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Section 2. Providing Supervision for Staff and Volunteers. The Tool Box needs your help. to remain available. Your contribution can help change lives. Engage colleagues, share ideas, and reinvent the in thesis, way you work. The Tool Box needs your help. to remain available.

Your contribution can help change lives. Engage colleagues, share ideas, and reinvent the way you work. What is providing supervision for staff and volunteers? Why should you supervise staff and volunteers? When should you provide supervision? How do you supervise staff and comparison/contrast rubric volunteers? Pilar, who had once been a homeless teenager, was a counselor for homeless children. Instrument In Thesis? She was trying to understand why she couldn’t seem to connect with one particular teen-age girl, a girl who seemed a lot like Pilar herself had been at that age. She brought up the essay rubric, issue in her biweekly meeting with her supervisor. They discussed the girl, her own feelings about the research, relationship, what she had tried so far.

The supervisor suggested some techniques for using body language and other non-verbal signals to tell the essay rubric, girl that Pilar cared about her needs and was on her side. They also talked about instrument Pilar’s own experiences, and writing about how her work with this girl might be bringing up things that were difficult for Pilar to research instrument in thesis, deal with At the and catering, next meeting, Pilar told her supervisor that she had tried several of the techniques they had discussed, and in thesis that she had also begun to better understand how her own feelings played into her counseling. All in essay texts all, she felt things had improved, and would continue to. Alejandro had been at the housing office for nearly a year, but he was still struggling to learn his job. He couldn’t seem to keep paperwork straight, and he had, as a result, made life difficult for a number of people trying to find affordable housing whose lives were difficult enough already. Furthermore, rather than apologizing when he made mistakes, he treated clients as if his errors were their fault. He and his supervisor had talked about the situation once before, and research instrument now the supervisor called him in again. “Your work has been unsatisfactory, and this is the second time I’ve had to tell you so,” the supervisor said. “If it continues this way, you could lose your job.” Before Alejandro could protest, the supervisor continued, “Let’s look at what you’re having problems with. We should be able to come up with some ways that you can improve your performance and lion essay kids do your job well, and I’ll try to help however I can. But we’ve already had this conversation twice; if we have it again, that will probably be the last time.”

Both of these scenarios are examples of research in thesis, supervision. Comparison/contrast Essay Rubric? In this section, we’ll discuss what supervision means, and how to go developing good supervision for staff and volunteers. What is providing supervision for staff and volunteers? When you hear the research in thesis, word “supervision,” you may picture a large, mean person looking over your shoulder trying to find fault with everything you do. There may be some supervisors who fit that description, but, in theory health and community service organizations, supervision is usually the opposite.

It’s helpful, and research instrument often welcomed by supervisers as a source of advice, information, and emotional support for work that can be demanding and belonging difficult. At the instrument in thesis, same time, supervisors are responsible for making sure that the lion essay kids, people they supervise are doing a good job – that they’re where they’re supposed to be when they’re supposed to be there, and research instrument in thesis that the work they do is of high quality. There are really two kinds of supervision, often both practiced by the same person, sometimes at the same time. One puts the supervisor in lion essay kids a teacher/counselor/mentor role, providing helpful and constructive feedback, developing a good relationship with the supervisee, and working with him to continually improve his understanding of and competence in his job. The other casts the supervisor in her role in the organizational chart, as an administrator responsible for making sure that those in her department do their jobs.

The two are not necessarily contradictory, but they do occasionally place supervisors in an uncomfortable position, as the case of Alejandro above illustrates. The duties of a supervisor may include training new workers, supporting and mentoring supervisees, providing professional development, assigning and creating projects, making sure plans are being carried out effectively, providing support, assisting with projects or activities, and identifying and addressing unsatisfactory performance. Research Instrument? All of these duties have the same goal: to help those supervised do the best job they can, and continue to essay rubric, learn and improve. Each of the paid staff members in your organization probably has (and should have) a job description laying out her responsibilities. Many volunteer programs also provide job descriptions for instrument in thesis volunteers, but staff supervision and volunteer supervision are different. Staff members are expected, perhaps after some initial training, to be professionals who know their jobs and can function independently. They understand the workings of the organization, know the field, and essay texts often are expected to instrument, make complex decisions about their actions without consulting with a supervisor.

Volunteers, on the other hand, are unpaid, and have chosen to help the organization for their own reasons – usually because they believe in what it’s doing, and want to have a role in it in some way. They are generally not professionals in the field, don’t necessarily know the essay on unemployment, workings of the organization (they may spend as little as an hour or two a week on their volunteer assignments), and may need a lot of ongoing guidance from research in thesis, a supervisor in order to perform well. A supervisor of volunteers may also have to pay more attention to logistics – scheduling, making sure everyone knows about meetings or changes, checking with people to ensure they fulfill their commitments, etc. – because volunteers aren’t tied to the organizational schedule in the same way employees are. Both staff members and volunteers should meet regularly with their supervisor. Depending on the position and the size and resources of the essay rubric, organization, these supervision meetings may always be individual, or may often be in a group. In the latter case, the research, group can often be helpful in identifying and working out problems or making suggestions about thesis theory resolving difficult situations. Whatever the research instrument in thesis, situation, supervisors should have a chance to lion essay kids, meet with supervisees individually at least a few times a year to review performance, call attention to problem areas, and research provide support or – where necessary – explain and try to help improve unsatisfactory work. Here’s where supervision becomes difficult. The supervisor should be an important source of comfort and help to lion essay kids, anyone she supervises. Instrument In Thesis? At the same time, it usually falls to her to be the texts, bearer of bad news when a supervisee’s job performance is, or has become, unsatisfactory. The supervisor is expected to – and should – provide as much support as possible in that situation, helping the staff member or volunteer to bring his efforts in line with the standards of the organization.

Neither the supervisor nor her supervisee can ignore the fact, however, that she may be the person who decides that – despite repeated warnings and efforts to correct the problem – performance has simply become or continued to be unacceptable, and the employee or staff member must be asked to leave. As must be obvious by now, supervision – which is considered an afterthought in many organizations – is both an important and a difficult job, one that requires a lot of thought and effort. That’s perhaps the most important point of this section: don’t take supervision for granted. It can be the difference between an organization that functions smoothly and one that’s continually in crisis. Why should you supervise staff and volunteers? Good supervision benefits both the individuals supervised and research instrument in thesis the organization: Supervision geared toward helping staff members and thesis theory volunteers gain competency makes them feel supported and valued, and makes the organization more competent and effective as well. Supervision can explain the requirements and responsibilities of staff members’ and in thesis volunteers’ positions, the methods they’re expected to use, and the organizational norms and culture, so that expectations are clear from the beginning. This can prevent problems later, or if they arise, provide a standard against activity, which performance, behavior, and relationships can be measured. Instrument? Poor performance by staff or volunteers reflects poorly in the community and with fundraisers. Thesis Activity Theory? Proper supervision can not only catch poor performance, but prevent it, by identifying areas of research instrument, concern and working on them with staff and volunteers.

Adequate supervision can help to recognize and address potential problems, such as staff burnout, before they become actual problems. Writing? Good supervision keeps staff and volunteers with the organization.. It makes them feel that someone cares whether or not they do a good job, and that there’s a solid structure supporting them if they run into research instrument in thesis, problems. These are factors that keep people happy with their jobs, and encourage them to stay. Good supervision models the type of relationship that should exist throughout the organization. Supervisors who understand their job treat all employees and belonging essay texts volunteers with respect, focus on the professional and research instrument in thesis personal needs and development of those they supervise, and inspire enthusiasm for lion essay kids the work and research loyalty to writing a paper, the organization’s vision and mission. Supervision, coupled with constructive feedback, can result in better employees who feel they are a more fully integrated part of the instrument in thesis, group. Thesis Theory? Again, the research in thesis, end result of this is a stronger, more effective organization. When should you provide supervision?

Supervision for new staff members and volunteers should begin as soon as they join the organization, and should continue on a regular basis throughout their stay. Regular supervision provides the opportunity for staff and volunteers to work out problems, to get to know the organization well, and to establish a good and productive relationship with their supervisor. By the same token, it allows the supervisor to get a clear picture of supervisees’ strengths and lion essay kids needs, to let them know how they’re doing, to help them work on areas where they’re not as strong, and to praise them for research what they do well. In situations where supervision is largely supportive and professional – counseling and psychotherapy, health, etc. – the ideal is that staff members, should meet with supervisors, either in a group or individually, once a week, or once every other week. (The staffs of some medical facilities, particularly teaching hospitals, may conduct a short group supervision session every day.) With volunteers in somewhat similar positions – school or adult literacy tutors, peer counselors, hotline staffers – the same might be true. For staff members and a paper online volunteers whose work may not be directly with participants, but whose supervision is geared more toward making sure they understand and can do their jobs, sessions may be less frequent – monthly or quarterly. In Thesis? Frequency may also depend on the number of lion essay kids, staff or volunteers a supervisor is responsible for, the flexibility of people’s schedules, and the resources of the instrument in thesis, organization.

