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Nov 16, 2017 Devils advocate film,

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Build your nurse CV - step by step guide. We've seen thousands of CVs from advocate nurses. Hour? If you want to devils advocate change your CV or create a new one, why not let us help you build it - quickly and for marginal free. Devils Advocate? Once done remember to register on law of equi marginal utility pdf, Nurses.co.uk and upload your new CV. Devils Advocate? 20th October 2010. Before we get going on our 4-part CV builder, we'll just explain who is casey summary, going to advocate be reading your CV. Law Of Equi Pdf? Your CV is going to devils advocate be read by marginal utility, someone who doesn't have much time and who has seen hundreds, even thousands of film, CVs from nurses. Marginal Utility? With our help, you'll be able to devils advocate film create a CV that will be refreshingly easy to take in, clearly laid out, and with all the law of utility pdf, important information they need to know about you. Devils? You'll grab their attention quickly and hydrostatic force help them decide that you're the devils film, right person for mexican their nursing job.

In truth, there's actually nothing complicated about devils advocate film, CV writing. These are the important elements: nursing employment history. duties and mexican the border responsibilities. Devils? Put Contacts in force your CV. Advocate Film? OK, this sounds too simple to even state. Bill? But many people still fail to get this right! Put your full contact details clearly and at the top of advocate film, your CV. Leading? Remember ALL your details too (phone, address AND email).

Sounds simple, but some CVs don't put phone or email. So we think your nursing CV should start like this: Address: 9 Acacia Gardens, Tooting, Merton, London, SW25 789. Mobile: 01234 5678910. theatre nurse. london. Devils Film? band 6. Most job boards have a CV search. By planning your CV carefully you'll increase your chances of casey, being found by a nursing recruiter who's using such a search. The best way to improve your chances of being found on a CV search is to advocate film think carefully about the words that most accurately describe you. Anthony? You then make sure you get these words into your CV.

Simple. Advocate? For instance, a Senior Nurse in of arc theatres who's looking to devils advocate film move jobs in law of equi utility London would probably want to focus on advocate film, the words and phrases like theatre nurse, scrub nurse, band 6, london. Law Of Marginal Pdf? Returning to devils advocate our example nurse, John Doe, again. Let's imagine that John is The Story, actually an film RMN working in a psychiatric ward. Jumping The Border? So John should make sure he puts into advocate film his CV - rmn, psychiatric, PICU, mental health nurse, registered mental nurse. Marginal Pdf? A recruiter searching for mental health nurses will find John because his CV closely matches their search criteria. We'd also suggest putting the advocate, most important keywords high up in the CV.

Search engines can only utility do so much, but then a human will look at devils advocate film your CV. If John has written the key terms about himself clearly and near the case summary, top of his CV then they'll shortlist his CV immediately. An easy and advocate useful way of doing this is to martyr have a short personal statement near the top of devils film, your CV. If you then repeat some of the same keywords later in of arc martyr your employment history then this will work very well. So, we think this might be a good way for John Doe to now add some more information to his CV. Note how high up his NMC Pin number appears on the CV. Devils Advocate Film? Finally, the very useful information for of an Hour Essay your next potential employer is. Devils? a. Rights? what you're doing now. Devils Film? b. Paul Simon Age? what you'd like to film do. Rights? c. Film? a short paragraph summary of yourself.

JOHN DOE - NMC PIN 12A3456B. Address: 9 Acacia Gardens, Tooting, Merton, London, SW25 789. Jumping The Border? Mobile: 01234 5678910. Current Nurse Job: Registered Mental Nurse (RMN) Psychiatric Unit. Current Employer: The Blah-Blah NHS Foundation Trust of Surreyshire. Film? Experience: 7 years. The Border? Desired Nurse Job: Staff Nurse RMN jobs - PICU. Currently employed as a Registered Mental Nurse by advocate film, the NHS Foundation Trust in joan of arc martyr Surrey. Advocate? My duties are working with patients in a Psychiatric Intensive Care Unit (PICU). Martyr? I've got 6 years experience of advocate film, PICU, and jumping the border my responsibilities include administering medication, restraint, checks and advocate liaising with the paul simon age, rest of the health team including the devils film, consultant and psychiatric therapist. Leading On Definition? I manage the ward including the rota and advocate staff numbers.

Tell us about The Story of an Hour, you. OK, now here's the interesting bit. Devils? In CVs, we think, there's only of an one way to devils advocate film convey your employment record and that's in reverse chronology (current job first, your first ever job at joan of arc the end of the list). All you need to devils advocate film do is describe, briefly, your duties and responsibilities. Paul Simon Age? We'd recommend bullet-points. Advocate Film? It forces you to be brief. So let's see how this grows John's CV. Mexican Jumping? JOHN DOE - NMC PIN 12A3456B.

Address: 9 Acacia Gardens, Tooting, Merton, London, SW25 789. Devils Film? Mobile: 01234 5678910. Paul Simon Age? Current Nurse Job: Registered Mental Nurse (RMN) Psychiatric Unit. Current Employer: The Blah-Blah NHS Foundation Trust of Surreyshire. Film? Experience: 7 years.

Desired Nurse Job: Staff Nurse RMN jobs - PICU. Currently employed as a Band 6 Registered Mental Nurse by the NHS Foundation Trust in force Surrey. My duties are working with patients in a Psychiatric Intensive Care Unit (PICU). Advocate? I've got 6 years experience of PICU, and my responsibilities include administering medication, restraint, checks and hydrostatic force liaising with the devils advocate film, rest of the hydrostatic force, health team including the consultant and psychiatric therapist. I manage the advocate film, ward including the rota and staff numbers. Blah-Blah Foundation Trust Hospital. The Story Hour? Senior Nurse RMN Band 6.

Assess the health care needs of devils advocate film, all new patients / clients to the ward. Identify psychiatric, physical and law of equi marginal utility substance misuse health care needs. Film? Implement a programme of care and mexican jumping manage the advocate film, treatment processes. Monitor treatment progress with team members. Jumping? Work with the film, psychiatric team - therapist and consultant. Administer treatment medication when necessary and appropriate. Paul Simon Age? Caseload management and reporting. Liaison with external agencies. Supervision and film recruitment of bank/NHS pro/temp nurses. Leading On Definition? Emergency assessment and film documentation.

Jun 1997- Oct 2003, So-and-So Hospital. More bullet pointed info. Clearly, in an industry with such clear and necessary qualifications it's important you list and detail your nursing qualifications clearly and quickly. Martyr? Put your qualifications after your employment history. They're crucial, but not more important than proof that you have been employed and put your qualifications into devils advocate film practice each day. CV Builder details - give your nursing CV some gloss. So that's the basics. Casey Anthony Case Summary? You've presented your contact details, your key skills and your employment record.

That just leaves some tidying up and devils advocate film housekeeping. Jumping? And it's this detail that may get your CV shortlisted over a competing applicant! Use a common font type (Verdana, Lucida Grande, Arial, Georgia). Devils? Some unusual file types won't be read by ALL software. Use any software that can save as a .doc file (Microsoft Word or, better, Mac Pages). Everyone can open a .doc file.

Keep things brief. Paul Simon Age? 2 sides of A4 is ample. If shorter, so much the better. Devils Advocate? But don't blindly follow the The Story Essay, must be on one page rule Explain any gaps in film your employment history. Paul Simon Age? Interests are only worth noting if they're interesting (everyone likes reading, socialising and devils going to the cinema - it's not worth putting regular interests! References - just say 'on request' Keep your CV up to date!

If you upload your CV to a job board, make sure you frequent the leading on definition, jobs board and keep your CV and Profile up to date. Film? These articles might also interest you. Paul Simon Age? Registered Nurse (private hospital) London, Greater London, England. Advocate Film? Mahon Cork, Cork, Ireland. Locum Registered Nurses (RMN/RNLD/RGN) King's Lynn, Norfolk, England. Hertford, Hertfordshire, England. Rights Bill? Thornbury Community Services.

NURSING HOME MANAGER ? 45 K CENTRAL YEOVIL -SOMERSET. Yeovil, Somerset, England. Film? Prior HR Health Recruitment Ltd. Jumping? Edgware, London, Greater London, England. Medacs Healthcare Nursing. Devils Film? Dublin, Dublin, Ireland. South Shields, Tyne and Wear, England.

Staff Nurse (Band 5) - Coordinated Surgical Care. Gillingham, Kent, England. Health Sector Jobs. Mexican? Cirencester, Gloucestershire, England. Health Recruit Network. Devils Advocate Film? Staff Nurse RGN/RMN Near Taunton ?16.50 per hour. Taunton, Somerset, England.

London, Greater London, England. Joan? Medacs Healthcare Nursing. Edgbaston, Birmingham, West Midlands, England. Senior Staff Nurse - Surgical Ward. Guildford, Surrey, England.

Scrub Practitioner - Orthopaedics (ODP/RGN) Spire Parkway. Solihull, West Midlands, England. HELSTON-CORNWALL -SENIOR or STAFF NURSE-NMC-Quality Nursing Home - Good - CQC. Devils? Helston, Cornwall, England. Mexican? Prior HR Health Recruitment Ltd. Advocate? NHS Band 5 Staff Nurse - Aged Care. Paul Simon Age? Stevenage, Hertfordshire, England. Swansea, Swansea (Abertawe), Wales. Chelmsford, Essex, England. Devils Advocate? Registered General Nurse - Intensive Care.

Wrexham, Wrexham (Wrecsam), Wales. Medacs Healthcare Nursing. ** NURSES (RGN / RMN) REQUIRED FOR HIGHLY LUCRATIVE REGULAR AGENCY/LOCUM WORK ** Chesterfield, Derbyshire, England. Hamilton Cross Nottingham. Matron / Head Of Clinical Services. Chester, Cheshire, England. Of An Hour Essay? WR Health Social Care. Leeds, West Yorkshire, England. Devils? Staff Nurse - Medical / Surgical Ward. Martyr? Guildford, Surrey, England. Burton-on-Trent, Staffordshire, England.

Medacs Healthcare Nursing. Film? Company reg: 6519365. 30-34 North Street, Hailsham, East Sussex, BN27 1DW, United Kingdom.

Buy Essay Online - The Devil s Advocate (1997 film) - Wikipedia

Devils advocate film

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Nov 16, 2017 Devils advocate film,

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How Do I Hate NPR? Let Me Count the Ways. Every few years I make an anthropological visit to my sister's home out west. Film. My sisterher name is equi pdf, withheld to protect the guiltyis a lifelong bureaucrat who's never worked for anyone who had to show a profit, and devils advocate, she is deeply suspicious of the law of marginal pdf, whole concept. She'll drive miles across the city to poke through the out-of-copyright videotapes at devils advocate film the public library rather than spend two bucks to casey case, rent one at the Blockbuster down the street. She regards any financial transaction between two parties not employed by devils advocate film the government as vaguely shady, if not downright illicit. Needless to say, she listens to National Public Radio. Every morning that I stay at her house, I'm awakened at 6 AM by the droning baritone of Bob Edwards, the anchor of Morning Edition . The program stays on until 8:30, when my sister dashes to her car and switches it on marginal, there to listen to the final half hour on her way to advocate, work. And in The Story of an Hour, the afternoon I usually have to leave the house to avoid being driven to homicide by the discordant tinkling of the All Things Considered theme, which echoes from film her radio from martyr 5 PM to devils advocate film, 6:30. Of course, lots of people have favorite news programs.

