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MAJOR ACHIEVEMENTS in KIMS Hospital: Corporate Tie ups: Tied up with Apollo Tyros, Binani Zinc Limited, Carborundum (CUMI), Cognizant Technologies, UST Global Services, Idea Cellular Limited, State Bank of Travancore, Corporation bank, SUDchemie, Ultratech Cements, Najath School, SCMS College, Aries Telecasting Limited. Insurance Tie ups: Vipul Medcorp TPA Limited, Health India TPA Limited, Max Bhupa General Insurance, AXA Assistance, Starwell Health Management, Family Health Plan TPA Limited, Good Health Plan Limited, Twaniya Insurance, East West Rescue, ICICI Lombard General Insurance, Emeditek TPA Services. MAJOR ACHIEVEMENTS in collapse communism, Lakeshore: Corporate tie up: Tied up with Indian Oil Corporation, Air India, RBI, Canara Bank Insurance Tie ups: Vipul Medcorp TPA Limited, Health India TPA Limited, Starwell Health Management. Comprehensive problem solving abilities, organizing and coordinating skills, good verbal and written communication skills, ability to clerk letter no experience, deal with people, willingness to work in a team, work under pressure. Husband’s Name : xyz. Date of Birth : 22.2.1982.
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International Radiology Center, This resume is a sample for the post of a Hospital Nurse. Nursing is collapse, a very famous, respectable and responsible post. A receptionist requires great speaking skills and etiquette to websites to buy, attend to collapse communism essays, all customers. In this job you should be well aware of the organization and your job Hospital Nurse. While hiring the enlightenment essay, staff for this post mostly Human Resource Manager in a hospital requires multiple qualities in collapse essays, the applicant. So you are required great experience, exposure along with strong and confident personality. Essay Focus? Attach some previous experience along as the HR Manager would want to ensure your abilities and capacity as this profession requires too much attentive mind that is able to cop with all the situations that may occur in a hospital. Images (if possible) and verified references and credits are a big help in this case. Communism? A resume Hospital Nurse sample is given below to help you express yourself in an impressive way and to cover all the necessary points required.
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McArthur Highway. Communism? Capas Tarlac. January 15, 2011 to August 30, 2011. (CLINIC NURSE/ RECEPTIONIST) Assisted the physicians by managing all secretarial work.
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Assisted patients in solving their queries by providing detailed and essays precise information. Perform the tasks of greeting patients and scheduling appointments. Perform responsibilities of red convertible, registering patients by following protocols of the essays, organization. Cover? Responsible for collapse essays checking and verifying accuracy of age of reason enlightenment essay, medical record of patients. Central Luzon Doctor’s Hospital Educational Institution. Course: Bachelor of Science in Nursing (Board Passer) Tarlac City, Philippines. Date of essays, Birth : September 05, 1984.
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The Collapse of Communism in Eastern Europe and the USSR
Seven Common Resume Mistakes Pastors Make. With some 400,000 congregations in the United States, the way each church secures a pastor is collapse, widely varied. Some churches receive pastors through a denominational appointment system. Other congregations seek a pastor totally independent of any hierarchy. They seek, interview, and vote in a totally autonomous fashion. Still other churches secure a pastor in some combination of the two approaches. In many of these situations, the church requests resumes of symbolism, prospective pastors as an collapse communism essays initial consideration process. I have worked with countless churches helping them to secure and understand the resumes they have received. Ap World Exam Essay Rubrics! Indeed I have looked at thousands of resumes.
Many of them are excellent. Others are, well, not. Allow me to collapse essays, share with you seven of the more common resume mistakes I see. Any one of these mistakes will likely cause that particular person to be eliminated from consideration. 1. Sloppy resumes. These sloppy resumes have careless grammatical and stylistic errors. Capitalization is random and exam rubrics, spacing is unpredictable. There is no discernible pattern to how the communism, different items on the resume are placed.
Just yesterday I heard from a church that eliminated a prospective pastor from consideration because his resume was so sloppy. “If he approaches ministry with this much disregard,” the layman told me, “he certainly will not do well at this church.” 2. Unverified statistics. It is excellent writing, common and acceptable to put such statistics as worship attendance and communism essays, the church budget of the pastor’s current church on the resume. Make certain that the red convertible symbolism, numbers are accurate. Otherwise it will appear that the pastor is essays, careless at best and duplicitous at worst. 3. Bad photos.
Not all pastors choose to put a photo on a resume. If the pastor does decide to use a photo, it should be one of high quality of essay focus, him or of him with his family. I still am surprised to see how many photos are candid shots that belong on collapse Facebook, or they are of writing, such poor quality that facial features are hardly discernible. 4. Collapse! Poor presentation of family. The mistakes here are usually one of symbolism, two extremes. Some pastors leave off their family entirely. The prospective church is left to wonder if the pastor’s family is a priority for communism essays, him.
On the essay focus statement, other extreme, I have seen resumes that include so much detail about the pastor’s spouse that it becomes muddled who is really seeking a position. 5. No sense of communism essays, prioritization. Typically, church leaders receiving resumes presume that how a pastor orders different areas on his resume reflects his priorities. If education is presented first, that is his priority. If family is noted first, that then becomes the perceived priority.
I have seen too many resumes that simply don’t make sense in the manner items are presented. 6. Failure to note ministry accomplishments. Those who receive prospective pastor resumes want to know more than the name and address of churches or other places of excellent writing, ministry and employment. They want to essays, know what was accomplished during that tenure. Research! Of course, pastors must be careful in how they present such information lest they appear to collapse, be bragging or failing to give God the glory. 7. Failure to explain gaps in exam rubrics, date.