How do you supervise staff and volunteers? Although staff and volunteers both need support, the differences in their jobs, as we’ve discussed, imply differences in the ways and the frequency with which they’re supervised. In order to ensure good supervision, it’s important to identify the right people to provide it and then train them, so that they have a clear understanding of gcse hospitality, what supervision is, the instrument, aspects of it that they should attend to, and the interpersonal skills they’ll need to practice in order to do it well. Who should supervise staff members and volunteers? In general, staff members should be supervised by whoever is ultimately responsible for the work they do. If your organization is large enough to have a number of writing a paper, departments, for instrument in thesis instance, then the argumentative essay on unemployment, people in each department may be supervised by the head of that department, or the members of instrument, each team within the department may be supervised by on unemployment, that team’s leader. Instrument In Thesis? In smaller organizations, the director may supervise everyone else, or may share supervision duties with (or delegate them to) an assistant director and/or one or more program directors. Having the person in charge be the belonging essay, supervisor isn’t always the best plan, however. Remember, we explained earlier that there are two kinds of supervision.

The teacher/counselor/mentor version, which is really about professional development, requires a supervisor who has direct and successful experience in the field. Where staff members have responsibilities that involve specific professional skills – counseling or psychotherapy, teaching, medicine, wellness promotion, occupational therapy, etc. – a supervisor with knowledge of the research in thesis, field can help them examine what they’re doing, spot and deal with areas of potential concern, and argumentative suggest alternatives based on experience. Research In Thesis? (You wouldn’t, for instance, want a hospital administrator with a degree in business supervising the clinical practice of doctors. Writing A Paper Online? ) If your organization promotes people from within, or specifically hires administrators and managers with experience in in thesis the field, this may not be an issue for thesis activity you. If not, you’ll have to decide how to provide good professional supervision. One possibility, if administrators don’t have field experience, is peer supervision, usually in a group. In this circumstance, there’s no question of one person or another being in research instrument charge. Group members might rotate facilitating meetings, or might appoint one person to facilitate because she’s particularly good at it. For most people who exercise it, supervision is only one aspect of their jobs. It’s an important enough aspect, however, that they should receive both initial and comparison/contrast ongoing training in it.

In many fields where supervision duties are assumed – particularly counseling and clinical psychology – there are graduate courses in supervision that virtually all practitioners are expected to have taken. What should supervision training cover? Some topics that might be included in instrument in thesis a supervision training: How to essay, involve all volunteers and staff members effectively How to enhance the instrument in thesis, value of volunteers to a program and to the paid employees How to include all volunteers and staff members in program planning and decision making How to evaluate performance How to provide performance feedback to volunteers and staff How to hold volunteers and staff members accountable for job performance How to help workers avoid burnout How to create a climate in online which volunteers and staff will be most productive How to build teams that include both volunteers and paid employees How to minimize tension between paid staff and volunteers The difference between formative (helping the in thesis, supervisee to improve and develop professionally through discussion, advice, and occasional counseling) and summative (judging employee performance) supervision. This might include some discussion – and perhaps role play – about what’s appropriate when, and how to combine the two if both are part of the supervisory role in the organization. The standard view of the supervisory relationship, as we’ve mentioned, is often negative. Supervisors are seen as overseeing and criticizing – perhaps in a hostile manner – the work of those they supervise. The reality is that effective supervision is a partnership. The supervisor provides professional and emotional support, information, advice, and a connection to the larger organization (passing on concerns, helping to gcse hospitality, obtain supplies and equipment, etc.), and supervisor and supervisee work on and solve problems together. For health and community service organizations, this type of in thesis, supervision makes sense not only activity, practically, but philosophically.

The supportive, partnership supervisory relationship reflects the democratic and humanistic ideals of most organizations of this type, and models and promotes the sort of relationship that staff and volunteers should develop with one another and with program participants. At the same time, supervisors in most organizations have responsibilities that go beyond support and advice. They’re responsible for making sure their supervisees have the knowledge, materials, space, etc. they need to do a good job, and they’re responsible as well for making sure work gets done well and on time. That’s the practical side of supervision, and it can determine whether or not the organization reaches its goals. What does good practical supervision consist of? Welcome new staff or volunteers and research in thesis distribute basic information. As soon as someone makes the commitment to work for your organization, whether as a staff member or volunteer, she should should receive a job description that clearly delineates her responsibilities, her place in the organizational chart, whom she will be supervised by a paper online, and whom she will supervise, etc. New staff members might be sent or given a card or note signed by all staff welcoming them to the organization; volunteers might get a similar card thanking them for joining the organization. Meet with new supervisees as soon as possible.

Supervisors should meet with a new staff member on his first day on the job, if possible – both to get acquainted and to get staff member’s most pressing questions answered. Part of the supervisor’s responsibility here might be to instrument, take him around and belonging introduce him to research instrument, other staff members, to show him the belonging essay, site’s facilities and procedures, and to make sure he has what he needs to research instrument in thesis, start work. One of the most important functions of this meeting is to hospitality and catering, give the new staff member an “anchor” – a person he feels he knows and can go to for help or information in those first few nervous days on a new job. First days for research in thesis new volunteers might be different, since they’re likely to be supervised by lion essay kids, whatever professional or staff member they’re working with, instead of, or in addition to, a volunteer coordinator. A new volunteer’s initial meeting is more likely to be with the supervising staff member, to get acquainted and to go over what the volunteer will actually do. People new to the organization should receive an orientation, either individually or in a group. Because of the ways they’re recruited, it’s probably more likely that a new staff orientation will be individual (perhaps part of the initial meeting with the supervisor) and a new volunteer orientation will be in a group.

Orientation should include: The background of the organization Projects the organization is currently involved in A brief introduction to instrument in thesis, other staff and argumentative essay on unemployment volunteers, and their general responsibilities Location of instrument in thesis, supplies, equipment, and facilities Organizational culture – whether people tend to eat lunch together, for instance, how staff and volunteers interact with one another and with participants, how serious work time is comparison/contrast expected to be, how people dress for work, etc. What kinds of decisions staff and volunteers are expected to make for themselves and what they should discuss first with supervisors. Train staff and volunteers. There should be both initial and ongoing training for research staff and volunteers. Rubric? Good training makes both staff and volunteers more confident and more competent, and helps keep the organization moving forward. Training should cover such areas as: Methods or techniques that the research instrument, organization uses in its work General information about the field – essential theory, new discoveries, current work, etc.

This might include visits to essay rubric, or from people from research instrument, other organizations engaged in similar efforts. Information about the population or issue the organization is thesis concerned with Interpersonal skills – communication, conflict resolution, problem solving, cultural sensitivity, etc. Once new staff and research instrument volunteers have received their initial orientation and training, a large part of their supervisor’s job is to remain aware of what they’re engaged in, whether they’re having difficulties with it, whether they need more training in particular areas, and whether they’re actually doing what their job descriptions and the norms of the organization demand. A staff member may be struggling with one aspect of a particular project, or have a hard time relating to a particular participant. A volunteer may do a great job when she’s there, but may not always show up when she’s scheduled. These are practical supervisory concerns, and supervisors have to keep on top of lion essay kids, them and intervene when necessary to make sure that the staff member or volunteer keeps doing his job. You can monitor supervisees in a number of ways: Keep a file for every staff member or volunteer which includes: Progress on her assigned projects, tasks, or duties A job description (the staff member or volunteer should also have a copy) A record of volunteer hours Any written performance evaluations Records of conversations about the staff member’s or volunteer’s performance Records of any grievances filed by the volunteer or staff member Records or copies of any awards, commendations, letters of praise, etc., received by the staff member or volunteer, or by the organization on behalf of work that staff member or volunteer has done. Instrument In Thesis? Records of online, individual professional development – courses, continuing education units, conferences, etc. – by the staff member or volunteer. Copies of any contracts between the supervisee and instrument the organization.

Performance evaluations should be conducted once or twice a year. They are important for a number of lion essay kids, reasons. Good ones are formative, helping the staff member or volunteer to instrument, do the best job he can. They provide a record of the supervisee’s progress in gcse hospitality his job – his professional development, what he’s learned, and what he does particularly well. They let him know that the organization cares about the research instrument, job he’s doing, and that it’s important. On the other hand, if a staff member’s work is unsatisfactory, they provide a basis for firing him. In the gcse hospitality and catering, U.S., at least, it’s fairly difficult to fire someone unless you have good cause. If that cause is well documented – the nature of the instrument in thesis, problem, the number of warnings, the number and nature of writing a paper online, attempts to correct the problem, etc. – then there’s much less threat of a lawsuit or other action by the employee.

Supervisors should at least occasionally observe supervisees’ work, if that’s appropriate. It generally isn’t appropriate for a supervisor to observe a counseling or therapy session, for instance, unless the supervisee is new to research instrument in thesis, the field and belonging texts still training. Even then, most supervision depends on audiotape, and informed participant permission is research instrument in thesis necessary even for that. Some teaching and counseling may be observed unannounced through a one-way mirror or on gcse and catering videotape, but, again, a blanket permission from particpants is necessary. Other observations – of doctors and nurses, for example – take place as a matter of course.

In many health and human service situations, personal observation is relatively uncomplicated, and takes place regularly. Some workplaces allow for almost constant observation, since supervisors and supervisees may occupy the same working space, or do the research instrument, same work at the same time. Revisit the supervisee’s job description with her on a regular basis, to make sure that it accurately reflects her actual work. If not, depending on the circumstances, either the work should be adjusted to hospitality, more closely adhere to the job description, or the job decsription should be rewritten to better describe the real character of the job. Talk with the supervisee’s co-workers – or in research instrument the case of volunteers, the writing a paper, staff members they work with – to research instrument, catch problems before they become major, and to gather praise to offer as well.

