A critical analysis of a patient's journey through Paediatric Essay

A critical analysis of a patient's journey through Paediatric Intensive Care Unit from a nursing perspective - Essay Example Even with the children who suffer the extreme form of this heart defect. The success rate has been very encouraging. The said infant suffered from Hypoplastic left heart syndrome (HLHS) which is an extension of congenital heart disease. It is the fourth most common type of congenital cardiac defect. It basically is a functional signal ventricle due to the congenital heart. HLHS is characterized by a multiple abnormalities related to heart including steosis or atresia of ventricular  inflow and outflow tracts of both the left side (Report of the New England Regional Infant Cardiac Program, 1980). In the 1980’s most of the infants died within the first month of their birth but since then due to various medical advancements and the advent of Norwood procedure, the survival rate has risen a great deal (Kirklin et al. 1980). The two treatments of the congenital heart being currently offered are either multi stages surgical palliation or the orthotopic cardiac transplantation. The mortality rate of the HLHS is considerably higher than other defects occurring due to the congenital heart disease. Additionally there is not much knowledge and information about the long-term follow-up related to the HLHS survivors (Caplan et al. 1996). The infants who are born with this disease are usually born on time and have relatively normal birth weight. It has also been researched that extra cardiac and malformationsare is present in about 2.3% of them (Report of the New England Regional Infant Cardiac Program). It has also been noticed that its occurrence is more in boys than in girls. Fortunately the chances of this disease being present in the siblings are only 0.5% of the times and only 2.2% for other extension of congenital heart disease (Wernovsky, Bove, 1998). The chances of survival post the cardinal surgery has been increased to 95% now. Unfortunately the exact cause of the HLHS has yet

Light and shadow in prayer Dissertation Example | Topics and Well Written Essays - 3750 words

Light and shadow in prayer - Dissertation Example Artists start from developing simple ideas, which in turn improve and become more significant in the world. Association of light and the church is an artistic style that has developed for a long period from 12th and 13th centuries. Since then, the use of light and darkness has developed to a level that is applauded by all church members, priests, believer and artists who engage in development techniques. it is in this view that the paper intents to provide a critical analysis of development of light and darkness in the church, the effect they have brought and the future of the artistic styles in using environment to enhance Godliness in the church. Introduction Architecture is the act of designing and creating buildings. It involves creating a style and a method of how a building is going to be constructed. This paper is going to define what prayer and the understanding what the church is. It will assess the early Christian communities and the origin of church building (Fletcher & Cruickshank, 2004). The paper will examine factors affecting the architectural churches and the origin of architectural church, the reformation and its influence in the church. The paper will look at modernism, a period after reformation and then asses the relationship between Light and shadow. Finally, it will look at the use of light in churches and prayer and light in the architectural churches (Pevsner, 2002). Meaning of Architecture ... The light is of great importance in the interior, also plays an important role in the perception of space. For centuries, religious buildings were created with particular attention to proper lighting the holy place. The natural light should not be forgotten in the architecture, and the words of Le Corbusier "Architecture is a smart, coordinated play of masses in the light," it should be the most important doctrine. Prayer Prayer is defined in so many ways and the various definitions that are given are normally associated with the experiences of those defining them. The first definition that we can talk of is prayer being a communication. Prayer is regarded as a means of communicating with God. Ordinarily, when people are communicating, it takes at least two people to communicate. When people are communicating, there is a message that is being sent to the receiver, the receiver is expected to encode the message and then give a feedback to the sender. When