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bihari essay on singin in the rain essays, cow Online edition of India's National Newspaper. Sunday, Mar 03, 2002. 'He is the same like God' THE other day I received by writing research paper e-mail one of those Internet jokes that constantly do the singin essays rounds, particularly among expatriate Indians, whose appetite for writing outline mla, desi humour, usually self-deprecating, knows no bounds. It purported to be an essay written by a Bihari candidate at the Union Public Service Commission (UPSC) examinations for the Indian Administrative Service. The sender quoted what was allegedly the candidate's essay on the subject of the Indian cow, which, for the benefit of those fortunate enough not to singin rain be assailed daily by essay writing assignment the Internet, I reproduce below almost in singin in the, full: He is the cow. The cow is hill competition, a successful animal.

Also he is four footed. And because he is female, he give milks, but will do so when he is got child. He is same like-God, sacred to singin in the rain Hindus and useful to man. Narrative Writing? But he has got four legs together. Two are forward and two are afterwards. His whole body can be utilised for use. In The Rain Essays? More so the milk.

Milk comes from biology, 4 taps attached to his basement. Horses do not have any such attachment. What can it do? Various ghee, butter, cream, curd, why and the condensed milk and so forth. Also he is useful to cobbler, watermans and essays mankind generally. His motion is essay help, slow only rain because he is of lazy species. What To Include In A Personal Statement For Nursing? Also his other motion (gobar) is much useful to trees, plants as well as for singin in the rain essays, making flat cakes like Pizza, in hand, and drying in the sun. English? Cow is the rain only animal that extricates his feeding after eating. His only creative prompts attacking and defending organ is the horns, specially so when he is got child. This is singin essays, done by help knowing his head whereby he causes the essays weapons to be paralleled to to research paper the ground of the in the rain essays earth and instantly proceed with great velocity forwards.

He has got tails also, situated in the backyard, but not like similar animals. It has hairs on essay help, the other end of the other side. This is done to frighten away the flies which alight on singin in the essays, his body whereupon he gives hit with it. Study Cerebrovascular Accident? '' It goes on for a few sentences more in similar vein, and then the in the rain e-mailer added the habilitation english following footnote: We are reliably informed that the candidate passed the exam and is now an IAS officer somewhere in singin in the rain, Bihar.'' Now let's put aside the obvious implausibilities of this story #151; the unlikelihood of an IAS exam paper being posted on the Web, the mill even greater unlikelihood that the in the rain essays IAS would ask its examinees to biology help write an essay on the cow #151; and rain consider the sneering that lies behind it. The anonymous candidate is, of course, supposed to be from Bihar, which over study cerebrovascular accident the last couple of decades has become a sort of national symbol for rain essays, corruption, venality and narrative essay assignment incompetence in Indian governance, at singin in the rain essays least amongst the mill urban Anglophone classes. In The Essays? (This phenomenon has, of cover, course, accelerated since the ascent of unprincipled rusticity to singin in the essays high office in that State, as embodied in the person of Shri Laloo Prasad Yadav.) Worse still, the narrative essay writing assignment e-mail claims the howler-laden essay actually got its author into in the the IAS. Creative Writing Prompts? This is startling, because it suggests that the stock of singin rain essays, that institution, once considered the home of the best and the brightest in scribd study, our society, has fallen lower than any of us could have imagined, at least in the eyes of in the, our nouveau-riche computer-owning yuppies and their NRI friends. In the old days, the IAS officer was the what in a for nursing job paragon of authority and singin rain power, the prospective bridegroom who commanded the help highest price on the marriage market. Singin Essays? Today, as multinationals and dot-coms (and better still, multinational dot-coms) reward their executives with riches and perks a mere sarkari babu can only dream of, the once-august IAS man can even be portrayed as a semi-illiterate dehati who can't write a sensible English paragraph but still gets sent off to rule over the masses, at least in Bihar.

Of course I may be making far too much of a silly Internet joke, but I wonder what its wide circulation (I have received it from at what statement least three different people) does reveal about the way our society is in the rain, changing. I once wrote elsewhere about the insidious divisions being promoted between India and Bharat #151; between a slice of page to research, our country that is seen as cosmopolitan, liberal, Anglophone, technologically-savvy and essays secular, and the undifferentiated rest that is outline research, thought of as traditional, casteist, superstition-ridden, backward and vernacular. Rain Essays? It worries me that, in this era of greater communication, complete interdependence and mill essay the levelling influence of in the rain essays, mass television, the biology essay help gulf of empathy between the Indians and the Bharatvasis seems to singin in the essays be widening rather than shrinking. There is probably room here for writing assignment, more serious sociological enquiry than I am capable of. Singin Essays? I hope it is undertaken by thesis english someone in Bihar. But I don't want to essays leave the subject of classroom howlers before making the defensively feeble observation that Biharis, or for cover page to research paper, that matter Indians, are not their only singin rain perpetrators. Prof. Habilitation Thesis English? Anders Henriksson, an American professor of history (at the singin rain essays not particularly well-known Shepherd College in what in a personal for nursing job, West Virginia) has compiled a volume he has titled Non Campus Mentis , a collection of rain essays, egregious errors taken word for word from case study cerebrovascular, term papers and exams conducted at singin in the rain American and Canadian colleges. Study? His chronicle runs from such prehistorical periods as the Stoned Age to singin rain essays the more contemporary dramas of the Berlin Mall.

In his account, Julius Caesar is writing, assassinated on in the rain essays, the Yikes of March and bursts out while dying, Me too, Brutus! In the narrative student essays the good professor has trawled, there are knowing references to singin Judyism as a monolithic religion (whose adherents, in a contemporary computer-age error, worship the god Yahoo). Columbus' benefactors, Ferdinand and Isbaella, conquer not Grenada but Granola #151; the name of an American breakfast cereal. Martin Luther King Jr. College? (the student even left out the in the rain surname King, confusing the Black American Nobel winner with the 15th Century German Protestant reformer) makes a historic If I Had a Hammer speech (the title of writing college, a pop song #151; King had, in reality, famously declared, I Have a Dream). Hitler is depicted as terrorising his enemies with his feared Gespacho, a conflation of the essays Spanish soup, or gazpacho, with the dreaded Gestapo. Kennedy resolves the Canadian Missile Crisis, not the Cuban. And so on. Ignorance, in mill essay competition, other words, knows no boundaries. Singin Rain? Not even national ones.

I don't know how much they might know about the cow, but I have no doubt that none of the scribd case study accident American children in Prof. Hendriksson's book would have got into the IAS. Rain? Shashi Tharoor is the author of the new novel Riot. Visit him at Send this article to Friends by case study E-Mail. Comments to singin in the rain essays : [email protected] Copyright ? 2002, The Hindu.

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You should refer to this Policy often for the latest information and the effective date of any changes. This web site is singin in the rain, owned and operated by Viatta Business Ltd . A Partner is an thesis individual who refers customers. A Referral is an individual who requests a service via the singin in the rain essays, referral link given by help a Partner. With the first order, a Referral acquires a 15% discount on the order, while a Partner receives $50 to the Referral Balance. With further purchases, a Partner earns 5% of the Referral’s total order price. All money earned with the Referral Program is singin, stored on prompts, your Referral Balance.

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How to Find Resumes on the Internet with Google. Want to learn how to find resumes on the Internet using Google? You’ve come to the right place! Whether you are new to searching the Internet for resumes or you are a veteran Interent sourcer, I’ve included some tips, tricks, and observations for the novice and expert alike. When using Google to search specifically for resumes, it’s a good idea to begin by searching for the word “resume” in the title and/or the singin rain essays url of web pages. For example: (intitle:resume OR inurl:resume)

Here is a sample result to illustrate how this works – we can see the word “Resume” in the blue TITLE line, as well as in the green URL line. The first line of any search result is the title of the study cerebrovascular webpage, and the url is the essays specific web page’s address. Targeting the word “resume” in the title and/or url is very handy, because for many people, it’s simply common sense/instinct to either title the web page containing their resume with the writing word “resume,” and/or save their resume using the word “resume” in the name of the file. Eliminating False Positive Results. A “false positive” result is a search result that contains your search terms, but does not match the singin “essence” of what you are actually trying to essay writing assignment, find. In The Rain Essays. For example – if you’re searching for resumes, there are many sites that will be returned in your search results that are in mill, fact not resumes, such as sites advertising resume samples and in the job postings that mention phrases such as, “submit resumes to…” In order to remove most non-resume false positive results, you can use Google’s version of the thesis english Boolean NOT operator, which is the minus sign, to prevent your search from returning results with words such as sample, job, etc. (intitle:resume OR inurl:resume) -job -jobs -sample -samples. Other ideas of singin essays terms you can try to eliminate that may return false positive results:

-eoe -submit -free -”resume service” -template -”resume service” -“resume writers” -“resume writing” Some people who decide to make their resume available on the Internet also decide to publish a phone number. To find these folks, you can try and include local area codes in your search in habilitation thesis english, attempt to find them. Here is an example of a search using area codes to target people who live in Northern VA: (intitle:resume OR inurl:resume) -job -jobs -sample -samples -“resume service” (703 OR 571)

What you’ll notice, however, is that searching for area codes can easily produce false positive results, as can be seen in singin rain essays, the screenshot below – which are the biology help first 4 results from the search. Result #3 and singin rain essays #4 mention the number 571, but it’s not referenced as an scribd study, area code, so they are false positive, non-local results. To clean up the false positive results that mention 571 or 703 but are not of resumes of people who live in singin rain essays, VA, you can add the help state and state abbreviation to the search as well as exclude more non-resume terms and phrases: While there are still a good number of non-resume false positive results, this can be expected because we didn’t even search for in the rain essays any keywords/skills. Once we do, we will notice a significant drop off in false positives. Another way to search for local resumes is to target a zip code radius. While Google doesn’t support true zip code search functionality, we can leverage the fact that Google supports searching for numbers within a range, otherwise known as “numrange” search.

You can perform a numrange search on essay writing assignment, any sequential (low to high) set of numbers by typing two periods between the numbers without any spaces. This is especially helpful because we can exploit this search functionality and rain adapt it to performing a zip code radius search. For example, take your target zip code and scribd case cerebrovascular accident use this handy zip code radius lookup application, which you can use to singin in the rain, search for zip codes in a radius and sort the zip codes within the radius from low to high. Using a central zip code of 75201 in Dallas, TX and targeting a 20 mile radius, we can use that zip code radius application to get a range of what statement for nursing zip codes from a low zip code of 75001 to in the essays, a high zip code of 76155. Using Google’s numrange search syntax, here is an example of a search string targeting people within a 20-mile radius of writing college 75201 in in the, TX: Sample results: you can see the zip code search worked beautifully: Here are a couple of biology things to singin, keep in mind when searching for local resumes: Not everyone will publish a phone number on biology essay help, their resume If they do publish a phone number on their resume, it could be a cell phone with a non-local area code if they relocated from another area – this is why is can be helpful to search for zip codes as well as area codes If they don’t publish a phone number at all, they should at least mention a city and/or state.

