The Shores of Light is an orchestral composition which seeks to explore musical processes of coherence and evolution at a deeper level. The piece charts the journey of a single musical identity across a shifting aural landscape. This thematic idea — a strongly modal melody reminiscent of both plainchant and folksong, which serves as both the initial premise and foundation for the piece — is rooted in serene yet archaic stasis. After a brief introduction, the theme is subjected to tremendous pressure by external forces, which eventually crush it beyond recognition via a series of 'destructive' harmonic, contrapuntal, and acoustic procedures. Reduced to a shadow of its former self, the theme then undergoes a series of transformations, culminating in restoration — not to its original form, but to a new identity which functions as part of a whole, a 'master' entity whose components have been discreetly but gradually cohering throughout. This final realization is glimpsed but not necessarily fulfilled (hence the "shores of light") and the work, while striving at every register to return to its initial tonic, ends on a note that suggests (somewhat ominously) the possibility of a cyclical process. It is the essential tension between hierarchical complexity (tonality) and disorder (perceptual dissonance generated either by highly chromatic aggregates, acoustic saturation, or both) which plays the most crucial role in this discourse. The evolution toward greater and greater cohesion is achieved, necessarily, in opposition to the chaotic undercurrent which threatens to overwhelm or shatter the 'cohering' elements at every turn. The final chorale is a triumph of the 'meek,' as the elements of noise and distortion (ie. disorder) are stripped away to reveal an image of luminous simplicity. The use of tonal and non-tonal material as metaphors for order and chaos seems to betray an arbitrary initial condition — after all, there is no explicit logical connection between these parameters. But order, like beauty or meaning, is a perceptual phenomenon that transcends its processes. For me, the true complexity of the tonal hierarchy lies in its emergent qualities — the layers of content that emerge from a highly structured syntax. Thus, the gradual accretion of jumbled musical letters into recognizable words, then coherent sentences, then paragraphs imbued with specific meaning, carries with its own symbolism and structural significance.

AIDS Saskatoon, considered as a health social movement, is the focus of this research. It uses notions of life-world, system and life-world colonization as well as the typology of politics introduced by Cohen and Arato to answer the questions:<p> Why did AIDS Saskatoon emerge?<p> Is AIDS Saskatoon a defensive or an offensive social movement?<p> The defensive movements action is directed inward to the lifeworld and civil society, while the offensive modes of movement activism directed outward to state and economic institutions. With regards to the first question, I argue AIDS Saskatoon was formed as a reaction to patterns of the colonization of the life-world of people living with HIV/AIDS. Relative to the second question AIDS Saskatoon is seen to be a creative response to the colonization process that takes an organizational form conducive to both defensive and offensive dimensions.<p> Data for this study were derived from ten qualitative interviews were conducted - five with individuals diagnosed HIV/AIDS positive, three with the AIDS Saskatoon administrative staff, and two with the founders of AIDS Saskatoon.

The Shores of Light is an orchestral composition which seeks to explore musical processes of coherence and evolution at a deeper level. The piece charts the journey of a single musical identity across a shifting aural landscape. This thematic idea — a strongly modal melody reminiscent of both plainchant and folksong, which serves as both the initial premise and foundation for the piece — is rooted in serene yet archaic stasis. After a brief introduction, the theme is subjected to tremendous pressure by external forces, which eventually crush it beyond recognition via a series of 'destructive' harmonic, contrapuntal, and acoustic procedures. Reduced to a shadow of its former self, the theme then undergoes a series of transformations, culminating in restoration — not to its original form, but to a new identity which functions as part of a whole, a 'master' entity whose components have been discreetly but gradually cohering throughout. This final realization is glimpsed but not necessarily fulfilled (hence the "shores of light") and the work, while striving at every register to return to its initial tonic, ends on a note that suggests (somewhat ominously) the possibility of a cyclical process. It is the essential tension between hierarchical complexity (tonality) and disorder (perceptual dissonance generated either by highly chromatic aggregates, acoustic saturation, or both) which plays the most crucial role in this discourse. The evolution toward greater and greater cohesion is achieved, necessarily, in opposition to the chaotic undercurrent which threatens to overwhelm or shatter the 'cohering' elements at every turn. The final chorale is a triumph of the 'meek,' as the elements of noise and distortion (ie. disorder) are stripped away to reveal an image of luminous simplicity. The use of tonal and non-tonal material as metaphors for order and chaos seems to betray an arbitrary initial condition — after all, there is no explicit logical connection between these parameters. But order, like beauty or meaning, is a perceptual phenomenon that transcends its processes. For me, the true complexity of the tonal hierarchy lies in its emergent qualities — the layers of content that emerge from a highly structured syntax. Thus, the gradual accretion of jumbled musical letters into recognizable words, then coherent sentences, then paragraphs imbued with specific meaning, carries with its own symbolism and structural significance.