communicating with God, the s ame process is expected to take place. The person communicating with God, sends a message to God where by God is expected to receive the message and give a feedback. The feedback from God is normally regarded as fulfilled expectations of the person who is communicating with Him (Giles, 2004). The diagram below shows a priest and a church member communicating to God together. http://img.tfd.com/wn/30/605C7-prayer.png In connection with communication is the notion that prayer is talking to God. Communication involves talking to someone just like in prayer it is believed that we talk to God and hence a conversation with God. We normally hold a conversation with people who can hear us. In prayer, we therefore recognize the presence of God whom we talk

Ethnicity and Culture in Disease Prevention Essay Example for Free

Ethnicity and Culture in Disease Prevention Essay Importance of addressing race, ethnicity, and culture when developing programs for prevention of disease Name: Subject: Instructor: Date: The campaigns against diseases have a number of times botched as a result of non-recognition of environmental, biological and behavioral factors as major determinants as of individual health. In public health, the three terms (ethnicity, race and culture) are often used interchangeably. The implementation of disease prevention programs in a community requires full knowledge of the health status of its members. With this regard, racial and ethnical categories often define populations in a manner that is meaningful to their health status (Nnakwe, 2009, p. 337). The concept of race, ethnicity and culture plays a significant role in understand human behavior. Thus it is rational to incorporate the aspect of race, culture and ethnicity a when designing disease prevention programs in communities. For instance, designing a disease prevention program require the use of social ecological framework. The framework focuses on interactions between an individual’s physical, cultural and social setting and thus it may be the only necessary move in a fight against disease in an ethnic group. In this case, the knowledge about a disease should not only be transferred but also needs to be cultivated thought peer support, supportive social norms and cultural values. Consider a case where the government decides to put up a facility for provision of free condoms at the core of a very conservative community as part of a program for prevention of HIV/Aids. Will such a program receive support from the community? Of course not as this will be taken as a violation of the community’s cultural values since it may lead to moral decay among its members. Therefore cultural values of a community must be addressed and prevention programs should be aligned with those values. Health care providers need to train on cultural competency in order to understand barriers and influence of culture and society on health behaviors as well as the use of behavior change tools that are culturally sensitive. Ethnicity /race may also affect, directly or indirectly, the success of a disease prevention program in a community, e. . cultural beliefs about HV/Aids (Edelman Mandle 2005, p. 48). For example the risk of obesity starts at a person’s prenatal period. Race/ethnicity may therefore affect the prevention of obesity since it influence the timing of pregnancy, number of pregnancies together with intervals between pregnancies. In conclusion, the public health approach towards prevention of disease must into consideration culture, race and ethnicity within a social ecological framework as an effort towards sustaining a disease free society.

Theories of Therapeutic Alliance

Theories of Therapeutic Alliance QUOTE:- The therapeutic alliance is a key concept and quintessential variable whose importance is commonly accepted. It is seen as a multi-dimensional concept, emerging trends indicate four dimensions, namely: the patients affective relationship to the therapist; the patients capacity to purposefully work in therapy; the therapists empathic understanding and involvement; the client/therapist agreement on the goals and tasks of treatment. B. JUST 1997 Essay The concept of the Therapeutic Alliance has its roots in the seminal works of Freud when he began formulating his theories in respect of the various concepts relating to the phenomenon and dynamics of transference. (Freud S 1912). Freud began to refer to the concept in his early writings in different terms as a the therapeutic, working, or helping alliance which encapsulated the idea that a relationship between therapist and patient was important