In addition to lion essay kids, knowing what your staff and volunteers are doing, you should be working with them as well. This includes giving them new responsibilities, and keeping communication with them open. Research Instrument In Thesis? The following tips will all help make your supervision more effective and your organization more productive. Constantly challenge workers to try new things and accept new responsibility. Thesis Activity Theory? Delegate responsibility whenever you can.

By encouraging professional growth, you will encourage staff members and volunteers to fully buy into research in thesis, your organization, and that is what can help your agency take off. Make sure that the lines of communication are wide open. This is absolutely necessary to ensure satisfied, dependable staff and belonging texts volunteers who get the job done and instrument in thesis make your organization successful. Make sure you are an comparison/contrast active listener – focus all your attention on the speaker, making sure there are no distractions, and that you are concentrating on the message the speaker is trying to get across. Instrument In Thesis? Try to keep those you are talking to from taking the defensive. A great way to do this is by using I instead of hospitality, you to start sentences. For example, I'm not sure I understand the approach you're taking on in thesis the media campaign.

Could you explain it to me? is likely to get a clearer, more open response than You aren't getting anywhere on the media project, are you? Make sure communication is complete; never assume that staff members or volunteers know what is supposed to be done or how you feel about a certain issue. Provide regular feedback both formally and informally to lion essay kids, those you supervise. Formal feedback may take place on an annual, biannual, or quarterly written evaluation forms. Informal feedback may not be much more than aa simple Hey! That looks great! Have you thought about adding this? when going by someone's desk. When providing formal feedback (either oral or written), you should strive to: Describe a worker's behavior instead of judging it Always appraise workers on research instrument how they are meeting or exceeding clear, predetermined standards Praise, praise, praise, the worker for strong or increased performance Decide whether other forms of feedback, such as self-assessment or peer review, would be appropriate at your organization to complement supervisory feedback.

Informal feedback shouldn’t be a sometime thing. there’s the offhand comment described above, but informal feedback can and should include regular meetings to discuss the job, the staff member’s or volunteer’s feelings about it, whatever questions he has, what he’d like to add to his responsibilities (or get rid of), etc. In many situations, it’s also important to help supervisees sort out the personal issues they bring to their work (remember the example about Pilar), and thesis how those issues affect what they do. This kind of supervision, as we discussed earlier, should take the form of a partnership. Supervisor and supervisee work together to find the best ways for the supervisee to learn and practice new skills, solve problems, resolve conflicts, and continue to improve in her job. This partner relationship should be the basis for research in thesis all supervision, and even when the supervisee is being held accountable for poor performance or unprofessional behavior, supervision shouldn’t feel like a power play, but rather like an interchange between equals with different responsibilities.

If there is a problem, intervene. Sometimes, even in the best of belonging, agencies, a staff member or volunteer isn't working up to instrument, potential or is causing interpersonal or other problems. In either situation, it’s the supervisor’s job to intervene, with sensitivity to everyone’s needs – the person in question, the other staff and volunteers affected, and the needs of the organization: Cool off first. Words spoken in the heat of the moment often become personal criticism instead of an objective comment on belonging essay the problem. Seek privacy. Don't confront the employee or volunteer in public or in a degrading manner. (And don’t make it obvious to everyone that you’re about to confront her – no “I want to see you in research my office NOW!”) Be as supportive as possible: this is a chance to argumentative essay, find out why she is not working as well as you might like, or why she’s disruptive.

You may be able to find out what’s behind the instrument, problem, and in doing so, find a way to help her transform into a real asset to the organization. Occasions do arise that require a supervisor to step in and deal with a problem. You should have set guidelines to cope with any problem that may surface. If the problem is poor job performance, you should: Clearly state what it is that you find deficient. Texts? Give specific examples. You're not working hard enough, isn't as helpful as, You often don't have the newsletter articles written by the weekly deadline.

It's also harder for instrument the employee to refute. Thesis Activity Theory? Give the employee the opportunity to describe his perspective, and really listen to what he has to say. It may well be there are reasons for instrument the problem that you aren't aware of. Note the requirements to fix the problem; then solicit employee ideas on corrective measures. Lion Essay Kids? Notify the employee of the instrument, consequences of continuing problems.

Monitor the employee's progress and explain (and apply) the gcse hospitality, consequences of failing to correct the problem. If the problem is a policy violation, you should: Listen. Give the employee the chance to explain her actions. You may want to deal very differently with problems that occurred for different reasons. Research? For example, the employee who took a four-hour lunch because his three year old broke her arm and he forgot to call might elicit more of your sympathy than the lion essay kids, employee who took a four-hour lunch for that great sale at the clothing store. Act objectively. Concentrate on dealing with the problem, rather than the research instrument, personalities involved.

Assume responsibility. Do not hide behind the rules or apologize for what you are doing. Your job is to enforce the rules. Give a clear warning that defines what will happen if such behavior happens again. Be sympathetic, but also be firm. The second time something of a similar nature happens, the lion essay kids, consequences defined earlier should be carried out in an immediate, consistent, and impersonal manner. The supervisors are not the in thesis, only ones in your group who have responsibilities to the group. Belonging? The following are some of the instrument in thesis, responsibilities of a good employee or volunteer. Be open and honest with other members of the organization regarding intent, goals, needs, and skills Understand the duties and time requirements of assignments before accepting them, and fulfill the belonging texts, commitment to the best of your ability Work to deserve being treated as a recognized and instrument in thesis respected member of the team Take the commitment seriously enough to participate in planning and argumentative essay evaluating the research, program and in training and comparison/contrast essay rubric learning opportunities Share ideas with others View other staff members and volunteers as allies that you can learn from Respect the research, confidentiality of the organization and its clients Seek, accept, and use honest feedback on performance Serve as goodwill ambassadors for your organization and its services to the community Be informed of change when it is needed.

The Florida Literacy Coalition’s Chapter 7: Supervision and Management of Volunteers , by Noemi Aguilar, is an argumentative example of how to in thesis, create a volunteer management program and why it is argumentative essay on unemployment crucial. Managing Volunteers: Balancing Risk and Reward , by Nonprofits’ Insurance Alliance of California and Alliance of Nonprofits for Insurance. Stress-Free Volunteer Supervision by Massachusetts Service Alliance, contains share worthy tips that will increase the likelihood for staff members to view volunteers as a way to research in thesis, ease their workload, not add to essay texts, it. Blanchard, K., Johnson, S. (1982). The one minute manager . New York, NY: William Morrow. Fisher, J. C., Cole, K. Research Instrument In Thesis? M. (1993). Argumentative On Unemployment? Leadership and instrument management of volunteer programs . San Francisco: Jossey-Bass. Goehring, E. (1993). Building a better staff: Vol.

2. Developing and keeping top notch staff . Frederick, MD: Aspen. Vineyard, S. Online? Basic volunteer management training packet . Heritage Arts. To order: phone (708) 964-1194 fax (708) 964-7338. Westheimer, I. J. In Thesis? (1977). The Practice of Supervision in Social Work . London: Ward Lock. Wilson, M. Argumentative On Unemployment? (Speaker). Instrument? How to motivate volunteers and belonging texts staff; How to plan for volunteer and staff success ; and instrument Recruiting and lion essay kids interviewing volunteers . Instrument? Video and Audio Cassettes.

Volunteer Management Associates. Lion Essay Kids? To order, call (800) 944-1470; for inquires, call (303) 447-0558. Wolf, J. (1991). Making things happen: How to be an effective volunteer . Instrument? Washington: Island Press. Monthly, Bimonthly, or Quarterly Publications Citizen Participation and Voluntary Abstracts. Association for Research on Nonprofit Organizations and Voluntary Action (ARNOVA)

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33 Writing Contests for research, Teens (Publication #038; Cash) In a world where J.K. Rowling#8217;s manuscript of #8220;Harry Potter#8221; was rejected 12 times and Kathryn Stockett#8217;s manuscript of #8220;The Help#8221; was rejected 60 times, it can be easy to become despondent about publishing your fiction, even more so for teenage writers aching to voice their thoughts to argumentative on unemployment, the world. However, there#8217;s an abundance of writing competitions year round for teens and writing contests for high school students #8212; you just need to know where to look. Research Instrument In Thesis? Here, I compiled a list of a paper online 33 writing contests for in thesis, teens. Genres include: fiction, poetry, nonfiction, screenplays, and essay on unemployment, plays. Some of these contests may sound like the competition is too stiff, especially if the organization receives thousands of submissions every year. But speaking from personal experience, you never know unless you try. In Thesis? Rejections will pile up for young authors, but so will acceptances accompanied by whoops and writing, fist pumps. Instrument In Thesis? Additionally, the experiences offered by certain teen contests such as working with professionals, revisiting your work, and perhaps even seeing it come to life either in a publication or on stage is indescribably rewarding and gratifying. So, young writers, submit on!

The theme is #8220;Making Meaning out of Ocean Pollution,#8221; and it challenges you to research, explore, interpret, and say something meaningful about the connections between human activities and the health of our oceans. Prizes range from $100-$1,500. Grades: Middle school High school. This is an anthology to look back on the past and view your younger work with pride. The author of the poem must have been age 15 or younger when the poem was written, and 18 or younger when submitted.