Targeting Resumes That Are Not Titled As “Resume” Although plenty of people do title their resume or the web page containing their resume with the word “resume,” there are some people who don’t. Rain. After searching for all of the hill essay results that DO contain the word “resume” in the URL or title of the web page, you need to try to eliminate them from future search results using Google’s NOT operator, the minus sign, to specifically target the singin in the essays results that don’t mention resume in the title or URL. For example: Don’t be tempted to try and write that as -(inurl:resume OR intitle:resume), because Google will not read that search string in the manner in competition, which you intend. Instead of eliminating results with the word “resume” in either the singin essays URL or the title, Google will in habilitation english, fact will do the exact opposite. Click here to see the sad reality. Sorry Google. Next, you’ll have to think about in the rain essays, words that are commonly found on resumes, such as “objective,” “summary,” “experience,” “employment,” “skills,” “history,” “education,” etc.

Then you’ll have to help, try and reduce false positive results of job postings, resume sample sites and such, and singin rain also target local results. Putting it all together, your search string could look like this: First page results: We can see that the first result is essentially of what in a a resume, yet the singin in the rain person saved their work history as “biodata.” See? Some people don’t use the word resume. :-) Looking at the second result, we can see that the word “resume” is actually highlighted in the url of the second result – which technically should not happen, as we coupled Google’s NOT/- operator with inurl:resume. Yet more proof that Boolean search does not = Internet search. In A Statement For Nursing. That’s 2 strikes, Google. The third result is singin in the essays, definitely not a resume – it is a LinkedIn directory by mill competition, name, within which is at least one positive hit on in the rain essays, our search terms. While there are no doubt resumes on the Internet that do not mention the word “resume,” anywhere within them, I have found that when you stray from hill essay competition, targeting the word “resume” in web page titles and URLs, you can quickly find yourself swimming in a sea of false positive results, which is a huge time drain. I believe the 80/20 Pareto principle solidly applies here: You will get 80% of your viable results from targeted resume searches and the other 20% from searching without targeting the word “resume.” Likewise, you can easily waste 80% of your time trying to sort through the sea of false positives in order to dig up the 20% of resumes that do not mention the singin rain term.

I’ve provided you with a quick overview of creative writing prompts how to singin, effectively utilize Google to search for resumes on the Internet. Be aware though – all is not perfect in when hunting for resumes in Google land – if you have not already, please read these 2 posts: The Internet has Free Resumes – So What?and Boolean search does not = Internet search. For those of you who read this post and asked why I: didn’t talk about searching for CV’s didn’t suggest using the tilde. operator in conjuntion with the word “resume” didn’t use - job when trying to eliminate false positive results didn’t talk about targeting filetypes didn’t talk about just searching for the word “resume” without using it in conjunction with inurl: or intitle: didn’t mention Google CSE’s. Excellent Article! Real insight seen in the description and also hands on narrative essay writing, expertise. In The Rain. I believe this way you could simply recruit using an creative writing, internet connection and nothing else. Essays. This is essay, very impressive. Also you will be able to get better candidature as opposed to people using job boards. Thanks Glen!

This really was a value addition to my efforts! I have tried the search as ‘ Java -intitle:resume -inurl:resume (objective OR summary) (experience OR history) education -job -jobs -sample -samples’ which you have mentioned. But I didn’t get any result from linkedin site. If I modify the essays search keyword as ‘ Java -intitle:resume -inurl:resume -job -jobs’ then I got result from linkedin site but it displays events also along with candidates. I found this article very interesting and mill competition appealing as I have been trying to learn ways to do sourcing for resumes on the internet. I am trying to learn ways to form such a string on either google or any other tool/site. Singin In The Essays. I am new to this and can hardly understand all the requirements.Could you be kind enough to post an article for the same? I have already subscribed on this site. Thanks a lot for your article, i have heard about scribd cerebrovascular accident, resume search in google but i dont know how to do it.

After reading your article i have got an idea to do it.. i will try. please post me the articles related to this search and job search in US. i do appriciate your help… Thank you so much. Hey, thanks a lot for all the information you are sharing with. Its real cool. How ever I would like to know more about sourcing the rain essays resume.

Please help me out. I’m really great full about what personal statement, this article. I’m currently new in the field of Human Resource. In The Rain Essays. And I’m currently using an scribd case accident, online subscription based resume search. But unfortunately, it’s not enough to fullfill my search. I’m currently looking for a faster and accurate resume search. Excellent article, with a ton of singin in the great search refining information. I have what seems like a dumb question that I must ask.

I am searching Google for Android engineers and have used the following string: android engineer OR Mobile Programmer resume filetype:pdf -guide -events -hire -amazon -job -jobs -manual. I have returned ok results… Here is help, my question, how do I eliminate European countries and Canada from singin in the rain, my results? I look forward to your reply. Thanks again. Internet Resume Search 2.0 does all the in a personal job internet search work for you using the major search engines including Google, Yahoo and essays Bing at: Thank you so much for this article.

Can you send me few tips with example to my personal gmail id [email protected] Great article! Thank you for sharing this knowledge. It’s going to be very useful for my searches. I do have one question though, how do I narrow a search for a SEO expert who needs to have worked on biology, one of the top Alexa 100 sites? Basically, how do I add criteria to singin in the essays, my search? how to type the keywords for the need requirment………

Designing was passion so got it worked for, have a look on the new trends of Designers. Hi Glen; I tried your string on Google and indeed was very helpful i getting resumes in USA, but i mostly work on European requirements, can you please advise how to source if i am looking out for profiles in essay, multiple countries in Europe with Bilingual language option. Thanks. Very informative, that’s exactly what i am looking for. Specially in rain, finding that quality resume which sometimes tends to be not so inviting after all,. You got a good theme but sometimes fail in editing, that’s sometimes the sickness of scribd case study a resume.

You’re right. Singin. And, are you kiddin’me, i’ve been looking that information for weeks. Personal Job. Great Post plus i like the website’s layout. I’m going to bookmark this up for the reliable information that i think i’m gonna be needing sooner or later. Awesome! I was looking for Boolean for zipcode and radius and singin in the got here exactly what I was looking for plus lot of additional new stuff..Excellent way of putting the essay help concept and explaination..Thanks for the article!

I am looking for guides on recruitment sales techniques such as how to close a candidate or a manager… does anyone can help? Thanks a lot in advance for in the essays your help! I learnt a lot from this article…..thanks a lot…… Finding the resume is easy but finding the good resumes with all the contents is very difficult!! Need job send your resume to [email protected], For what type of Position and biology Company? there is an advanced search in google homepage…u can search for resumes from there in different formats and techniques…try them till u find the right one. thanks. Thank you so much for writing this article! It is by far the most useful and singin in the rain easy to scribd study cerebrovascular, understand introduction to Boolean I have found. I have a bit of a tailored question for you, what is singin in the rain, your success in using Boolean to essay help, find data scientists? I’ve been having a hard time finding them and was wondering if I was doing something wrong or if they just don’t tend to post their resumes online.

I would greatly appreciate any insights you have to offer! (I didn’t see an article about this in your blog but sorry in advance if it is in there and I missed it.) can u please mention the in the essays strings to search resumese with complete details. oh i need to fix my problem in various ways, how could help me in this situation … Cathey is a sourcing and mill hill essay competition recruiting thought leader with over singin essays, 16 years. of experience working in large staffing agency and global RPO. environments (1,000 recruiters and nearly 100,000 hires annually).

Starting out his career as a top producing recruiter, he quickly. advanced into senior management roles and now currently serves as the. SVP of Strategic Talent Acquisition and assignment Innovation for Kforce, working. out of in the their renowned National Recruiting Center with over 300. recruiters. Often requested to what in a personal statement, speak on in the, sourcing and recruiting best. practices, trends and help strategies, Glen has traveled internationally to. present at many talent acquisition conferences (5X LinkedIn Talent. Connect – U.S. Singin In The Rain Essays. ’10, ’11, ’12, Toronto ’12, London ’12, 2X Australasian.

Talent Conference – Sydney Melbourne ’11, ’12, 6X SourceCon, 2X. TruLondon, 2X HCI) and is regularly requested to habilitation thesis, present to companies. (e.g., PwC, Deloitte, Intel, Booz Allen Hamilton, Citigroup, etc.). This. blog is his personal passion and does not represent the views or. opinions of anyone other than himself. – See more at: Good afternoon, this seems very interesting. I am a recruiter and trying to search for a position within a certain area – how do I do this?

Maria Gomez. pls tell about a article on singin in the rain, web designer that work on hill essay competition, the web designer company and also know the method of in the rain create websites.

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10 Free Business Plan Templates for singin in the rain essays, Startups. Business plans can seem daunting to someone who has never written one. The business idea itself might be fairly simple to explain, but if you want to apply for a loan, raise investor capital, or simply have a solid, documented direction for your company, you#39;re going to need to write a business plan. What To Include In A Personal Job! Luckily for singin in the rain essays, entrepreneurs, there are templates out mill essay there that allow you to plug in all of the information, instead of singin in the struggling with formatting and figuring out what you need to include. There are web-based business plan tools, but you may find it easier to use Microsoft Word and PDF-based templates. Here are 10 free templates you can download and use to create your first business plan. [See Related Story: The Dos and Don#39;ts of Writing a Great Business Plan], known as the authority on business plans, offers a free Word business plan template, complete with instructions and what to include in a personal a table of contents. Rain! It also offers standard business plan sections such as executive summary, company summary, products and services, market analysis, strategy, management summary, and financial planning. Once you register, you will be able to download the materials and choose from a wide range of businesses in hill essay different industries in which to base your plan. Whether your business is online, service-based, or a food establishment, Bplan#39;s Word business plan templates are comprehensive and are a great option for beginners and new business owners. provides business tools, with a collection of business plans free in PDF, PowerPoint and in the essays Word.

The templates can be viewed can downloaded through the biology SeamlessDocs platform. The site includes a template for singin essays, a variety of specific business types, a business plan model that outlines the different parts of a business plan, and customizable templates that allow users to add their logos and business information. If you need a guide to writing a business plan, also provides a download for study cerebrovascular, that. This step-by-step business plan builder, offered by Law Depot, covers structure, product marketing, SWOT (strengths, weaknesses, opportunities, threats), operations, and singin details specific to your business in habilitation their templates. Once the singin template is complete, you can download and print. The plan builder asks specific questions to help focus your answers and makes your business plan concise and comprehensive. MOBI, or My Own Business Institute, is hill essay competition part of Santa Clara University#39;s Center for Innovation and Entrepreneurship. Singin! They offer a fifteen-section business plan template, including the business profile, licenses/permits and location, which are available for free download in Word as individual templates, or as a larger all-in-one document. Narrative Essay Assignment! All download are compatible with current and singin older versions of Word (2003 and earlier). In A For Nursing! MOBI also covers topics associated with startups, but also provides information on how to run a business, including employee management, how to handle problems, and e-commerce. Office Depot#39;s Business Resource Center contains free business plan samples for retailers, manufacturers and service providers.

The business tools include downloadable rich text format (RTF) business plan templates, which is in the Word compatible. Excel business plan financials are also available for manufacturers and service providers, while the biology essay retailer business plan template is complete with forecasting and financial tables, but this requires Microsoft Word version 6.0 or later. Catering to businesses owned by women,;s free one-page business plan templates can be used by anyone who wants to start a business. Rain Essays! The PDF templates come filled in with example information for small consulting businesses, boutique clothing stores and nonprofit organizations, but you can delete that information to be left with a template that works for narrative essay writing, any business venture. Singin! The template has space for information such as vision, mission statement, objectives, strategies and action plans. Creative Writing Prompts! When you create a free business plan with Rocket Lawyer, you get the advantage of an in the rain, attorney#39;s advice to make sure your document is legally sound. Mill Essay! The template is questionnaire-style and asks for key information about your business such as founders, structure and industry, marketing plans, financial projections, etc.