I don't think my father missed more than half-a-dozen telecasts of The Huntley-Brinkley Report in his entire life. But what moves my sister's obsession with NPR from the mildly eccentric to the downright bizarre is that it's her sole source of force news. She never watches network television news, and she'll tune in a local program only when she knows it's running a story about one of her bureaucratic projects. Devils Advocate. She subscribes to a local paper, but only for the arts listings. This has led to some grave disappointments in my sister's life. She is summary, still perplexed that the ERA didn't make it into the Constitution, since, she told me, NPR reported that the devils, election of hydrostatic force Jimmy Carter made it a sure thing. Devils Film. And she was dumbfounded when the Christic Institute's lawsuit, which alleged that the entire national security apparatus of the U.S. government was nothing more than a drug ring, was dismissed by a federal judge before coming to trial. NPR, she said, had made it all sound so reasonable. (The fact that the suit was filed by an NPR stringer, to my sister's way of leading thinking, only confirmed its validity.)

Once in a while, I gently hint to my sister that her worldview might be slightly better rounded if she would acknowledge that perhaps Linda Wertheimer is film, not the final authority on hydrostatic, everything under the advocate, sun. My suggestions are always met with scorn. You can get your news from giant corporations if you want to, she snaps. I'd rather get mine from people who aren't motivated by profit. I'd rather get my news from people who think like me. For a long time I considered my sister a harmless aberrationan upscale version of the paul simon age, guys you occasionally read about who think they get secret messages from Elvis through their fillings. But as the devils, years have passed, I've met more and more people who share her fetish for NPR. In fact, NPR itself likes to brag about the cultish devotion of its listeners. The network's 1991 annual report includes letters from a number of hopelessly fixated groupies who regard NPR roughly the same way John Hinckley regarded Jodie Foster.

One listener boasts that he and his wife recently drove from Buckhannon, West Virginia, to Portland, Oregon, and back, listening to NPR every foot of the joan martyr, 6,500 miles. Advocate. Another, from The Story of an Hour Randolph, Massachusetts, flatly declares: If I am informed at all about anything current, it is advocate film, because I listen to hydrostatic, NPR. With my sister, these listeners share the peculiar belief that they're better informed because they obtain all their information from a single sourcethat exposing themselves to an alternative would not only not add to their knowledge, but would actually subtract from it. Most NPR listeners, I'm sure, wouldn't trust an economist who bragged that he accepted only the scholarship of Milton Friedman, or a politician who read only the advocate, works of Lenin. But somehow they think their own understanding of the world is enhanced by basing it exclusively on a news organization that labors in paul simon age, an antiquated, one-dimensional medium and whose entire staff wouldn't fill the city room at the New York Times . This is something of a mysterythat highly educated, well-to-do people (for that is what NPR's listeners are, mostly) would adopt the kind of intellectual isolationism that we would ordinarily associate with survivalist cults holed up in the Ozarks. Like survivalists, NPR listeners are not exactly numerousThere are more people falling off the face of the earth than there are listening to NPR, observes Bill McCleneghan, ABC Radio's vice president for advocate researchbut, like survivalists, their very existence is a troubling enigma.

You always have to wonder: Do they know something the Hour Essay, rest of devils advocate us don't? Recently I decided to get to the bottom of this. I became an paul simon age undercover NPR listener. To my family and film, friends, I kept up a facade of normality, reading my regular newspapers and watching television news. Case Summary. But, in the privacy of my bedroom, away from the world's prying eyes, I got up every morning at 6 and listened to all three hours of Morning Edition (the length of the program varies from market to devils advocate, market). And every afternoon at 5 I mixed a stiff drink and hydrostatic force, settled in for 90 minutes of All Things Considered . My conclusion: I'd rather be a survivalist. YOU DON'T HAVE TO BE TED KENNEDY TO LISTEN TO NPR, BUT IT HELPS. The charge that NPR's newscasts have a leftward spin goes clear back to the network's origin in 1970. Just two years later, Richard Nixon, angered by what he perceived as programming bias at NPR and its television cousins at the Public Broadcasting Service, vetoed their appropriations. He later reversed his decision, to the eternal dismay of advocate film conservatives, who've been braying about NPR ever since. Every time I turn on NPR, I think I'm listening to the Democratic National Committee, Bob Dole complained last year.

Nixon and Dole, of The Story of an Essay course, are hardly arbiters of political neutrality. But the truth is that you don't have to be a graduate of the film, Spiro Agnew School of Korrect Journalism to recognize a persistent liberal bias in NPR newscasts. The evidence is all over the place, and it doesn't take a microscope to find it. Take, for example, NPR's coverage of the battle over joan of arc Bill Clinton's $16 billion economic stimulus package. During the week I listened (April 12 to 16), this was a hot topic. Readers of the New York Times , the Washington Post , and just about every other newspaper in America knew that Senate Republicans hadagainst all expectationsstuck together in maintaining a filibuster against the bill, and that it was in film, serious trouble. But I'll bet my sister and her friends had no idea. All week, NPR portrayed an indomitable Bill Clinton riding a tidal wave of public support against a faceless andmore importantly, in the context of radiovoiceless Republican rabble. During the hydrostatic force, first three days of the devils, week, NPR ran 11 stories on Clinton's campaign for the package, all of them centered around speeches by the president or Al Gore. For three full days their voices echoed over the NPR airwaves, accusing Republicans of fighting to withhold immunizations from poor children and of being antiprogress.

Often their sound bites were followed by the comments of NPR reporters, adding that audiences were enthusiastic or the president's message struck a nerve. For good measure, there was an interview with Cokie Roberts, noted NPR expert on you-name-it, in which she allowed as how there's more than a little racism in anyone who opposes aid to cities. And senior news analyst Daniel Schorr urged Clinton to stand up in the name of principle and tell those dirty partisan Republicans: No more Mr. Nice Guy. On Definition. This is advocate film, your president speaking. And where was the Republican rebuttal to all this? Well, it wasn't to be found on of an Essay, NPR.

It wasn't until the devils advocate film, afternoon of April 15, the fourth day that I listened to the network, that I heard a Republican voice on paul simon age, the subject of the filibuster. And even then, it was a Republican analyst apparently conceding that the filibuster would probably collapse, but insisting it was a moral victory nonetheless. Devils. The theme of reporter Elizabeth Arnold's story was that Republicans had taken advantage of the fact that Clinton had been briefly distracted by the death of his father-in-law. (Those bounders!) But the of an Hour, candidate whose discipline seldom faltered during a tumultuous election year is back on devils advocate, solid footing, Arnold reassured her listeners. The next morning she offered more comfort: President Clinton may have stumbled a bit . . . but he's not ready to take a legislative fall. Of An Hour Essay. Actually, he was; the devils advocate, White House was already offering desperate compromises to moderate Republicans in hopes of hydrostatic salvaging some of the stimulus package, and in less than a week it would be stone-cold dead. NPR took a similarly partisan course in advocate, coverage of The Story of an Hour another of the week's big stories, the discovery of a document in Soviet archives stating that the North Vietnamese held back several hundred American POWs when the two countries signed a peace treaty in 1973. All week, NPR stories quoted anonymous congressional staffers expressing doubts about the devils, authenticity of the document. Fair enough; there are a lot of marginal pdf troublesome questions about its origin and contents. On the other hand, there are also highly qualified people who argue that the document is genuine, including Zbigniew Brzezinski.

And the Harvard researcher who found it, Stephen Morris, was in New York, where the New York Times , the Washington Times , and devils advocate, ABC's Nightline all managed to find him. But NPR either couldn't find him or couldn't be bothered to paul simon age, confront him. Instead they ran sound bites of Morris and Republican senator Robert Smith that had been taped off a Nightline broadcast two nights earlier. Theirs were the only voices that appeared on the radio all week in support of the document's authenticity. Although NPR couldn't track down any sources of their own to back up Morris, reporter John Greenberg did manage to find someone to impugn him.

Greenberg interviewed John McAuliff of the U.S.-Indochina Reconciliation Project, who dismissed the film, document as a fake because Morris has been involved in an active polemic against marginal pdf people who favor normalization of relations [between Vietnam and the U.S.]. . . . He has a viewpoint. Now, if Greenberg had called some conservative think tank or political organization, he might have gotten an additional comment that sounded something like this: John McAuliff has been involved in licking the boots of Vietnamese communists for more than two decades, first as a prominent antiwar activist and now as a professional apologist, and of course he can't accept the advocate, document because it would prove that, for of arc all these years, he's either been hopelessly stupid or willfully deceptive in his depiction of the Hanoi government. He has a viewpoint. Do you think Greenberg made that phone call? Do you think pigs have wings? In the NPR dialectic, only anticommunists are suspected of partiality.

So the broadcast made no mention at all of advocate McAuliff's background. Similarly, when Robert Siegel interviewed Eugene Terre Blanche, the head of South Africa's Afrikaner Resistance Movement, he introduced him as a right-wing extremist. (Accurate, even mild.) But during the interview, Siegel referred to law of equi pdf, Chris Hani, the recently murdered head of the South African Communist Party, only as a popular black public figure. (Especially misleading because it appears Hani was killed less because of his race than because of advocate his party affiliation.) You might think that after two decades of threats from Republicans to lay waste to law of equi marginal pdf, NPR, its reporters (or their editors, if such exist, which I doubt from the devils advocate, windiness of some of the pieces) would at least make an The Story Hour effort to be more circumspect about coloring their stories. But it doesn't seem to work that way. Several times I heard them tripped up by devils advocate film their own reporting. For instance, one morning reporter Kathy Lohr filed a story about the Operation Rescue training camp in Florida, where antiabortion protesters learn the tricks of their trade. Lohr solemnly informed her listeners that the camp's executive director teaches antiabortion troops not to leading on definition, use their own name when gathering information about doctors who work in abortion clinics. But the sound bite from the devils film, executive director himself didn't quite square with her interpretation: It's just better if they don't know who's asking for the information. We can surprise them with information a lot better that way, and they can't go back and try to cover their trail. So that's important.

Use other people that aren't as well-known as you may be. (Emphasis added.) Assigning lesser-known members of the group to gather information is a far cry from doing it under a false name. Ethically speaking, it doesn't even strike me as a close call. And I'll bet that if Lohr were reporting on how prochoice people sometimes infiltrate antiabortion groups to joan of arc, gather information for lawsuits, she wouldn't have condemned the practice. Sometimes NPR reporters were so thoroughly contradicted by devils advocate their own stories that it was downright funny.

My favorite was a story about Clinton and the news media by Andy Bowers. The thesis of the law of pdf, piece was that the first few months of the devils advocate film, Clinton administration seem to have strained the bond between the people and the press because reporters have been so rough on Clinton. To prove it, Bowers interviewed some residents of Jefferson City, Missouri. Said the first one: Media is doing their typical bashing the guy in charge, like always. It's nice to leading on definition, see them do it to a Democrat. Chimed in another: They baby him. Advocate. They follow him around, they really don't challenge him.

Added a third: I don't believe George Bush in his first 100 days made near as many people mad as Bill Clinton. Yup, it sounds like the citizens of Jefferson City are just about ready to storm the offices of the TV networks with torches and pitchforks, demanding fair play for law of marginal Clinton. Lest there be any confusion, Bowers interviewed University of advocate Missouri journalism professor George Kennedy. Joan Martyr. He explained just what those untutored Jefferson City louts, with their poor command of English, were really trying to devils advocate film, say: There's a fairly widely held sense in of an Hour Essay, the public that there really ought to be a kind of honeymoon, that simple fairness dictates that the new president ought to have a chance to get his program up and running before we start picking it apart. (I wonder if Kennedy thinks the public was well served when the devils advocate film, news media let the Vietnam war get up and running before asking any tough questions.) By the end of his report, even Bowers seemed hopelessly confused by what he was trying to joan of arc, say. He quoted a Los Angeles Times poll showing that two-thirds of those responding think the press is too chummy with the devils advocate film, government. Paul Simon Age. And there were more quotes from Jefferson City. There's so much we don't know that goes on over there [in Washington], said one.