for therapeutic success. We note, in the context of this essay, that Freud’s opinion was that such a working arrangement was important but not essential for a therapeutic outcome. His early comments tended to refer to the â€Å"positive feelings that develop between doctor and patient â€Å" although, as his theories evolved, these concepts developed into more concrete forms. As is the case with most evolving concepts it was developed and expanded by a number of other notable figures. Zetzel looked at a number of different types of alliance formation (Zetzel E R 1956) and Greenson conceptualised this in a fuller form drawing a distinction between the real and adaptive forms of this type of relationship and drawing attention to the transferential properties and the possibility of the transference of fantasy in the adaptive elements of the alliance. (Greenson R R 1967) Working at about the same time as Greenson in the USA, Rogers characterised the Therapeutic Alliance in the terminology of â€Å"Client-centered therapy† and, for the first time in the literature, we find a reference to such an alliance being considered â€Å"essential† rather than â€Å"desirable† for the possibility of a positive outcome. (Rogers C R 1965). Rodgers referred to the Therapeutic Alliance as an â€Å"empathetic bond† which had to be actively developed by both doctor and patient and was an essential precursor to any form of exploration of the patient’s problems. Bordin expanded and generalised this concept further still and sought to increase its usefulness by adapting it to psychotherapy in all of its various forms. (Bordin E S 1979) and, in a seminal move towards Just’s analysis, proposed three elemental components of the Therapeutic Alliance, namely the identification of the goal, the identification of the task in hand and the formation of the doctor / patient bond of trust and empathy. In consideration of the title of this essay we should consider this analysis more fully. Bordin conceived of the Therapeutic Alliance as a totally bipartisan construction which required an equal (but different) input from both therapist and patient. This construction required the mutual identification and recognition of the shared goals that were going to be achieved together with an agreed and accepted delineation and acknowledgement of the various tasks necessary to achieve these goals and the bond which he saw as and â€Å"attachment bond generated primarily from mutual respect and empathyâ€Å". (Bordin E S 1979). It follows from this analysis, that Bordin conceived the Therapeutic Alliance not as something which arose spontaneously form the efforts and interaction of therapist and patient, but as the actual vehicle and mechanism by which psychotherapy worked. His attempts to apply this concept to the various contemporary forms of psychotherapy culminated with the realisation a nd articulation that the different forms of psychotherapy focussed in on, and exploited different aspects of the Therapeutic Alliance at different stages of the treatment. This finding is echoed in other writings. As we have outlined, the concept of the Therapeutic Alliance has its origins in the psychodynamic traditions of psychotherapy but has been embraced by the other traditions as well. Those theorists who are grounded in the cognitive school also acknowledge the establishment of a collaborative relationship between therapist and patient as an essential prerequisite to effective therapy. (Beck A T et al. 1979) More recent work as sought to quantify the nature and depth of the Therapeutic Alliance in the various disciplines. Martin’s tour de force on the subject is an impressive meta-analysis which sought to quantify the relationship between the strength of the Therapeutic Alliance and the eventual outcome of treatment. (Martin D J et al. 2000).His findings suggest that it depends how one quantifies the Therapeutic Alliance as to how strong the relationship is found to be. This is an area that we shall return to shortly. Horvath takes this point further with a similar meta-analysis across various forms of psychotherapy and comes to the conclusion that the impact of the Therapeutic Alliance is roughly similar in the different forms and the efficacy of outcome is directly related to the strength of the Therapeutic Alliance bond, irrespective of which particular mode of measurement is used. (Horvath A O et al. 1991). These issues, and indeed the thrust behind Just’s terminology of the Therapeutic Alliance as being the â€Å"quintessential variable are all totally dependent on just how one defines or measures the concept. It is clear from the discussions