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There are six business plan sections to choose from (Executive Summary, Company Description, Market Research, Product/Service Line, Marketing and Sales, Financial Projections), and you can save and work on your file anytime you want. The $100 Startup#39;s One-Page Business Plan. Looking for a no-fuss business plan template that gets straight to the point? The $100 Startup, a New York Times and Wall Street Journal best seller, offers the One-Page Business Plan, a simple form that asks several questions you can quickly answer to get up and running. This free business plan template covers everything from your business overview to finances, marketing, goals and challenges. Other resources that The $100 Startup offers include a one-page consulting business plan, one-page marketing plan, product launch guide and more. In The Rain Essays! Additional reporting by Sara Angeles and narrative writing assignment Marci Martin. In The Essays! Editor#39;s note: If you#39;re looking for information to help you with business plan services, use the questionnaire below to have our sister site provide you with information from to include statement, a variety of vendors for free.

Jennifer Post graduated from Rowan University in 2012 with a Bachelor#39;s Degree in Journalism. Having worked in the food industry, print and online journalism, and marketing, she is now a freelance contributor for singin essays, Business News Daily. When she#39;s not working, you will find her exploring her current town of Cape May, NJ or binge watching Pretty Little Liars for the 700th time.

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cecs resume critique Friday, May 22, DHLPMR Journal Club. Med Care Res Rev 66(3):235-271, 2009. Qual Saf Health Care 17(Supp 1):i13-i32, 2008. Karen Homa selected this month's article by singin in the essays, Alexander and Hearld (attached), and she also includes a recently published article concerning the SQUIRE guidelines.

Karen invited lead authors of the essay latter article---Greg Ogrinc and Sue Mooney---to join the discussion if available. The selected article is a recent review of the research methods used to study QI. As you read the review think about the SQUIRE framework for publishing QI work. What parts of Alexander and Hearld's review map to the SQUIRE framework? Were there any parts of the SQUIRE guidelines missed or not examined in their review?

Did Alexander and Hearld reveal any contradictions in their article? Critical review of the in the literature Connection with our current work Good reading Good conversation Good communication Identify gaps - develop research opportunities Help each other learn Learn more about each other Challenge each other in a safe, respectful environment Have the opportunity to critique our own presentations, manuscripts. Safety Health professional education Service redesign Organizational behavior, culture Innovation and habilitation thesis, diffusion Regulation and accreditation Policy Microsystems Health services research QI research Translational research. DHLPMR residents, coaches, and program management group, VA Quality Scholars, any other interested staff, residents, or students. Which articles will we read? We will be inviting people to in the rain essays, suggest articles - we will come to you, or you can come to us if you see something that you think would be good. We encourage you suggest a couple questions for creative college, people to have in mind as they read the in the rain article(s).

Tina Foster and Jim Heimarck will coordinate this process. We would especially welcome suggestions from literature that you read that others in case study accident, the group may not, such as specialty-specific journals, or journals which are not medical. Additionally, although we will focus on only a couple articles a month, this is essays a good place for us to share information about what we've been reading. The Journal Club meets on creative writing prompts the first Friday of every month from singin rain 12:15 to 1:15 pm in writing prompts, the Video Conference Room on singin the 3rd floor of the Novell Bldg, Lebanon. Residents and writing assignment, staff from each of our institutional sites (DHMC and Concord Hospital) participate via V-tel connection. You can attend in the V-tel conference room on Level 2 (left at bottom of stairwell coming from main rotunda) at DHMC, or in the Fourth Floor conference room at Concord Hospital.

At the beginning of each academic year, responsibility for the monthly article selection(s) and 2-3 thought-provoking questions will be assigned to residents and staff members who will submit them (electronically, preferably) to in the, Jim Heimarck for distribution two weeks in advance of the creative writing prompts meeting. Essays? The reference(s), and related questions will be distributed to regular attendees of the habilitation Journal Club and posted on singin essays this web site. Friday, April 24, DHLPMR Journal Club. Haynes, Alan B, et al. A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population. Steve Liu selected this month's readings on the topic of surgical checklists; the first is the attached NEJM article on surgical checklists and the second is Atul Gawande's New Yorker commentary on this subject. Narrative? Questions for the JC discussion are: Checklists, in in the, the traditional sense, are used to ensure that simple (yes or no answers) tasks are completed. Do you think that the tasks that were addressed either in the ICU study or the surgical checklist are simple, complicated, or complex? There were dramatic improvements in the outcome measures both in the ICU and the surgical study. Do you think the mill hill results that were seen were primarily from completion of the tasks in the checklist or could they be due to in the rain, changes in the context or setting in which the checklists were implemented?

In other words, do you think the use of the mill essay checklists changed the culture and professionals who participated in the study? As we have seen in multiple practicum projects, is this a case where a seemingly simple intervention leads to singin rain, complex changes in in a personal job, the context/setting in which it was implemented? What is the future of checklists in medicine? What other settings could they be useful in? Atul Gawande believes that the test pilot culture of medicine currently prevents more widespread adoption of checklists and standardization. What do you think are the barriers to more widespread adoption/implementation of checklists? In your own practice and in the, practicum work, could you envision a balance between standardization and provider autonomy? What are the tasks that could be amenable to mill competition, a checklist and singin in the, what tasks should be left for what in a personal job, providers and in the essays, patients to address on their own? Friday, March 27, DHLPMR Journal Club.

Regan-Smith, Martha, et al. Teaching Residents Chronic Disease Management Using the Flinders Model. J Cancer Educ 21(2):60-62, 2006. Battersby, Malcolm, et al. Scribd Study? SA HealthPlus: A Controlled Trial of a Statewide Application of in the a Generic Model of Chronic Illness Care. Millbank Quarterly 85(1):37-67, 2007.

Martha Regan-Smith selected the mill hill essay competition attached articles and will lead the discussion concerning the Flinders Model for singin in the rain essays, Chronic Disease Management. Mill Hill Essay? She offers these questions to consider. How does this model change the in the rain patient's role in scribd study, his/her own care? How does this model change the provider's role in his/her care? How does this contribute to Wagner's Chronic Disease Care model? Friday, February 9, DHLPMR Journal Club.

Meyer, Brett C., et al. Efficacy of site-independent telemedicine in the STRokE DOC trial: a randomised, blinded, prospective study. Lancet Neurol 2008;7:787-95. Tracie Caller selected the singin in the attached article and offers these questions to creative prompts, consider. How do you think telemedicine can affect both quality and cost/value of health care? Telemedicine involves integration of microsystems within multiple institutions.

What are the challenges faced in this process? How might you implement such a system in your own institution, and how would you know it was working (or not working)? Friday, January 9, DHLPMR Journal Club. Hahn, Karissa, et al. Diabetes Flow Sheet Use Associated with Guidelines Adherence Ann Fam Med 2008;6(3):235-238. Chris Allen selected the in the essays attached article and offers these questions to consider.

Why do you think that flow sheet use had less effect on outcomes than it has in mill hill essay competition, other areas such as ICU care? Why do you think that flow sheets were used in such a small percentage of the sampled primary care patients with DM? In your opinion, will flow sheets prove to be a valuable tool for improving diabetic patient care? Do you think that results of rain essays this study (lack of improvement in outcome targets) are more a consequence of the primary care setting/system or of the nature of the disease? Friday, December 5, DHLPMR Journal Club. Feinmann, Jane Patient Safety: Cutting Out Human Error BMJ 2008;337:a2370. Weick, KE and Sutcliffe, KM. Hospitals as Cultures of biology help Entrapment: A Re-Analysis of the Bristol Royal Infirmary. California Management Review 45(2):73-84, 2003.

Martha Regan-Smith selected the rain essays above articles and statement for nursing, offers these questions to consider. How do these papers give you a new perspective on your improvement work? Identify cultural blind spots in/around your improvement project. What easy explanation for less than the rain best care have you heard? How do these papers relate to Dr. Edwards' Leadership Lessons Series presentation?

November 7, 2008 Journal Club: Ames, Daniel R. and Flynn, Francis J. What Breaks a Leader: The Curvilinear Relationship Between Assertiveness and english, Leadership J Personality Soc Psych 2007;92(2):307-324. Sharon Alroy-Preis selected the article and states, Please tell everyone that I'm sorry it's a little long ( 15 pages. ) but this is in the rain essays a subject I struggle with and would like to hear others' opinion and experience Her questions to consider: 1. Have you found your balance in this topic? 2. If yes - how did you find it? think of situations that helped you clarify how to maintain the balance. 3. If not - do you feel you are over or under and what can be done to improve the narrative writing assignment balance? October 3, 2008 Journal Club: Wachter RM, Flanders SA, Fee C, et al. Singin In The? Public Reporting of Antibiotic Timing in Patients with Pneumonia: Lessons from essay help a Flawed Performance Measure Ann Int Med 2008;49:29-32.

Hayward RA. Performance Measurement in Search of a Path. NEJM 2008;356:9. Steve Liu offers 2 articles for discussion. one is an article from the Annals of Internal Medicine on singin essays antibiotic timing for CAP and the other is an editorial to another related article from the NEJM. Here are questions for discussion: 1. What are some difficulties that you have encountered in what in a statement for nursing job, developing performance measures for singin in the rain, the population in your practicum or CLAR work? How do you differentiate clinical guidelines from performance measures? 2. Have you encountered or can you envision any unintendend consequences of measuring performance in your LPMR work or in other improvement interventions that you have seen in your home department? What are some ways to minimize the effects of these unintended consequences?

3. How can the use of the simple, complicated and complex typology help in discriminating between measures that should be all-or-none (with a goal of 100%) and those that should be measured with bands of performance (with goals between 60-80%)? September 5, 2008 Journal Club: Scott JG, Cohen D, DiCicco-Bloom B, et al. Scribd Study? Understanding Healing Relationships in singin in the rain essays, Primary Care. In A For Nursing? Ann Fam Med 2008;6(4):315-322. Meza JP, Fahoome GF. The Development of an Instrument for singin in the rain, Measuring Healing. Ann Fam Med 2008;6(4):355-360.

Pippa Shulman selected the attached articles and poses these questions for habilitation english, your consideration as you read: 1) Is healing an important measure? does it contribute to overall satisfaction or can we measure outcomes to in the rain, validate healing as important? Does a healing relationship improve outcomes or just the relationship between physician and patient? 2) Would it be possible to habilitation thesis english, measure trust or hope in the patient/physician encounter? August 1, 2008 Journal Club: Davidoff F. Improving peer review: Who's responsible? BMJ 2004;328:657-658. Jefferson T, Wager E, Davidoff F. Measuring the Quality of Editorial Peer Review JAMA 2002;287(21):2786-2790. Manish Mishra selected the attached article and singin in the, asks that you think of this article's message in relation to the peer reviewed journals in which our papers appear, and the medical writing course presented in mill, our Friday didactics sessions. Manish has invited Tom Mead (medical library background), David Stevens (who conducts our medical writing course), and Frank Davidoff (co-author of this article) to join the conversation, if available. July 11, 2008 Journal Club:

Liu SK, Homa KA, Butterly JR, Kirkland KB, Batalden PB. Improving the in the simple, complicated, and complex realities of community-acquired pneumonia. Glouberman S, Zimmerman B. Complicated and Complex Systems: What Would Successful Reform of Medicare Look Like? Commission on the Future of Health Care in Canada, July 2002. Paul Batalden and assignment, Steve Liu will lead this discussion about these two articles.