The only way a reporter is devils film, gonna get on the inside is by playing the joan, game, declared another. Advocate Film. It sounds to me like what Jefferson City wants is not a honeymoon but a divorce. Laurence Jarvik, a conservative critic of public broadcasting, once asked plaintively: Why is it that there's room at NPR for a practicing witch, but not a practicing conservative? (By the way, this was notas the of an Hour Essay, uncharitable might have suspecteda reference to Nina Totenberg, but to reporter Margot Adler, who actually casts spells and stuff like that.) This, I suspect, has a good deal to advocate, do with the ideological drift of NPR's news. It's not that the force, network's editorial brain trust meets each morning to plot the day's campaign to rid America of Republican taint. Advocate. It's that the newsroom is composed almost entirely of casey summary like-minded people who share one another's major philosophical precepts. When my sister says that she wants to hear news from people who think like me, she's put her finger on the problem. Their thinking is apparent in both what they report and their approach to it. They believe that government is the film, fundamental agent of change, that government can and should solve most problems.

They believe most of those solutions involve spending large sums of money. They believe that taxes are not only an appropriate way of on definition raising money, but an important social responsibility. They believe that, although individuals cannot always be trusted to devils advocate film, make correct choices, bureaucrats usually can. In short, NPR reporters are the leading on definition, kinds of devils advocate people who voted for hydrostatic Michael Dukakis and devils advocate, Bill Clinton, not as the lesser evils but enthusiastically, in the firm belief that what the world needs is better social engineering. Their umbilical attachment to the state is most clearly visible when it comes to stories concerning taxation. NPR reporters will have their eyes put out with red-hot pokers before they'll question the sanctity of a taxany tax. Consider a story filed by Daniel Zwerdling, NPR's correspondent in law of equi marginal, Nairobi. Kenya's government is devils film, close to going bankrupt, Zwerdling said by way of introduction. Hospitals can't afford to buy medicines.

The national telephone system is breaking down. Schools can't afford to buy benches, so children sit on the floor. The Story Hour. And when you call the police to tell them thieves are breaking into your house, the police say they can't help you unless you give them a ride because they don't have cars. And why is Kenya broke? One root of the devils advocate, problem is that most of the paul simon age, people who are supposed to pay taxes never do, Zwerdling explained. And it must be the most important root, in advocate film, his eyes, because he never identified another. The rest of the law of utility pdf, story was about advocate film, a new tax-collection system that has been blocked by Kenyan president Daniel arap Moi. In point of actual fact, Kenya ought to be able to make its government work without collecting a shilling in taxes.

Until recently the marginal pdf, country was getting a staggering $1 billion a year in Western aid, which ought to have covered the advocate, entire Kenyan budget with money left over for doughnuts all around. Of An Essay. But in advocate, 1991 the donor nations began cutting back because of the breathtaking waste and theft that go on in Kenya's 300 or so state-owned industries. (One particularly nimble Kenyan kleptocrat, former energy minister Nicholas Biwott, is casey case summary, estimated by the British government to have made off with hundreds of millions of devils film dollars all by himself.) Ask any foreign diplomat or independent economist in Nairobi for the top five reasons the Kenyan economy is crumbling, and tax collection will be at the bottom of the listif it's mentioned at paul simon age all. But at NPR it leads the hit parade. If NPR reporters were scandalized by the reluctance of Kenyan cattle herders to keep funding London penthouses for advocate that nation's thieving rulers, then imagine how they feel about comparatively affluent Americans who try to beat the tax system. As April 15 approached, NPR correspondents foamed at the mouth about the The Story of an Hour, dire consequences of tax evasion. In North Carolina, NPR reported, the government will put your name in the paper. In Virginia they'll put it on television. And stiffing Uncle Sam (who, coincidentally, funds NPR's sugar daddies at the Corporation for Public Broadcasting)well, don't even think about it. If you plan to devils advocate film, miss the deadline or try to do some fancy paper shuffling on deductions, warned All Things Considered host Linda Wertheimer in her sternest voice, you may want to think again. Her warning was somewhat undercut by the interview that followed, in which a Forbes editor said the casey summary, IRS only audits 1 percent of all tax returns.

But Wertheimer did perk up considerably when the editor agreed that if they [the IRS] catch you, they can kill you. What do you mean? inquired Wertheimer excitedly. Her enthusiasm dampened only slightly upon learning that the word kill had been used metaphorically. To their credit, NPR reporters do seem to have a vague notion that some Americans don't share their zeal for devils taxes. So when the White House floated a trial balloon suggesting that Clinton is considering a value-added tax (VAT), they tried to Hour, soften the blow. Bob Edwards interviewed NPR reporter Patricia Neighmond about how the VAT works. After she explained that it entails taxing each and every step of a product's manufacture, Edwards observed that as the taxes mounted, there would be an increasingly higher price on devils advocate film, the product. Well, it would seem so, Neighmond replied, apparently holding out some hope that friendly emissaries from the planet Zork would swoop down and pay the taxes, sparing earthlings the pain.

Later that day, on The Story of an Hour, All Things Considered , Daniel Schorr carefully instructed his listeners that they shouldn't blame Clinton for the VAT. The fact is that, having in February rejected the idea of a VAT tax, Mr. Clinton is being forced to consider it again, Schorr affirmed. Devils. Alas, this raised more questions than it answered. Who, exactly, was forcing the president? Did Hillary have her cattle prod out again?

Was Janet Reno threatening to send FBI agents over to the White House to practice Texas fire drills? Schorr, obviously constrained by national security concerns, wouldn't say. Law Of Equi Marginal Pdf. But, he consoled, the VAT has its charms. What makes it attractive, he noted, is what has made it attractive to European countries and Canada. Here the veteran reporter was clearly the advocate film, victim of hydrostatic a technical glitch.

What he was trying to say was, what has made it attractive to European countries and Canada, compared to being sodomized by a herd of rabid camels. Devils Advocate. As the next morning's Post reported, It would be hard to find a person, institution or program in Canada that is hated more [than the equi marginal, VAT]. Undaunted, Schorr continued: On the plus side, a value-added tax could raise so much money that it might be possible to offer cuts in other taxes. As he spoke, I could almost hear a sigh of relief echoing from Takoma Park and the rest of the NPR ghettos around Washington. Schorr had saved the day. Most estimates have put the maximum potential revenue from the VAT at around $68 billion. Meanwhile, estimates of the cost of devils film Hillary's new health program (which is what the equi utility pdf, VAT is supposed to fund) range anywhere from $100 billion to $150 billion. Only a steel-trap mind like Schorr's could have performed the complex mathematical functions necessary to turn a $30 billion shortfall into devils film a tax-cutting surplus. Literally no subject is casey anthony case summary, safe from NPR's love affair with taxes. Even a piece on how name-brand products are losing market share to generics ended with a wild (and, of course, unanswered) tirade by advocate film an antismoking Nazi demanding a 40-cents-a-pack tax on cigarettes.

The flip side of taxation is subsidy, and NPR reporters never question the need for that, either. I listened in amazement to a story by law of equi marginal utility Dan Charles on a new half-billion-dollar handout to military contractors to convert them into civilian industries. Devils Film. It sounded like a piece on some kind of The Story Hour Essay arts-and-crafts program for retarded kids, with arms merchants bubbling on about how they were learning to make golf clubs instead of missile launchers. Not once did it occur to film, Charles to ask a simple question: If it's in the economic interest of these companies to convert anyway, then why should the of arc martyr, government pay them to devils advocate film, do it? The reason he didn't ask, I'm sure, is that he shares the belief of technocrats that economies and hydrostatic, societies, deprived of adult supervision, will quickly devolve into chaos and bedlam. Social engineers view the world as a huge Skinner box through which they must guide us pigeons with little rewards and penalties. It's a vision enthusiastically shared by NPR reporters, who react with ill-concealed horror at any suggestion that the pigeons might seize control of the laboratory. One of the devils film, most telling moments of my ordeal-by-NPR came while Linda Wertheimer was interviewing a computer developer on what will happen when computers are linked into leading on definition televisionsthe so-called intelligent TV. He predicted the devils advocate film, development of casey anthony case summary literally hundreds of new interactive television networks and services that would give the individual TV viewer an incredible amount of power to program for advocate film their own tastes rather than have to rely on these programming guys. Replied a perturbed Wertheimer: Is there any way we can dodge this bullet? The idea that the government might impede rather than advance societal development is The Story of an Essay, utterly alien to NPR.

One morning I listened as John McChesney reported the announcement that the giant cable company TCI would spend $2 billion to build a broad-band fiber-optic communications networkthe data superhighway that will permit the development of the intelligent TV. McChesney made the astonishing assertion that TCI was undertaking the project not because of the devils film, incalculable billions of dollars in martyr, profits it may generate, but because of Bill Clinton's aggressive promotion of an devils information infrastructure. In fact, the private sector has been trying for some time to get the federal government to paul simon age, permit the creation of a data superhighway. MCI, ATT, and Sprint already have the fiber-optic networks in place. But federal rules and devils, regulations have prevented them from being hooked up to individual homes. McChesney is certainly aware of thishe even touched on the point later in his reportbut that didn't stop him from declaring that the private sector was acting only because the government told it to. YOU WANT AN ALTERNATIVE, LOOK IN THE THESAURUS. NPR's founders thought they were creating government-funded underground radio. Force. Their original statement of purpose called for programming that would promote personal growth rather than corporate gain, and not only devils advocate, call attention to a problem, but be an on definition active agent in seeking solutions.

If it had worked out that way, NPR news might be a lot more interesting. Devils Advocate. But it didn't. NPR is not a national version of, say, a Pacifica station, where an of an Essay announcer might analyze the virtues of different brands of film LSD or urge people to go naked on of arc, Election Day. Instead, it's a house organ of respectable inside-the-Beltway liberalismnews written by and for aging yuppies whose idea of adventuresome politics is telling Dan Quayle jokes. In fact, NPR's toughest critics these days come from the left, and they hammer away at this very point. Film. Quoting Democrats instead of Republicans, the paul simon age, critics argue, offers an alternative in roughly the same way that Cheez Whiz is an alternative to Velveeta.

One of the most savage recent critiques of NPR news came from Charlotte Ryan, a professor of sociology at Simmons College and devils advocate, codirector of Boston College's Media Research and Action Project. She studied every weekday broadcast of of arc Morning Edition and All Things Considered from September through December 1991, reading the transcripts of 2,296 stories. (Her ennui threshold is obviously a good deal higher than mine.) NPR's regular coverage mirrored that of advocate commercial news programming, Ryan concluded. NPR stories focus on joan, the same Washington-centered events and public figures as the commercial news, with the White House and Congress setting much of the political agenda. NPR's sources often paralleled those of Nightline and other network public affairs shows, with a similar tilt toward government sources and politically centrist or conservative think tanks and publications. Ryan found that more than three-fifths of NPR's domestic stories were reported from Washington, and only 10 percent from the midwest. The sources most commonly quoted were government officials.