Ages: 18 or younger. Number of submissions: #8220;Thousands#8221; are submitted, 50 are chosen. If you have a novel over argumentative essay, 20,000 words, submit it to this contest where a community of readers will read your story. The more they love it, the better chance you have of winning a publishing deal. Think of it as American Idol for your novel . Plus, all published authors with Inkitt receive these great perks: $6,000+ invested into your book launch 25% royalties on every copy sold Cover design and research instrument in thesis, professional editing Publicity on writing online Amazon (over 90% of their books become bestsellers right after launching) This is a fantastic contest that can get you a ton of exposure and research, even result in a book deal. Read the reviews on their website and writing online, submit today. It#8217;s free and easy to upload your manuscript and have readers start reading your work immediately. Any and all types of writing are welcome. Long short stories, short short stories, prose poetry, traditional poetry, blackout poetry, creative accounts of your life and experiences, essays about yourself, essays about what you love, plays, scripts, letters, lists, rants, lyrics, journal writing. The Princeton University Poetry Contest recognizes outstanding work by research instrument in thesis student writers in the 11th grade.

Prizes: First Prize – $500, Second Prize – $250, Third Prize – $100. Students in belonging texts the 10th, 11th, and 12th grades enter in one of the following categories: poetry (a group of research instrument in thesis three poems), fiction (a short story or one-act play), or nonfiction (a personal or academic essay). First-place winners in essay texts each category are awarded a prize of in thesis $500; second-place winners receive $250. If you need help turning that book idea into a real manuscript, there is no better book than #8220;Go Teen Writers.#8221; From secret revision techniques to character advice, this helpful book will help get you to the next level of writing. Teen literary magazine published quarterly.

Seeking writers ages 13-18 to submit fiction, novel excerpts, poetry, plays, nonfiction, new media, and cross-genre. Submit your best one-act play (one per lion essay kids playwright!) to the New Voices competition and you can potentially win cash, software from fabulous sponsors Final Draft and Great Dialogue, and even publication! Ages: 19 or younger. Eligibility for this annual playwriting contest is limited to students in the eleventh grade. Prizes: First Prize – $500, Second Prize – $250, Third Prize – $100.

The jury consists of in thesis members of the Princeton University Program in Theater faculty. Gcse Coursework? Through Lewis University, Jet Fuel Review is run entirely by research students under the supervision of faculty advisers Dr. Simone Muench and Dr. Jackie White. Jet Fuel Review is looking for quality in writing, whether it be in thesis activity theory poetry, prose, non-fiction, or artwork. Submission periods: August to October; January to March. Since 1923, the Scholastic Art Writing Awards have recognized the vision, ingenuity, and talent of in thesis our nation’s youth. Through the Awards, students receive opportunities for recognition, exhibition, publication, and scholarships.

Students across America submitted nearly 320,000 original works during our 2016 program year across 29 different categories of art and activity, writing. Submissions period: September to research instrument, December. In this handbook for young writers, #8220;Spilling Ink,#8221; professional authors give advice to teens who want to online, become authors. By mixing personal anecdotes with practical advice, this book offers everything a young author will need to create incredible stories. One Teen Story is an award-winning literary magazine for readers and writers of young adult literature. Subscribers receive one curated and edited work of short fiction each month in the mail or on instrument their digital devices. Submission period: September to May. 13.

The Claremont Review. The editors of the Claremont Review publish the comparison/contrast essay best poetry, short stories, short plays, visual art, and photography by young adults. Research Instrument In Thesis? We publish work in many styles that range from traditional to modern. We prefer pieces that explore real characters and reveal authentic emotion. Submission period: September to April. Sponsored by Hollins University, the Nancy Thorp Poetry Contest is in its fifty-second year. The contest awards prizes for the best poems submitted by young women who are sophomores or juniors in high school or preparatory school. Prizes up to $5,000 are awarded to winners.

Winners are chosen by students and lion essay kids, faculty members in instrument in thesis the creative writing program at Hollins. Each year, young writers with and without disabilities, in U.S. grades 6-12 (or equivalents) or ages 11-18 for non-U.S. students, are asked to lion essay kids, explore the disability experience through the art of research instrument in thesis script writing for stage or screen. Writers may craft scripts from their own experiences and observations, create fictional characters and settings, or choose to write metaphorically or abstractly about the disability experience. Winners in these divisions will receive $500 for arts programs at their schools. Grades: 6-12 OR Ages: 11-18. The National YoungArts Foundation identifies and nurtures the most accomplished young artists in and catering the visual, literary, design and performing arts and instrument, assists them at critical junctures in their educational and argumentative, professional development. Additionally, YoungArts Winners are eligible for nomination as a U.S. Presidential Scholar in the Arts, one of the nation’s highest honors for instrument in thesis, high school students who exemplify academic and writing a paper, artistic excellence.

Ages: 15-18 OR Grades: 10-12. The Critical Pass Review is now accepting submissions online for its Critical Junior Poet#8217;s Award Contest, an editor#8217;s choice award for exceptional promise in the art of poetry. Applicants between the ages of 13 and 18 can enter for free. The winner will receive a $100 cash prize, a $20 iTunes card, a CD of master poets reading their poetry, publication of his/her winning work in The Critical Pass Review #8216;s Summer 2016 issue, and more. Submissions period: November to March. #8220;Leap Write In!#8221; is from acclaimed author Karen Benke, who does a fantastic job helping teen writers to generate ideas for instrument in thesis, their next story. This book has an amazing spread of writing prompts, all designed to get your heart on the page and the reader#8217;s heart in their throat. The Patricia Grodd Poetry Prize for Young Writers recognizes outstanding young poets and essay, is open to high school sophomores and juniors throughout the world.

The contest winner receives a full scholarship to research in thesis, the Kenyon Review Young Writers workshop. The Glazner Creative Writing Contest is an opportunity for high school juniors and seniors to argumentative essay on unemployment, compete for a chance at publication in Santa Fe University of Art and Design’s online journal, Jackalope Magazine . To enter, students must submit up to 10 pages of work in any genre to our contest email address ( #117;de.#121; 1507225691 #116;#105;#115;#114;#101; 1507225691 v#105;nu#101; 1507225691 #102;#97;tn#97; 1507225691 #115;#64;tse 1507225691 #116;#110;o#99; 1507225691 ). Deadline: November to December. The Young Authors Writing Competition is a national competition for high school writers of fiction, creative nonfiction and poetry. It began as a local contest in 1995, and since then has expanded into a national competition that has received tens of thousands of submissions from students across the country. Research Instrument? 1st Place: $300, 2nd Place: $150, and 3rd Place: $50. Submission period: November to January. The OddContest is an theory annual competition for speculative (science fiction, fantasy, or horror) stories or prose poems no longer than 500 words. Prizes: $50 to first place; Odyssey Con membership and free books to top 3. Research? Ages: 18 or younger. Selected writers will be invited to New York, expenses paid, for our Young Playwrights Conference to work with some of texts this country’s most exciting professional theater artists, and to hear their plays read in our Off-Broadway Readings Series. Accepting Fiction, Creative Non-Fiction, Poetry, and Essays.

Winners and Finalists will be recognized at instrument the 7th Annual University of Idaho Hemingway Festival, and cash prizes will be awarded in each category. Winners will also be considered for publication in belonging essay texts an online University of Idaho publication. There will be one winner and one Finalist in each category with one Overall Grand Prize Winner. Cash prizes up to $500. Interlochen Arts Academy is a high school boarding school and research, summer camp. Comparison/contrast Essay Rubric? It online literary journal accepts submissions from high school students in five categories: Fiction, Non-fiction, Poetry, Screen/Stageplay and Hybrid form. Research Instrument In Thesis? Up to 6 pieces total. Submissions Period: February to March. Aerie International was born of a desire to offer outstanding young writers and artists an opportunity to share, edit, and publish their work internationally. What makes this journal unique is that it is designed, edited and published entirely by high school students. Students whose work is argumentative on unemployment, selected received $100 in addition to a copy of the research in thesis magazine.

Focusing on themes central both to the Holocaust and to ethical decision making in our world today, the contest gives students from public, private and parochial schools the opportunity to share their creative works in response to survivors’ oral testimonies. Participating schools may submit a total of essay on unemployment three entries from three individual students in research instrument in thesis the following categories: art, film, prose, and/or poetry. #8220;Writing Magic#8221; is for every young author who wants to create a world that magically transports the reader. Belonging? She focuses on the core advice every writer needs: how to write beginnings and endings, how to research instrument, create unforgettable characters, and how to write snappy dialogue that keeps readers laughing and crying. The festival includes plays written in lion essay kids workshops at Writopia’s labs across the country and plays submitted to our competition from playwrights around the research instrument in thesis world from argumentative, playwrights in 1st through 12th grade (ages 6 to 18). Plays are professionally produced in New York.

Grades: 1-12 OR Ages: 6-18. Since 1993, 12 plays are chosen by a panel of theatre professionals from submissions across America. Winning playwrights are provided careful mentoring and direction from research instrument, industry professionals to help prepare their work for public performance and comparison/contrast rubric, hone their skills, talent and confidence. Nowhere else in the nation can young playwrights receive the research instrument prize of seeing their vision come to life on lion essay kids stage in research a professional production featuring known actors from film, television and theatre. Hospitality And Catering? The plays are crafted by seasoned professional directors and each is given several public performances in a month-long Festival.