You are asked to consider a patient encounter you've had in the last month and come prepared to discuss the simple, complex, and complicated aspects of that encounter. June 13, 2008 Journal Club: Kass N, Pronovost PJ, Sugarman J, Goeschel CA, Lubomski LH, Faden R. Rain? Controversy and Quality Improvement: Lingering Questions About Ethics, Oversight, and Patient Safety Research. The Joint Commission Journal on Quality and Patient Safety 2008;34(6):349-53. Kisha Weiser selected the attached article and includes the additional note: this is the reference to which the article frequently refers: Pronovost P et al. An intervention to decrease catheter-related bloodstream infections in the ICU.

N Engl J Med 2006;355:2725­2732. Study Cerebrovascular Accident? Erratum in: N Engl J Med 2007;356:2660. In The Essays? Her questions for you to consider as you read are: Many of us are going to be going to institutions with less experienced IRBs and less experience in scribd case, QI work. What regulatory oversight needs to be in place, if any? Collecting data, especially when the rain data is not flattering poses some medicolegal risk. Of course, not collecting data does not protect either. How might a QI oversight committee provide some medicolegal protection? What would a robust QI oversight committee look like? What would its function be?

May 2, 2008 Journal Club: Nease DE, Nutting PA, Dickinson WP, Bonham AJ, Graham DG, Gallagher KM, Main DS. Case Study Cerebrovascular? Inducing Sustainable Improvement in Depression Care in Primary Care Practices. In The? The Joint Commission Journal on Quality and Patient Safety 2008;34(5):247-55. Mao Fontanilla will be leading the dialogue and offers the following questions for your consideration: What was (were) the process change intervention(s) in scribd cerebrovascular accident, this study? What is the underlying assumption behind a modified improvement collaborative approach and why is it thought to rain essays, be applicable for complex adaptive systems? What outcomes were measured? Were they appropriate and writing assignment, relevant? Was there a role for tracking clinical outcomes? Would it have been relevant?

Were the case studies at the end of the singin study helpful? If so, how? What can we learn from this improvement initiative? Is there anything that we can use for our individual practicum projects? April 11, 2008 Journal Club:

Martin DR, O'Brien JL, Heyworth JA, Meyer NR. Biology Help? Point Counterpoint: The Function of Contradictions on an Interdisciplinary Health Care Team. Qual Health Res 2008;18:369. Karen Homa has selected this article and will lead the singin essays dialogue; she writes. This qualitative study explores contradictions and how revealing these can create opportunities for improvement/collaboration. I believe contradictions can be revealed during changes made in case study, a system. Rain? So read through this article and lets talk about how contradictions (what are they) might be operating in your QI work.

Looking forward to the discussion. March 7, 2008 Journal Club: Pawson R, Greenhalgh T, Harvey G, Walshe K. Realist review - a new method of systematic review designed for complex policy interventions. Journal of Health Services Research Policy 2005;10(1):21-34. Greenhalgh T, Kristjansson E, Robinson V. Realist review to understand the efficacy of school feeding programmes.

BMJ 2007;335;858-861. The attached readings introduce a concept to habilitation english, be explored more actively in the months ahead. Paul Batalden has invited one of the authors to a day-and-a-half discussion of the subject in early April, and suggested the concept be discussed at our Journal Club in advance of that visit. Hank Kutz agreed to lead this discussion and notes that you'll have some extensive reading. He offers the following: What are the fundamental differences between the singin in the rain essays realist review and mill essay competition, the SQUIRE guidelines in conveying context of singin in the improvement work? Are they mutually exclusive? What is the underlying core theory behind your improvement work? (practicum, CLAR. etc.)

What are the underlying assumptions tied to the core theory of your improvement? What ties your improvement project to in a personal statement job, the particular context in which you are working the most: 1) the core theory behind your improvement strategy or 2) your assumptions surrounding that theory? For those of you like me whose brain now hurts. just a general introduction and discussion of the key points realist review will likely fill up more time than we have! February 1, 2008 Journal Club: Wachter RM, Foster NE, Dudley RA. Medicare's Decision to singin in the rain, Withhold Payment for Hospital Errors: The Devil Is in to include in a personal for nursing, the Details. Singin In The? The Joint Commission Journal on Quality and Patient Safety 2008;34(2):116-23. This month's article was selected by narrative assignment, Andrew Chi, who offers the following questions for you to consider while reading the singin rain article: What do you think of Medicare's new policy, theoretically, financially, and mill hill essay competition, practically? How might Medicare's new policy affect your practice of essays medicine and the kind of scribd case study care your patients will receive? Can you give specifics?

What do you think about the proposed non-reimbursable events/conditions on Tables 2-4? Which do you agree with, and which do you disagree with? In summary, what are the problems and/or benefits that you foresee with this big Medicare change? January 4, 2008 Journal Club: Gawande A. The Checklist; If something so simple can transform intensive care, what else can it do? The New Yorker , December 10, 2007. Pronovost PJ, Berenholtz SM, Goeschel CA, Needham DM, Sexton JB, Thompson DA, Lubomski LH, Marsteller JA, Makary MA, Hunt E. Creating High Reliability in Health Care Organizations. Singin In The? Health Services Research 41:4, Part II (August 2006). This month's article was selected by Sarah Greer, who invites you to join this conversation. December 7, 2007 Journal Club:

Stroebel CK, McDaniel RR, Crabtree BF, Miller WL, Nutting PA, Stange KC. How Complexity Science Can Inform a Reflective Process for mill hill competition, Improvement in rain essays, Primary Care Practices. J Qual Patient Safety 2005;31(8):438-46. This month's article was selected by Lora Council, who invites you to join this conversation; she notes the intent is for help, us to continue our discussion from last journal club as to how quality improvement can best be done in singin in the, the context of what to include personal statement for nursing a complex system. Questions to consider as you read: Would any part of your project benefit from improving the quality of relationships between agents rather than working to improve the singin individual agent? In what ways have you acted as a facilitator?

How is thesis english facilitating your project creating sustainability? Leading change in singin essays, a complex system requires different leadership skills than straightforward CQI. English? Have you used any RAP type skills as a leader of your change? Would developing RAP leadership skills enhance your current project? November 2, 2007 Journal Club: Burke W, Psaty BM. Personalized Medicine in the Era of Genomics.

JAMA 2007;298(14):1682-4. Dr. Fontanilla, who will lead the DHLPMR Journal Club discussion on Nov 2, offers these questions to consider for our dialogue: What does personalized medicine mean to you? Do you practice personalized medicine? Genomics-based knowledge and essays, tools promise the ability to approach each patient as the biological individual he or she is. Can you give examples of how genomics is being applied in habilitation thesis, your specialty? What is your experience with genetic testing? What are the singin in the essays drivers of the genomics movement?

What are the habilitation thesis benefits of genetic testing? In what situations would you advocate for genetic testing? What are the possible negative effects of singin rain genetic testing? Is risk-based prevention preferable to population-wide measures in the context of limited public health resources? October 5, 2007 Journal Club: Boonyasai RT, Windish DM, Chakraborti C, Feldman LS, Rubin HR, Bass EB. Effectiveness of Teaching Quality Improvement to Clinicians: A Systematic Review. JAMA 2007;298(9):1023-37. Batalden P, Davidoff F. Teaching Quality Improvement: The Devil Is in narrative essay, the Details. JAMA 2007;298(9):1059-61. Auden McClure, who selected the articles and singin rain, will lead Friday's discussion, notes that the journal club will focus primarily on Paul's JAMA article and a discussion around teaching QI.

Paul's article references the 32 page Boonyasai systematic review and so it is provided as background. September 7, 2007 Journal Club: Auerbach AD, Landefeld CS, Shojania KG. The Tension between Needing to Improve Care and Knowing How to Do It. N Engl J Med 2007;357(6):608-13. Beth Prairie selected this month's article and will lead our discussion, and she offers a few questions to consider (below) as you read the article. She also asks you to consider the following: What do you think is the purpose of this piece? Take each argument (see Table 1 for accident, summary) - If you had to singin in the essays, pick a side for each, where would you fall? Do you agree with the author's assertion that . quality improvement is on common ground with the rest of biomedicine? (p. 612) Why or why not?

August 3, 2007 Journal Club: McDonald R, Harrison S, Checkland K, Campbell SM, Roland M. Impact of financial incentives on clinical autonomy and internal motivation in primary care: ethnographic study. BMJ 2007;334. Campbell S, Reeves D, Kontopantelis E, Middleton E, Sibbald B, Roland M. Creative Writing College? Quality of in the essays Primary Care in England with the Introduction of Pay for Performance. N Engl J Med 357;2. This month's journal club will pick up on the Pay-for-Performance theme we spoke about last year. Lisa Pastel, who selected these articles-- as well as last year's articles on the same subject -- also provides the letter to the editor that we prepared a year ago.

At that time we expressed concern about the assumption that financial incentives are needed to scribd accident, improve care as well as concern about the singin rain unintended consequences of Pay-for-Performance. These two articles (one from the BMJ, the other from NEJM) directly address both of thesis these issues. Is this the right direction for us to continue in? Will this actually improve the quality of care in a sustainable way? Are there areas in medicine where this kind of intervention would not work? Is this the right way to singin rain essays, provide the best care to our patients?

July 6, 2007 Journal Club: Glouberman S, Zimmerman B. Complicated and Complex Systems: What Would Successful Reform of Medicare Look Like? Commission on the Future of Health Care in Canada, July 2002. The article for discussion is attached and is already familiar to some involved with our residency program. This paper begins by what personal for nursing, distinguishing simple, complicated and complex problems, and singin in the essays, provides a framework for understanding healthcare systems in which we work. June 1, 2007 Journal Club: Randolph G, Fried B, Loeding L, Margolis P, Lannon C. Organizational Characteristics and Preventive Service Delivery in Private Practices: A Peek Inside the narrative assignment Black Box of in the rain Private Practices Caring for Children. Pediatrics 2005;115;1704-1711. The attached article was selected by Auden McClure, who will also lead our Friday discussion. May 4, 2007 Journal Club:

Ockene JK, Edgerton EA, Teutsch SM, Marion LN, Miller T, Genevro JL, Loveland-Cherry CJ, Fielding JE, Briss PA. Integrating evidence-based clinical and community strategies to improve health. Am J Prev Med 2007;32(3):244-52. The attached article was selected by Kristin Anderson, who provides these questions to consider as you read it: The article suggests that system integration through better pathways is the key to better outcomes for patients. Do you have specific examples from your own projects as examples where better connections can be made between microsystem/mesosystems/macrosystems? What are the essay writing assignment barriers? On page 248, the authors suggest that system breakdown occurs where macro/mesosystems are not available to in the rain essays, support clinicians.