And, if you're one of those people who like their news drawn from and delivered by advocate film a politically correct mixture of races and sexes, then NPR definitely is not for you; you may be surprised to learn that Ryan found that most of the network's sources and commentators were the dreaded Pale Penis People. Portions of force her study must be taken with a grain of saltRyan is surely the only person in America who believes that Nina Totenberg's coverage of the fall 1991 Supreme Court nomination was biased in favor of Clarence Thomasbut the week I listened to NPR, it sounded pretty much the devils film, way she described it. The vast majority of stories reported on Morning Edition and All Things Considered come off the Associated Press wire or are rewritten from the Washington Post , the paul simon age, New York Times , and the Wall Street Journal . Most of them are event driven: Clinton makes a speech, the Labor Department issues economic statistics, the U.N. issues a new warning about Bosnia, Janet Reno does a photo op. Anybody listening to devils advocate film, ABC or CBS radio news would hear nearly all of this, and without the numbing repetition. (One day I listened to Morning Edition report nine different times that the leading, jury in the Rodney King trial was still out, with no new developments.) Only once during the week I listened to NPR did I hear a story of any significance that didn't appear in all the other major news media. On April 15, John Nielsen reported, several days ahead of the pack, that the Clinton administration would sign the Rio de Janeiro biodiversity treaty that had been deep-sixed by George Bush. Good job.

But mostly what the scoop illustrates is the precarious niche that NPR has carved for advocate film itself: It shuns the alternative label, but it doesn't have the casey anthony summary, resources or the devils advocate, talent to successfully compete with the mainstream media. Breaking a single story in a week is hardly going to of arc martyr, put the fear of film God in leading, Peter Jennings or Max Frankel. Not even the most delirious NPR staffer would make that claim, of advocate film course. The standardand cleverly hedgedboast of NPR people is the one NPR reporter Alex Chadwick made at a recent public-radio fund-raiser in leading on definition, Hartford: We've evolved past being an alternative medium to being, I think, the dominant radio news organization in the country. To which the only sensible reply is: So what? Being the dominant radio news organization might have meant something in advocate film, the days when Ed Murrow was broadcasting live accounts of Nazi air raids from London.

But for the past 30 years, radio news has been on the scrap heap. On Definition. A poll released earlier this year by devils advocate the National Association of paul simon age Broadcasters showed that only devils advocate, 16 percent of Americans consider radio an important source of news, compared with 69 percent for television and 43 percent for hydrostatic newspapers. And just 7 percent picked radio as the devils film, most credible news medium. (By the equi marginal utility, way, Chadwick is most assuredly not talking about numbers of listeners when he uses the word dominant. Morning Edition and All Things Considered have less than 3 percent of the radio audience at any given moment.) Newspapers offer their readers depth and eclecticism. Television offers its viewers drama. Radio offers its listenerswell, not much. A headline service, to let them know what they can see on the evening news or read in the morning paper or find on CNN at any time of the day or night. NPR reporters argue that they compensate for advocate film radio's shortcomings by offering longer stories.

Whether longer is better is casey anthony case, a debatable point. Devils Advocate Film. In theory, I think it's great that there's someone out there doing long, highly produced radio news stories, says one industry insider. But in practice, I don't know. I was listening to Morning Edition the other day on the way to work, and paul simon age, they ran this story on devils film, a ballet company for autistic children in South Africa. It went on for seven, seven-and-a-half minutes. Essay. And finally I was thinking to myself, Who cares? It's just too much. When NPR tries to cover hard news, its storieseven when they stretch on for six or seven minutesare rarely long enough to rise above the sort of devils advocate shallow sound-bite once-over for which television is so justly criticized.

John Burnett's seven-and-a-half-minute preview of the special election in Texas to fill Lloyd Bentsen's seat was typical. Hydrostatic. He reported that the interim appointee, Bob Krueger, would probably get into a runoff. But beyond that, it was pretty murky. Krueger earned high praise in his two terms as a congressman. From whom? For what? Dunno. His brief record in the Senate has already come under fire.

Why? Well, the only thing Burnett had time to mention was that Krueger broke with Clinton over gays in devils advocate, the military. Law Of Marginal Utility Pdf. Having lived in Texas myself, I don't imagine that was terribly unpopular. But we've already moved on to the Republicans. Leader: state treasurer Kay Bailey Hutchison. Advocate. She's running because I want to go to Washington and change it. Into what? Sorry, gotta move on. There's a candidate named Richard Fischer, a buddy of Ross Perot's.

He's spent $4 million of his own money on hydrostatic force, this race. What's his party? What's his platform? Where is he in the polls? Too bad, we're outta here. But if seven-and-a-half minutes is devils advocate film, too little for hard news, it is assuredly too much for most NPR feature stories. Hydrostatic. Did anyone listening to devils film, Morning Edition in Portales, New Mexico, or Senatobia, Mississippi, really want to of arc martyr, hear Lynn Neary's eight-and-a-half minutes on yuppie angst about living in Mount Pleasant and devils advocate, Columbia Heights? (Sample quote: Violence sensitizes you to all the other abrasions in Hour Essay, the urban environment.) Quite aside from being inside-the-Beltwayism run completely amok, this is simply bad journalism. And now we've come to the real secret of film NPR news: Bad journalism is not just an occupational hazard, the occasional and inevitable accident that occurs in paul simon age, every news organization. Bad journalism happens on the quarter hour at NPR.

Bad journalism is, often, policy at NPR. How shall we count the advocate film, ways? The dull scripts, so formulaic that even the reporters privately make fun of them. Last year, when NPR was running a long, long, long series of stories on local people shunted aside by development in Latin America, several reporters formed a pool. Recalls one: We bet on paul simon age, how long each story would go before it cued a strumming guitar, followed by a grandfather mourning his lost son, then singing long-forgotten revolutionary songs. The infatuation with ethnicism, to the extent that NPR stories are sometimes barely comprehensible. Devils Advocate Film. NPR reporters love to have exotically accented English in case summary, their pieces, even if it's pure gibberish. Here's the way Nexis transcribed a quote from a Thai official whose tape-recorded English-language comments were included in a report by devils advocate Mary Kay Magistad on problems on the Thai-Cambodian border: We have spent a lot of money to neighbor of Cambodia, like you see here, and the business along the border, like the summary, business [unintelligible] with Burma, the same that the devils film, people who live along the border, their triptheir trip, you know?

It is the nature of the businessman. I've listened to the same quote three times on on definition, tape and I can't translate it any better than Nexis did. The star reporters who throw their weight around, getting away with crap that would have a college intern fired in ten seconds. Nina Totenberg (one of the three powerful NPR womenCokie Roberts and Linda Wertheimer are the othersto whom some male reporters refer collectively as the fallopian jungle) reported one morning on advocate film, a topless dancer suing a Dallas club for age discrimination. Equi Marginal Utility. She introduced her story with a crack about sagging hopes. I'd call that stupid and sophomoric; if Clarence Thomas had said it, I'll bet Totenberg would have called it something much more serious. (In Totenberg's defense, she's certainly not the first allegedly feminist NPR reporter to use language that would be derided as sexist swill coming from a man. Susan Stamberg once opened an interview with novelist John Irving: Mr. Irving, on the basis of devils advocate your brilliant writing, and your photograph on paul simon age, the dust jacket of Garp , most of the women on our staff have told me they'd like to run away with you.) Circle-jerk journalism, when reporters interview reporters. I don't recall the last time I picked up the advocate, Post and found a front-page interview of Ann Devroy by David Broder. The Post and, as far as I know, every other news organization in Americareports the news by reporting the news rather than interviewing other reporters about the news.

That's not the way it works at NPR. Eight times in five days I heard NPR reporters interview other reportersusually other NPR reporters. And I'm not counting four interviews with reporters like new Pulitzer recipient George Lardner Jr. Leading On Definition. who were, at least arguably, actual news makers; nor am I counting several foreign journalists interviewed as part of larger stories about their countries. Devils Advocate. At best, these pieces were flaccid. I would be interested in what an economist thinks about the value-added tax. I might be interested in what a merchant thinks about it, or a truck driver, or a housewife.

I am emphatically not interested in what an NPR reporter thinks. But several of the interviews with reporters developed into anthony summary something considerably worse than flaccidity. When Bob Edwards talked to Bill Sloat, a Cleveland Plain Dealer reporter covering the inmate takeover of a maximum-security prison in Ohio, NPR used the opportunity to pass along unattributed rumors and speculation that Sloat could never have gotten past his own editors. Sloat started with the observation that I think [the atmosphere at the prison] has grown a little more tense overnight. I have nothing to base it on, but it's just a feeling. He bottomed out by mentioning that six inmates had already been killed and film, he had heard rumors that some of the bodies were mutilated. Now, nobody will confirm that. Sloat's rumormongering, though, was model journalism compared to the interview Edwards had done with Cokie Roberts the day before. Hydrostatic Force. Supposedly this was an interview about the Republican attack on Clinton's economic stimulus package (Roberts being so much more knowledgeable about that than an actual Republican), but Roberts quickly shifted the subject to a special congressional election in the Mississippi Delta.

There's a black candidate versus a white candidate, Roberts said. And this is advocate film, where you really see the words 'city' or 'inner city' become something of a code word for race. Paul Simon Age. The white candidate, who's a Republican, is saying that his opponent is a liberal from the city, as opposed to film, himself, who's a conservative from the joan of arc martyr, country. And that's just sort of a way of letting people know that the opponent is black. I don't think a deaf, dumb, and advocate film, blind martian could have gotten this story more ridiculously wrong. First, the casey anthony case summary, Democratic candidate had just survived a brutal and film, highly publicized primary election. So everyone already knew he was black. Force. Second, everyone already knew he was black anyway, because Mississippi is the devils film, most race-conscious place in America. I can't think of an election of any importance in my lifetime when everybody didn't know the race of all the candidates, says Sallie Anne Gresham, a native Mississippian and the managing editor of the Delta Democrat-Times , the on definition, Delta's largest newspaper. (Hey, if NPR can use journalists as talking heads in their pieces, why can't I?) Third, the majority of the voters in the congressional district are black. (So is Mike Espy, who resigned the advocate, seat to casey anthony summary, become secretary of agriculture.) So it wouldn't exactly have been shrewd politics for the Republican to make an issue of the Democrat's race.

And he didn't. Instead, the Republican embraced the devils advocate film, black vote, spoke frequently of his respect for Martin Luther King, and tried to appeal to the social conservatism of rural black voters by pointing out casey, that his opponent was a liberal from the city. The Democrat, by contrast, made race an explicit issue; he campaigned in devils advocate, large part on the platform that black people could only on definition, be properly represented by a black congressman. He won. The practice of putting reporting positions up for sale. NPR people prefer to use the euphemistic term underwriting.

Whatever you call it, eight of NPR's reporters are fully funded by corporations or foundations, confirms an NPR spokesperson. I wonder what the founders would have said back in 1970 if they'd been told that someday NPR would have a science reporter paid for by Hewlett-Packard? NPR officials insist that the advocate film, outside funding has no impact on the way they report the news. Martyr. But of devils film course it does. NPR has eight, count 'em, eight reporters on its science desk. But it has no labor reporter, no crime reporter, and until a few weeks ago had no Pentagon reporter. Can you guess which desk has seven underwritten reporters? Underwriting also accounts for the fact that NPR has a full-time reporter in Kenya doing stories about tax collection, while it relies on a stringer to cover South Africa, where one of the most exciting stories of the decade is paul simon age, unfolding. Daniel Zwerdling, the Kenya correspondent, is funded with a $100,000 grant from the devils advocate, Affinity Group for Southern Africa, a consortium of 50 or so foundations. It's a group of foundations that are promoting economic development in southern Africa, explains Michael Sinclair of the Kaiser Family Foundation, who coordinates the Affinity Group. Anthony. We went to NPR with a proposal to supplement their regular news reporting from devils southern Africa with regular reporting on on definition, economic issues.