If a pastor has a two or three year gap on his resume, he needs to explain it. It is collapse essays, better to provide a succinct explanation of what transpired leading toward those years than to leave the recipients wondering. What have you noticed about pastors’ resumes? What would you add to my list? Pastor to Pastor is the Saturday blog series at ThomRainer.com. Pastors and staff, if we can help in any way, contact Steve Drake, our director of ap world essay, pastoral relations, at Steve.Drake@LifeWay.com . Collapse! We also welcome contacts from laypersons in churches asking questions about pastors, churches, or the pastor search process.
Jane Wilkinson says. Thank you so much for this blog. I hope it is read widely. I am on a pastor search committee of statement, a nondenominational church in Illinois. Your words are incredibly on target. Our committee has made numerous comments about how sloppy some of the resumes are. Collapse! We have tried to overlook the mistakes on the resumes but, frankly, the candidates we seem to favor are those that took the time to do a quality resume. The sloppy resumes leave us with the impression that the candidate has a poor work ethic and that he is too lazy to proofread read something he writes.
I encourage pastors to get outside readers to websites research papers, proofread their resumes. I hate to essays, see an otherwise good candidate not be considered because of reason enlightenment, two or three pages of essays, a document. Thom Rainer says. Thanks Jane. Great input! What about rubrics, those of us who have completed our seminary training, but the only ministry experience that we have had outside of an pastoral internship has been the various areas of service as a layperson. Some people have said not to include it because it was not “full time paid ministry”. Some have said to include it. I have tried both ways and after two years I am still searching for a full time vocational ministry opportunity. Well stated observations. Another resource we’ve produced in Michigan is our SIMPLIFIED SEARCH TEAM TRAINING.
We frequently recommend it to prospcetive pastors/staff to essays, hear what we are recommending to research, search teams. A section of the training is on “how to evaluate resume’s.” Maybe it will be helpful to communism essays, your readers. Ap World Exam Rubrics! It is communism essays, available at: http://bscm.e-quip.net/presentations/show/2974. Thom Rainer says.
The worth of essay focus, a ministry is communism essays, not measured by its compensation level or whether you are compensated at age of reason, all. Collapse Communism! I strongly encourage pastors to focus, include ALL ministry experience, paid and non-paid. Before I served as pastor, I asked the leadership of my church if I could give ten to twenty hours a week as a non-paid minister of evangelism and outreach. They were happy for me to do so and to give me the title I requested. Thom Rainer says.
Steve Drake says. Thanks Dr. Rainer for engaging such an important practical issue for ministers. If it isn’t true elsewhere, it is communism essays, certainly true here: “You don’t get a second chance to make a first impression.” I have had students and friends who have said, “I’m not sending resumes. God knows where I am, if He wants me to symbolism essay, move, He can send the communism essays, committee to me.” It is certainly true that God knows where we are, but if He is willing to use a donkey to get someone’s attention, I have no problem realizing He might just use a resume too.
More and more in to buy papers, our day, I think it would be good for communism essays, ministry candidates to provide video footage online on YouTube or Vimeo sites to let the searching group have an “up close and personal” look at writing, the candidate. Recently I was called by a committee asking for a recommendation of a young man. Everything I said about the candidate was already confirmed in essays, his mind because he had read three years of the age of enlightenment essay, candidate’s blog. That church called the candidate and wonderful things are happening among them. Good post Dr. Rainer!
I would also encourage folks to write a brief philosophy of collapse essays, ministry for the resume. A church can learn a lot about a candidate from a brief but well worded statement describing one’s view of ministry and the church. Now, for a list of things search committees do wrong… Robbie Perkins says. Jonathan…I agree. When I sent a resume to ap world essay, the church where I am currently serving as pastor I gave a “ministry philosophy” in the form of a cover letter. Dr. Rainer… you mentioned a perceived priority in the listing of collapse essays, info on a resume, is there an order that you might recommend?
Thom Rainer says. My preference is to provide brief biographical information first, like date of birth and place of birth. Within the bio, I note my family members, including how long I have been married and the age of cover no experience, my children if they aren’t adults. Second, I provide a brief ministry and doctrinal statement. Communism! Third, I note my education, not because of its priority but because readers expect it near the top. I then note my ministry experience and then secular experience. Miscellaneous items like published works and focus statement, denominational experience go near the last, followed by references. There is no best order, but those priorities are my preference and most common on collapse the resumes I see.
I have my resume’ in almost the same order you described here. I have also reworked my resume’ with consideration given to websites to buy research, the advice you provided in this article. All of the information in question covers two pages. I also provide a third page that lists four references. I wish I could post it on here to let you see it, as I have put a lot of collapse communism, work into organizing it. But I am wondering if it is too long. Some have given me the advise that pastor search committees do not really spend a lot of age of essay, time pouring over communism resumes. So I should just keep it short and age of reason enlightenment essay, sweet by providing just the nuts and bolts; just grab their attention without providing the essays, detail I have given. Websites To Buy Research! So how do I find a happy medium here?
Thom Rainer says. Most of the pastor resumes I see are 4-5 pages. The search committees tell me they do like the detail as long as it is essays, not obvious fluff and filler. Thom Rainer says. See my blog on October 3, 2011 where I address that very issue. Thanks. Robbie Perkins says.
Thanks Dr. Rainer. Jim Orchard says. A little off topic but related, search teams how about a little email letting us know you have received the excellent essay, resume and then if you have decided to drop our resume from the list let us know with a note saying thank you for your interest so we can move on with our search for a church. Thom Rainer says. Thanks. See my blog of October 3, 2011 where I address that matter to search committees. Sam Loveall says. Dr. Rainer, here’s a tip for your readers that you didn’t include – – be sure to fill in all the collapse essays, blanks.
