transmission and minimize impacts to coastal ecosystems where cables are routed. Several strategies are under consideration in the United States to develop optimized architectures for the orderly construction of an offshore grid. As part of this effort, close coordination between state and federal agencies is needed to streamline the offshore permitting process and reduce regulatory uncertainty. Wind turbines are being developed that can help with voltage control, regulation (automatic generation control), synthetic inertial response, and frequency regulation. Some of these features are untested, and, in many parts of the United States, wind turbine owners and operators have no incentive to provide these services because no market mechanism exists to pay the owners for providing these added capabilities. There is also a need to provide controls at the wind plant level, which would allow wind plants to behave more like conventional generation. The wind stakeholder community can collaborate with others to develop needed control strategies at the wind plant level, building upon newly emerging turbine capabilities. The grid effects of distributed wind generation, alone and integrated with other forms of distributed generation, need to be better understood in order to facilitate mitigation and removal of integration barriers and to accelerate deployment. Better distribution system modeling tools, informed utilities, and standards development can reduce costs and increase confidence in distributed wind integration. This revision will establish a framework for distributed generation that supports the grid and allows high levels of penetration. Increased utility confidence in offshore wind and reduced cost of offshore wind due to aggregation of power, lower environmental footprint, reduced transmission congestion, and possible higher capacity value. Key Themes: Reduce Wind Costs; Expand Developable Areas Markets Addressed: Offshore Offshore wind electricity will typically be injected into heavily congested urban centers. As such, the integration of offshore wind in certain markets will have global utility effects that reduce the market price of electricity, at least for the near term. The capacity value of offshore wind differs from that of land-based wind and, in some regions, provides stronger matching with load during peak summer months. Both of these effects significantly influence the economics of offshore wind technology for the Wind Vision Study Scenario. Modeling tools and information that utilities can use to evaluate integration of distributed wind into distribution systems. Improved distributed wind power integration and delivery into distribution systems and increased utility confidence in this integration. Key Themes: Reduce Wind Costs; Expand Developable Areas Markets Addressed: Distributed 274 Chapter 4 Wind Electricity Delivery and Integration 4. If improperly sited, however, wind power facilities may present a number of socioeconomic, conflicting use, and environmental risks. These risks, or even the perception of risk, may pose obstacles to wind deployment throughout the United States.

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Land surrounding wind power plants is typically able to support other land uses medications in checked baggage generic carbimazole 5mg without a prescription, such as ranching and farming medications related to the lymphatic system buy carbimazole 20 mg on-line. Continued wind deployment will need to be executed with sensitivity to the potential impacts on avian medications during childbirth buy 20mg carbimazole, bat medicine wheel images generic carbimazole 10 mg line, and other wildlife populations; the local environment; the landscape; and communities and individuals living in proximity to wind projects. When wind power is a more significant part of the electricity generation portfolio, as is the case in the Study Scenario, electricity system costs are less sensitive to market fluctuations in fossil fuel prices. In addition, deployment and operation of wind power plants reduces demand for fossil fuels, including natural gas, leading to lower fuel prices within and outside of the electric sector and supporting cost savings for consumers. The predictable, longterm costs of wind power create downward price pressure on fossil fuels that can cumulatively save consumers $280 billion from lower natural gas prices outside the electric sector. Note: Cumulative costs and benefits are reported on a Net Present Value basis for the period of 2013 through 2050 and reflect the difference in impacts between the Central Study Scenario and the Baseline Scenario. Electric sector expenditures include capital, fuel, and operations and maintenance for transmission and generation of all technologies modeled, but excludes consideration of estimated benefits. In particular, offshore wind offers the ability to reduce wholesale market power clearing prices and consumer costs in transmission-congested coastal areas, supports local jobs and port development opportunities, and offers geographic proximity to densely populated coastal regions with limited renewable power alternatives. Distributed wind applications, including customer-sited wind and wind turbines embedded in distribution networks, offer a number of unique attributes relevant to the Wind Vision. On-site distributed wind turbines allow farmers, schools, and other energy users to benefit from reduced utility bills, predictable costs, and a hedge against the possibility of rising retail electricity rates. These suppliers maintain domestic content levels of 80­85% for turbine and tower hardware and are well positioned to capitalize on export opportunities, including growing global demand for decentralized electricity. Overcoming these costs and achieving the Study Scenario would require an array of actions (detailed in Chapter 4), but analysis also suggests that robust deployment of wind offers the opportunity to realize a range of additional benefits. Based on current estimates, these benefits exceed the expected near- and mid-term investments and other costs that might result from continued growth of wind energy, across nearly all analyzed scenarios. Critics argue that the costs associated with deployment and operation of wind power offset the potential benefits. This chapter informs both perspectives by providing a detailed accounting of various impacts associated with wind deployment under the Wind Vision Study Scenario. While Chapter 2 is a retrospective analysis, Chapter 3 provides an assessment of potential future impacts. Changes in electricity rates, annual electricity consumer costs or savings, and cumulative system expenditures are quantified and reported based on a range of future fossil fuel prices and cost trajectories for wind technology. Issues related to electric system reliability, operations and markets, and public acceptance and local impacts are also considered and discussed. The Wind Vision impacts assessment relies on scenarios of future wind deployment to estimate incremental impacts. As discussed in Chapter 1, the Study Scenario uses prescribed wind energy penetration levels of 10% by 2020, 20% by 2030, and 35% by 2050, a portion of which is assumed to be offshore wind. Impacts from the Study Scenario are compared with the Baseline Scenario, which holds wind capacity constant at year-end 2013 levels. This approach allows for the quantification of impacts from all future wind deployment. More comprehensive discussion of the development of the Study Scenario and the Baseline Scenario is in Chapter 1. In addition to detailing the impacts assessment and general quantification of costs and benefits, this chapter discusses the electric sector modeling methods and relevant modeling inputs. Each of these sections is based on a comparison of the Study Scenario with the Baseline Scenario. Given uncertainties about future wind energy costs as well as the cost of fossil generation, sensitivities are also considered in order to provide further insight. The focus is principally on a comparison of the Study Scenario under central conditions. Percentage wind energy penetration is calculated as the share of total wind generation relative to total end-use energy demand. Distributed wind turbines connected to the transmission grid are represented within the larger land-based designation. Turbines sited to serve onsite customer needs (connected to the distribution grid) are not captured in the Wind Vision report or its quantitative analysis due to limited modeling capabilities. These modeling capabilities are under development and a vision report specific to distributed wind is planned for 2015. A range of results is often presented and is based on other considerations (apart from the fossil fuel prices and wind cost assumptions that are the basis of the sensitivities in Sections 3.