Now, the obvious question is: What if Zwerdling starts filing stories about acts of tyranny and expropriation in Zimbabwe, or an Iranian-backed secession movement in Tanzania-you know, things that don't exactly encourage economic development? What if he reports that a lot of the devils film, governments in southern Africa are run by swindling brutesand that economic aid only perpetuates their regimes? We don't have any control over the reporting, Sinclair says. But would the paul simon age, Affinity Group keep funding a reporter who did those stories? I don't think that would play a role in evaluating the funding, he insists. He sounds sincere, and I'm sure Sinclair believes his own words. I don't know if I do.

And I wonder if Daniel Zwerdling and his editors do. OK, I'M CONVINCED. YOUR SISTER'S AN IDIOT. WHAT'S IT TO ME? Well, you pay for it.

That may come as a surprise; through a propaganda campaign that's been successful beyond its wildest dreams, NPR has convinced most people that it no longer depends on advocate, tax dollars for its existence. The NPR claim that less than 3 percent of its funding comes from the force, federal government is accepted as gospel almost everywhere. But what that figure really represents is a clever bookkeeping trick. Devils Advocate Film. In 1987, the Corporation for paul simon age Public Broadcastingthe quasi-independent organization in advocate, charge of distributing the annual $300-million-plus federal subsidy to public broadcastingstopped funding NPR directly and started giving the casey anthony summary, money directly to devils, public radio stations, which then hand it back to NPR in the form of dues. That covers about two-thirds of NPR's $46 million annual budget. Then there's the matter of that $198 million satellite NPR uses to distribute its programming: yup, paid for with tax dollars. (NPR also makes a nice chunk of change by leading renting out the satellite's excess capacity to a private paging company.) And without taxpayer dollars, there wouldn't be any public stations to run NPR's programs.

Of the total $377 million spent on public radio in fiscal 1991, nearly half was provided by advocate film local, state, and federal government. Of Arc Martyr. Taxes are the lifeblood of the entire industry. So remember: You're paying Cokie Roberts $60,000 a year for her half-baked ranting about racism in America. You're paying Daniel Schorr $95,000 a year to demonstrate Martian mathematics. You're paying Linda Wertheimer $97,000 a year for advocate film anti-tax-evasion public service announcements. You're paying Carl Kasell $90,000 a year, Robert Siegel $101,000 a year, and equi marginal pdf, Bob Edwards $134,000 a year to imitate the bloodless drone of devils advocate HAL the The Story of an Hour, computer.

Maybe you think it's a good deal. I'm sure my sister does. Art accompanying story in printed newspaper (not available in advocate, this archive): illustration/Andrew Epstein.

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UC Essay Prompt 3: Talents and Skills. I believe all students who need to answer four of the new University of California Personal Insight Questions should seriously consider the third one, otherwise known as UC Essay Prompt 3. If youre a student who has focused on devils advocate one special talent or skill in your life, and are recognized in that field as among the best, this is your chance to share that in detail. However, you dont need to be a star at force your talent or skill to write an effective essay about devils advocate it. And your talent or skill doesnt even need to hydrostatic force be impressive. Here is UC Essay Prompt 3 in full (the following three paragraphs): What would you say is your greatest talent or skill? How have you developed and demonstrated that talent over time? Things to consider: If theres a talent or skill that youre proud of, this is the film, time to share it. You dont necessarily have to be recognized or have received awards for leading on definition your talent (although if you did and you want to talk about, feel free to devils do so). Why is this talent or skill meaningful to hydrostatic force you?

Does the talent come naturally or have you worked hard to develop this skill or talent? Does your talent or skill allow you opportunities in or outside the classroom? If so, what are they and film, how do they fit into your schedule? UC essay prompt 3 mainly needs to equi pdf feature something that you are passionate about. As long as you can show why you love it and advocate, how hard you have worked at it, almost any activity could be a great topic. If you are a star at ice-skating or drama or coding, again, this is your big chance to share your story about this passion. Even if you have included this talent or skill heavily in your application (listing accolades and paul simon age, awards), you can still write about devils advocate film it for UC essay prompt 3. This is your chance to go beyond your impressive status with this talent or skill and share how you got into Hour it, what inspired you, how hard you worked and what obstacles you overcame to excel. The most important part of this essay would be to devils explain why your impressive status mattersto you, to of arc others and to the world. Has it changed you?

Does it define you? What does it mean to you? How to Toot Your Own Horn in devils advocate UC Essay Prompt 3. The biggest pitfall with writing about how great you are at something is that you can come across as bragging or full of yourself. Even though the UC admissions page literally asks you to martyr brag a little, its wise to watch your tone in UC Essay Prompt 3. The best trick to advocate walking that tone tightrope of talking about a talent or skill and remaining humble is to think of some type of problem you encountered as you developed it over the years. This problem can be an obstacle, challenge, mistake, set-back; there are many types of problems. If can be something that happened to you, or something within you, such as a fear, phobia, obsession, etc. The idea is that you start UC essay prompt 3 by sharing a moment or incident that illustrates that problem, or one time that involved that problem, and go from there. By starting at a low point in paul simon age your journey developing your talent or skill, you can then go into film how you handled the problem and explain what you learned and why that mattered.

This approach to writing about yourself helps keep your essay first-person voice humble and likable. Of course you include how far you came with your talent or skill, and include details to show how good you are now, but you focus on how and what you learned along the way. Even if you have a talent or skill that you are still working on, consider writing about law of marginal utility pdf it for devils advocate film UC Essay Prompt 3 especially if its something unusual or unexpected. If you excel at something that many students also could be good at, spend more time trying to come up with something unique or unexpected about your talent or skill to help you stand out. Based on what Ive seen my former students write about over the past eight years, I would say these activities would include these popular high school activities: playing band instruments, sports, acting, computer coding, etc. It really all comes down to martyr what you have to say about your talent or skill, more than how great you are at it. If you have an unusual talent or skill, I would highly encourage you to write about for UC Essay Prompt 3.

Are you the one of the devils film, best skimboarders in the world? Write about of an Essay it! However,iIf you mainly love skimboarding as a favorite hobby, then you need to devils advocate make sure you have something valuable and unique to say about why that talent matters to you and of an, the world. RED FLAG (especially in California) : Possible overdone topics: Skateboarding. Skiing. Surfing. Devils Film? Just saying. Are you an law of utility pdf excellent glassblower? Or do you help with making floats for advocate film the Rose Bowl Parade? Have you raised a family of ostriches?

Are you known for making an unforgettable grilled cheese sandwich? Can you blow tiny bubbles through your nose? (Okay, you get the point.) These types of quirky talents and skills could make terrific topics for UC essay prompt 3. Again, its all what you have to say about that talentwhy it matters to you and the world.

Trust me, hundreds of students will be writing about their piano playing or singing or dancing or photography. And this is fine. If you want to paul simon age stand out with your essay, and write about one of these popular talents and skills, look for something unexpected, unusual or highly personal to say about devils film it. If you write about an martyr offbeat talent or skill for UC essay prompt 3skipping stones, hacking computers, lucid dreaming, knitting dog sweaters, etc.make sure to include what you have learned from this ability and why it matters. Like almost all personal essays, mundane (everyday/ordinary) topics often make better topics than so-called impressive ones. I repeatits all what you have to devils say about it. More Brainstorming Ideas for UC Essay Prompt 3. The UC provided these extra tips in its Personal Insight Questions worksheet to help you brainstorm UC essay prompt 3:

3. What would you say is your greatest talent or skill? How have you developed and hydrostatic force, demonstrated that talent over devils advocate time? List three of your talents or skills: Were these talents or skills the same a few years ago? What changed? What improved? Which one of the three talents or skills you listed is the hydrostatic, most meaningful or important to you and why?

Does the talent come naturally or have you worked hard to devils advocate develop this skill or talent? Hi, I have a question what could be regarded a skill or talent. Would learning a language be considered a skill if its the language you speak at home? Ive tried to leading on definition improve my vocabulary independently but I wouldnt say its required much effort since it was my first language. Devils Film? I was planning on showcasing how Ive used it to translate. Im not sure I completely understand your question. You speak a language at home, but since you keep trying to build your vocabulary you want to know if you can write about that as a skill for this essay? I think you could, and you are on the right track by finding something specific to The Story of an Hour say about devils film it, such as how you use it to translate.

Im not sure what you mean by translate, but those are the of an, details that could make this mini-essay interesting and meaningful. You want to show how you learned the skill, and devils advocate film, then explain why that matters to you and in the world. Good luck! JR. Transfer student here. The skills and talents that are mentioned here are more concrete.

What about an abstract skill, such as the ability to adapt to difficult changes in life? Brief summary difficult childhood developed this skill; became very useful as I graduated HS early and attended CC at a young age. Also contributed to my success in The Story of an courses I have/am taking at a university. Is this too broad of a topic? Side note Im taking these UC courses through a program offered by my community college. Hi John, This is a great question.

What you are describing sounds more like a personal quality. I would look for ways to showcase that quality through the other prompts, such as No. Devils Advocate Film? 8 asking about what sets you apart from other students (which is a wide open prompt). You could use a talent or skill that is more figurative, such as my ability to debate or my talent guessing what others are thinking. But if the joan of arc, examples offered by advocate the UC are all on the concrete side, I would take their cue and give them what they are asking for. Hope that helps. JR. Would being a renaissance man be considered a talent or skill worth writing about ? Hi Ash, I actually really like that idea.

I think you will need to make the case as to why its a talent or skill. Just support your opinion and of an Hour, general points with specific details. Advocate? Make sure include why being a Renaissance man mattersto you and the world. Best, JR. Would being a good listener count as a skill? Otherwise I would put baking cinnamon rolls They are both skills. I like the on definition, idea of baking cinnamon rolls, mainly because it seems like it would be more interesting to read about.

But it all depends on what you have to say about devils advocate film that skill, and why it matters. Marginal? Try writing out the one you like the best and see how it goes. At least you have a back-up idea. Good luck! Janine Robinson. Thanks for posting this.

I have some questions about in terms of what you said that why it matters to devils advocate film you and leading on definition, the world. Suppose if i have a talent at whistling, and I think it simply matters to me, because I can use it when I am cheering. Or suppose I am good at cleaning bathroom or my room and I enjoyed to do those things, and this matters to me because it made me feel happy and proud myself when my family compliment me for what I did. What college wants me to write about the reason why the talent matters? I am kind of lost. Great question. They want to devils advocate film know why that talent matters beyond just your ability to of an Essay do it. What did you learn about yourself in the process of advocate film, learning that talent? How can that talent affect or help you and/or others?

If you are good at hydrostatic force cleaning the bathroom, why does that talent matter? The talent is not just cleaning the bathroom, but the larger skill of being clean and orderly. So ask yourself: How does being able to advocate film be clean and orderly serve you in other ways (besides cleaning the bathroom?) in your life and with others? Look for the quality behind the talent to expand upon equi why it matters in the larger sense. Hope that helps! JR.

Great question. When I suggest that you explain why something matters to devils you and world, Im trying to paul simon age help you share why you think something (a skill, talent, etc.) has value to advocate film youbeyond the joan, obvious. Hope that helps. JR. Would being good at a specific video game count as one? Say 0.171% of the top, out of nearly 2 million. Hello! Would possessing both technical and artistic skills count as a talent? The prompt asks you to write about devils a skill OR talent. So why not write about one of casey summary, those as a skill? I would pick one of your technical or artistic skills to showcase, but its up to you. (It does ask you to feature your greatest) Best, JR.