presented already that it is a â€Å"multidimensional concept†. One is certainly tempted to observe, from a brief overview of the literature, that it has at least as many dimensions as there are authorities writing on the issue. Although such a comment is superficially clearly bordering on the flippant, is can be taken at a much deeper level as a reflection of the fact that the Therapeutic Alliance is defined and measured by different authors in different ways. Historically the evolution of the ability to measure the strength of the alliance has evolved in much the same was (and to some extent in parallel) as the actual formulation of the concepts of the Therapeutic Alliance itself. (Luborsky L et al. 1983). In essence, a judgement of the extent to which one considers the Therapeutic Alliance essential rather than simply desirable, is dependent on the way that one either quantifies or measures it. If we consider the implications of this statement further we can cite comments by two authorities that we have quoted earlier in a different context. In their critical analysis of the role of the Therapeutic Alliance in the field of general psychotherapy, Horvath and Luborsky suggest that research is unlikely to provide guidance to clinical practice unless the relations between clearly defined therapist actions in specific contexts and the effect of these interventions on process or outcome can be demonstrated (Horvath A O, Luborsky L 1993 Pg. 568 ) The effectiveness of the Therapeutic Alliance is also demonstrably effected by other factors. In his book the Heart and Soul of Change, Miller (et al. 1999) puts forward the suggestion that what is of fundamental importance in establishing the alliance is not the persuasion, or theoretical background of the therapist, nor even how empathetic the therapist actually is to the problems of the patient (even if the criteria that one uses is how empathetic the therapist believes that they are being) but is actually the degree to which the patient believe that the therapist understands their own perceptions of reality. To quote Miller â€Å"It the client’s theory of change not the therapist’s that is important.† This thread of argument is taken further with Gabbard’s analysis (Gabbard G O et al. 1994) that the efficacy of the eventual therapeutic intervention, if measured in terms of transference interpretations, defence interpretations, and supportive interventions is ultimately dependent on factors that are therapist independent such as the strength of the patient’s ego, the state of readiness that the patient has reached in terms of their own self-exploration or elaboration, the current phase of the therapeutic process and even the timing within any particular session. Which implies that it is both dynamic and variable. If we consider the third of Just’s four dimensions, that being that the therapists empathic understanding and involvement is an essential prerequisite for the formation of the Therapeutic Alliance, then we can see that Gabbard’s analysis is clearly at odds with Just’s. It is fair to observe that Gabbard is not alone in his assertions as Sexton’s slightly later and incredibly detailed assessment of the status of the Therapeutic Alliance, came to essentially the same conclusions. (Sexton H C et al. 1996). A rather more controversial view is expressed by Kernberg who was admittedly considering the phenomenon of Therapeutic Alliance in the specific context of severe personality disorder (Kernberg O F 1994) and came to the conclusion that the Therapeutic Alliance has to be initially very strong to allow the possibility of negative transference in order for the therapist to sometimes avoid the possibility of either premature termination of therapeutic stalemates. To an extent, he vicariously supports Miller’s contentions by pointing out that the practical strength of the Therapeutic Alliance is largely independent of the therapist’s wishes if one is dealing with a patient who is angrily attacking or even overtly manipulating the frame and goals of treatment. He adds the comment that in these circumstances the strength of the Therapeutic Alliance is largely determined by the level of the patient’s intrinsic anxiety state. Perhaps this can be interpreted as an extension or perhaps a paraphrasing of Miller’s later suggestion. It therefore follows that if we are to agree or to disagree with Just’s original statement, we need to consider just how we can quantify the strength of the various parameters of the Therapeutic Alliance. This is no easy topic and the literature on the subject is vast. One of the first significant and serious