Who do you think has the responsibility to improve those connections? On page 250, the authors address the habilitation english fact that there are cases where program implementation is singin in the essays difficult when there is a lack of evidence. Do we have an to include statement, ethical responsibility to in the rain, act without evidence? The authors use computer linked systems for referrals as an example of how linkages between systems can occur. Building on our discussion about leadership in biology essay, April, are there specific examples where we can act to improve those connections? How do/should we prioritize areas of concern? April 6, 2007 Journal Club: Flin R, Yule S. Leadership for safety: industrial experience. Essays? Qual Saf Health Care 2004;13;45-51. This month's discussion will be led by Chris Cook, who has selected the attached article for thesis english, discussion.

The theme of this discussion will focus on in the rain essays our (residents') vision of our future in leadership roles regarding patient safety as the creative writing prompts second years move on to new positions and the first years transition to executing the rain practicum.: In the next two years where do you see yourself (supervisor, middle manager, senior leader) with respect to patient safety or quality activities? Are there situation specific examples? If your role changes depending on situation how do you anticipate shifting your mental focus? Generic strategies to habilitation, assist leaders in fostering safety are discussed. In The Rain? Can you give specific examples of things that might encourage patient safety? For the senior leaders in what in a personal statement for nursing job, the group, how have you tried to instill a culture of safety? March 6, 2007 Journal Club: Goldmann D. System Failure versus Personal Accountability - The Case for Clean Hands. N Engl J Med 355;2: July 13, 2006. This month's discussion will be led by essays, Gavin Cotter, who apologizes for the short lead time to read the article and provides the following comment:

What does accountability mean to you? Consider your own project: Who is personal statement for nursing job accountable? What are the consequences for a violation? This article presents the required elements for Hand Hygiene: a model for system responsibility to personal accountability. How would you make a similar case for your own project? February 6, 2007 Journal Club: George B, Sims P, McLean AN, Mayer D. Singin In The Rain Essays? Discovering Your Authentic Leadership.

Harvard Business Review February 2007. This month's discussion will be led by Sally Ward, who provides the following comment: January 2, 2007 Journal Club: Brennan Ramirez LK, Hoehner CM, Brownson RC, Cook R, Orleans CT, Hollander M, Barker DC, Bors P, Ewing R, Killingsworth R, Petersmarck K, Schmid T, Wilkinson W. Indicators of Activity-Friendly Communities: An Evidence-Based Consensus Process. Am J Prev Med 2006;31(6):515-524. This month's discussion will be led by Brian Shiner, who provides the essay following comment:

Governmental Public Health Project: I am working with a health-promotion project in Keene for singin in the essays, persons with severe mental illness. Issues like transportation frequently come up when participants stop going to the gym, gain weight back, etc. Given our large referral region at what in a statement, DHMC and essays, the diversity of places that our patients come from, how do we make relevant recommendations about physical activity? December 1, 2006 Journal Club: Gawande A. Biology Help? Casualties of singin in the rain War - Military Care for the Wounded from Iraq and Afghanistan. N Engl J Med 2006:351(24);2471-75. Hogan MP, Pace DE, Hapgood J, Boone DC. Case Study Cerebrovascular? Use of singin in the essays Human Patient Simulation and the Situation Awareness Global Assessment Technique in Practical Trauma Skills Assessment. Narrative Essay Writing? J Trauma 2006;61:1047-1052. This month's discussion will be led by Sarah Greer, who has provided two articles and the following description:

November 3, 2006 Journal Club: McDonald R, Waring J, Harrison S. Rules, safety and in the essays, the narrativisation of identity: a hospital operating theatre case study. Sociology of Health Illness 2006;28(2):178-202. Christian CK, Gustafson ML, Roth EM, Sheridan TB, Gandhi TK, Dwyer K, Zinner MJ, Dierks MM. A prospective study of patient safety in the operating room. Surgery 2006;139:159-73.

This month's discussion will be led by Beth Prairie, who has provided two articles for discussion. She will draft a letter to the editor in response to the Christian, et al article; this draft will be distributed in advance of the meeting. Beth also provided some questions for what in a personal statement, you to rain, ponder as you read: Do you believe in the concept of a safety culture? Re: Christian article. What do you think of their methodology? October 6, 2006 Journal Club:

Doran T, Fullwood C, Gravelle H, Reeves D, Kontopantelis E, Hiroeh U, Roland M. Pay-for-Performance Programs in Family Practices in the United Kingdom. N Engl J Med 2006;355(4):375-84. Petersen LA, Woodard LD, Urech T, Daw C, Sookanan S. Does Pay-for-Performance Improve the Quality of Health Care? Ann Intern Med 2006;145(4):265-272. This month's discussion will be led by Lisa Pastel, who suggests two articles for discussion. She will be preparing a letter to the editor for to include in a statement, consideration during the discussion, in response to the NEJM article. Singin Rain Essays? Additionally, she offers the following commentary and scribd case cerebrovascular, questions to consider as you read the in the rain essays articles: Does pay-for-performance improve quality of care? September 1, 2006 Journal Club: Amalberti R, Auroy Y, Berwick D, Barach P. Five System Barriers to Achieving Ultrasafe Health Care. Ann Intern Med 2005;142:756-764.

This month's discussion will be led by Ken Deem and Martha Regan-Smith. The article was recommended by Paul Batalden after it produced a thoughtful dialogue, at a recent Summer Symposium, about barriers to creative writing prompts, improved safety in health care organizations. The article addresses 5 high-level organizational dimensions in essays, managing risk and safety. Who is in a position to utilize these concepts to improve the health care industry? August 4, 2006 Journal Club:

Eric Howell, MD, from habilitation Johns Hopkins' Bayview Campus, who is singin speaking earlier in the day at the Medicine Grand Rounds on the issue of transitions of care between hospitalists primary care, will join the Leadership Preventive Medicine Journal Club to continue dialogue about issues surrounding Readmissions Hand-offs in the context of the attached articles. Can we predict readmissions among chronic illnesses? July 7, 2006 Journal Club: Schafer S, Gillette H, Hedberg K, Cieslak P. A Community-wide Pertussis Outbreak: An Argument for Universal Booster Vaccination. Arch Intern Med 2006;166:1317-1321. This month's discussion will be led by Travis Harker and Julie Sorensen, with credit to Jason Aaron who suggested this timely article for the DHMC community. June 2, 2006 Journal Club: Stevenson KM, Dahl JL, Berry PH, Beck SL, Griffie J. To Include In A Personal? Institutionalizing effective pain management practices: Practice change programs to singin in the rain essays, improve the quality of narrative writing assignment pain management in small health care organizations. J Pain Symptom Manage 2006;31:248--261. This month's article was selected by Brian Boulay, who will lead the discussion.

He provides the following questions to consider as you read: The scope of this project is singin essays much larger than that of a microsystem. The authors sought to adapt evidence-based care in prompts college, multiple settings. What are the challenges that come with expanding the scope of quality improvement efforts beyond the microsystem? May 5, 2006 Journal Club: Durbin CG. Team model: Advocating for the optimal method of in the care delivery in the intensive care unit. Crit Care Med 2006; 34[Suppl.]:S12-S17). This month's article was selected by what personal statement for nursing job, Chris Cook, who will lead the discussion, and he provides the following questions to consider as you read:

Are teams routinely employed in your practice environment? If so how are they developed? April 7, 2006 Journal Club: Bernat JL, Peterson LM. Singin? Patient-Centered Informed Consent in Surgical Practice. Habilitation? Arch Surg 2006;141:86-92. This month's article was selected by Ken Deem, who is in the rain essays pleased to report that Dr. Creative College? Lynn Peterson, one of the co-authors of this month's article, will be joining the in the Journal Club discussion.

In this article, Bernat and creative writing college, Peterson review the doctrine of informed consent and essays, discuss some of the challenges faced when informed consent is what to include in a personal statement for nursing job seen as a process rather than a signature on a form. Informed consent is reconceptualized as a process with related situations, issues and singin essays, controversies. What processes are identified? Are specific steps for each process considered? What are they? Can you map one of these processes based upon information provided in the article? March 7, 2006 Journal Club: Overdyk FJ, Harvey SC, Fishman RL, Shippey F. Successful Strategies for Improving Operating Room Efficiency at Academic Institutions. Anesth Analg 1998;86:896-906.

This month's discussion will be led by Erica Boulay, who selected the article and posed the following questions to narrative essay writing, ponder as you read the article: Was the description of the improvement effort sufficient to permit another hospital to duplicate it? February 7, 2006 Journal Club: Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical Practice Guidelines and Quality of Care for Older Patients With Multiple Comorbid Diseases: Implications for Pay for Performance. JAMA 2005;294:716-724. This month's discussion will be led by Lora Council, who selected the article and rain, posed the following questions to ponder as you read the article: After reading the college article, do you agree that clinical practice guidelines do not provide an appropriate, evidence based approach for assessing quality of rain care in thesis, older adults with several comorbid diseases? January 3, 2006 Journal Club: Safdar N, Dezfulian C, Collard HR, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: A systematic review.

Crit Care Med 2005;33(10):2184-93. This month's discussion will be led by David Kelley, who selected the article and posed the following questions to consider as you read the article: In your opinion, were the authors successful in their quest? What characteristics of the meta-analysis supported their conclusions? What characteristics of the meta-analysis seemed to weaken their assertions? Statistically Significant Heterogeneity: does this present characteristic of the singin in the rain included set of articles in the meta-analysis cause concern for biology, you?

Why? What 2 broad categories contribute to singin in the rain essays, heterogeneity in a meta-analysis? A Forest plot can visually demonstrate the in a statement for nursing magnitudes of effect variance between articles in a meta-analysis. Singin In The Essays? Should the authors have included a Forest plot? Could this type of plot have allowed the reader to ascertain whether the significant inter-article variance resulted from a small number of help outliers or gross incongruence? Do you feel that the large number of study types strengthened or undermined the authors' assertions? Why? Could the study selection paradigm been modified to singin in the, yield a stronger, more congruent collection of narrative essay writing assignment studies? Would this increase in singin, congruence necessarily conveyed more validity to the authors' assertions?

If you had unlimited resources at your disposal, how would you attack the question on the above three pt parameters? In the reality of restricted resources, how would you change your plan of mill hill essay attack from #4? Do you consider them worth the expenditure of resources to address? December 2, 2005 Journal Club: Dong M, Giles WH, Felitti VJ, Dube SR, Williams JE, Chapman DP, Anda RF. In The? Insights Into Causal Pathways for Ischemic Heart Disease: Adverse Childhood Experiences Study. Circulation , 2004;110:1761-1766. This month's discussion will be led by Jason Aaron, who selected the article, and Jeff Fetter from the Med-Psych program who finds this subject to hill competition, be an area of interest.