Each year the Austin International Poetry Festival (AIPF) recognizes youth poets by instrument in thesis publishing their work together in a truly diverse anthology. We welcome international poets from kindergarten through high school grade level or age to submit up to three poems. Winter Tangerine is a literary journal dedicated to the electric. To the salt. The sugar.

We want bitter honey, expired swee ts. We want catalysts. Accepting submissions of poetry, prose, drama, visual art, and short film. Submission period: April to October. Activity Theory? The Adroit Journal, published at research instrument in thesis the University of Pennsylvania is texts, open to all writers. The Adroit Prizes for Poetry and Prose are awarded annually to two students of research secondary or undergraduate status whose written work #8220;inspires the masses to believe beyond feeling the work.#8221; In other words, we strive to receive the absolute best work from emerging young writers in high school and college, and the best of the best will receive these two lovely awards. Submission Period: To be announced. Essay? Hanging Loose Magazine is a professional magazine that welcomes high school submissions. Payment plus 2 copies. Send 3 to instrument in thesis, 6 poems, or 1 to 3 short stories, or an equivalent combination of poetry and prose to High School Editor, Hanging Loose, 231 Wyckoff Street, Brooklyn, NY 11217. Identify yourself as a high school age writer.

An online publishing opportunity for young writers. The New Pages Young Author’s Guide. A resource for young authors to find places to submit their work! Hi there#8230;#8230; Are these competition opportunities open to people outside of the USA? We are in South Africa and would love to comparison/contrast rubric, submit #128578; Thanks very much. Research In Thesis? I think many are, though you#8217;ll have to check with each one. Hey, I#8217;m also from SA! Would you like to chat on Whatsapp? Some say that deadlines are from September to May. Is this May 2017, or 2016?

May 2017, because the post was written only a few months ago. Cheers! There isn#8217;t much for some one who#8217;s 20. Thesis Activity? Are there any, I#8217;m from India. People who are in research instrument their 20s can apply to rubric, all the adult contests (meaning the majority of research in thesis writing contests out hospitality, there!) Thank you so much for this list! I#8217;ve been looking for a list like this for a while. Instrument In Thesis? Thanks! Could you please add our contest to this list as well? The name of our contest is Lifesaver Essays Essay Writing Contest and writing, the details can be found on our official webpage http://lifesaveressays.com/essay-contest. I am an instrument 11 year old living in New Zealand, I mostly do creative writing. Are any of gcse hospitality and catering coursework these contests for me?

Yes, most of them allow for international submissions. Instrument In Thesis? Hello Alex yes some of these essay contests can be for you it depends. I am a student myself in high school and live in San Diego California. The ocean essay could be for you since you are 11 years old. Hope this helped. Argumentative? Where do I turn in the essay. Where do we turn in the story ? If you want to submit to each contest, I would suggest visiting their website and following the guidelines. I am odudu uduak from Nigeria and l am 11. I love writing and in thesis, l want to know contest will permits international submission.

Many of these contests request #8220;previously unpublished work#8221; only. Belonging Texts? From your personal experience, what exactly does this mean? For example, would winning a regional-only award from Scholastic Art-and-Writing render the piece #8220;published,#8221; although (I believe) Scholastic works are not available for public reading/viewing until the national level? Or would you be allowed to still submit the award-winning work to a contest requesting #8220;previously unpublished#8221; content? Thanks in instrument in thesis advance! #128578; If the award didn#8217;t come with publication, then it#8217;s not published. It#8217;s only writing, published if it#8217;s online or available to the public. Research Instrument? Hope that helps! Submit away! Do you have any contest that has a deadline after march? Contests usually take breaks over the summer (holding to a school schedule), but check the deadlines above to make sure. I was wondering if these contests are for the year 2017?

The deadlines only mention the months, not very helpful. It was written in 2016. A Paper Online? Listing only the months keeps it perennially fresh, because the contests are often in the same months for each year. DO you have any for research, 7th graders? I am writing a short fiction story that I would love to enter.

Most of the middle school ones are for playwrights and poetry. Thank you very much. No, these are the only ones I have, sorry. do u have anything for 6th graders. hi we are running a short story writing contest for young writers. Comparison/contrast Essay? We thought you may be able to help the research young writers by spreading the word! here is the link! I#8217;m an editor at Teen Ink Magazine. We are a national magazine that has been publishing teens for over 25 years. In fact, we publish about 150 teens in each monthly issue.

We also run writing contests throughout the year. For more information, please go to: http://www.TeenInk.com. I am intetrested in short poem writing. Sometimes writing on comparison/contrast essay rubric social issues. Could you help me understand a little more how to instrument, go about getting my work known.

Make it the best you can make it, get friends to read it and hospitality coursework, give you feedback, and then submit to these contests. Thanks so much for the list! It was super helpful!

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case study pneumonia Department of Pediatrics, University of Hawaii John A. Burns School of Medicine. Chapter VI.11. Pulmonary Infections. Return to Table of Contents. A previously healthy 4 year old boy is brought to an urgent care center by his mother for difficulty breathing for one day. Three days prior he had developed a runny nose, cough, and low grade fevers with a temperature maximum of 101 degrees F (38.3 degrees C).

He continued to take liquids well, but his solid intake has decreased. His temperature this morning was 103 degrees F (39.4 degrees C) and he was breathing fast and working hard to in thesis, breathe. Belonging Essay? He does not have any ill contacts. He has never been hospitalized or had any surgeries. Research? He was born at term without any complications. He is not taking medications other than acetaminophen. His immunizations are up to date for lion essay kids, his age (except he had not received the in thesis pneumococcal conjugate vaccine). His parents and 10 year old sister are healthy and the remainder of his family history is non-contributory. There are no smokers in the household, and he has not traveled recently. He does not have a history of choking or vomiting.

He has not had frequent ear or skin infections. He does not have a history of writing a paper online foul-smelling stools. Exam: VS T 40 degrees C (104 degrees F), P 130, RR 40, BP 100/70, oxygen saturation 87% in room air. His height and weight are in the 50th percentile for his age. He is awake and research instrument in thesis alert, in argumentative on unemployment, moderate distress. His conjunctiva and TMs are normal. Research Instrument? His nasal mucosa is erythematous with yellowish discharge.

His lips and mucous membranes are dry. His neck is supple, with several small anterior cervical lymph nodes. Lungs: Moderate subcostal, intercostal, and supraclavicular retractions, symmetric expansion, dullness to a paper, percussion at the right base, increased vocal fremitus over the right base, decreased air entry over right lower lobe with crackles, no wheezes. Heart: Tachycardia, regular rhythm without murmur. Pulses are 2+, and capillary refill time is 3 seconds.

His abdomen, skin, and neurological examinations are unremarkable. CBC WBC 20,000, 70% segs, 11% bands, 15% lymphs, 3% monos, 1% eos. Instrument In Thesis? Hemoglobin 12.4, platelet count 280,000. Chest x-ray (CXR): Right lower lobe opacity consistent with a round pneumonia (technically air/space disease, commonly called infiltrates by most physicians). Because of the thesis activity theory hypoxia, he is research instrument in thesis, given supplemental oxygen (with subsequent improvement in oxygen saturation), as hospitalization arrangements are made. A 20 cc/kg infusion of normal saline was given through an intravenous (IV) line and then maintenance fluids are started. A blood culture is obtained and he is started on IV cefuroxime. He improves over the next day. Comparison/contrast Essay? His respiratory distress slowly resolves and he is research instrument in thesis, weaned off supplemental oxygen over the next two days.

His blood culture shows no growth. He is discharged home on comparison/contrast essay rubric high dose amoxicillin for a total of 10 days of therapy. His discharge diagnosis is research instrument, probably pneumococcal pneumonia. Acute childhood respiratory infections cause significant morbidity and mortality worldwide. Mortality is high in developing countries with up to one-third of essay texts deaths in children less than 5 years caused by acute respiratory infections (ARI) (1). The disparity in mortality is due to the severity of infection (perhaps due to differences in nutrition, overall health, immunization practices, and research instrument medical care availability) since the incidence of acute respiratory infections is similar between developed and developing countries with infants experiencing about 4-8 episodes per year (1).

In the US, mortality from ARIs has declined since 1968 (1,2). There are 2 basic classification systems used for acute respiratory tract infections: the case-management classification system used by the World Health Organization (WHO) and the traditional clinical classification system (1). The case management system divides ARIs by symptoms (i.e., stridor, wheezing, and no wheezing) and their severity (i.e., mild, moderate, severe, and very severe). The traditional system classifies ARIs by upper respiratory tract infections (e.g., acute otitis media, pharyngitis), middle respiratory tract infections (e.g., croup and epiglottitis), and lower respiratory tract infections (e.g., bronchiolitis, bronchitis, pneumonia). Therefore, studies evaluating ARIs are not uniform and use different definitions from clinical findings alone to clinical findings in thesis activity, combination with other various ancillary tests (e.g., chest radiography). Of the research in thesis acute respiratory infections, pneumonia has the highest mortality rate accounting for approximately 70% of the worldwide 4.5 million deaths from acute respiratory infections (4).

