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Principles for Working with Families The models of treatment supported with demonstrated effectiveness required clinicians working with families to: Coordinate all elements of treatment and rehabilitation to ensure that everyone is working toward the same goals in a collaborative, supportive relationship. Pay attention to the social as well as the clinical needs of the client. Provide optimum medication management. Listen to families and treat them as equal partners in treatment planning and delivery. Explore family members expectations of the treatment program and for the client. Assess the family s strengths and limitations in their ability to support the client. Help resolve family conflict through sensitive response to emotional distress. Address feelings of loss. Provide relevant information for client and family at appropriate times. Provide an explicit crisis plan and professional response. Help improve communication among family members. Provide training for the family in structured problem-solving techniques. Encourage the family to expand their social support networks, for example, participation in multifamily groups and/or family support organizations such as the National Alliance for the Mentally Ill. Be flexible in meeting the needs of the family. Provide the family with easy access to a professional should work with the family cease.

Huston et al. 1985). A variation of T wave inversion is the presence of biphasic T waves, which typically occur in leads V3 V5 (Estes et al. 2001). These ST-T wave changes are attributed to training-induced sympathetic nervous system alterations and usually normalize with exertion and possibly with deconditioning (Estes et al. 2001). However, not all extreme ST-T wave changes in athletes are brought about by the athletic heart syndrome and underlying pathology must be excluded when ST-T wave changes are accompanied by symmetric deeply inverted T waves, ST depression, prolonged QT interval, or the absence of normal septal Q waves. In addition to ST-T wave changes, the electrocardiogram (ECG) in well-trained athletes may show mildly increased P wave amplitude suggesting right atrial enlargement, notched P waves consistent with left atrial enlargement, incomplete right bundle branch block (RBBB), as well as voltage criteria for right and left ventricular hypertrophy (Huston et al. 1985). Among endurance athletes, 32 76% of subjects meet voltage criteria for LVH, whereas 18 69% of subjects meet criteria for right ventricular hypertrophy (Estes et al. 2001). This frequency is brought about by both biventricular enlargement and the thin body habitus of most endurance athletes. A variety of abnormal ECG patterns occurred in 40% of 1005 competitive athletes, but only 10% of the athletes with striking abnormal ECGs had echocardiographically determined structural cardiac abnormalities (Pelliccia et al. 2000). This study indicates that false positive ECGs, representing a component of athletic heart syndrome, may pose a

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The technical description Butler Burgher uses to define the income approach may initially appear somewhat complex if you are not familiar with the methodologies used for the quantitative analysis of financial statements. Do not allow yourself to become discouraged by the technical nature of the income approach. Remember, proper and accurate valuation is the key to your success in this business. Without this very crucial key, the door will remain locked, and you will be left standing on the outside wondering why you cannot open the door. Take comfort in the fact that the case studies that follow in 8 outline in detail exactly how this valuation process works. Let us break down the income approach to its most fundamental level by examining a basic financial instrument. For example, assuming a market interest rate of 5 percent, how much would you be willing to pay for an annuity yielding $10,000 per annum The answer is easily solved by taking a simple ratio of the two values, as follows: Present value = income $10,000 = = $200,000 rate 0.05

considers him an important source of information, and if they do, he is. Drudge is a network Mentat, an adviser to what I call a Network Army elsewhere in this book, and an example of an emerging model in the World Without Secrets. The network Mentat may be an independent media organization (such as http://www.indymedia.org, or Drudge), or a member of such an organization, or a self -appointed expert acting independently. I m an example of the latter. I appointed myself as Mentat to a Network Army of harmonica players and fans when I created my Web site (http://www.hunterharp.com) in 1997; it now draws about 800 hits a week. My credentials (author of a method for jazz harmonica players; session player for 15 years for film, TV, record, and commercial work; two CDs released under my name as leader, and so on) apparently qualify me for the role, but other harmonica Mentat Web sites are offering advice to players, and some that are attracting as many (or more) visitors as mine are run by novices who ve never released a recording or played a note for pay. (I mean, who elected them ) In my case, theirs, and Drudge s, the ultimate proof of qualif ication is the arrival of a fascinated Network Army at our doorsteps.

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