AIDS Saskatoon, considered as a health social movement, is the focus of this research. It uses notions of life-world, system and life-world colonization as well as the typology of politics introduced by Cohen and Arato to answer the questions:<p> Why did AIDS Saskatoon emerge?<p> Is AIDS Saskatoon a defensive or an offensive social movement?<p> The defensive movements action is directed inward to the lifeworld and civil society, while the offensive modes of movement activism directed outward to state and economic institutions. With regards to the first question, I argue AIDS Saskatoon was formed as a reaction to patterns of the colonization of the life-world of people living with HIV/AIDS. Relative to the second question AIDS Saskatoon is seen to be a creative response to the colonization process that takes an organizational form conducive to both defensive and offensive dimensions.<p> Data for this study were derived from ten qualitative interviews were conducted - five with individuals diagnosed HIV/AIDS positive, three with the AIDS Saskatoon administrative staff, and two with the founders of AIDS Saskatoon.

This manuscript presents the author's experience as a fulltime graduate engineer at Freese and Nichols, Inc. (FNI), a professional engineering an servicebased consulting firm, as a Record of Study (ROS) for the Doctor of Engineering (DE) degree at Texas A&M University. Through the course of the internship, the author was to familiarize himself with FNI organizational procedures and fulfill established internship objectives concerning technical, managerial, strategic, and societal achievement. In meeting the above requirements, the author describes the history and key aspects of the FNI business, discusses established managerial procedures at FNI, presents direct work experience on projects during the DE internship period, and presents outcomes towards the internship objectives. FNI has a storied history, and the FNI business model centers around its ability to sell its employees time on projects; it requires technical expertise and client relationships that facilitate selection for the work. FNI's organizational structure and managerial procedures are designed to emphasize the company's differentiated strategy towards high quality customer service. The author worked on several projects throughout the internship; however, the primary role was via the Highlands Bond Program, which involved the design of multiple water resources structures. Through the awareness of the FNI business concept and these projects, the key outcomes of the DE internship were noted, as numbered below. 1) The author fulfilled all internship objectives. 2) As a function of the projects, technical/engineering skills were applied and learned, and a greater appreciation for the interconnectedness of technical disciplines was developed. 3) The author concluded that the Assistant Project Manager (APM) role, of which the author served while on the internship, offers significant managerial and strategic benefits to FNI, and that the role can facilitate faster individual growth and greater project ownership. 4) Strategically, all projects are important in a business, even if they are less technically advanced. 5) Recommendations that could potentially improve the engineering programs at Texas A&M include a) providing greater emphasis on developing the soft skills of engineering, and b) potentially adding dam management/design and pipeline/pump station design to the water resources portions of the Texas A&M Curriculum. 6) The author noted that FNI is a well-managed company, and that his observations during the DE internship reinforced this statement.

The purpose of the present study was to begin to develop an understanding of how primary care resident physicians work with patients with personality disorder-type characteristics and processes. Participants include fifteen primary care resident physicians from a community health clinic. Participants individually viewed two video vignettes of an actor-patient being interviewed by a physician. Participants were asked how they would respond to statements the actor-patient made during the course of watching the video and then answered general questions about reactions to the actor-patient and working with patients with personality disorders. Using a naturalistic qualitative analysis, data were analyzed for categories and themes. The results of the analyses are presented within a basic framework for understanding how primary care residents work with and approach the doctor-patient relationship, and treat patients with personality disorder characteristics and associated personality processes. Broad themes emerge from the data. Content of residents' responses suggests two response styles: attention to patient's presenting physical concern or identify and potentially address underlying psychological and emotional concerns. Residents characterize the establishment of a relationship with this patient population as either a distancing, paternalistic approach, or an engaging and collegial relationship. Levels of self-awareness of reactions to patients consist of either a willingness to address personal reactions or a tendency to not identify or discuss those reactions. Residents also demonstrate a dichotomous response to willingness to work with this patient population characterized by either hesitancy to do so, or a desire to engage and attempt to work with these patients. A framework for understanding the possible effects and motivating variables behind these styles is presented. The predominant effects of the residents' interactions styles are either a distancing/paternalistic relationship or an engaging/collegial relationship. Two themes appear to characterize residents' motivations: the resident was driven by self-needs or patient-needs. These results may be useful in developing an initial theory of this previously unexamined dynamic. Moreover, these results may be useful in helping physicians better develop relationships with patients, especially through improvement in recognizing and utilizing personal reaction to patients. Future inquiries directed towards understanding what physician variables contribute to these two basic interaction styles identified here may be useful.