During a search for a new youth minister, we received a resume that began with a cover letter (that I very much wish I had kept.) The letter writer went to great lengths to explain just how God had been leading this young man to our congregation. Intense prayer, advice from others, deep soul searching – – things like that. I wish I could remember the exact words of the “climax” sentence of the letter, but it went some thing like this: “I am convinced that God has great things planned, and excellent, I look forward to essays, speaking with you about serving with (church name) as we seek His further will for…” I’m surprised to hear you say to include a family section on your resume. Coming to the ministry from the business world (where I was a hiring manager) I would never have thought to desk cover no experience, include info about family since that is one thing you most definitely would not put on a resume for a secular job. Also, I hope that when you work with churches you remind them that this is a two-way street and collapse, they are under scrutiny by ap world, potential pastors just as the collapse communism essays, candidates are under scrutiny by them. I’ve had churches contact me seeking a resume who failed to provide any information or very little information or sloppily presented information and the message this sends is that they think they are so wonderful that anyone would be blessed to be their pastor.
As true as that may be, I would have no way of age of reason enlightenment, knowing how good they are by the info they make available and how they present it. Thanks for these tips and please take it the right way when I say that I hope I never have to use them. Sometimes, it’s hard for pastors and other ministry professionals to view their calling in job terms. But, at least one person on a Search Committee is going to be a business person and are accustomed to seeing professional resumes. They are going to communism, assume that your resume indicates how one will run their church and lead them spiritually. Will they be able to count on you to handle things professionally, when someone confesses an addiction problem that would ruin their standing in essay writing, the community? Will you professionally help families who have been in bitter disputes for years, when a loved one dies? Many churches are worried about communism, decline and want to know if you are able to lead them toward spiritual and numeric growth. Does your resume give them confidence you can? Do you have any great online or other resources to red convertible, help pastors develop a ministry resume or portfolio? Great stuff.
Thanks, definitely brought clarity to a foggy situation. Steven Zeigler says. I desire to collapse communism, be a worship leader. I have had no paid positions. I have only worked with two pastors and have done three years of essay focus statement, mission work in the U.S. God has put his hand on me to be a worship leader. I am working 36 hours a week to communism, support my family of four and I am age 47 now. I have not gone to bible college. I have had formal training for five years on organ and I have four years of performance with my college I attended many years ago. I have helped lead worship for five years at age of reason enlightenment essay, a preivously attended church and sang on the choir, yet it has never been a paid position. I now serve on the choir with the Church I am attending.
I have attended a worship school with Steve Swanson. Communism! Not a college. I have asked my pastor to work with him, yet he has never called me or asked to come. My pastor has said, he agrees that God has a call on my life for pastor of worship. Front Desk Clerk Letter! Where should I start and what should I do to apply for this position? I do believe God has opened this door for me and I have prayed. I have called the collapse communism essays, church to ask questions about the clerk cover no experience, position. Collapse! Anything above that, I am unsure what to essay rubrics, do.
Please help. Mark Carlton says. Why do Southern Baptist churches focus so little on Singles’ ministry? With the adult population in the US at collapse, more than 50% single, why do churches seem to disregard singles? I live in excellent essay writing, a city with over communism essays a million population and not one Southern Baptist Church has a strong singles ministry.
Southern Baptist used to at least have a large singles conference once a year at websites research papers, Ridgecrest but that conference has significantly dwindled while the singles population has grown substantially. The church is losing its influence because this segment of the population is being ignored.
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2017 MBA Essay Questions: Duke Fuqua. 2017 Duke Fuqua Full-Time MBA Essay Questions Class of collapse 2020. They#8217;re keeping the focus, questions the collapse communism essays, same again which is kinda good, since they#8217;re decent questions, but it#8217;s kinda disappointing, given how all the to buy papers, other schools are working so hard to collapse communism, innovate. Websites To Buy Papers. It could be said that Duke was an early adopter of the more innovative form of bschool essay, with their 25 Random Things list, and we do concede that that#8217;s a great question which applicants tend to have fun with, and which can reveal a lot about communism essays, a person. But#8230;. keeping the clerk cover no experience, status quo is kinda communicating that Duke is fine with how things are going, and it just seems like they#8217;re a little bit stalled out and stagnant right now. Granted, they hit #3 on the BusinessWeek rankings in 2016, so who is the #8216;Snark to say? Anyway, here are those questions that you#8217;ll be tackling: Three short-answer questions of up to 500 characters each (please note we said CHARACTERS and collapse communism essays not WORDS yes these need to be SHORT): What are your short-term goals, post-MBA? What are your long-term goals?
Life is full of uncertainties, and excellent essay plans and circumstances can change. Collapse Essays. As a result, navigating a career requires you to essay, be adaptable. Collapse Communism Essays. Should the short-term goals that you provided above not materialize what alternative directions have you considered? Duke is pretty much the only school that invites you to present a #8220;Plan B#8221; for your career goals. For most other applications you#8217;ll want to front cover letter no experience, focus on just one set of collapse essays goals. Two essays; we recommend not going more than perhaps 750 words at the most for essay each. Please please please don#8217;t go down to 10-point font even though they say that you can. See the communism, full set of requirements around essay length and excellent essay writing formatting and the questions in essays their entirety as posted on the Duke application website . Rubrics. [A very involved preamble, then:] [T]he Admissions Committee also wants to collapse, get to know you—beyond the professional and academic achievements listed in your resume and transcript. Front Desk Cover Letter No Experience. You can share with us important life experiences, your likes/dislikes, hobbies, achievements, fun facts, or anything that helps us understand what makes you who you are. Share with us your list of #8220;25 Random Things#8221; about YOU. [Another preamble about communism, Fuqua, then:] Based on your understanding of the Fuqua culture, how do you see yourself engaging in excellent essay writing and contributing to our community, outside of the classroom? That second question is quite similar to what Wharton is essays asking, and it#8217;s also got a lot of parallels with Columbia essay 2 as well as with the MIT pre-interview #8220;mission#8221; essay.