Please consider their questions as you read the article: What are the singin rain essays implications of the ACE Model (Adverse Childhood Experiences)? November 4, 2005 Journal Club: Wall RJ, Ely EW, Elasy TA, Dittus RS, Foss J, Wilkerson KS, Speroff T. Using real time process measurements to reduce catheter related bloodstream infections in the intensive care unit. Qual Saf Health Care , 2005;14;295-302. This month's discussion will be led by Gavin Cotter and Kathy Kirkland, who selected the article and questions. Please consider their questions as you read the article: Comment on the process undertaken to define the what to include in a statement clinical microsystem (i.e. flow diagram/Interdisciplinary team). Was it complete in your opinion? If no, then what other approaches would you undertake? October 7, 2005 Journal Club:

Katzelnick DJ, Von Korff M, Chung H, Provost LP, Wagner EH. Applying Depression-Specific Change Concepts in a Collaborative Breakthrough Series. Journal on Quality and Patient Safety , 31;7:July 2005. This month's discussion will be led by Brian Shiner, who has teamed with Tom Oxman in selecting the article and questions. Please consider their questions as you read the in the rain essays article: This large implementation and personal job, dissemination study lacked a control group. Singin In The Rain? Does this prevent the mill hill essay competition results from being clinically useful? September 2, 2005 Journal Club:

Weick KE, Sutcliffe KM. Essays? Hospitals as Cultures of Entrapment: A Re-Analysis of the what to include in a personal statement Bristol Royal Infirmary. Singin In The Rain Essays? California Management Review , vol. 45, no. 2, Winter 2003. This month's discussion will be led by Kisha Weiser, who has teamed with Steve Liu in article selection and question formulation. Please consider their questions as you read the article: Presumably, we are all limited (and freed) by narrative essay writing, our culture. How would you begin to recognize or expose sets of underlying assumptions and practices within your own culture, to which you are entrapped? August 5, 2005 Journal Club: Kotter JP.

Leading Change: Why Transformation Efforts Fail. Harvard Business Review , March-April 1995. This month's article is singin rain offered by Concord Hospital's Bill Gunn. Please consider the biology help following questions as you read the article: The author studied transforming actions in major corporations. Essays? which of these observations, if any, apply to the change process in healthcare microsystems? July 1, 2005 Journal Club:

Glouberman S, Zimmerman B. Complicated and Complex Systems: What Would Successful Reform of Medicare Look Like? Commission on the Future of Health Care in Canada, July 2002. This month's article was selected by Paul Batalden, who provided the mill hill following questions to stimulate your thinking about change in organizations: What are examples of these three different types of systems in direct patient care? How might you know if you have labeled them correctly? June 3, 2005 Journal Club: Farrelly MC, Davis KC, Haviland ML, Messeri P, Healton CG. Evidence of a Dose-Response Relationship Between truth Antismoking Ads and Youth Smoking Prevalence.

Am J Public Health. 2005;95:425-31. This month's article was selected by Sharon McDonnell and she provides the in the rain essays following introduction and questions to stimulate your preparation: Please read the attached article prior to the session. a. watch a few examples of TV advertising developed and shown by truth. Consider societal level or health determinant-based public health interventions such as the scribd study cerebrovascular truth anti-smoking campaign and singin rain essays, compare these with other, perhaps more familiar, public health interventions. The comparisons might include cost, efficiency, effectiveness, and what others?

May 6, 2005 Journal Club: Relman AS. Medicine and the Free Market: The Health of Nations. The New Republic. 03/07/05. This month's article was selected by John Trummel and he offers the following questions for your consideration: Do you buy the argument that healthcare is not a business?

If so, what implications does this have for our present system of healthcare? April 1, 2005 Journal Club: Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, Lilly CM, Stone PH, Lockley SW, Bates DW, Czeisler CA. Effect of Reducing Interns' Work Hours on narrative writing assignment Serious Medical Errors in Intensive Care Units. N Engl J Med. Singin In The Rain? 2004;351(18):1838-48. This month's article was selected by Julie Sorensen, and she offers the mill essay following questions for your consideration: Comment on in the rain essays the study design.

Any weaknesses in the design? Would something like the writing Intervention Schedule be possible in your institution? March 1, 2005 Journal Club: Bradley EH, Holmboe ES, Mattera JA, Roumanis SA, Radford MJ, Krumholz HM. Data feedback efforts in quality improvement: lessons learned from US hospitals. Qual Saf Health Care. 2004;13;26-31. This month's article was selected by Steve Liu, and he offers the following questions for your consideration: Public reporting of quality measures has become increasingly important to this institution through the singin quality measures web site ( Nationally, it is also taking on more importance as CMS begins to report quality measures for 4000 hospitals on their web site ( and writing college, could begin to base reimbursement on in the rain these measures. Writing Prompts College? Do you think that this method of feedback to singin, institutions through the internet and pay-for-performance initiatives can promote improvement efforts within our hospital and nationally?

February 1, 2005 Journal Club: Shojania KG, Grimshaw JM. Evidence-Based Quality Improvement: The State Of The Science. Health Affairs. 2005;24(1):138-50.

This month's article was selected by prompts college, Sally Ward, and she offers the following questions for participant consideration: The article states that the paradigm of EBM should be applied to research in the area of quality improvement (QI) and argues that randomized designs are even more essential to QI than to clinical medicine. Do you agree with the author's argument? January 4, 2005 Journal Club: Murray M, Tantau C. Same-Day Appointments: Exploding the Access Paradigm.

FPM. September 2000. O'Hare CD, Corlett J. The Outcomes of Open-Access Scheduling. Rain Essays? FPM. February 2004. This month's articles were selected by creative writing prompts college, Travis Harker, and he offers the singin in the following thought-provoking questions for participants: The O'Hare article argues that open access scheduling has dramatically improved their system of care delivery in scribd case study accident, many ways that both doctors and patients care about. How would you approach promoting this idea in in the rain, your system of english care?

What would be barriers? Would it work in your specialty? December 3, 2004 Journal Club: Coomarasamy A, Khan KS. Singin In The? What is the thesis evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review. In The Rain? BMJ. Mill Hill Competition? 2004;329;1017.

This month's article, What is the evidence that postgraduate teaching in singin in the rain, evidence based medicine changes anything? A systematic review, was selected by mill essay competition, Matt Cole, and he offers the following thought-provoking questions for rain, participants: The authors systematically reviewed the effects of standalone (Table 1) versus clinically integrated teaching methods (Table 2). Is this a fair comparison, given that none of the case accident studies compared the two teaching methods to each other? Recall some of your experiences of both methods during your training? Which did you prefer? Why? November 5, 2004 Journal Club:

Armstrong EG, Mackey M, Spear SJ. Medical Education as a Process Management Problem. Acad Med. Singin In The Rain Essays? 2004;79(8):721-8. Brian Boulay selected this month's article and what to include in a, will lead the discussion. His questions for in the rain essays, consideration are: Reflect on your experience in medical school. Is it consistent with the case study and the authors' arguments against the current system?

Did you perceive any problem at to include in a statement for nursing, the time? October 1, 2004 Journal Club: Elgerg S. Quality Improvement in rain, Family Practice: A Recipe for Change. Am J Med Quality. 2004;19(2):83-7. Kristin Anderson selected this month's article (attached) and will lead the assignment discussion.

Her questions for singin essays, consideration are: With respect to the Q1 level, What does culture of medicine mean for you? Do you think it limits the quality of care that you deliver? September 3, 2004 Journal Club: Ogrinc G, Headrick LA, Mutha S, Coleman MT, O'Donnell J, Miles PV. Study Accident? A Framework for Teaching Medical Students and Residents about in the rain, Practice-based Learning and Improvement, Synthesized from a Literature Review. Acad Med. 2003;78:748-56.

Jared Barton selected this month's article (attached) and will lead the discussion. His questions for discussion are: Is the Dreyfus level of Professional Development and Knowledge Performance useful for developing the help construct by rain, which the panel categorized its recommendations? a. Is the narrative writing article clear and understandable? August 6, 2004 Journal Club: Thom DH, Ribisl KM, Stewart AL, Luke DA, et al. Further Validation and Reliability Testing of the Trust in Physician Scale. Med Care. May 1999;37(5):510-7. Thom DH et al. Physician Behaviors that Predict Patient Trust.

J Family Practice. April 2001;50(4):323-8. Thom DH, Hall MA, Pawlson LG. Measuring Patients' Trust In Physicians When Assessing Quality Of Care. Health Affairs. Jul/Aug 2004;23(4):124. Questions to think about: What is your response to the concept of singin in the rain measuring patient trust in providers? July 9, 2004 Journal Club: Drucker PF.

What Makes an Effective Executive. Harvard Business Review. June 2004:58-63. Paul Batalden and Jim Heimarck collaborated on selecting the article, and offer the following questions for participants: Drucker describes 8 common practices of case accident a successful leader. In The Rain Essays? Do they make sense to essay, you? Have you observed them in action in individuals leading an organization (whether large or small)? Describe a situation in singin essays, your experience that portrays effective use of these practices.

Have you observed other practices of effective managers that you think should be added to the list? June 4, 2004 Journal Club: Burke JP. Infection Control - A Problem for Patient Safety. N Engl J Med. 2003;348(7):651-6. Gawande A. Hill? Notes of a Surgeon: On Washing Hands. N Engl J Med. In The Rain? 2004;350(13):1283-6. Klass P. Perspective: Index Case.

N Engl J Med. Mill Competition? 2004;350(20):2023-6. Carolyn Murray selected the articles for in the rain, June and her questions for the group are: How do current systems of care in your clinical practice relate specifically to infection risks to your patients? (examples: antibiotic prescribing patterns, correctly timed surgical antibiotic prophylaxis, hand washing culture) May 7, 2004 Journal Club: Zuger A. Dissatisfaction with Medical Practice. Narrative? N Engl J Med. Singin Rain Essays? 2004;350(1):69-75. The article was selected by what in a personal job, Steve Liu, and discussion will consider these questions: Knowing that there are regional and specialty variations in singin rain, physician satisfaction, what is narrative essay writing your opinion of the local satisfaction at DHMC and Concord? March 2, 2004 Journal Club:

Merenstein, D. A piece of my mind: Winners and losers. JAMA. Singin Rain? 2004;291(1):15-16. Perron L, Moore L, et al. PSA screening and mill hill essay, prostate cancer mortality. CMAJ. In The Essays? 2002;166(5):586-91. Vis AN. Does PSA screening reduce prostate cancer mortality?. CMAJ.

2002;166(5):600-01. Discussion will consider these questions: Is the shared-decision making model advisable for young physicians given the risk of this experience? February 3, 2004 Journal Club: Berwick DM. Disseminating Innovations in what personal statement job, Health Care. JAMA.

2003;289:1969-75. Collins BA, Hawks JW, Davis R. In The Essays? From Theory to Practice: Identifying Authentic Opinion Leaders to Improve Care. Managed Care. July 2000. January 2, 2004 Journal Club:

Pierluissi E, Fischer MA, Campbell AR, Landefeld CS. Discussion of Medical Errors in Morbidity and Mortality Conferences. JAMA. 2003;290:2838-42. December 2003 Journal Club: Souba WW. The New Leader: New Demands in a Changing, Turbulent Environment.

J Am Coll Surg. 197;1:July 2003. Souba WW. Academic Medicine and the Search for Meaning and Purpose. Academic Medicine. 77;2:February 2002. November 7, 2003 Journal Club: Kuperman GJ, Gibson RF. Computer Physician Order Entry: Benefits, Costs, and Issues.

Ann Intern Med. 2003;139(1):31-39. Primer on Dissecting a Medical Imperative. Effective Clinical Practice. November/December 2000;3:6. Norton R. Unintended Consequences.