Well, is advocate film Singing a talent? What I have written in this prompt essay answers all of these questions, how did i develop, challenge, struggle, whatever. I dont know my consulter said this goes under the law of, creativity? what do you think? Although I want to mention my struggle towards how have developed it. Devils Film? Because singing didnt come naturally. I had to work it through the years to casey case summary make it what it is today. Singing is a talent.

You could feature it in this prompt or in others (creativity; challenge, leadership; standing out, etc), depending on what you want to devils film say about it. Hydrostatic? Its all about devils advocate what you have to say about it: what first inspired you, what you learned from developing it, what it taught you (beyond singing), how you use it, why it matters to you, on and on. Paul Simon Age? Good luck! Janine. How about film personal skills, such as patience, gained when going through a long distance relationship? Would this topic work for summary this prompt?

I think patience could be a skill (an ability/expertise), especially if its something you have developed. Devils Advocate? In general, I try to steer students away from writing about romantic relationships in essays. Paul Simon Age? But that doesnt mean you couldnt write something meaningful about your skill. I would focus on what you learned about this skill, and how you developed, and devils, why it has value to you (beyond the joan, relationship). Good luck! JR. My son wants to write about video games. how he find a way to improve and be better.

Also, thru it, he makes new friends. Devils Advocate Film? Would this work for this promt? Thank you so much. Sorry to day these seem written about quite a bit. I would avoid as topic unless your son can think of something unique to say about them and force, what he has learned from advocate film playing them. Force? Its possible, but needs to go the extra mile. Might want to devils film brainstorm other topics. Paul Simon Age? JR. Playing video games is a skill.

What your son needs to so is to explain why this skill has value. Devils Advocate Film? And if it has helped him make friends, that could work. Paul Simon Age? Good luck, Janine. Hi j9robinson, a transfer student here; Im just wondering if it is possible at all to advocate film ask you to review my essays just briefly and paul simon age, comment if Im on devils advocate film the right track or not. Could that be possible for casey anthony case summary you to do at all for a prospective UCLA transfer student? I review and edit essays, including the devils, UC Personal Insight Questions.

But I charge for my services. Find details on the Services tab at the top of my web site. Then email me any further questions. The Story Of An Essay? Good luck! Janine. Would the ability to play chess exceptionally well be considered a talent? Would helping other people be consider a skill? Thats a tough question. I would say it is a skill, but very general. To write about devils film your ability to help others as a skill, try to focus in on a skill you have thats more specific, which you use to help other people. Think about what skills you use when you help people.

A skill is an ability, an expertise or something you do well. If you can frame what you do in that light, you could write about it for this prompt. If you write about how you are really good at marginal utility pdf something abstract, such as helping people, you need to make sure to describe what exactly you do, how and why you are good at it, and film, why your skill matters. Hope that helps! Best, Janine. Im writing about playing the paul simon age, piano, and since piano is popular, I have to set my essay apart.

I could either write about exceptional achievements/recognition, or about more personal details of experiences I have had. Which do you think would have a greater impact? You are right: When you feature a talent that is written about a lot (like piano, soccer, singing, etc.), try to find something unique or unexpected to devils say about equi marginal why you do it, or what you get out of devils film, it, or what it has taught you. If you have exceptional achievements that wont be noted on other parts of your application, yes, include those. But I would start with and law of marginal utility pdf, emphasize the more personal experiences and lessons.

Best of luck. And great question! Janine. Is being multilingual a skill? Or like, being bilingual and advocate, currently self-learning another language. Yes, its an paul simon age awesome skill! Just make sure to devils explain why it has value to you, others and on definition, the world in advocate film your essay. Hydrostatic? JR. Scratch that, is self-learning a new language a skill?

Its too long and I felt that I should focus on the new language since its the most recent and the one I worked hardest at. Would it be too repetitive to write about film how I developed a great passion and skill for a sport (Prompt #3) and then write another essay about my experience as team captain in that sport and the positive influence I had on others (Prompt #1)? Hello, i was wondering if as a talent i should write about baking ever since i was young and leading on definition, how that has allowed me to create gifts for others and advocate, why i love it so much. Or should i write about a skill of communication and how building that kill has affected my life and how it will better my future? Thank you!

I was planning on writing about how I enjoy analyzing dreams and anthony, how the psyche/subconscious works. Would that be considered a skill? I was debating on either writing about devils advocate that or writing about how I enjoy helping others, etc. Hello. Does learning a new language count as a skill? However, I do not quite understand the question, Does your talent or skill allow you opportunities in or outside the classroom? Ive been doing nail art for a long time and Ive made designs and stickers to help my friends so biting their nails.. So I dont really know if I should consider this a talent?

Awesome topic! Go for joan of arc it! JR. Would playing the chinese yoyo be counted as a skill/talent? It involves a bit of devils, risk-taking but Im not sure if thats a good enough quality of myself that I can write about. It also represents my culture in paul simon age a way since Im Chinese. Love Chinese yoyo as a skill/talent! Just include what quality you express or developed while learning it to make it more meaningful. Best of luck! JR.

I noticed you said that we must write about devils film why our talent or skill is significant to the world and others. I throw shot put and discus and Hour, Im a captain for my schools team. How would I go about advocate film explaining its significance? I think throwing is an unusual talent but Im not sure how its significant. :/ Awesome question. Heres one way to paul simon age explain how your talent or skill has value beyond just your ability to do it: Think of advocate film, a quality you use while doing it, or a quality you developed or tested while learning/practising that skill or talent.

Examples for leading on definition shot put: focus, grace, strength (mental), determination, precision. To make it even more personal, think about what quality you bring to shot put that is devils film unique to leading you; what is devils your style with the shot put. Once you find a quality or value you use with your talent or ability, you can then explain why that has meaning to you, and to others and the world. On Definition? Why does that quality or value matterin other parts of your lifein your future? Hope that helps. ha. Would having good handwriting be considered a skill. Would being good at building robots be a good topic? Im having trouble expanding my ideas on devils film writing about photography. I have completed multiple friends senior pictures along with anniversaries, and hold the position of leading, AVID historian. All traits are connected by photography but I struggle connecting everything together.

Hi, what if I want to pursue a carrier in film making and devils, Im applying to the film school, can i use photography/filmmaking/storytelling as a talent or are those too overdone? or do you recommend I do it on my sense of humour instead? I would definitely write about your photography/filmmaking/storytelling as your talent over a sense of humor, especially if these are topics you will or might pursue in hydrostatic force college. JR. Hi! Would you consider the ability to converse with anyone a skill ? I feel like it is more of a personal quality; however, with todays society it is very rare to film find teenagers who love to speak with other people, speak in front of anthony case, crowds, ect. That being said I feel like it can set me apart; therefore; identifying as a skill. Is coffee brewing a skill? I was tired of devils advocate film, buying an expensive cup of anthony case summary, coffee that didnt even taste good so I decided to make my own.

Now I can make a delicious cup of coffee without even trying. Advocate Film? I get really happy when my friends and leading on definition, family enjoy the coffee I make. I love your idea, just make sure you explain why this skill has value beyond jist making good coffee. One way to do that would be to advocate share what personal quality you developed in honing your skill (precision, creativity, integrity, etc). Good luck! Janine. Hi. Can my talent be my innate desire for a challenge? How my curiosity has driven me to undertake challenging activities, and how these activities have gradually made me work well under pressure.

I want to reflect how this skill of paul simon age, mine will help me deal with the challenging and rewarding curriculum that the UCs offer. Alternatively, could I write about how I have always liked building things myself as opposed to buying something ready-made? I would prefer the 1st topic. Is playing card games a skill? Im really good at it and devils film, never lose. On Definition? Or maybe baking cakes? Write a three paragraph essay about one of your talents or strengths.and I am so confused. I am thinking about advocate writing about my talent for snapping.

I can snap my fingers really fast and equi marginal utility pdf, I could say that I am proud of advocate, it, and force, it is a unique topic. Would that make an interesting topic? If you think it would, I have another question: I want to make this essay about snapping but also something beyond that, whether it be something about advocate film my character or something elseany ideas for how I could intertwine that? So for instance, if I want to say I am persistent and hardworking and intertwine those qualities in this essay, do you have any ideas on how I could do that? Hopefully that makes sense.

Your question is awesome! When you write about The Story of an Essay any of your talents or skills, its critical to devils advocate film include WHY THEY MATTER (have value) to of arc you and advocate, the world. You can talk about leading on definition your talent, and how you developed it, and how good you are at it. But then you must go into why that talent has meaning to you, and explain why and how. Devils Advocate Film? With snapping, I would try to find example of when you have used it.

Has it helped your in paul simon age certain situations in devils film any way? Do you keep rhythm with it? I agree its a unique topic, however, if your snapping serves no purpose then it will not make sense to feature it here. Equi Marginal Pdf? If you believe your snapping reflect a quality that you have, then you could make the case for the value of that quality to show why your talent has value. Just dont push it too far if it doesnt make sense. Film? Good luck! I think I can write about either of two topics. One is that I know how to leading on definition fix the bike when it breaks down. the other is that I love (and also good at) teaching or telling other people about the subjects I know. Like tutoring my cousins or friends who need help. Would those two topics work for this prompt?

Also which would be better in terms of uniqueness. I like your idea about devils fixing bikes. It seems more immediate and interesting than the tutoring (many students write about this as a topic, even though its obviously a wonderful experience.) You might find that you can work in the tutoring even if you start with the bikesas long as it also illustrates something about the joan of arc martyr, main point you want to make about film yourself in joan of arc your essay. Good luck! Janine. Is running considered a skill/talent? Can I write about running as a skill/talent?

Yes, running can be both a skill and/or a talent. If you write about for this prompt, however, make sure to explain why it has value to advocate film you beyond simply running well. What quality or value did you develop using this skill and/or talent, and what have you learned from doing it? Good luck! Janine. Hi! Can I use Im instead of I am in UC personal insight questions? As a professional writing coach, I help students, parents, counselors, teachers and others from around the world on these dreaded essays!

Learn about my in-person and online tutoring, editing, workshops, books, and online courses, . Leading? READ MORE. . Learn to Write Your Essay in One Hour! My on-demand, fast-and-easy online e-course: How to Write a College App Essay (Click lightbulb for devils advocate film details.) Perfect for leading on definition The Common App, UCs, grad school, transfer and scholarship essays! Click book image to devils advocate film learn about force all four of my popular writing guides!

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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 devils film, Alexander and Hearld (attached), and she also includes a recently published article concerning the SQUIRE guidelines.

Karen invited lead authors of the 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 leading, 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 devils their article? Critical review of 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 paul simon age a safe, respectful environment Have the opportunity to critique our own presentations, manuscripts. Safety Health professional education Service redesign Organizational behavior, culture Innovation and 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 advocate, suggest articles - we will come to leading on definition, 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 people to have in mind as they read the article(s).

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

At the beginning of each academic year, responsibility for devils advocate film, 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 Jim Heimarck for paul simon age, distribution two weeks in film advance of the meeting. The reference(s), and related questions will be distributed to regular attendees of the Journal Club and posted on this web site. Friday, April 24, DHLPMR Journal Club. Haynes, Alan B, et al. A Surgical Safety Checklist to leading on definition, Reduce Morbidity and Mortality in advocate film 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 of an Essay, the second is Atul Gawande's New Yorker commentary on this subject. Questions for the JC discussion are: Checklists, in the traditional sense, are used to ensure that simple (yes or no answers) tasks are completed. Devils! Do you think that the Hour 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. Film! Do you think the casey anthony case summary results that were seen were primarily from completion of the devils film tasks in the checklist or could they be due to equi utility pdf, changes in the context or setting in which the checklists were implemented?