Duke was the first to age of, start with this type of question, so you can see how they#8217;ve put an communism essays emphasis on culture for a long time. Our Duke 2017 MBA Application Guide is ready to help you #8212; it covers everything that this school likes to see in red convertible an application! Duke Daytime MBA Deadlines Class of collapse 2020. Remember, regardless of which round you intend to apply in you can get on campus from front desk clerk no experience September 11 to October 5 to take advantage of their Open Interview period #8212; which is highly recommended!! Early Action (binding): September 12, 2017 Round 1: October 10, 2017 Round 2: January 3, 2018 (ouch that hurts this one is IMMEDIATELY after the holiday the only one worse is communism essays Ross) As with other schools, we don#8217;t suggest apply in Round 3 at Duke and in fact, if you#8217;re an international applicant, they won#8217;t let you due to exam rubrics, visa issues. That being said: In recent years, Duke said they were still accepting applications even after their Round 3 deadline had passed. Which is weird, and, we feel, not entirely fair. It#8217;s pretty darned difficult to get in then.
Were they really trying to say that they didn#8217;t have enough good candidates for their class at that late date? When every other school out there was turning away well-qualified applicants right and left all season? Hmmm. EssaySnark is not a fan of this. Collapse. Check out the to buy papers, Duke Essay Guide for 2017 to learn more on rounds, interviewing, and multi-school strategies including Duke Fuqua!
Duke has two phases of interviews: the Open Interview Period when anybody can come to campus and collapse communism interview at will; and symbolism the By-Invitation Interview Period. EssaySnark strongly recommends that everyone go through the Open Interview; it#8217;s a huge opportunity and collapse communism essays if you#8217;re serious about Fuqua you won#8217;t miss out on to buy papers, it! This year#8217;s Open Interview Period is communism September 7 to October 5, 2017; see details at Duke#8217;s Interview Process page . You do not need to essay rubrics, apply in collapse communism the Early Action round in order to take advantage of the Open Interview; applicants planning on submitting at any time may do so. You really should consider it. Excellent. Duke Student Blog this used to be an collapse essays dedicated admissions blog but now it#8217;s just a topic of red convertible essay posts on essays, the student blog. It still has some useful info for BSers so we#8217;ll leave the desk, link. Hmmm#8230; Not much there huh? Duke just isn#8217;t the most social media savvy school we#8217;ve ever encountered. We#8217;ve reviewed a number of essays Duke essays on the blahg: The Duke adcom looks for the same strong career goals and personal angles as Ross and other schools, so check these reviews out for websites some additional guidance:
In terms of the Fuqua Principles, you might want to peruse some posts we#8217;ve written about Berkeley: Haas and culture and A BSer is sick of the #8220;culture#8221; shtick. For Reference: Duke#8217;s Past-Season MBA Essays Analysis. Essays. We don#8217;t have every year listed out front desk cover separately here since Duke has kept nearly the same essays and requirements for many years running. Collapse. Click to ap world exam, view 2016 info. Duke used pretty much the same questions, as they have been doing for collapse communism many years now. In 2016, they cleaned up the #8220;culture/contribution#8221; prompt which made it easier to tackle for Class of 2019 applicants compared to what previous crops of BSers had to essay, deal with. We#8217;ve done lots of posts on the Duke essays over the years, so that#8217;s an collapse communism essays advantage, too! 2016 Early Action and Open Interviews. Essay Focus Statement. The most important thing to know about Duke right now? That they offer OPEN INTERVIEWS on campus in late summer, for collapse essays a rather short window of time.
It#8217;s HIGHLY RECOMMENDED that everyone regardless of which application round you#8217;re aiming for makes plans for a trip out to Durham for this opportunity. We discuss the reason enlightenment, reasons why in our Duke app guide. Duke Early Action is binding, however they have a standard Round 1 that follows only a few weeks later. If you#8217;re not fully convinced that Fuqua is the place for you, then stick with Round 1 but if you are ready to commit, then Early Action can be a real advantage. [end discussion of early-season 2016 info] Click to view 2015 questions. Last year#8217;s questions (these are old) Excellent.
Duke has kept its same questions for 2015 except that they#8217;re giving you more space in the important Career Goals short-answer questions. YAY DUKE!! Our Fuqua strategy guidecovers everything you need to know on tackling these questions and the essays. Three short-answer questions just 250 characters each #8212; NOW 500 CHARACTERS EACH! THAT#8217;S HUGE! You#8217;ll be able to collapse communism essays, actually pitch a complete career path now. What are your short-term goals, post-MBA? What are your long-term goals?
Life is full of uncertainties, and plans and circumstances can change. Research Papers. As a result, navigating a career requires you to be adaptable. Should the short-term goals that you provided above not materialize what alternative directions have you considered? Two essays, up to two double-spaced pages each: [T]he Admissions Committee also wants to get to collapse communism essays, know you—beyond the professional and academic achievements listed in your resume and transcript. You can share with us important life experiences, your likes/dislikes, hobbies, achievements, fun facts, or anything that helps us understand what makes you who you are. Share with us your list of #8220;25 Random Things#8221; about age of reason enlightenment, YOU.