attempts to produce some form of measuring tool came in the form of the Luborskys Penn Helping Alliance scales (Luborsky L et al. 1983). This had a number of serious shortcomings and was modified many times in the years immediately after its publication. The Penn Helping Alliance questionnaire was an offshoot of this collaboration and this evolved further into a 19 item scale. Many difficulties arose in the original tools because, to a degree they were dependent on the degree of benefit that the patient had already received from any previous attempts at therapy. A number of commentators made the suggestion that the tools, in order to maximise their applicability and usefulness, should be as independent as possible from the degree of benefit that the patient had already received. (Marmar C R et al. 1989). If we return to our consideration of Bordin’s tripartite assessment of the Therapeutic Alliance which can be considered a fundamental progenitor of Just’s model, then we can cite Horvath and Greenbergs Working Alliance Inventory (Horvath H O et al. 1989) as a useful tool to measure the Therapeutic Alliance in terms of the three subsections of the Bordin definition mentioned earlier. This is perhaps the best direct justification and support of Just’s hypothesis that we can find as Bordin’s threefold thrust of assessment is essentially the same as three of the four elements of Just’s and the fourth element that Just included of the therapist’s empathetic understanding and involvement as being an â€Å"essential prerequisite† of the Therapeutic Alliance, is largely dismissed by authorities such as Gabbard and Sexton who we have cited earlier. Clearly we do not presume to make a judgement as to which authority is essentially correct as we have to observe that the evidence base to support either view is not particularly strong. To return to the original thrust of the concept of measurement, we can state that authorities have regarded Horvath and Greenbergs Working Alliance Inventory as being highly reproducible and as having high levels of interrater reliability in both the 36 item and the shorter 12 item version. (Horvath H O et al. 1989) A degree of vindication for Just’s analysis of the Therapeutic Alliance can be found in the California Psychotherapy Alliance Scales (CALPAS) , which essentially measures the strength of the therapist / patient alliance as a multidimensional construct. It uses four subscales to assess the strength of the bond namely: (i) the patients capacity to work purposefully in therapy, (ii) the affective bond with the therapist, (iii) the therapists empathic understanding and involvement (iv) the agreement between patient and therapist on the goals and tasks of treatment. Which, in essence, cover the four basic premises of Just’s hypothesis. Like the other scales already referred to, the CALPAS scale utilises a 6 point Likert scale for each item. This particular scale has achieved wide acceptance in research literature with a good predictive ability which appears to be valid across the majority of psychotherapeutic disciplines including cognitive behavioural therapy (Fenton L R et al. 2001), psychodynamic psychotherapy (Barber J P et al. 2000) and across several other different treatment areas (Gaston L et al. 1991). It has been found to be especially useful among neurotic patients, but it does appear to be only a weak predictor of outcome with cocaine-dependent patients (Barber J P et al. 1999). In terms of the arguments set out earlier, we note that all of the scales that we have already cited have both a therapist rated and patient rated version as well as an independent observer version. If one considers the literature we can see that the patient self-reported versions tend to give better predictions of outcome than those reports that are therapist based (particularly when assessed early in treatment trajectory). This gives credence to Miller’s view that it is the patient ‘s perception of the Therapeutic Alliance which is the single most important prediction measure of outcome in the psychotherapeutic field. Thus far in this essay we have largely considered the presence of the Therapeutic Alliance as being a comparatively static modality which is either present or not. Although we have acknowledged some views that refer to its dynamic state, we should perhaps examine this in more detail. We have referred to the evolution of the strength of the Therapeutic Alliance as therapy progresses, but we should point to the fact that a number of authorities refer to the relationship of either the variability of the fundamental stability of the Therapeutic Alliance