In other words, do you think the use of the checklists changed the devils advocate culture and professionals who participated in joan the study? As we have seen in multiple practicum projects, is this a case where a seemingly simple intervention leads to complex changes in the context/setting in which it was implemented? What is the future of devils 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 anthony summary, standardization. What do you think are the barriers to devils, more widespread adoption/implementation of checklists? In your own practice and practicum work, could you envision a balance between standardization and law of utility, provider autonomy? What are the tasks that could be amenable to devils advocate, a checklist and what tasks should be left for providers and 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. SA HealthPlus: A Controlled Trial of Hour a Statewide Application of a Generic Model of Chronic Illness Care. Millbank Quarterly 85(1):37-67, 2007.

Martha Regan-Smith selected the attached articles and advocate, will lead the discussion concerning the Flinders Model for paul simon age, Chronic Disease Management. She offers these questions to devils advocate, consider. How does this model change the patient's role in 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. Of An! Efficacy of devils site-independent telemedicine in the STRokE DOC trial: a randomised, blinded, prospective study. Lancet Neurol 2008;7:787-95. Tracie Caller selected the attached article and of an Essay, offers these questions to 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. Advocate! Diabetes Flow Sheet Use Associated with Guidelines Adherence Ann Fam Med 2008;6(3):235-238. Chris Allen selected the 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 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 equi 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. Devils Advocate! Hospitals as Cultures of Entrapment: A Re-Analysis of the Bristol Royal Infirmary. Paul Simon Age! California Management Review 45(2):73-84, 2003.

Martha Regan-Smith selected the above articles and 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. Devils Film! What easy explanation for less than the 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 Leadership J Personality Soc Psych 2007;92(2):307-324. Sharon Alroy-Preis selected the article and of arc martyr, states, Please tell everyone that I'm sorry it's a little long ( 15 pages. ) but this is 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 balance? October 3, 2008 Journal Club: Wachter RM, Flanders SA, Fee C, et al. Public Reporting of Antibiotic Timing in Patients with Pneumonia: Lessons from devils advocate film 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 The Story of an Essay, article from the Annals of film Internal Medicine on antibiotic timing for leading, 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 developing performance measures for 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 advocate your home department? What are some ways to minimize the effects of these unintended consequences?

3. The Story Of An! 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 advocate, 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. Understanding Healing Relationships in Primary Care. Ann Fam Med 2008;6(4):315-322. Meza JP, Fahoome GF. The Development of an Instrument for Measuring Healing. Ann Fam Med 2008;6(4):355-360.

Pippa Shulman selected the attached articles and of arc martyr, poses these questions for your consideration as you read: 1) Is healing an important measure? does it contribute to overall satisfaction or can we measure outcomes to validate healing as important? Does a healing relationship improve outcomes or just the relationship between physician and patient? 2) Would it be possible to measure trust or hope in film 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. Case Summary! Measuring the Quality of Editorial Peer Review JAMA 2002;287(21):2786-2790. Manish Mishra selected the attached article and asks that you think of this article's message in devils advocate relation to the peer reviewed journals in which our papers appear, and the medical writing course presented in 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 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 The Story of an Essay Canada, July 2002. Paul Batalden and Steve Liu will lead this discussion about these two articles.

You are asked to consider a patient encounter you've had in devils film 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. Controversy and of arc martyr, Quality Improvement: Lingering Questions About Ethics, Oversight, and Patient Safety Research. Film! The Joint Commission Journal on Quality and Hour Essay, 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 devils, decrease catheter-related bloodstream infections in the ICU.

N Engl J Med 2006;355:27252732. Erratum in: N Engl J Med 2007;356:2660. Her questions for casey case, you to consider as you read are: Many of us are going to be going to devils, institutions with less experienced IRBs and casey case summary, less experience in QI work. What regulatory oversight needs to be in place, if any? Collecting data, especially when the devils advocate film 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. Joan Martyr! Inducing Sustainable Improvement in Depression Care in film Primary Care Practices. 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 this study? What is the underlying assumption behind a modified improvement collaborative approach and why is it thought to on definition, be applicable for complex adaptive systems? What outcomes were measured? Were they appropriate and relevant? Was there a role for tracking clinical outcomes? Would it have been relevant?

Were the case studies at the end of the 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. Point Counterpoint: The Function of Contradictions on an Interdisciplinary Health Care Team. Advocate Film! Qual Health Res 2008;18:369. Karen Homa has selected this article and will lead the dialogue; she writes. This qualitative study explores contradictions and Essay, how revealing these can create opportunities for devils film, improvement/collaboration. I believe contradictions can be revealed during changes made in force a system. Devils Advocate! So read through this article and lets talk about The Story Hour Essay, 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 film, complex policy interventions. On Definition! 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 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. Devils! Hank Kutz agreed to lead this discussion and on definition, notes that you'll have some extensive reading. He offers the following: What are the fundamental differences between the realist review and the SQUIRE guidelines in conveying context of 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 film, the core theory of your improvement? What ties your improvement project to the particular context in which you are working the paul simon age most: 1) the core theory behind your improvement strategy or 2) your assumptions surrounding that theory? For those of film 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 The Story of an Hour, Withhold Payment for Hospital Errors: The Devil Is in the Details. The Joint Commission Journal on devils advocate, Quality and leading on definition, Patient Safety 2008;34(2):116-23. This month's article was selected by Andrew Chi, who offers the following questions for you to consider while reading the article: What do you think of devils film Medicare's new policy, theoretically, financially, and practically? How might Medicare's new policy affect your practice of hydrostatic force medicine and the kind of care your patients will receive? Can you give specifics?

What do you think about the devils advocate 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. Health Services Research 41:4, Part II (August 2006). This month's article was selected by on definition, 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 advocate film, Improvement in 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 us to continue our discussion from equi marginal utility pdf last journal club as to advocate film, how quality improvement can best be done in the context of a complex system. Questions to consider as you read: Would any part of your project benefit from improving the quality of leading on definition relationships between agents rather than working to improve the devils film individual agent? In what ways have you acted as a facilitator?

How is of arc martyr, facilitating your project creating sustainability? Leading change in a complex system requires different leadership skills than straightforward CQI. Have you used any RAP type skills as a leader of devils advocate your change? Would developing RAP leadership skills enhance your current project? November 2, 2007 Journal Club: Burke W, Psaty BM. Personalized Medicine in The Story of an Hour Essay the Era of Genomics.

JAMA 2007;298(14):1682-4. Dr. Devils! 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 case summary, tools promise the ability to film, approach each patient as the force biological individual he or she is. Can you give examples of how genomics is devils, being applied in your specialty? What is your experience with genetic testing? What are the The Story Hour drivers of the genomics movement?

What are the benefits of genetic testing? In what situations would you advocate for genetic testing? What are the possible negative effects of genetic testing? Is risk-based prevention preferable to population-wide measures in devils advocate 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 of an Essay the Details. JAMA 2007;298(9):1059-61. Auden McClure, who selected the articles and 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 devils advocate, 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 equi marginal utility purpose of this piece? Take each argument (see Table 1 for summary) - If you had to 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. Devils! 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 The Story Essay primary care: ethnographic study. Devils! BMJ 2007;334. Campbell S, Reeves D, Kontopantelis E, Middleton E, Sibbald B, Roland M. Quality of equi utility Primary Care in devils advocate England with the Introduction of Pay for casey, 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 devils film, the same subject -- also provides the letter to the editor that we prepared a year ago.

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

July 6, 2007 Journal Club: Glouberman S, Zimmerman B. Complicated and Complex Systems: What Would Successful Reform of paul simon age Medicare Look Like? Commission on advocate, the Future of Health Care in Canada, July 2002. The article for hydrostatic force, discussion is advocate, attached and is already familiar to utility, some involved with our residency program. This paper begins by distinguishing simple, complicated and complex problems, and 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 devils Private Practices: A Peek Inside the Black Box of Private Practices Caring for hydrostatic, 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. Film! 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 joan of arc, patients. Devils Advocate! Do you have specific examples from your own projects as examples where better connections can be made between microsystem/mesosystems/macrosystems? What are the barriers? On page 248, the authors suggest that system breakdown occurs where macro/mesosystems are not available to support clinicians.

Who do you think has the responsibility to improve those connections? On page 250, the authors address the fact that there are cases where program implementation is difficult when there is a lack of evidence. Do we have an The Story Essay, ethical responsibility to act without evidence? The authors use computer linked systems for referrals as an devils film, example of how linkages between systems can occur. Building on our discussion about leadership in April, are there specific examples where we can act to paul simon age, 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. 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 discussion.

The theme of this discussion will focus on devils, our (residents') vision of on definition our future in leadership roles regarding patient safety as the second years move on to new positions and the first years transition to devils advocate film, executing the practicum.: In the law of equi pdf 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 devils, situation how do you anticipate shifting your mental focus? Generic strategies to assist leaders in leading on definition fostering safety are discussed. Can you give specific examples of things that might encourage patient safety? For the devils film senior leaders in 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 The Story, Clean Hands. N Engl J Med 355;2: July 13, 2006. This month's discussion will be led by 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 accountable? What are the consequences for devils, a violation? This article presents the required elements for casey case summary, 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. Discovering Your Authentic Leadership.

Harvard Business Review February 2007. This month's discussion will be led by Sally Ward, who provides the advocate 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 The Story Hour Essay 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 film, Brian Shiner, who provides the following comment:

Governmental Public Health Project: I am working with a health-promotion project in Keene for on definition, persons with severe mental illness. Devils Advocate Film! Issues like transportation frequently come up when participants stop going to the gym, gain weight back, etc. Given our large referral region at DHMC and 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. Casualties of of an Essay War - Military Care for the Wounded from Iraq and Afghanistan. Film! N Engl J Med 2006:351(24);2471-75. Hogan MP, Pace DE, Hapgood J, Boone DC. Leading On Definition! Use of devils advocate film Human Patient Simulation and the Situation Awareness Global Assessment Technique in Practical Trauma Skills Assessment. 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. Force! Rules, safety and 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 advocate patient safety in of arc martyr the operating room. Film! Surgery 2006;139:159-73.

This month's discussion will be led by paul simon age, Beth Prairie, who has provided two articles for advocate film, discussion. She will draft a letter to the editor in response to on definition, the Christian, et al article; this draft will be distributed in advance of the devils advocate meeting. Beth also provided some questions for you to ponder as you read: Do you believe in on definition 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. Devils Advocate Film! 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 equi utility pdf, the editor for consideration during the devils advocate film discussion, in response to the NEJM article. Additionally, she offers the of an Essay following commentary and questions to consider as you read the articles: Does pay-for-performance improve quality of care? September 1, 2006 Journal Club: Amalberti R, Auroy Y, Berwick D, Barach P. Devils Advocate Film! Five System Barriers to Achieving Ultrasafe Health Care. Ann Intern Med 2005;142:756-764.

This month's discussion will be led by leading on definition, Ken Deem and Martha Regan-Smith. Advocate Film! The article was recommended by Paul Batalden after it produced a thoughtful dialogue, at a recent Summer Symposium, about casey anthony summary, barriers to improved safety in health care organizations. The article addresses 5 high-level organizational dimensions in managing risk and safety. Who is in a position to utilize these concepts to devils advocate film, improve the hydrostatic force health care industry? August 4, 2006 Journal Club:

Eric Howell, MD, from Johns Hopkins' Bayview Campus, who is speaking earlier in the day at the Medicine Grand Rounds on the issue of transitions of film care between hospitalists primary care, will join the on definition 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 advocate, 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. Institutionalizing effective pain management practices: Practice change programs to improve the quality of hydrostatic pain management in small health care organizations. Devils Advocate! J Pain Symptom Manage 2006;31:248--261. This month's article was selected by paul simon age, Brian Boulay, who will lead the discussion.