Choose one: When asked by collapse communism, your family, friends, and colleagues why you want to go to Duke, what do you tell them? Share the reasons that are most meaningful to you. Red Convertible Essay. [A very involved question asking you to understand the 6 Fuqua Values and then:] At the end of your 2 years at Fuqua, if you were to receive an award for exemplifying one of the 6 Principles listed below, which one would it be and why? Your response should reflect your knowledge of Fuqua and the Daytime MBA program and experience, and the types of activities and leadership you would engage in as a Fuqua student. Collapse Communism. Very minor changes to the wording of that option #2 question: They deleted the phrase #8220;should reflect the research you have done.#8221; Hmmm. Interesting, Duke! For the career goals, Duke is writing pretty much the only school that invites you to present a #8220;Plan B.#8221; For most other applications you#8217;ll want to stick with just ONE set of communism essays goals. It#8217;s tough enough to convey those in the limited space the schools allow!! At least now, Duke has recognized that their requirements were a little overly restrictive before. You have a fighting chance this year, Brave Supplicant! You#8217;re applying at like the best time ever. Front. #128521; Also, that second question sure does have traces of collapse communism essays Berkeley-Haas lingering around it! Unsurprising.
Both of these schools have a distinct focus on culture, and age of both want you to understand what that culture is communism about before applying. The risk with the second option for essay 2? You could come across a little stilted if you try too hard. Check out the Duke Essay Guide to red convertible symbolism essay, learn more. Early Action (binding): September 15, 2015 (two days earlier than 2014) Round 1: October 14, 2015 (almost a week earlier than last year) Round 2: January 5, 2016 (same day as last season) Even though Round 3 is closed, they#8217;re accepting apps on a rolling basis until April 25 (with decision coming on May 6 are they saying that they would really be able to admit you in that little time. we don#8217;t suggest trying now) [end discussion of Fuqua#8217;s last year questions] Click to collapse communism, view 2014 questions. Duke won our informal Best MBA Questions contest for two years in a row (2012 and 2013) their essay questions are awesome! We#8217;ve therefore been thrilled that they#8217;ve kept them exactly as they are for ap world so long including this year!
They keep resisting the urge to make changes just because all the communism, other schools are changing. Bravo, Fuqua! #128512; [end discussion of Duke#8217;s 2014 application] We#8217;ve got the 2016 SnarkStrategies Guide for Duke available to to buy research, help you craft a strong strategy for collapse essays this great school! 2017 MBA Application Strategy Guides. The 2017 Darden MBA Application Guide - rewritten almost from scratch to help you with the 2017 app! The 2017 Michigan Ross Essay Guide - totally new to help you with the clerk, nine short-answer options and your career goals! The 2017 MIT Essay Guide with brand-new material on the cover letter and the 'introduce yourself' video. The 2017 Duke Essay Guide - covers the 25 Random Things essay and all the rest too! The 2017 Harvard MBA Application Guide - refreshed with new details and strategies for your Class of 2020 app. Brave Supplicants' latest reviews on The 'Snark. I think that the reviewer raised a lot of good points, but a) three pages of feedback on a 250 word . As a re-applicant, I knew I needed considerable improvement to communism, my pitch in order to maximize my . Excellent. What were we snarking about at this time in past years?
2016 : ($) If you get fired, do you need to tell the adcom? 2016 : Good luck for HBS applicants! 2014 : Did you just discover EssaySnark? 2013 : Success Story! A Journey to the Center of America: A Saga (Part 2: The First Year) 2013 : More on visiting schools 2012 : ($) What about a lower-ranked program? (No, lower than that) 2012 : ($) Duke's main essay: What do you tell your family, friends, and colleagues?
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case study pneumonia Department of Pediatrics, University of Hawaii John A. Burns School of Medicine. Chapter VI.11. Pulmonary Infections. Return to Table of collapse essays Contents. A previously healthy 4 year old boy is brought to an urgent care center by his mother for difficulty breathing for one day. Three days prior he had developed a runny nose, cough, and low grade fevers with a temperature maximum of 101 degrees F (38.3 degrees C).
He continued to take liquids well, but his solid intake has decreased. His temperature this morning was 103 degrees F (39.4 degrees C) and he was breathing fast and working hard to breathe. He does not have any ill contacts. He has never been hospitalized or had any surgeries. He was born at term without any complications. He is not taking medications other than acetaminophen. His immunizations are up to date for his age (except he had not received the pneumococcal conjugate vaccine). Rubrics! His parents and 10 year old sister are healthy and the remainder of collapse communism his family history is non-contributory. There are no smokers in the household, and he has not traveled recently. He does not have a history of choking or vomiting.
He has not had frequent ear or skin infections. He does not have a history of foul-smelling stools. Exam: VS T 40 degrees C (104 degrees F), P 130, RR 40, BP 100/70, oxygen saturation 87% in age of enlightenment essay room air. His height and weight are in the 50th percentile for his age. Collapse! He is awake and alert, in moderate distress. His conjunctiva and TMs are normal. His nasal mucosa is erythematous with yellowish discharge.
His lips and reason mucous membranes are dry. His neck is supple, with several small anterior cervical lymph nodes. Lungs: Moderate subcostal, intercostal, and supraclavicular retractions, symmetric expansion, dullness to percussion at the right base, increased vocal fremitus over the right base, decreased air entry over right lower lobe with crackles, no wheezes. Heart: Tachycardia, regular rhythm without murmur. Pulses are 2+, and capillary refill time is 3 seconds.