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Against the backdrop of commonsense divisions between public politics and privacy medicine on airplane buy generic carbimazole 10mg online, ethics treatment lyme disease discount 10 mg carbimazole, or the ordinary treatment associates order generic carbimazole online, I argue that these anthropologies of poetry offer a surprise in thinking about what counts as politics my medicine carbimazole 20mg fast delivery. I train my attention on some recent works in anthropology, which is to say works written in the past 30 years. Compared to the historical reach of poetic traditions in the region, these are indeed quite recent. It expressed and contained the spirit of the times not only because of the "heterogeneity" of topics it had reassembled and reorganized in peculiar ways but also because of its wide celebration" (1999: xiii). As Islam spread beyond Arab societies, this tension between divine speech and human speech was translated into new contexts. However, rather than the simple denigration of poetry as human speech, the tension at the heart of Islam has animated an abundance of poetic output in many languages other than Arabic, and in religious traditions in the region that have been in close contact with Islam. This historical reach of poetic traditions is an integral aspect of the anthropological studies that I examine in this chapter. Hence, in asking what counts as the politics of poetry in recent studies, I am asking what, in light of this long history, has come to count as the politics of poetry. This is not a review chapter but an approach to the standing literature that cuts a path through a set of works that are not always in conversation with one another. This path passes through the heart of some works, and brushes up against others in a partial way. I next take up the question of subjectivity in poetry by focusing on forms of relatedness that disperse the subject across a field of social relations. Ethics: PoEtry and ValuEs In a study based on research in rural Yemen, Steve Caton (1990) described his effort as an inaugural "ethnography of poetry. No sooner had Caton begun that analysis than he found himself swept up in the subtle and intricate world of tribal politics. One genre of poetry that appears obviously political is the one suited to the occasion of dispute mediation-the zamil. When tribes slid into conflict over water rights, escalating violence, or possible abductions, the mediating process was conducted in large part through poetry. Caton describes processions of men with rifles cast over their shoulders approaching the warring parties with poetry on their lips and song in the air. The negotiation of rights and the offer, amendment, or refusal of settlement terms were often conducted entirely in verse. The answer lies partly in the dependence of the zamil genre on another genre of poetry. For in addition to those moments of poetic discourse devoted to the topic of the conflict at hand, there is a preceding moment that specifies the addressee of the poem. Furthermore, the addressee is identified as one (or a group) who upholds a particular set of moral virtues, among which piety and tribal honor are paramount. As Caton argues, the identification of the addressee is not a superfluous event, but in fact establishes the conditions for a negotiation by identifying the various parties as those who uphold a general set of moral norms. Thus, the poetic description of hospitality, virtue, and tribal custom should also be understood as a prescriptive or stipulating event that mobilizes a normalizing force among the parties to the dispute. This particular device of attributing virtue through terms of address, in turn, relies on the silent presence of another genre of poetry-the balah-that is suited to the occasion of the wedding. By naming a few virtues proper to tribal life, the poet invokes the entire set that is more thoroughly elaborated as praise of the groom, the hosts, and the guests of a wedding. The ascendance of the modern state, though, has introduced several transfigurations in the forms, practices, and vocabularies of political life. One way to approach his work is through the question: what has been the fate of tribal virtues under the modern state? Throughout these years, prominent poets engaged enormous audiences through compositions that were distributed on cassette in the voices of distinguished singers. By focusing on cassette poetry, Miller begins to answer this question, providing detailed descriptions of its context, composition, recording, sale, and circulation. By renewing genres of poetry that were deeply rooted in tribal practice and religious scholarship that was unevenly distributed in northern and southern regions, this singer helped to forge a listening public of Yemenis that emphasized a common cultural heritage that crossed borders (2007: 389). Through intertwining written and oral practices, tribesman and scholars had long carried on political dialogue through poetry. Miller shows how cassette poetry bore the marks of this history in taking up the most contemporary of political developments.

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