to a number of both clinical and empirical implications. (Hatcher R L et al. 1996). As long as three decades ago Luborsky wrote about the dynamic nature of the Therapeutic Alliance which was actively responsive to the dynamic and changing demands of the evolution of the various phases of therapy. (Luborsky L 1976). A further aspect of this dynamism is to be found in the writings of Bordin who, while acknowledging that the role of the therapist is generally one of support, noted that the role of the therapist tends to be the dominant factor at the beginning of the therapeutic relationship and this evolves into a more shared responsibility as goals and treatment plans are both articulated and defined. He writes that it is the inevitable cycle of the Therapeutic Alliance bond being strained, ruptured and then repaired that is central to the therapeutic process. (Bordin E 1980) Writers such as Gelso and Carter (Gelso C J et al. 1994) formalised (some would say stylised) the evolution of the alliance over the therapeutic interaction as involving â€Å"a weakening after an initial development, followed in successful therapy by an increase to earlier, high levels.† Other authorities have taken a more idiosyncratic view, which may reflect their own personal experience rather than necessarily an informed overview. Horvath characterises the typical trajectory as â€Å"an initial phase of development for the alliance, held to occur within the first five therapy sessions (and probably peaking during the third session), followed by a second, more critical phase, during which the therapist challenges maladaptive patterns, the effect of which is a weakening or rupturing of the alliance that must be repaired if therapy is to continue successfully†. (Horvath A O et al. 1994). In order to provide a balanced picture of the literature, one could also cite the opinion of Greenberg who appears to have a more philanthropic outlook when he describes the process of evolution of the Therapeutic Alliance in successful therapies as â€Å"either rising or holding a steady value over time†. (Greenberg L S 1994) In consideration of the evidence that we have assembled thus far we can state that the Therapeutic Alliance, in Just’s words, is clearly a key concept. We would suggest that the evidence points to the fact that not only is it a key concept but that it is both crucial and fundamental to the whole discipline of psychotherapeutic intervention. References Barber J P, Luborsky L, Crits-Christoph P, Thase M, Weiss R, Frank A, Onken L, Gallop R: 1999 Therapeutic alliance as a predictor of outcome in treatment of cocaine dependence. Psychotherapy Research, 1999 ; 9 (1) : 54 – 73 Barber J P, Connolly M B, Crits-Christoph P, Gladis L, Siqueland L: 2000  Alliance predicts patients outcome beyond in-treatment change in symptoms.  J Consul Clin Psychol 2000 ; 68 (6) : 1027 – 1032 Beck A T, Rush A J, Shaw B F, Emery G: 1979  Cognitive Therapy of Depression.  New York : Guilford Press, 1979 Bordin E S: 1979  The generalizability of the psychoanalytic concept of the working alliance.  Psychotherapy : Theory, Research and Practice 1979 ; 16 (3) : 252 – 260 Bordin E: 1980  A psychodynamic view of counseling psychology.  The Counseling Psychologist 1980 ; 9 : 62 – 66 Fenton L R, Cecero J J, Nich C, Fankforter T L, Carroll K M: 2001  Perspective is everything: the predictive validity working alliance instruments.  Journal of Psychotherapy Practice Research 2001 ; 10 (4) : 262 – 268 Freud S: 1912  The dynamics of transference.  Standard Edition 1912 ; 12 : 97 – 108 Gabbard G O, Horwitz L, Allen J G, et al: 1994  Transference interpretation in the psychotherapy of borderline patients: a high-risk, high-gain phenomenon.  Harv Rev Psychiatry 1994 ; 4 : 59 – 69 Gaston L, Marmar C R, Gallagher D, Thompson L W: 1991  Alliance prediction of outcome beyond in-treatment symptomatic change as psychotherapy processes.  Psychotherapy Research, 1991 ; 1 (2) : 104 – 113 Gelso C J, Carter J A: 1994 Components of the psychotherapy relationship: their interaction and unfolding during treatment.  Journal of Counseling Psychology 1994 ; 41 : 296 – 306 Greenberg L S: 1994  What is real in the relationship? Comment on Gelso and Carter (1994).  Journal of Counselling Psychology 1994 ; 41 : 307 – 310 Greenson R R: 1967  The Technique and Practice of Psychoanalysis.  New York : International Universities Press, 1967 Hatcher R L, Barends A W: 1996  Patients view of the alliance in psychotherapy: exploratory factor analysis of three alliance measures.  J Consult Clin Psychol 1996 ; 64 : 1326 – 1336 Horvath H O, Greenberg L S: 1989  Development and validation of the Working Alliance Inventory.  