Although mortality from pneumonia in children in the United States has declined by 97% between 1939 and 1996 (5), pneumonia continues to be a leading cause of morbidity in children. The risk of thesis acquiring pneumonia is highest in children less than 5 years of age (1). The etiology of pneumonia varies and depends on: the age of the child, where the pneumonia was acquired (i.e., community vs. nosocomial), local epidemiology (e.g., influenza epidemics), host factors (e.g., immunologic status, recent or intercurrent antibiotic use, vaccination, and research overall health status of the thesis child), and environmental factors (e.g., travel, season of the year, daycare, or crowded living conditions) (4,6-9). Determination of the precise etiology of research in thesis pneumonia often requires invasive testing (e.g., lung biopsy), and therefore, this is argumentative essay on unemployment, done infrequently. Rather the etiology of pneumonia is usually based on generalizations in in thesis, the relevant clinical setting.

In the neonatal period, the most common cause of bacterial pneumonia is group B beta-hemolytic streptococci (GBS) and gcse and catering coursework gram negative enteric bacilli (e.g., E.coli), the instrument same organisms associated with neonatal sepsis (4). Writing A Paper Online? In infants and children outside of the neonatal period, viruses are the most common cause of pneumonia (4,6,10-11) and respiratory syncytial virus (RSV) is one of the most common causes in infancy, especially in premature infants (9,12). Of the bacterial pathogens, Streptococcus pneumoniae (pneumococcus) occurs most frequently (6,9,11,13); however, the studies isolating S. pneumoniae were performed prior to the licensure of the pneumococcal conjugate vaccine (6). In Thesis? Outcome analysis of the 7-valent pneumococcal conjugate vaccine demonstrated that up to 33% of chest radiograph confirmed pneumonia were prevented in immunized patients compared to those who were not immunized (14). Therefore, a different bacterial pathogen may supersede S. pneumoniae as the most common cause of bacterial pneumonia in the coming years. Other organisms to consider are Chlamydia trachomatis in infants 3-19 months of age (4) and Mycoplasma and thesis activity Chlamydia pneumoniae in children and adolescents (8-9,11-12). In special cases, for example, patients with neuromuscular impairment and impaired swallowing, aspiration pneumonia with anaerobic bacteria should be considered (15). The etiology of pneumonia varies in other conditions including immunosuppressed patients, nosocomial infections, cystic fibrosis patients, and anatomic airway anomalies (e.g., tracheostomies). In addition, the etiology of pneumonia is complicated since mixed infections (e.g., viral-bacterial) can occur in 16-34% of patients (7,11,13). The lower respiratory tract in healthy persons is sterile (16).

Bacteria access the respiratory tract by inhalation, microaspiration, or by in thesis, hematogenous spread. If bacteria gain access to alveoli, host immunologic systems begin to work on eliminating bacteria. There are 2 major mechanisms by thesis activity, which lung defenses work to keep the airways sterile: physical defenses (i.e., mucociliary clearance and lymphatic drainage) and mechanisms that destroy bacteria (i.e., opsonization, specific immunoglobulin G antibody (IgG), alveolar macrophage ingestion, or complement mediated bacterial lysis) (17). If these mechanisms fail, polymorphonuclear leukocytes (PMNs) are recruited with a resultant inflammatory response. Perpetuation of this inflammatory response leads to pneumonia. There are 4 major histologic steps seen in pneumococcal pneumonia described by Tuomanen, et al (18): engorgement, red hepatization, grey hepatization, and resolution. Engorgement is associated with presence of bacteria in the alveoli and an associated serous exudate.

This then progresses to red hepatization secondary to leakage of erythrocytes into the alveoli. The next phase, grey hepatization, results from leukocyte migration to in thesis, the affected area with intravascular fibrin deposition disrupting perfusion to the area. The final phase results in resolution, with phagocytosis of pneumococci and clearance of fibrin and other debris. Outside of the neonatal period, pneumonia is suspected in thesis activity theory, patients with clinical signs and symptoms suggestive of impairment of the lower respiratory tract. Distinguishing bacterial from other causes of pneumonia cannot be accomplished by clinical findings alone (7). Symptoms of pneumonia are nonspecific and include: fever, ill appearance, cough, fatigue, decreased appetite and sometimes, abdominal pain. Signs of research lower respiratory tract involvement include: tachypnea (greater than 50 breaths/minute in children less than 12 months, and essay greater than 40 breaths/minute for older children) (4), cyanosis, increased work of in thesis breathing (i.e., use of accessory muscles, grunting), pleuritic pain, and abnormal auscultatory findings. These signs do not differentiate a viral from bacterial process. A chest radiograph is used to verify the writing a paper clinical suspicion of pneumonia and characterize the disease process, but may not be performed on every patient. Viral respiratory tract infections are often associated with hyperinflation, perihilar peribronchial infiltrates, segmental or lobar atelectasis, and hilar adenopathy (19). Instrument? Lobar consolidation and essay texts fluffy alveolar infiltrates with air bronchograms are more characteristic of bacterial infection (13).

However, there is overlap between these two groups (13). Computed tomography and ultrasound of the chest are used in special circumstances (e.g., evaluate for pleural effusion, adenopathy, improved imaging of lung architecture) but these are not routinely obtained (4). Commonly used screening laboratory tests such as white blood cell count with differential, erythrocyte sedimentation rate (ESR), and the C-reactive protein (CRP) are not accurate in research instrument in thesis, differentiating between bacterial, viral, mixed, or idiopathic causes of childhood pneumonia (7). Determination of precise etiology of pneumonia is difficult due to the lack of sensitive and specific tests. Many clinicians treat pneumonia empirically with minimal laboratory or radiographic evaluation and thus up to 80% of non-bacterial pneumonia may be treated with antibiotics (6).

This approach is satisfactory when clinical risk is deemed to belonging, be low. When a more precise diagnosis is required, more invasive techniques are required. Bacteria found in the blood, pleural fluid (thoracentesis), or lung tissue is instrument in thesis, considered diagnostic in a patient presumed to gcse and catering coursework, have pneumonia (4). Blood cultures are only positive in 1-8% of pneumonia (11) but continue to be recommended (4). Some question the necessity of blood culture after cost-based analyses (6, 11).

Transthoracic needle aspirates, transtracheal aspirates, and open lung biopsy (the gold standard for diagnosis) are rarely performed due to the risk involved for these procedures (11,20), except in severe cases or in immunocompromised hosts (4). Sputum is often contaminated with organisms unrelated to the specific etiology (16) and is difficult to obtain in children less than 8 years old (4). A sputum sample that may be helpful is characterized by many polymorphonuclear cells and a bacteria of single morphology on gram stain (4). In Thesis? Bronchoalveolar lavage from bronchoscopy is difficult to interpret as well. The results are non-specific (i.e., higher neutrophil counts than lymphocyte counts in patients with infection) and the organism found may or may not be the etiologic agent (16). Bacterial serology and bacterial antigen testing are often difficult to interpret (4,6). Bacterial cultures of the nasopharynx or throat correlate poorly with lung tissue cultures and are not helpful in establishing a diagnosis (16). Specific viral antigen testing, along with cultures for suspected pathogens, serologies for Mycoplasma and Chlamydia, and PPD skin testing for tuberculosis may be helpful (6). Pneumonia is treated with antimicrobials when the clinical suspicion for writing a paper, bacterial etiology is high. Research Instrument In Thesis? Greater pneumonia severity and findings that are consistent with bacterial pneumonia (e.g., lobar consolidation, leukocytosis, high fever) are more likely to warrant antimicrobial treatment.

Young infants, unreliable parents, poor access to medical care, and more severe infections often require hospitalization. Treatment of pneumonia is often empirically based and thus, information on antibiotic resistance patterns and mechanisms of resistance is important to determine the thesis activity theory most appropriate treatment. For S. pneumoniae, the most common mechanism of resistance to penicillins is alteration of penicillin-binding sites that can be overcome with higher doses of the research instrument drug (6). For macrolides, alteration to the 50S ribosomal binding site of the macrolide inhibits binding of the antibiotic and thus, prevents protein synthesis inhibition (6). In addition, there is also an increase in efflux pumps for macrolides and this property can be overcome by using macrolides that achieve high tissue concentrations at the site of infection (e.g. azithromycin) (6). Penicillin resistant pneumococci are often resistant to multiple drugs including macrolides and trimethoprim-sulfamethoxazole (21).

Therefore, high-dose amoxicillin and/or azithromycin are recommended for empiric treatment of community-acquired pneumonia in children (6,8-9,11-12,20). Some clinicians will use clinical factors and ancillary tests in aggregate such as age, exposures, CXR pattern, fever, and a paper leukocytosis, to stratify the risk to instrument in thesis, favor pneumococcus (high dose amoxicillin would be better) or Mycoplasma/Chlamydia (macrolide would be better). For those children requiring hospitalization, a second or third generation cephalosporin, occasionally in combination with a macrolide, is generally recommended (8,20). Most treatment regimens are continued for a total of 7-14 days although this is thesis, based on little evidence (4). Pneumonia due to Staphylococcus aureus is uncommon, but particularly severe. Research Instrument In Thesis? S. aureus pneumonia usually results from inhalation of organisms, but it may also occur in patients with a cutaneous source (e.g., impetigo, boils, abscesses) with hematogenous spread or staphylococcal bacteremia from another source (e.g. Lion Essay Kids? osteomyelitis, central line infection). If S. aureus pneumonia is instrument in thesis, suspected, vancomycin should be started empirically. Culture and sensitivity data permits changing to an alternate antibiotic later.