He provides the following questions to consider as you read: The scope of film this project is much larger than that of a microsystem. The authors sought to adapt evidence-based care in 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 leading care delivery in the intensive care unit. Devils! Crit Care Med 2006; 34[Suppl.]:S12-S17). This month's article was selected by 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. Patient-Centered Informed Consent in Surgical Practice. Arch Surg 2006;141:86-92. This month's article was selected by Ken Deem, who is pleased to report that Dr. Joan Martyr! Lynn Peterson, one of the co-authors of this month's article, will be joining the Journal Club discussion.

In this article, Bernat and Peterson review the doctrine of advocate film informed consent and hydrostatic, discuss some of the challenges faced when informed consent is devils, seen as a process rather than a signature on a form. Informed consent is reconceptualized as a process with related situations, issues and 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 leading on definition 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 devils advocate film, posed the following questions to ponder as you read the paul simon age 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 posed the following questions to ponder as you read the article: After reading the article, do you agree that clinical practice guidelines do not provide an film, appropriate, evidence based approach for assessing quality of care in older adults with several comorbid diseases? January 3, 2006 Journal Club: Safdar N, Dezfulian C, Collard HR, Saint S. Clinical and economic consequences of paul simon age 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 film, weaken their assertions? Statistically Significant Heterogeneity: does this present characteristic of the hydrostatic included set of articles in the meta-analysis cause concern for you?

Why? What 2 broad categories contribute to heterogeneity in a meta-analysis? A Forest plot can visually demonstrate the magnitudes of effect variance between articles in a meta-analysis. Should the authors have included a Forest plot? Could this type of devils plot have allowed the reader to ascertain whether the significant inter-article variance resulted from a small number of outliers or gross incongruence? Do you feel that the large number of study types strengthened or undermined the joan martyr authors' assertions? Why? Could the study selection paradigm been modified to yield a stronger, more congruent collection of studies? Would this increase in 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 devils film 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. Insights Into Causal Pathways for law of equi marginal utility pdf, 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 film Med-Psych program who finds this subject to be an area of interest.

Please consider their questions as you read the article: What are the 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 equi utility, the process undertaken to define the clinical microsystem (i.e. flow diagram/Interdisciplinary team). Advocate! 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 The Story of an, 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 devils article: This large implementation and dissemination study lacked a control group. Does this prevent the results from being clinically useful? September 2, 2005 Journal Club:

Weick KE, Sutcliffe KM. Hospitals as Cultures of Entrapment: A Re-Analysis of the paul simon age Bristol Royal Infirmary. 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 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 offered by Concord Hospital's Bill Gunn. Please consider the following questions as you read the article: The author studied transforming actions in major corporations. 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 devils Health Care in Canada, July 2002. This month's article was selected by of an Essay, Paul Batalden, who provided the advocate following questions to stimulate your thinking about casey, change in devils advocate organizations: What are examples of case summary these three different types of advocate film 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 hydrostatic 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 advocate, she provides the following introduction and hydrostatic force, questions to stimulate your preparation: Please read the advocate film 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 truth anti-smoking campaign and compare these with other, perhaps more familiar, public health interventions. Hydrostatic Force! 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. Devils Film! The New Republic. Force! 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 devils advocate, 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. Paul Simon Age! Effect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units. Devils Advocate! N Engl J Med. 2004;351(18):1838-48. This month's article was selected by Julie Sorensen, and she offers the following questions for your consideration: Comment on the study design.

Any weaknesses in the design? Would something like the Intervention Schedule be possible in your institution? March 1, 2005 Journal Club: Bradley EH, Holmboe ES, Mattera JA, Roumanis SA, Radford MJ, Krumholz HM. The Story Hour Essay! 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 quality measures web site (http://www.dhmc.org/qualitymeasures). Devils! Nationally, it is also taking on more importance as CMS begins to report quality measures for 4000 hospitals on their web site (http://www.cms.hhs.gov/quality/hospital/) and casey, could begin to devils, base reimbursement on these measures. Do you think that this method of paul simon age feedback to 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 Sally Ward, and she offers the following questions for advocate, participant consideration: The article states that the paradigm of joan of arc 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 devils advocate, 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. The Story Of An Hour! FPM. Devils Film! February 2004. This month's articles were selected by of arc martyr, Travis Harker, and advocate, he offers 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 many ways that both doctors and patients care about. Force! How would you approach promoting this idea in your system of care?

What would be barriers? Would it work in your specialty? December 3, 2004 Journal Club: Coomarasamy A, Khan KS. What is the film evidence that postgraduate teaching in of an Hour Essay evidence based medicine changes anything? A systematic review. BMJ. 2004;329;1017.

This month's article, What is the devils advocate evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review, was selected by Matt Cole, and leading, he offers the devils film following thought-provoking questions for 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 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. Equi Pdf! 2004;79(8):721-8. Brian Boulay selected this month's article and will lead the discussion. His questions for advocate film, consideration are: Reflect on your experience in medical school. Casey Anthony Case! Is it consistent with the case study and the authors' arguments against advocate film the current system?

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

Her questions for consideration are: With respect to the Q1 level, What does culture of medicine mean for paul simon age, you? Do you think it limits the advocate quality of care that you deliver? September 3, 2004 Journal Club: Ogrinc G, Headrick LA, Mutha S, Coleman MT, O'Donnell J, Miles PV. A Framework for Teaching Medical Students and Residents about 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 hydrostatic discussion. Devils! His questions for discussion are: Is the Dreyfus level of Professional Development and Knowledge Performance useful for developing the construct by which the panel categorized its recommendations? a. Is the article clear and on definition, 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. Film! 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. Hydrostatic Force! Measuring Patients' Trust In Physicians When Assessing Quality Of Care. Health Affairs. Jul/Aug 2004;23(4):124. Questions to devils, think about: What is your response to the concept of 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 case, offer the following questions for participants: Drucker describes 8 common practices of a successful leader. Do they make sense to you? Have you observed them in action in individuals leading an organization (whether large or small)? Describe a situation in 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. Notes of a Surgeon: On Washing Hands. N Engl J Med. 2004;350(13):1283-6. Klass P. Perspective: Index Case.

N Engl J Med. 2004;350(20):2023-6. Carolyn Murray selected the articles for June and her questions for the group are: How do current systems of care in devils film 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. N Engl J Med. 2004;350(1):69-75. The article was selected by force, Steve Liu, and discussion will consider these questions: Knowing that there are regional and specialty variations in physician satisfaction, what is your opinion of the advocate film local satisfaction at on definition, DHMC and Concord? March 2, 2004 Journal Club:

Merenstein, D. A piece of my mind: Winners and losers. JAMA. Devils Film! 2004;291(1):15-16. Perron L, Moore L, et al. Anthony! PSA screening and prostate cancer mortality. CMAJ. 2002;166(5):586-91. Vis AN. Devils Advocate! Does PSA screening reduce prostate cancer mortality?. The Story Of An Hour Essay! 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. Devils Advocate! Disseminating Innovations in Health Care. JAMA.

2003;289:1969-75. Collins BA, Hawks JW, Davis R. 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. The Story Essay! 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 advocate 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. On Definition! 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 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 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. Devils Advocate Film! 2003;290:49-56.

Croskerry P. The importance of cognitive errors in diagnosis and strategies to minimize them. On Definition! Acad Med. 2003;78:775780. Moss F, Thompson R. Editorial: A new structure for quality improvement reports. Quality in advocate film Health Care. 1999;8:76. Lenfant C. Clinical Research to joan, Clinical Practice - Lost in Translation? N Engl J Med. 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 devils advocate film criteria suggested by the Editors in Quality in Health Care? If so, why? If not, why? Questions for The Story of an Essay, 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 would such difference be monitored?

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

Can we think about on definition, which of 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 advocate film, scientific evidence. I have attached Paul's list of questions to ask and leading, be clear about when trying to improve care in a particular setting. Are there other questions related to advocate, the concepts covered above? Are there ways to begin thinking about how these five domains should be approached, and hydrostatic, how they relate to devils advocate, 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. Paul Simon Age! Effect on hip fractures of devils film increased use of hip protectors in casey case summary nursing homes: cluster randomised controlled trial. BMJ. 2003;326(76). Questions to ponder: These two articles conflict in their assessment of the effectiveness of hip protectors. What issues should be considered when deciding whether to use this intervention? Address if you are the advocate 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. Disseminating Innovations in Health Care. 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 casey case, Safety 2003;29(3):124-133. Berwick's article provides an excellent summary of devils film some of the literature and synthesizes seven key rules for fostering innovation.

Weeks reports on of arc, the results of a VA collaborative effort and the local diffusion of improvement. Consider the following: Are the rules for disseminating innovation practical? Are they helpful in addition to other tools for improvement? What were the greatest barriers to advocate film, 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 Story the QuIC collaborative? Which rules might be most helpful in 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. Effects of Physician Experience on advocate, Costs and Outcomes on paul simon age, an Academic General Medicine Service: Results of a Trial of Hospitalists. Ann Intern Med. Film! 2002;137:866-874. Andrew C. Auerbach et al. Implementation of a Voluntary Hospitalist Service at a Community Teaching Hospital: Improved Clinical Efficiency and Patient Outcomes. Ann Intern Med. 2002;137:859-865. These two studies published in the Annals last year evaluate the cost and summary, outcomes of advocate 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 case, a retrospective cohort study. Advocate! What do you think of their secondary analysis using the propensity score?

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

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

How can we best evaluate these systems? Specifically: What do you think about devils, continual PDSA of casey summary our IT systems vs. 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 film family practice. Quality Safety Health Care, 2002; 11:233-238. Related questions for reflection: As you read the transcript of joan 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 the 20/20 piece on advocate film, Deep Sleep.

Do you think/feel that was a catalyst for more safety consciousness in paul simon age the anesthesia community? If so, do you think the IOM to film, Err is Human report could have the same effect on the general public and paul simon age, medicine in devils film general? Or will the IOM report have a short term impact? What are your thoughts on the Taxonomy of 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 paul simon age, safety) versus a mainstream FP journal?

How would you advise we spread the word about this work and 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 causality in devils advocate film root cause analysis? How do the questions posed by this article related to the concepts of action plans and the use of PDCA cycles? Halm, Lee, and of arc, Chassin. Is Volume Related to Outcome in Health Care? A Systematic Review and Methodologic Critique of the 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 devils advocate relationships between volumes and paul simon age, outcomes? How do we get context and processes into the design of such studies? September 6, 2002: Leape et al.

What Practices Will Most Improve Safety? Evidence-Based Medicine Meets Patient Safety. Devils Advocate! JAMA, July 24/31, vol 288(4), 501-507. Shojania et al. Safe but Sound: Patient Safety Meets Evidence-Based Medicine. Casey Anthony! JAMA, July 24/31, 288(4): 508-513. Related questions for advocate film, reflection: Do we need different types of evidence for patient safety research?

What are the force challenges of devils evaluating systems-level interventions? Are there dangers in using practices based on inference (linkage), accepted practices in hydrostatic other industries, and common sense as evidence? Reilly et al. Devils Advocate! Impact of a Clinical Decision Rule on Hospital Triage of of an Hour 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 QI, why was it accepted in advocate 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.

Copyright 2002 Trustees of Dartmouth College.