J Couns Psychol 1989 ; 36 (2) : 223 – 233 Horvath A O, Symonds B D: 1991  Relation between working alliance and outcome in psychotherapy: a meta-analysis. Journal of Counseling Psychology 1991 ; 38 : 139 – 149 Horvath A O, Luborsky L: 1993  The role of the therapeutic alliance in psychotherapy.  J Consult Clin Psychol 1993 ; 61 : 561 – 573 Horvath A O, Gaston L, Luborsky L: 1994  The therapeutic alliance and its measures, in Psychodynamic Treatment and Research, edited by Miller L, Luborsky L, Barber J et al.  New York, Basic Books, 1994, pp 247 – 273 Kernberg O F: 1994  Severe Personality Disorders: Psychotherapeutic Strategies.  New Haven, CT, Yale University Press, 1994 Luborsky L, Crits-Christoph P, Alexander L, Margolis M, Cohen M: T 1983  Two helping alliance methods for predicting outcomes of psychotherapy: a counting signs versus a global rating method.  Journal of Nervous and Mental Disease 1983 ; 171 : 480 – 492 Luborsky L: 1976  Helping alliance in psychotherapy, in Successful Psychotherapy, edited by Cleghhorn JL. New York; Brunner / Mazel, 1976, pp 92–116 Marmar C R, Gaston L, Gallagher D, Thompson L W: 1989  Towards the validation of the California Therapeutic Alliance Rating System. Psychological Assessment:  J Consul Clin Psychol 1989 ; 1 : 46 – 52 Martin D J, Garske J P, Davis M K: 2000  Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review.  J Consulting and Clin Psych 2000 ; 68 : 438 – 450 Miller E A et al. 1999  The Heart and Soul of Change  APA : Detroit 1999 Rogers C R: 1965  Client-Centered Therapy.  Boston : Houghton Mifflin, 1965 Sexton H C, Hembrek K, Kvarme G: 1996  The interaction of the alliance and therapy microprocess: a sequential analysis.  J Consult Clin Psychol 1996 ; 64 : 471 – 480 Zetzel E R: 1956  Current concepts of transference.  Journal of Abnormal and Social Psychology 1956 ; 53 : 16 – 18 ################################################################ 11/01/07 Word count 3,493 PDG

Critical Discourse Analysis Essay -- Social Discourse

Critical Discourse Analysis Jan blommaert and Chris Bulcaen makes a brief introduction to the study of Critical Discourse Analysis (CDA). CDA intends to use social-theoretical method in discourse analysis and is primarily linguistically based (Blommaet & Bulcaen, 2000, p.447). It intends to analyze the structural relationships of dominance, discrimination, power and control through a textual study (Blommaet & Bulcaen, 2000, p.448). Based on the assumption that social discourse is constructed and socially conditioned, CDA explores the power dynamics in this process. According to Fairclough, CDA analysis can be divided into three-dimensions: first, discours-as-text which analyzes the textual linguistic elements as concrete instances of discourse; second, discourse-as-discursive-practice, especially focusing on discourse processes like speech act, coherence and intertexuality; third, discourse-as-social-practice which examines the effects and the hegemonic process in the discourse (Blommaet & Bulcaen, 2000, p.448-9). While both the second and the third dimension consider the arrangement of text elements or quotes as intertexuality, the second dimension makes the interaction between text and context visible and the third dimension makes the discursive power dynamic visible as well. Moreover, they point out that CDA aims to undertake a social responsibility to correct particular discourses for â€Å"change, empowerment, and practice-orientedness† (Blommaet & Bulcaen, 2000, p.449). Because of this, CDA pay large attention to social topics and works on two main directions: power and ideology, and change of the structuralist determinism (Blommaet & Bulcaen, 2000, p.452). Although it ambitiously put such great emphasis on social phenomena o... ...te in the 1960s which reflected two opposite public opinions on Television and radio respectively. More current example could be the different experience of a same news text people read on a mainstream newspaper and on a facebook sharing page. As Blommaert and Bulcaen suggest the incorporation of linguistic and nonlinguistic dimensions, this could be taken into consideration in further studies. Reference: Blommaert, J., & Bulcaen, C. (2000). Critical discourse analysis. Annual Review of Anthropology,29, 447-66. Schroder, K.C. (2007). Media discourse analysis: researching cultural meaning from inception to reception. Texual Cultures: Texts, Contexts, Interpretation 2, 2, 77-99. Steensland, B. (2008). Why do policy frames change? actor-idea coevolution in debates on welfare reform. Social Forces, 86(3), 1027-54.