Abstract Traditionally, doctors and patients are based on different cognitions and ways of thinking to communicate with each other. Doctors are often holding dominated role in the process. The knowledge of doctors is coming from the curricula that they have learned at medical school and their clinical experience, whereas the knowledge of patients is coming from their health experience and the information which was reported in the common medical magazines and journals. Because of the different cognitive modes of medicine between doctors and patients, the efficiency of doctor-patient communication is usually unsatisfied. With the popularity of medical information, the rise of consumers¡¦ consciousness, and the change of health insurance system, patients are asking better quality of medical treatment now. Thus, the quality of doctor-patient communication seems to be more important. This research was employed by case study. The doctors and outpatients of the pediatrics department were selected as the research sample. Totally, the sample included six senior doctors with three different levels of hospital and 30 outpatients. The dialogs of interrogation enquiry between these doctors and patients were collected. The analytic framework was derived from Brown and Levinson¡¦s politeness theory, Grice¡¦s conversational maxims, and Roter¡¦s analytical system of doctor-patient communication behavior. This study analyzed the politeness strategies used during doctor-patient communication, and also found the communication modes that were frequently emerging in the diagnostic processes. The research results show that the maximum politeness strategies used in pediatrics clinics is the bald on record. This reveals a kind of consensus on the importance of communication efficiency for doctors and patients. Most of patients adopt more polite strategies to communicate with doctors for medical knowledge. The results also suggest several commonly-seen dialog modes providing the further self-awareness and self-observation for doctors and patients. Indirect communication, the off-record politeness strategies are also appeared in the dialogues of doctors and patients. This study contributed toward gaining the efficiency of doctor-patient communication, thus may be helpful in the saving of medical resources. Keywords: doctor-patient communication, politeness theory, therapeutic behavior, pediatrics clinics

Background/Objectives: Compassion fatigue (CF) is severe emotional and physical exhaustion resulting from unresolved burnout and/or secondary traumatic stress. Prevalent in registered nurses and physicians, CF negatively impacts both the caregiver and the care provided and is associated with job attrition. There is no direct measure for CF. Risk is assigned according to the intensity of each constituent part and the relationships between these parts. The purpose of this practice inquiry was to describe the risk for CF among doctor of nursing practice (DNP) students seeking nurse practitioner certification, a previously unstudied and potentially at-risk population. Design: A descriptive study was performed to describe: 1) the prevalence of compassion satisfaction; 2) the prevalence of burnout; 3) the prevalence of secondary traumatic stress; 4) the prevalence of risk profiles developed by Stamm (2010); and 5) the relationship between demographic characteristics and CF risk profiles in a sample of DNP students. Setting: The University of Arizona, College of Nursing between August 24, 2013 and November 19, 2013. Participants: 59 graduate nursing students seeking nurse practitioner certification and a DNP degree self-selected to participate in the study. Measurements: The Professional Quality of Life Scale-5 (ProQOL 5) was utilized to measure the components of CF: compassion satisfaction, burnout, and secondary traumatic stress. Patient demographics included: gender, age, years in nursing, nursing specialty, and employment status. Results: The DNP student population appears to be at-risk for CF, with 69% of the sample falling outside of the "low risk" CF profile. Stamm's (2010) five risk profiles were expanded to assign a level of risk to the 63% of participants who did not land in an existing profile. There were no statistically significant relationships between demographic variables and the expanded CF risk profiles, consistent with previous studies on the individual ProQOL components. A weak trend of increasing CF risk with years of nursing practice suggests that accumulated exposure to suffering increases CF risk. However, a small sample size and self-normalization in the ProQOL 5 limit the generalizability of the findings. Conclusion: DNP students are an at-risk population; therefore, we recommend incorporation of CF awareness and risk reduction into the DNP curriculum. Applicability of the ProQOL 5 test is hindered by scoring inconsistencies and self-normalization bias and we propose solutions. We additionally propose the concept of a single numeric index to quantify individual CF risk. Use of a single continuous variable pertaining to CF risk is likely to be crucial for future characterization, screening, and interventions.

No description available.

Thesis (MEd (Human Resources Studies))--University of South Australia, 1995