The Concise Encyclopedia of Economics. At the VA we have a computer physician order entry system - reputably one of the best in the country. In our experience however, we have seen a decline in certain types of error (transcription error, handwriting error), but we continue to have significant problems with medication error. We have been examining medication error at the time of discharge and have found new, unanticipated errors including: loss of patients outpatient medication list after transfer to inpatient and therefore inability to confirm discharge list with previous outpatient list, problems with cut amp paste etc. I found NO literature on how to to include in a for nursing job, deal with unintended consequences - how would you begin to systematically address or pre-emptively address unintended consequences? What does one do about these unintended consequences anyway?

September 5, 2003 Journal Club: There are three articles and an editorial for singin in the rain essays, this session. Ferguson TB, Peterson ED, Coombs LP et al. Use of continuous quality improvement to increase use of process measures in patients undergoing coronary artery bypass graft surgery: A randomized controlled trial. JAMA. 2003;290:49-56.

Croskerry P. The importance of cognitive errors in diagnosis and strategies to minimize them. Prompts? Acad Med. 2003;78:775780. Moss F, Thompson R. Editorial: A new structure for quality improvement reports. Quality in Health Care. 1999;8:76. Lenfant C. Clinical Research to Clinical Practice - Lost in singin in the essays, Translation? N Engl J Med. Scribd Study Cerebrovascular Accident? 349;9:August 28,2003. Questions for the JAMA article and QSHC editorial: What makes the JAMA article a quality improvement study?

Is it? Would it meet the criteria suggested by the Editors in Quality in Health Care? If so, why? If not, why? Questions for the Academic Medicine article: How could this be made useful to practicing physicians interested in decreasing their diagnostic errors? How could practitioner practice be assessed for diagnostic errors? What difference could it make and singin essays, would such difference be monitored?

July 11, 2003 Journal Club: McGlynn EA, Asch SM, Adams J et al. The quality of health care delivered to adults in biology, the United States. N Engl J Med. 2003;348(26):2635-45. Barabasi AL, Bonabeau E. Singin In The Essays? Scale-free networks. Sci Am. 2003;288(5):60-9. Paul's slide depicts 5 knowledge domains, all of which are important to writing college, consider when thinking about how to improve health care and the health of populations: Linking Science and Context.

Can we think about which of singin in the essays these domains are addressed in the articles we read for Journal Club? What are the questions we want to ask about the literature that addresses these domains? Most of us are familiar with the kinds of questions we ask about scientific evidence. I have attached Paul's list of narrative questions to singin, ask and be clear about when trying to improve care in a particular setting. Are there other questions related to the concepts covered above? Are there ways to begin thinking about how these five domains should be approached, and how they relate to each other? June 13, 2003 Journal Club: van Schoor NM, Smit JH, Twisk JWR, Bouter LM, Lips P. Prevention of Hip Fractures by External Hip Protectors: A Randomized Controlled Trial. JAMA.

2003;289(15):1957-1962. Meyer G, Warnke A, Bender R, Muhlhauser I. Hill Essay Competition? Effect on hip fractures of singin increased use of hip protectors in nursing homes: cluster randomised controlled trial. Biology Help? BMJ. 2003;326(76). Questions to ponder: These two articles conflict in their assessment of the effectiveness of hip protectors. Essays? What issues should be considered when deciding whether to use this intervention? Address if you are the hospital administrator, and if you are leading a fall reduction team. What is the impact of studying one fall and injury reduction strategy in isolation?

What needs to be done to resolve the dilemma of these conflicting results? May 2, 2003 Journal Club: Donald M. Berwick. Writing Assignment? Disseminating Innovations in Health Care. Essays? JAMA. 2003;289(15):1969-1975. Mills PD, Weeks WB, Surott-Kimberly BC. A Multihospital Safety Improvement Effort and the Dissemination of New Knowledge. Joint Commission on Quality and mill essay, Safety 2003;29(3):124-133. Berwick's article provides an excellent summary of some of the singin in the essays literature and synthesizes seven key rules for fostering innovation.

Weeks reports on the results of a VA collaborative effort and the local diffusion of improvement. Consider the following: Are the rules for mill competition, disseminating innovation practical? Are they helpful in in the rain, addition to other tools for improvement? What were the creative writing greatest barriers to diffusion of innovation for the teams as reported in the Weeks article? What other barriers might there be? How could the 7 rules have helped the teams in the QuIC collaborative? Which rules might be most helpful in singin essays, a collaborative environment?

Which rules could be most helpful when you're leading an improvement team in your local setting? February 7, 2003 Journal Club: David Meltzer et al. Narrative Writing Assignment? Effects of Physician Experience on Costs and Outcomes on an Academic General Medicine Service: Results of a Trial of Hospitalists. Ann Intern Med. Rain? 2002;137:866-874. Andrew C. Habilitation? Auerbach et al. Implementation of a Voluntary Hospitalist Service at a Community Teaching Hospital: Improved Clinical Efficiency and singin in the rain essays, Patient Outcomes. Ann Intern Med. 2002;137:859-865. These two studies published in the Annals last year evaluate the scribd accident cost and singin in the, outcomes of care provided by hospitalists.

Consider the following: Are these quality improvement studies? Why or why not? What is a hospitalist? Can you tell from the methods section of these papers? Auerbach is a retrospective cohort study. What do you think of their secondary analysis using the case propensity score?

Could this be applied to other, non-randomized studies? The Leapfrog group has endorsed intensivists as a method of improving the quality of care. They would like your opinion on hospitalists - yes or no? January 3, 2003 Journal Club: Tobin Norris.

Mental health and general practice: improving linkages using a total quality management approach. Related questions for reflection: Reflect on singin essays your own experiences in the integration (or lack thereof) between primary care and mental health services in narrative assignment, caring for patients with severe and chronic mental illness. Consider the singin essays pros/cons of provider-focused vs. patient-focused measurement when evaluating efforts to improve systems integration. Joubert. PQM - Psychiatry Quality Management. Following the current revolution of computerizing medical records, Joubert offers a glimpse into the potential future of integrating CQI into what in a statement job the electronic record. As current and singin essays, future leaders in thesis, quality healthcare, we will be the targeted consumers of such software.

How can we best evaluate these systems? Specifically: What do you think about continual PDSA of our IT systems vs. Singin In The? purchasing their package? How does a detailed QI/record system for one specialty or service affect interdisciplinary work? Would it contribute to the segregation of services as discussed in Tobin Norris? If not, in what settings would you consider using this new type of clinical software? November 2002 Journal Club:

Ellison P. Anesthesiology, Volume 84(4): April 1996; pages 965-975. Dovey, Phillips and Green. A preliminary taxonomy of medical errors in hill essay competition, family practice. Singin In The Rain? Quality Safety Health Care, 2002; 11:233-238. Related questions for reflection: As you read the transcript of Pierce's speech do you see that culture emerging? Or being purposefully developed? If so to either of these what are key points to its development? Pierce spends some time on mill hill the 20/20 piece on singin Deep Sleep.

Do you think/feel that was a catalyst for more safety consciousness in the anesthesia community? If so, do you think the scribd study IOM to Err is rain essays Human report could have the same effect on the general public and medicine in general? Or will the IOM report have a short term impact? What are your thoughts on the Taxonomy of creative writing college errors in family medicine article? Could this be a springboard and a framework for outpatient based error analysis? If so, is the message diluted with this published in this journal (aimed at safety) versus a mainstream FP journal?

How would you advise we spread the word about this work and rain essays, frame work? Hofer and Hayward. Are Bad Outcomes from Questionable Clinical Decisions Preventable Medical Errors? A Case of Cascade Iatrogenesis. Annals of Internal Medicine, 137(5): 327-333.

Related questions for reflection: How should we think about the questions related to post hoc establishment of english causality in root cause analysis? How do the questions posed by this article related to singin in the rain, the concepts of assignment action plans and in the, the use of PDCA cycles? Halm, Lee, and Chassin. Is Volume Related to Outcome in Health Care? A Systematic Review and Methodologic Critique of the biology essay Literature. Annals of Internal Medicine, 137(6): 511-520.

Related questions for reflection: How might we think about designing methodologies that would better help us tease out relationships between volumes and outcomes? How do we get context and processes into the design of singin in the rain such studies? September 6, 2002: Leape et al.

What Practices Will Most Improve Safety? Evidence-Based Medicine Meets Patient Safety. Hill Competition? JAMA, July 24/31, vol 288(4), 501-507. Shojania et al. Safe but Sound: Patient Safety Meets Evidence-Based Medicine. JAMA, July 24/31, 288(4): 508-513. Related questions for reflection: Do we need different types of singin in the rain evidence for patient safety research?

What are the challenges of mill evaluating systems-level interventions? Are there dangers in using practices based on inference (linkage), accepted practices in other industries, and common sense as evidence? Reilly et al. Impact of a Clinical Decision Rule on Hospital Triage of singin in the essays Patients With Suspected Acute Cardiac Ischemia in the Emergency Department. JAMA, July 17, vol 288(3), 342-350. Related questions for reflection: What separates the two? If this is creative writing QI, why was it accepted in a prominent journal? What strategies can we use to make our QI projects and QI research appealing to leading journals? Lebanon, NH, USA 03766. Phone: (603) 653-3229.

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final essay This is your penultimate writing assignment for the course. You will want to pay extra attention to detail here as this will serve as your final demonstration of understanding. Throughout the singin essays reading, you were asked to keep track of quotations in order to prepare for this essay. If you did not, you can access the pdf version of each text online. Keep reading for more details on your assignment. S/HE: A Final Examination of Gender in Text. The structuralist school emerges from theories of writing language and singin in the rain essays linguistics, and statement for nursing it looks for underlying elements in singin in the culture and literature that can be connected so that critics can develop general conclusions about the individual works and the systems from which they emerge. In fact, structuralism maintains that . practically everything we do that is specifically human is narrative writing expressed in language (Richter 809). Structuralists believe that these language symbols extend far beyond written or oral communication. Structuralists assert that, since language exists in patterns, certain underlying elements are common to all human experiences.

Structuralists believe we can observe these experiences through patterns: . Singin In The! if you examine the physical structures of all buildings built in urban America in 1850 to discover the underlying principles that govern their composition, for example, principles of mechanical construction or of artistic form. you are using a structuralist lens (Tyson 197). Structuralism is used in literary theory, for example, . if you examine the structure of a large number of short stories to discover the underlying principles that govern their composition. principles of narrative progression. or of cerebrovascular accident characterization. you are also engaged in structuralist activity if you describe the structure of a single literary work to discover how its composition demonstrates the underlying principles of a given structural system (Tyson 197-198). theory of modes, or historical criticism (tragic, comic, and thematic); theory of symbols, or ethical criticism (literal/descriptive, formal, mythical, and anagogic); theory of myths, or archetypal criticism (comedy, romance, tragedy, irony/satire); theory of genres, or rhetorical criticism (epos, prose, drama, lyric) (Tyson 240). Using a specific structuralist framework (like Frye's mythoi). how should the text be classified in terms of its genre? In other words, what patterns exist within the text that make it a part of other works like it? Using a specific structuralist framework. In The Rain! analyze the text's narrative operations. can you speculate about the relationship between the. [text]. and the culture from which the text emerged? In other words, what patterns exist within the text that make it a product of a larger culture? What patterns exist within the text that connect it to the larger human experience?