His abdomen, skin, and neurological examinations are unremarkable. CBC WBC 20,000, 70% segs, 11% bands, 15% lymphs, 3% monos, 1% eos. Hemoglobin 12.4, platelet count 280,000. Communism Essays! Chest x-ray (CXR): Right lower lobe opacity consistent with a round pneumonia (technically air/space disease, commonly called infiltrates by most physicians). Because of the hypoxia, he is symbolism, given supplemental oxygen (with subsequent improvement in oxygen saturation), as hospitalization arrangements are made. A 20 cc/kg infusion of collapse normal saline was given through an intravenous (IV) line and then maintenance fluids are started. A blood culture is obtained and he is started on IV cefuroxime. He improves over the next day. Research Papers! His respiratory distress slowly resolves and he is weaned off supplemental oxygen over the next two days.
His blood culture shows no growth. He is essays, discharged home on high dose amoxicillin for a total of enlightenment essay 10 days of therapy. Communism Essays! His discharge diagnosis is probably pneumococcal pneumonia. Acute childhood respiratory infections cause significant morbidity and mortality worldwide. Mortality is high in developing countries with up to one-third of deaths in children less than 5 years caused by acute respiratory infections (ARI) (1). The disparity in mortality is due to the severity of infection (perhaps due to differences in nutrition, overall health, immunization practices, and excellent medical care availability) since the essays incidence of acute respiratory infections is similar between developed and essay focus statement developing countries with infants experiencing about 4-8 episodes per year (1).
In the collapse US, mortality from ARIs has declined since 1968 (1,2). There are 2 basic classification systems used for acute respiratory tract infections: the ap world rubrics case-management classification system used by the World Health Organization (WHO) and collapse the traditional clinical classification system (1). The case management system divides ARIs by symptoms (i.e., stridor, wheezing, and no wheezing) and their severity (i.e., mild, moderate, severe, and very severe). The traditional system classifies ARIs by clerk no experience, upper respiratory tract infections (e.g., acute otitis media, pharyngitis), middle respiratory tract infections (e.g., croup and epiglottitis), and collapse lower respiratory tract infections (e.g., bronchiolitis, bronchitis, pneumonia). Therefore, studies evaluating ARIs are not uniform and use different definitions from clinical findings alone to excellent essay writing clinical findings in combination with other various ancillary tests (e.g., chest radiography). Of the acute respiratory infections, pneumonia has the highest mortality rate accounting for approximately 70% of the worldwide 4.5 million deaths from acute respiratory infections (4).
Although mortality from pneumonia in children in the United States has declined by 97% between 1939 and 1996 (5), pneumonia continues to be a leading cause of morbidity in children. Communism Essays! The risk of acquiring pneumonia is highest in essay rubrics children less than 5 years of age (1). The etiology of pneumonia varies and depends on: the age of the child, where the pneumonia was acquired (i.e., community vs. nosocomial), local epidemiology (e.g., influenza epidemics), host factors (e.g., immunologic status, recent or intercurrent antibiotic use, vaccination, and overall health status of the child), and communism environmental factors (e.g., travel, season of the year, daycare, or crowded living conditions) (4,6-9). Determination of the excellent essay writing precise etiology of pneumonia often requires invasive testing (e.g., lung biopsy), and therefore, this is collapse, done infrequently. Rather the etiology of pneumonia is usually based on generalizations in the relevant clinical setting.
In the neonatal period, the most common cause of bacterial pneumonia is group B beta-hemolytic streptococci (GBS) and gram negative enteric bacilli (e.g., E.coli), the same organisms associated with neonatal sepsis (4). In infants and children outside of the neonatal period, viruses are the most common cause of pneumonia (4,6,10-11) and respiratory syncytial virus (RSV) is rubrics, one of the most common causes in infancy, especially in premature infants (9,12). Of the bacterial pathogens, Streptococcus pneumoniae (pneumococcus) occurs most frequently (6,9,11,13); however, the studies isolating S. pneumoniae were performed prior to the licensure of the collapse essays pneumococcal conjugate vaccine (6). Outcome analysis of the 7-valent pneumococcal conjugate vaccine demonstrated that up to 33% of chest radiograph confirmed pneumonia were prevented in immunized patients compared to those who were not immunized (14). Therefore, a different bacterial pathogen may supersede S. pneumoniae as the most common cause of bacterial pneumonia in the coming years. Other organisms to consider are Chlamydia trachomatis in exam essay infants 3-19 months of age (4) and collapse essays Mycoplasma and Chlamydia pneumoniae in children and adolescents (8-9,11-12). In special cases, for example, patients with neuromuscular impairment and impaired swallowing, aspiration pneumonia with anaerobic bacteria should be considered (15). The etiology of pneumonia varies in other conditions including immunosuppressed patients, nosocomial infections, cystic fibrosis patients, and essay statement anatomic airway anomalies (e.g., tracheostomies). In addition, the etiology of pneumonia is complicated since mixed infections (e.g., viral-bacterial) can occur in 16-34% of patients (7,11,13). The lower respiratory tract in healthy persons is sterile (16).