Pleural effusion (empyema), pneumothorax, and comparison/contrast pneumatoceles often complicate S. In Thesis? aureus pneumonia. Pleural effusions can be classified in several ways. They can be a transudate or an exudate based on their protein content. A subpulmonic effusion versus an empyema is more clinically relevant. The former implies a transudate which is usually sterile, while the term empyema is usually used to describe pus (purulent exudate) with a positive gram stain and culture. The overall outcome in children with pneumonia is excellent. A Paper? The majority of children will recover without complications (11). Follow up chest radiographs are not required routinely, but should be performed for patients with complicated pneumonia, persistent respiratory problems, pleural involvement, and neonates (4,22).

About 80% of in thesis infiltrates on lion essay kids CXR will resolve by 3-4 weeks and the remainder will usually resolve by 3 months (22). Recurrent pneumonia with radiologic clearance between episodes requires further evaluation (e.g., immunodeficiencies, gastroesophageal reflux, pulmonary anomalies, etc.) (4). Bronchiolitis is the leading cause of hospitalization for respiratory tract infections in young children (4,23-25). Research Instrument In Thesis? Respiratory syncytial virus (RSV) is the gcse hospitality primary cause of bronchiolitis, but parainfluenza virus, human metapneumovirus, and research adenovirus may also cause bronchiolitis (23-24). In the United States, the majority of RSV infections occur during the months of November to March (4,23). RSV infections account for a significant amount of morbidity and thesis activity health care expense in the young age group (24). RSV is transmitted by direct contact with large droplets or fomites. Transmission can be limited by good handwashing (23). RSV bronchiolitis results from the spread of RSV to instrument in thesis, the lower respiratory tract after an incubation period 2-8 days where the virus undergoes replication in the nasopharynx (23).

The infection results in lion essay kids, infiltration of the respiratory epithelium with resultant inflammation and research instrument in thesis necrosis, sloughing of the epithelium and increased mucus production causing airflow limitation in the small airways leading to the hallmarks of the disease (23). Thus, affected infants have signs of airflow limitation including hyperinflation, atelectasis, and wheezing. The diagnosis is often made on clinical grounds during the RSV season. Diagnostic testing can be done by immunofluorescence and thesis theory enzyme-linked immunoabsorbent assay (ELISA) tests if the research diagnosis is unclear. Therapy is often supportive which may include: supplemental oxygen, fluids, and essay texts upright positioning. Aerosolized ribavirin is the only known proven therapy for RSV infection, but its expense, potential toxicity, difficulty of administration, and lack of research instrument conclusive evidence for its efficacy (24,26) limit its use. The use of bronchodilators and corticosteroids are controversial and may only lion essay kids, be mildly effective at best (i.e., not been proven to be highly efficacious) (24-26).

For those with moderate to research in thesis, severe disease, helium-oxygen mixtures or nasal continuous positive airway pressure may be beneficial in improving gas-exchange and symptomatology (27-30). Montelukast, a leukotriene antagonist, has recently been reported to make a difference in activity, future wheezing episodes (31). Prophylaxis with palivizumab (RSV monoclonal antibody) or RSV-IVIG is given to select pediatric populations recommended by the American Academy of Pediatrics during RSV season to reduce RSV infection risk (32). Growing premature infants and research instrument in thesis infants with congenital heart disease and lion essay kids other chronic lung conditions are at increased risk for RSV pneumonia, apnea and research instrument in thesis respiratory failure. Healthy term infants with RSV usually develop mild bronchiolitis. Older children, teens and essay adults with RSV will usually have cold symptoms.

Bronchiolitis is usually a self limited disease and research complete resolution takes about 4-8 weeks. In neonates and young infants, bronchiolitis may present with apnea and minimal respiratory symptoms, but the apnea is usually short-lived (33). Although bronchiolitis self-resolves, patients with RSV bronchiolitis may be predisposed to future episodes of wheezing (34). RSV infection can recur since there is an incomplete and gcse hospitality and catering poorly sustained immune response (23). In summary, bronchiolitis and pneumonia significantly impact the pediatric population. Determining likely etiologies of pneumonia and research in thesis understanding effective treatment modalities will improve patient outcomes. Acknowledgments: I would like to thank Edward Fong, MD, Leslie Barton, MD and John Mark, MD for their critical review of the chapter. 1. Which of the following is the most common cause of pneumonia outside of the neonatal period? 2. S. Hospitality? pneumonia resistance to penicillins is instrument, due to: . . . . . a. Production of beta-lactamase.

. . . . . b. Alteration of comparison/contrast rubric penicillin binding proteins. . . Research? . . Argumentative On Unemployment? . c. Increased efflux pumps. . . . Instrument In Thesis? . Thesis Activity? . d. Research In Thesis? Low tissue bioavailability. 3. True/False: Nasopharyngeal and throat cultures are useful in determining etiology of bacterial pneumonia. 4. True/False: Lobar consolidation on chest x-ray provides conclusive evidence for bacterial pneumonia. 5. Which factor does not appear to affect the etiology of pneumonia?

. . . . Rubric? . b. Vaccination status. . . . . . Research? c. Current antibiotic use. 6. The most common cause of bronchiolitis is: . . . . . a. Respiratory syncytial virus. . . Essay? . . . Instrument? b. Human Metapneumovirus. 7. True/False: Bronchiolitis may initially present with apnea and gcse coursework minimal respiratory symptoms. 8. Treatment of bronchiolitis should include all of the research instrument following except: a. Supplemental oxygen for argumentative on unemployment, infants with hypoxia. Research Instrument? b. Intravenous fluids and close monitoring of nutritional status. c. Good handwashing. Texts? d. Antibiotics. 9. True/False: Corticosteroids and bronchodilators are highly efficacious therapies for RSV bronchiolitis. Pneumonia case presenting with abdominal pain: Yamamoto LG. Abdominal Pain with a Negative Abdominal Examination. Research In Thesis? In: Yamamoto LG, Inaba AS, DiMauro R (eds).

Radiology Cases In Pediatric Emergency Medicine, 1994, volume 1, case 3. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v1c03.html. Staph pneumonia case: Yamamoto LG, Young LL. Tachypnea and Abdominal Pain. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1995, volume 2, case 5. Argumentative On Unemployment? Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v2c05.html. Series of research instrument pediatric chest radiographs: Yamamoto LG. Test Your Skill In Reading Pediatric Chest Radiographs. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1995, volume 3, case 20. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v3c20.html.

Another series of pediatric chest radiographs: Yamamoto LG. Test Your Skill In Reading Pediatric Chest Radiographs. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1996, volume 4, case 5. Thesis? Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v4c05.html. 1. Graham NMH. The Epidemiology of instrument in thesis Acute Respiratory Infection in Children and Adults: A Global Perspective.

Epidemiol Rev 1990;12:149-178. 2. National Center for Health Statistics. National Vital Statistics report (www.cdc.gov) 2001;49(1):14. 3. Dixon RE. Comparison/contrast? Economic Costs of Respiratory Tract Infections in the United States. Research Instrument In Thesis? Am J Med 1985;78(6B): 45-51.

4. Activity? Miller MA, Ben-Ami T, Daum RS. Chapter 39-Bacterial Pneumonia in instrument in thesis, Neonates and Older Children. In: Taussig LM, Landau LI (eds). Pediatric Respiratory Medicine, first edition. 1999, St. Louis: Mosby, pp. Belonging Essay Texts? 595-664. 5. Dowell SF, Kupronis BA, Zell ER, Shay DK. Mortality From Pneumonia in Children in the United States, 1939 Through 1996. N Engl J Med 2000;342(19):1399-1407.

6. Bradley JS. Management of Community-Acquired Pediatric Pneumonia in an Era of Increasing Antibiotic Resistance and Conjugate Vaccines. Research? Pediatr Infect Dis J 2002;21(6):592-598. 7. Nohynek H, Valkeila E, Leinonen M, Eskola J. Activity Theory? Erythrocyte Sedimentation Rate, White Blood Cell Count and Serum C-reactive Protein in Assessing Etiologic Diagnosis of Acute Lower Respiratory Infections in in thesis, Children. Essay Texts? Pediatr Infect Dis J 1995;14(6): 484-490.

8. Nelson J. Community-Acquired Pneumonia in in thesis, Children: Guidelines for Treatment. Pediatr Infect Dis J 2000;19(3):251-253. 9. Heiskanen-Kosma T, Korppi MN, Jokinen C, et al. Etiology of Childhood Pneumonia: Serologic Results of lion essay kids a Prospective, Population-Based Study. Pediatr Infect Dis J 1998;17(11):986-991. 10. McIntosh K. Research Instrument? Community-Acquired Pneumonia in Children. N Engl J Med 2002;346(6);429-437. 11. Hospitality Coursework? Ruuskanen O, Mertsolon J. Childhood Community-Acquired Pneumonia.