In other words, can we connect patterns and elements within the text to essay other texts from other cultures to map similarities that tell us more about the common human experience? This is essays a liberal humanist move that assumes that since we are all human, we all share basic human commonalities. Though a number of different approaches exist in feminist criticism, there exist some areas of commonality. This list is excerpted from Tyson: Women are oppressed by habilitation english patriarchy economically, politically, socially, and psychologically; patriarchal ideology is the primary means by which they are kept so In every domain where patriarchy reigns, woman is singin in the other: she is what to include personal statement marginalized, defined only by her difference from male norms and singin essays values All of what in a statement for nursing job western (Anglo-European) civilization is deeply rooted in patriarchal ideology, for example, in the biblical portrayal of singin in the rain Eve as the origin of creative sin and death in the world While biology determines our sex (male or female), culture determines our gender (masculine or feminine) All feminist activity, including feminist theory and rain literary criticism, has as its ultimate goal to change the world by prompting gender equality Gender issues play a part in every aspect of human production and experience, including the production and experience of literature, whether we are consciously aware of these issues or not (91). Feminist criticism has, in many ways, followed what some theorists call the three waves of creative college feminism: First Wave Feminism - late 1700s-early 1900's: writers like Mary Wollstonecraft ( A Vindication of the Rights of Women , 1792) highlight the inequalities between the sexes.

Activists like Susan B. Anthony and in the essays Victoria Woodhull contribute to writing prompts college the women's suffrage movement, which leads to National Universal Suffrage in 1920 with the passing of the in the rain Nineteenth Amendment Second Wave Feminism - early 1960s-late 1970s: building on more equal working conditions necessary in America during World War II, movements such as the National Organization for Women (NOW), formed in 1966, cohere feminist political activism. Writers like Simone de Beauvoir ( Le deuxième sexe , 1972) and Elaine Showalter established the groundwork for the dissemination of feminist theories dove-tailed with the American Civil Rights movement Third Wave Feminism - early 1990s-present: resisting the perceived essentialist (over generalized, over simplified) ideologies and a white, heterosexual, middle class focus of second wave feminism, third wave feminism borrows from post-structural and contemporary gender and race theories (see below) to expand on marginalized populations' experiences. Writers like Alice Walker work to . reconcile it [feminism] with the concerns of the mill hill black community. [and] the survival and wholeness of her people, men and women both, and for the promotion of dialog and community as well as for the valorization of singin in the essays women and of all the varieties of work women perform (Tyson 97). Essential Questions: How is the relationship between men and scribd case study accident women portrayed? What are the power relationships between men and in the rain essays women (or characters assuming male/female roles)? How are male and female roles defined? What constitutes masculinity and femininity? How do characters embody these traits? Do characters take on what in a personal job, traits from opposite singin genders?

How so? How does this change others’ reactions to mill essay them? What does the work reveal about the operations (economically, politically, socially, or psychologically) of patriarchy? What does the work imply about the in the possibilities of sisterhood as a mode of resisting patriarchy? What does the work say about women's creativity? What does the history of the essay work's reception by the public and by the critics tell us about the operation of patriarchy? What role the work play in terms of women's literary history and literary tradition? (Tyson) How to Begin/Questions to Consider: The idea of the tragic hero can be seen across genres. The tragic hero is the main character in a tragedy whose tragic flaw leads to his downfall.

Is Okonkwo a tragic hero? If so, explain how his story evokes both pity and fear. Analyze Okonkwo’s tragic fall and subsequent downfall using specific examples from the essays text. Biology Help! Pull in characters from the other texts and in the examine these same questions. Then, make a connection to the significance of this across various genres, texts, cultures, etc. The role of thesis english women in Things Fall Apart is often submissive to that of the men, but there are also some instances in singin in the essays which women hold tremendous power. Do readers see women as ‘lesser’ because we often see them through the eyes of Okonkwo? Does Okonkwo treat different women differently? Is his understanding of femininity the same as the Igbo culture’s?

Pull in characters from the other texts and examine these same questions. Then, make a connection to the significance of narrative essay this across various genres, texts, cultures, etc. Despite historic, gender, and cultural variances, Hester, Victor, Marlow, Hamlet, and in the rain Okonkwo each present a representation of the tragic hero befitting the context of the mill hill story. Hester's fall from singin in the, grace was symbolized in her moral impropriety, while Victor and Marlow became victims of their own social desires, and Hamlet and Okonkwo each suffer the effect of narrative writing assignment hubris. Despite these progressive differences, each story follows a traditional arch of the tragic hero, leaving the reader to scrutinize the in the tragic endings they foretell. If you choose a feminist perspective, you will be looking at the text for an analysis of gender roles and/or portrayal. Choose several characters and hill essay competition texts to fit your thesis, which should be molded around the notion of gender roles and identity.

What are you going to argue and what is the significance? Choose from 3 of the 5 major texts we have studied: Scarlet Letter, Frankenstein, Heart of Darkness, Macbeth OR Hamlet, and Things Fall Apart . Use the eText versions of each text provided here: 5-7 pages, MLA Format A works cited page Extensive in-text support (quotes, summary, paraphrase) Explain explicit and implied meaning Answer the in the essays question to the fullest extent Follow a clear and well organized structure/development Engaging introduction and scribd cerebrovascular accident conclusion Develop and argue a debatable, academic thesis proper grammar/proofreading. May 29-30 : LAB DAYS (2 copies of Rough Draft for Friday) 1/2 day May 31 : peer editing #1. 1/2 day *May 31 : peer editing #2/revision time. June 3 : Final due via Edmodo (11:59p/close of singin in the day) European structuralists such as Roman Jakobson, Claude Lévi-Strauss, and Roland Barthes (before his shift toward poststructuralism) attempted to develop a semiology, or semiotics (science of signs). Barthes, among others, sought to thesis recover literature and singin in the rain essays even language from the isolation in which they had been studied and to show that the laws that govern them govern all signs, from road signs to articles of clothing. Structuralism was heavily influenced by competition linguistics, especially by the pioneering work of Ferdinand de Saussure.

Particularly useful to structuralists was Saussure’s concept of the phoneme (the smallest basic speech sound or unit of pronunciation) and his idea that phonemes exist in two kinds of relationships: diachronic and synchronic. A phoneme has a diachronic, or horizontal, relationship with those other phonemes that precede and singin essays follow it (as the words appear, left to right, on this page) in study cerebrovascular accident a particular usage, utterance, or narrativewhat Saussure, a linguist, called parole (French for singin, word). A phoneme has a synchronic, or vertical, relationship with the narrative writing entire system of language within which individual usages, utterances, or narratives have meaningwhat Saussure called langue (French for tongue, as in native tongue, meaning language). An means what it means in English because those of us who speak the language are plugged into singin essays the same system (think of it as a computer network where different individuals can access the same information in the same way at a given time). Following Saussure, Lévi-Strauss, an anthropologist, studied hundreds of myths, breaking them into their smallest meaningful units, which he called mythemes. Removing each from its diachronic relations with other mythemes in thesis a single myth (such as the myth of Oedipus and singin in the essays his mother), he vertically aligned those mythemes that he found to thesis english be homologous (structurally correspondent). He then studied the relationships within as well as between vertically aligned columns, in an attempt to understand scientifically, through ratios and rain proportions, those thoughts and creative writing college processes that humankind has shared, both at singin in the essays, one particular time and across time. Whether Lévi-Strauss was studying the structure of myths or the structure of villages, he looked for recurring, common elements that transcended the biology differences within and among cultures. Structuralists followed Saussure in preferring to think about the overriding langue, or language of myth, in which each mytheme and mytheme-constituted myth fits meaningfully, rather than about in the rain essays, isolated individual paroles, or narratives.

Structuralists also followed Saussure's lead in believing that sign systems must be understood in case cerebrovascular accident terms of singin in the rain binary oppositions (a proposition later disputed by poststructuralist Jacques Derrida). In analyzing myths and texts to find basic structures, structuralists found that opposite terms modulate until they are finally resolved or reconciled by what to include in a job some intermediary third term. Singin In The Essays! Thus a structuralist reading of Milton's Paradise Lost (1667) might show that the war between God and the rebellious angels becomes a rift between God and sinful, fallen man, a rift that is healed by the Son of essay writing assignment God, the singin essays mediating third term. Although structuralism was largely a European phenomenon in its origin and development, it was influenced by American thinkers as well. In A Personal Statement For Nursing Job! Noam Chomsky, for instance, who powerfully influenced structuralism through works such as Reflections on Language (1975), identified and distinguished between surface structures and singin essays deep structures in language and linguistic literatures, including texts. Adapted from The Bedford Glossary of Critical and Literary Terms by Ross Murfin and Supryia M. Ray. Habilitation Thesis! Copyright 1998 by in the essays Bedford Books. French feminist criticism garnered much of its inspiration from Simone de Beauvoir’s seminal book, Lé Deuxiéme Sexe (1949; The Second Sex ). Beauvoir argued that associating men with humanity more generally (as many cultures do) relegates women to an inferior position in society.

Subsequent French feminist critics writing during the 1970s acknowledged Beauvoir’s critique but focused on language as a tool of male domination, analyzing the ways in which it represents the world from the what personal male point of view and arguing for the development of a feminine language and writing. Although interested in singin in the essays the subject of feminine language and writing, North American feminist critics of the 1970s and early 1980s began by analyzing literary textsnot by abstractly discussing languagevia close textual reading and mill hill historical scholarship. One group practiced feminist critique, examining how women characters are portrayed, exposing the patriarchal ideology implicit in the so-called classics, and demonstrating that attitudes and traditions reinforcing systematic masculine dominance are inscribed in the literary canon. Another group practiced what came to be called gynocriticism, studying writings by singin in the rain women and examining the narrative female literary tradition to singin find out how women writers across the ages have perceived themselves and essay help imagined reality. While it gradually became customary to singin in the rain essays refer to narrative essay writing assignment an Anglo-American tradition of feminist criticism, British feminist critics of the 1970s and singin rain early 1980s objected to the tendency of scribd study some North American critics to find universal or essential feminine attributes, arguing that differences of race, class, and culture gave rise to crucial differences among women across space and time. British feminist critics regarded their own critical practice as more political than that of North American feminists, emphasizing an engagement with historical process in order to rain promote social change.

By the early 1990s, the assignment French, American, and British approaches had so thoroughly critiqued, influenced, and assimilated one another that nationality no longer automatically signaled a practitioner’s approach. Today’s critics seldom focus on woman as a relatively monolithic category; rather, they view women as members of different societies with different concerns. Feminists of color, Third World (preferably called postcolonial) feminists, and lesbian feminists have stressed that women are not defined solely by in the the fact that they are female; other attributes (such as religion, class, and sexual orientation) are also important, making the problems and goals of one group of women different from what personal statement job, those of another. Many commentators have argued that feminist criticism is by definition gender criticism because of its focus on the feminine gender. But the relationship between feminist and gender criticism is, in fact, complex; the two approaches are certainly not polar opposites but, rather, exist along a continuum of attitudes toward sex, sexuality, gender, and language.

Adapted from The Bedford Glossary of Critical and Literary Terms by essays Ross Murfin and Supryia M. Scribd Cerebrovascular Accident! Ray. Copyright 1998 by Bedford Books.