Bacteria access the respiratory tract by inhalation, microaspiration, or by hematogenous spread. If bacteria gain access to alveoli, host immunologic systems begin to work on eliminating bacteria. There are 2 major mechanisms by which lung defenses work to keep the airways sterile: physical defenses (i.e., mucociliary clearance and lymphatic drainage) and mechanisms that destroy bacteria (i.e., opsonization, specific immunoglobulin G antibody (IgG), alveolar macrophage ingestion, or complement mediated bacterial lysis) (17). If these mechanisms fail, polymorphonuclear leukocytes (PMNs) are recruited with a resultant inflammatory response. Perpetuation of this inflammatory response leads to pneumonia. There are 4 major histologic steps seen in collapse communism pneumococcal pneumonia described by Tuomanen, et al (18): engorgement, red hepatization, grey hepatization, and resolution. Engorgement is associated with presence of red convertible symbolism bacteria in the alveoli and an associated serous exudate.
This then progresses to red hepatization secondary to communism leakage of erythrocytes into the alveoli. The next phase, grey hepatization, results from leukocyte migration to to buy papers the affected area with intravascular fibrin deposition disrupting perfusion to the area. The final phase results in resolution, with phagocytosis of pneumococci and communism clearance of fibrin and other debris. Outside of the neonatal period, pneumonia is suspected in patients with clinical signs and symptoms suggestive of impairment of the symbolism essay lower respiratory tract. Collapse Communism! Distinguishing bacterial from other causes of pneumonia cannot be accomplished by clinical findings alone (7). Symptoms of pneumonia are nonspecific and include: fever, ill appearance, cough, fatigue, decreased appetite and sometimes, abdominal pain. Ap World Rubrics! Signs of collapse communism lower respiratory tract involvement include: tachypnea (greater than 50 breaths/minute in children less than 12 months, and greater than 40 breaths/minute for red convertible essay, older children) (4), cyanosis, increased work of breathing (i.e., use of accessory muscles, grunting), pleuritic pain, and abnormal auscultatory findings. These signs do not differentiate a viral from communism essays, bacterial process. A chest radiograph is used to verify the clinical suspicion of pneumonia and characterize the disease process, but may not be performed on every patient. Viral respiratory tract infections are often associated with hyperinflation, perihilar peribronchial infiltrates, segmental or lobar atelectasis, and hilar adenopathy (19). Lobar consolidation and fluffy alveolar infiltrates with air bronchograms are more characteristic of exam essay bacterial infection (13).
However, there is overlap between these two groups (13). Collapse Communism Essays! Computed tomography and ultrasound of the red convertible essay chest are used in special circumstances (e.g., evaluate for pleural effusion, adenopathy, improved imaging of lung architecture) but these are not routinely obtained (4). Commonly used screening laboratory tests such as white blood cell count with differential, erythrocyte sedimentation rate (ESR), and the C-reactive protein (CRP) are not accurate in differentiating between bacterial, viral, mixed, or idiopathic causes of childhood pneumonia (7). Determination of precise etiology of pneumonia is difficult due to the lack of sensitive and collapse communism essays specific tests. Excellent! Many clinicians treat pneumonia empirically with minimal laboratory or radiographic evaluation and thus up to 80% of non-bacterial pneumonia may be treated with antibiotics (6).
This approach is communism, satisfactory when clinical risk is deemed to essay focus be low. Communism! When a more precise diagnosis is required, more invasive techniques are required. Bacteria found in the blood, pleural fluid (thoracentesis), or lung tissue is to buy papers, considered diagnostic in a patient presumed to have pneumonia (4). Blood cultures are only positive in 1-8% of pneumonia (11) but continue to be recommended (4). Some question the necessity of blood culture after cost-based analyses (6, 11).
Transthoracic needle aspirates, transtracheal aspirates, and open lung biopsy (the gold standard for collapse essays, diagnosis) are rarely performed due to the risk involved for these procedures (11,20), except in severe cases or in immunocompromised hosts (4). Sputum is essay statement, often contaminated with organisms unrelated to the specific etiology (16) and is difficult to obtain in children less than 8 years old (4). A sputum sample that may be helpful is characterized by many polymorphonuclear cells and a bacteria of collapse single morphology on gram stain (4). Bronchoalveolar lavage from focus statement, bronchoscopy is difficult to interpret as well. The results are non-specific (i.e., higher neutrophil counts than lymphocyte counts in patients with infection) and the organism found may or may not be the etiologic agent (16). Bacterial serology and bacterial antigen testing are often difficult to interpret (4,6). Bacterial cultures of the nasopharynx or throat correlate poorly with lung tissue cultures and are not helpful in establishing a diagnosis (16). Specific viral antigen testing, along with cultures for collapse, suspected pathogens, serologies for Mycoplasma and Chlamydia, and PPD skin testing for tuberculosis may be helpful (6). Pneumonia is treated with antimicrobials when the clinical suspicion for bacterial etiology is high. Focus! Greater pneumonia severity and findings that are consistent with bacterial pneumonia (e.g., lobar consolidation, leukocytosis, high fever) are more likely to warrant antimicrobial treatment.
Young infants, unreliable parents, poor access to medical care, and more severe infections often require hospitalization. Treatment of pneumonia is often empirically based and thus, information on antibiotic resistance patterns and mechanisms of resistance is essays, important to determine the most appropriate treatment. For S. pneumoniae, the most common mechanism of essay focus statement resistance to penicillins is alteration of penicillin-binding sites that can be overcome with higher doses of the communism drug (6). For macrolides, alteration to the 50S ribosomal binding site of the macrolide inhibits binding of the antibiotic and thus, prevents protein synthesis inhibition (6). In addition, there is also an increase in efflux pumps for macrolides and essay this property can be overcome by collapse communism essays, using macrolides that achieve high tissue concentrations at reason enlightenment the site of infection (e.g. azithromycin) (6). Penicillin resistant pneumococci are often resistant to communism multiple drugs including macrolides and trimethoprim-sulfamethoxazole (21).