Sem Resp Infect 1999;14(2):163-172. 12. Research? McCraken, GH Jr. Etiology and writing a paper Treatment of Pneumonia. Pediatr Infect Dis J 2000;19(4):373-377. 13. Korppi M, Kiekara O, Heiskanen-Kosma T, Soimakallio S. Instrument In Thesis? Comparison of Radiological Findings and Microbial Aetiology of argumentative Childhood Pneumonia. Acta Paediatr 1993;82: 360-363. 14.

Overturf GD, Committee on Infectious Diseases, American Academy of Pediatrics. Technical Report: Prevention of instrument in thesis Pneumococcal Infections, Including the thesis activity theory Use of Pneumococcal Conjugate and Polysaccharide Vaccines and Antibiotic Prophylaxis. Pediatrics 2000;106(2):367-376. 15. Brook I, Finegold SM. Bacteriology of Aspiration Pneumonia in Children. Pediatrics 1980;65(6):1115-1120. 16.

Laurenzi GA, Potter RT, Kass EH. Bacteriologic Flora of the instrument Lower Respiratory Tract. N Engl J Med 1961;265:1271-1278. 17. Green GM, Kass EH.

The Role of the Alveolar Macrophage in the Clearance of Bacteria from the Lung. J Exp Med 1964;119:167-175. 18. Tuomanen EI, Austrian R, Masure HR. Pathogenesis of Pneumococcal Infection. Lion Essay Kids? N Engl J Med 1995(19);332:1280-1284. 19. Wildin SR, Chonmaitree T, Swischuk LE.

Roentgenographic Features of Common Pediatric Viral Respiratory Tract Infections. Am J Dis Child 1988;142:43-46. 20. Hart CA, Duerden BI. Respiratory Infections. J Med Microbiol 2002;51:903-914. 21. Research Instrument? Whitney CG, Farley MM, Hadler J, et al.

Increasing Prevalence of Multidrug-Resistant Streptococcus Pneumoniae in the United States. N Engl J Med 2000;343(26):1917-1924. 22. Grossman LK, Wald ER, Nair P, Papiez J. Belonging Texts? Roentgenographic Follow-Up of Acute Pneumonia in Children. In Thesis? Pediatrics 1979(1);63:30-31. 23. Texts? Hall CB.

Respiratory Syncytial Virus and Parainfluenza virus. N Engl J Med 2001;344(25):1917-1928. 24. Greenough A. Respiratory Syncytial Virus Infection: Clinical Features, Management, and Prophylaxis. Research? Curr Opin in Pulm Med 2002;8:214-217. 25. Jartti T, van den Hoogen B, Garofalo RP, et al.

Metapneumovirus and Acute Wheezing in Children. Thesis Activity? Lancet 2002;360:1393-1394. 26. Patel H, Platt RW, Pekeles GS, Ducharme FM. In Thesis? A Randomized Controlled Trial of the activity theory Effectiveness of Nebulized Therapy with Epinephrine Compared with Albuterol and Saline in research in thesis, Infants Hospitalized for Acute Viral Bronchiolitis. J Pediatr 2002(6);141:818-824.

27. Hollman G, Shen G, Zeng L, et al. Helium-Oxygen Improves Clinical Asthma Scores in Children with Acute Bronchiolitis. Crit Care Med 1998;26(10):1731-1736. 28. Martinon-Torres F, Rodriguez-Nunez A, Martinon-Sanchez JM. Heliox Therapy in Infants with Acute Bronchiolitis. Pediatrics 2002(1);109:68-73.

29. Beasley JM, Jones SEF. Continuous Positive Airway Pressure in Bronchiolitis. Belonging Essay Texts? British Medical Journal 1981;283:1506-1508. 30.

Soong W, Hwang B, Tang R. Continuous Positive Airway Pressure by Nasal Prongs in Bronchiolitis. Pediatr Pulmonol 1993;16:163-166. 31. Instrument In Thesis? Bisgaard H for the Study Group on Montelukast and Respiratory Syncytial Virus. Essay? A Randomized Trial of Montelukast in Respiratory Syncytial Virus Postbronchiolitis. Am J Respir Crit Care Med 2003;167:379-383. 32. Halsey NA, Abramson JS, Chesney PJ, et al.

American Academy of Pediatrics: Prevention of instrument in thesis Respiratory Syncytial Virus Infections: Indications for the Use of Palivizumab and Update on the Use of RSV-IGIV. Thesis? Pediatrics 1998;102(5):1211-1216. 33. Bruhn FW, Mokrohisky ST, McIntosh K. Apnea Associated with Respiratory Syncytial Virus Infection in Young Infants. J Pediatr 1977;90:382-386.

34. Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B. Respiratory Syncytial Virus Bronchiolitis in Infancy is an Important Risk Factor for instrument, Asthma and Allergy at Age 7. Am J Respir Crit Care Med 2000;161:1501-1507. Answers to questions. 1.c. Overall, viruses cause the majority of pneumonias in children; however, the incidence of viral pneumonia decreases with age, becoming less common in lion essay kids, older children and adolescents.

4.False. Lobar pneumonias are more likely to be of bacterial etiology, but this is not definitive since some lobar pneumonias will still be viral.

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I love my friends. My boyfriend is amazing. Research Instrument In Thesis? I have four brothers. Three are older than me, one is younger. My best friend in the whole world is activity, Alex Michelle. My boyfriend , Zachary Ross, is my everything I'd be so lost without him.

My mom is amazing, she's always. ? My Narrative Essay I believe that “Love at first sight” is real. An actual feeling you get when you first lay eyes on that one special person. More special than anybody you’ve ever met. The person that your heart just immediately falls in love with and decides that it wants to spend eternity with that. when your boyfriend moved interstate to study. * The colors of a parade when you had your first sighting of Santa. * * 4 Write down what you were feeling at in thesis the time. Feelings are the mechanism through which you can evoke much of the descriptive elements in your essay . * . Across a Hundred Mountains Short Essay. Chicano/ Latino Short Essay Juana and Adelina’s Experience The novel Across a Hundred Mountains by Reyna Grande is a story about two young girls and their struggling journey to find happiness between two conflicting and distinct worlds: the United States and writing Mexico. Juana on one side wants to get. stay forever.

That became a ground shaking experience when I went into to instrument in thesis 6th grade and essay rubric all the friends that I had in elementary school were no longer my so called friends. So I learned how to make new ones, that was almost foreign to me. Since I grew up with those girls, I had always relied on them, we. famous for her essays and an interesting one is instrument, Living with Strangers, where Hustvedt enlightens us with her viewpoints on the two different types of living; suburban and urban. Siri Hustvedt shows exactly what a talented writer she is in this essay . Hustvedt manages to place the comparison/contrast essay Living with.

Descriptive Essay Rough Draft English 12A September 9, 2013 The Day I Found Out I Was Pregnant It was on April 28, 2013, the most exciting day of instrument, my life. On this day I found out that I am pregnant. At first I didn’t believe it, but then it hit me. Later that day I had to tell my boyfriend the news. E-structor Response Form (Your marked-up essay is argumentative essay, below this form.) HOW THIS WORKS: Your e-structor has written overview comments about your essay in the form below. Your e-structor has also embedded comments [in bold and in brackets] throughout your essay . Thank you for choosing Smarthinking's OWL;.

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The Stupidest Decision of My Life. At the age of 19 I made what my parents thought at the time to be the stupidest decision of my life, to move to Greenville, NC. I had grown up in Raleigh, NC and was desperate to get away, not only from my parents, who I believed to be quite controlling, but also away from the monotony of life as it. holidaying abroad. There are many destinations with exquisite panoramas in the world. Out of those Switzerland is the most preferred destination. In my opinion, Switzerland is the best travel destination because of the natural beauties, diverse cultures and food.

First of all, Switzerland is the best. I plan on giving it my all. I don’t plan on research giving up even after the completion of my bachelor’s degree. After, my completion I plan on getting a job as a Disability Service worker. While I am working there, I plan on belonging essay texts moving forward and research in thesis work on my master’s degree. So this is my journey on thesis returning. Essay 1 Drunk driving should be prevented at research instrument all costs.

There are multiple reasons why no one should get behind the wheel while being intoxicated. I strongly wish everyone would be more serious about drunk driving because of many reasons. You are not only putting yourself in danger but you are also. turning conflict to her own advantage. Argumentative? I will give a synopsis of the movie and the characters roles to each other and the main character. I will be sharing my own personal views and analyzing the difference in conflict and functions of instrument in thesis, communication and belonging essay power between the in thesis characters.

I will explain the purpose. connection with an thesis, author before, until I read an essay from this book called “The Women’s Open.” Sedaris’ way of writing is very unique. He begins most of these stories with a short passage that ends up foreshadowing an event that will later happen. “ My sister Lisa became a woman on the fourteenth hole. My Best Friend’s Girl The movie “ My Best Friend’s Girl” is research instrument in thesis, about a guy, who get dumped by his girlfriend and in desperation to get his girlfriend back, hires his friend to take her out on a worst date of her life just to comparison/contrast essay rubric show how great her former boyfriend is. This plan backfire him and his ex-girlfriend. • A formal essay has an opening paragraph that tells the reader what you're going to instrument in thesis tell him. It has at activity theory least 3 paragraphs to instrument elaborate on what you said in writing a paper the opening paragraph. Then it has a closing paragraph which summarizes what you've said. A formal essay never uses the research instrument words 'I' or 'me' or 'you.

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