An Analysis of Donne’s A Valediction: of Weeping Essay -- Valediction

An Analysis of Donne’s A Valediction: of Weeping    William Empson begins his critical essay on John Donne's "A Valediction: of Weeping" with the statement below.   Empson here plays the provocateur for the critic who wishes to disagree with the notion that Donne's intentions were perhaps less than the sincere valediction of a weeping man.  Ã‚  Ã‚   Indeed, "A Valediction" concerns a parting; Donne is going to sea and is leaving his nameless, loved other in England, and the "Valediction" is his emotive poesy describing the moment. "...the language of [A Valediction: of Weeping] is shot through with a suspicion which for once he is too delicate or too preoccupied to state unambiguously, that when he is gone she will be unfaithful to him.   Those critics who say the poem is sincere, by the way... know not what they do."  Ã‚   --- William Empson, "A Valediction: of Weeping," John Donne: a Collection of Critical Essays (ed. H. Gardner)   Ã‚  Ã‚   There is little argument as to what Donne is feeling at surface level: he is sorrowful and grieving because he must be apart from his loved one, who has become his world (a metaphor which is carried out in the second stanza).   Empson is indeed correct when he says that the poem is not unambiguous.   There is a large range of interpretations that can be made based upon the language in the poem, and these are focused around the source of Donne's grief.   Ã‚  Ã‚   It is easy for one to picture a grieving sailor leaving his lover, but what makes this man grieve?   It is the innate love between two people who are intensely focused upon each other which must be put on hold?   Is it some additive emotion that consists of two people who are about to suffer separation and loss of a lover?   Or is it, as Empson p... ..., Donne and his lover/other struggle with their sadness just before separation.   Donne realizes that this may be a futile goal, but he also sees the importance of composure if their relationship - his "world" - that he credits to her is going succeed.   Donne seems to have no dearth of sincerity in this poem.   He is also purposeful in writing it; Donne himself was a man of great passion, and who had to go out to sea.   "A Valediction: of Weeping" seems not to be the valediction of a jealous lover, but of a conscientious other making a concerted effort not to let jealousy and self-pity control his farewell to a lover. Works Cited: Donne, John. "A Valediction: Of Weeping". The Longman Anthology of British Literature: Volume 1A. 2nd ed. Ed. Damrosch, David, Christopher Baswell and Anne Howland Schotter. New York: Addison-Wesley Educational Publishers, Inc, 2003.

How Can an Individual’s Sense of Identity be Communicated Through Their Choice of Music?

In today's society individuality can be expressed in many different ways. The use of physical adornments such as clothes and makeup are the first things that spring to mind when discussing ways and methods of identification. However, with the mass media having such a huge influence on the young people of today, it is becoming very easy to determine one's identity through the music they enjoy listening to. This essay seeks to determine how an individual identity can be clearly communicated through choices of music. To a certain extent, music has had an interesting effect on the way individuals express their sense of identity. The 1960's Mods and Rockers are a good example of this. Two different types of people existing in the same society, who were easily distinguished to the type of clothing they wore and their social activities- it could be argued that this has certain relevance to tastes in music. The Mods were, of course, happy to settle for the newly released music of the time. Whereas the Rockers weren't satisfied with the new renditions and so preferred to stick with classic rock music. This eventuated in the two groups leading wholly different ways of life, and the appearances and attitudes of both groups became a likeness of the particular ‘identities' which are recognizable in society today. Today, there is a greater variety of music available to the mass public, and this has inevitably resulted in many different identities being formed. The 1980's trance scene along with the new input of R ‘n' B and Hip Hop (Black rap style music) has influenced a number of new music acts to recreate versions of the biggest hits. This has helped in creating a new identity that many nightclubs cater for. What is known as the ‘Kev', ‘Townie' or ‘Shaz' has been formed! These short names are used to describe people of a certain identity. Usually people of these youth subgroups are fans of hard dance music which they listen to on a regular basis on their personal CD players in public places and are also well known for their up to date flashy mobile phones, sports clothing and tacky jewellery, as well as the occasional baseball cap. There is a rather large congregation of ‘Kevs/Townies' on Saturday nights when they drive their flashy cars around the town centre. ‘Moshers', ‘Goths', ‘Metallers' or ‘Grungers' all form another subgroup which relies almost completely on music taste which is quite the opposite to the group discussed in the last paragraph. ‘Grungers' are people who usually prefer to listen to music such as Nirvana and Red Hot Chili Peppers, and just generally most forms of rock and metal music. Their sense of dress is relatively easy to identify, as a certain identity has been created by the huge mass of youngsters turning to the ‘Grunger' image in the last few years. The ‘hoodie' has become a highly symbolic item of clothing, which many of the group members will wear when congregating. This can be teamed with baggy jeans and trousers, multiple piercings, dyed hair, visible tattoos and other common objects such as various bracelets and jewellery, although hardly ever gold or silver. The two groups previously discussed are the two huge societies in which the members' behaviour is almost completely influenced by popular music. As it is possible to see from the descriptions above, an individuals' sense of identity can be relatively easy to configure when using popular music as the determining factor. Due to this, increasing amounts of youth subgroups are being formed purely by musical taste.