Therefore, high-dose amoxicillin and/or azithromycin are recommended for empiric treatment of community-acquired pneumonia in children (6,8-9,11-12,20). Some clinicians will use clinical factors and exam essay ancillary tests in aggregate such as age, exposures, CXR pattern, fever, and leukocytosis, to stratify the risk to favor pneumococcus (high dose amoxicillin would be better) or Mycoplasma/Chlamydia (macrolide would be better). For those children requiring hospitalization, a second or third generation cephalosporin, occasionally in combination with a macrolide, is communism essays, generally recommended (8,20). Most treatment regimens are continued for a total of 7-14 days although this is based on exam essay little evidence (4). Pneumonia due to collapse communism essays Staphylococcus aureus is uncommon, but particularly severe. S. aureus pneumonia usually results from writing, inhalation of organisms, but it may also occur in patients with a cutaneous source (e.g., impetigo, boils, abscesses) with hematogenous spread or staphylococcal bacteremia from another source (e.g. osteomyelitis, central line infection). Essays! If S. aureus pneumonia is suspected, vancomycin should be started empirically. Symbolism Essay! Culture and sensitivity data permits changing to an alternate antibiotic later.
Pleural effusion (empyema), pneumothorax, and pneumatoceles often complicate S. aureus pneumonia. Pleural effusions can be classified in several ways. They can be a transudate or an exudate based on their protein content. A subpulmonic effusion versus an empyema is more clinically relevant. The former implies a transudate which is usually sterile, while the collapse communism essays term empyema is usually used to statement describe pus (purulent exudate) with a positive gram stain and collapse culture. The overall outcome in children with pneumonia is excellent. The majority of children will recover without complications (11). Follow up chest radiographs are not required routinely, but should be performed for reason enlightenment essay, patients with complicated pneumonia, persistent respiratory problems, pleural involvement, and neonates (4,22).
About 80% of infiltrates on CXR will resolve by 3-4 weeks and the remainder will usually resolve by 3 months (22). Communism Essays! Recurrent pneumonia with radiologic clearance between episodes requires further evaluation (e.g., immunodeficiencies, gastroesophageal reflux, pulmonary anomalies, etc.) (4). Bronchiolitis is the leading cause of hospitalization for excellent essay writing, respiratory tract infections in young children (4,23-25). Respiratory syncytial virus (RSV) is the primary cause of bronchiolitis, but parainfluenza virus, human metapneumovirus, and adenovirus may also cause bronchiolitis (23-24). In the United States, the majority of collapse RSV infections occur during the months of November to red convertible symbolism essay March (4,23). RSV infections account for a significant amount of collapse morbidity and reason enlightenment essay health care expense in communism essays the young age group (24). RSV is transmitted by essay focus statement, direct contact with large droplets or fomites. Transmission can be limited by collapse, good handwashing (23). RSV bronchiolitis results from the spread of exam RSV to the lower respiratory tract after an incubation period 2-8 days where the virus undergoes replication in the nasopharynx (23).
The infection results in infiltration of the respiratory epithelium with resultant inflammation and necrosis, sloughing of the epithelium and increased mucus production causing airflow limitation in the small airways leading to the hallmarks of the disease (23). Thus, affected infants have signs of airflow limitation including hyperinflation, atelectasis, and wheezing. The diagnosis is essays, often made on clinical grounds during the RSV season. Red Convertible Essay! Diagnostic testing can be done by immunofluorescence and enzyme-linked immunoabsorbent assay (ELISA) tests if the diagnosis is collapse communism, unclear. Therapy is often supportive which may include: supplemental oxygen, fluids, and upright positioning. Aerosolized ribavirin is the excellent only known proven therapy for RSV infection, but its expense, potential toxicity, difficulty of collapse communism administration, and lack of conclusive evidence for its efficacy (24,26) limit its use. The use of ap world essay rubrics bronchodilators and corticosteroids are controversial and may only be mildly effective at best (i.e., not been proven to be highly efficacious) (24-26).
For those with moderate to severe disease, helium-oxygen mixtures or nasal continuous positive airway pressure may be beneficial in improving gas-exchange and symptomatology (27-30). Montelukast, a leukotriene antagonist, has recently been reported to make a difference in future wheezing episodes (31). Prophylaxis with palivizumab (RSV monoclonal antibody) or RSV-IVIG is given to select pediatric populations recommended by the American Academy of Pediatrics during RSV season to collapse reduce RSV infection risk (32). Growing premature infants and infants with congenital heart disease and other chronic lung conditions are at statement increased risk for RSV pneumonia, apnea and respiratory failure. Healthy term infants with RSV usually develop mild bronchiolitis. Communism! Older children, teens and adults with RSV will usually have cold symptoms.
Bronchiolitis is usually a self limited disease and red convertible essay complete resolution takes about 4-8 weeks. In neonates and young infants, bronchiolitis may present with apnea and minimal respiratory symptoms, but the apnea is usually short-lived (33). Although bronchiolitis self-resolves, patients with RSV bronchiolitis may be predisposed to collapse essays future episodes of reason enlightenment wheezing (34). RSV infection can recur since there is an incomplete and communism poorly sustained immune response (23). In summary, bronchiolitis and pneumonia significantly impact the pediatric population. Determining likely etiologies of pneumonia and understanding effective treatment modalities will improve patient outcomes. Acknowledgments: I would like to thank Edward Fong, MD, Leslie Barton, MD and John Mark, MD for their critical review of the age of enlightenment chapter. 1. Which of the following is the most common cause of pneumonia outside of the neonatal period? 2. S. pneumonia resistance to penicillins is due to: . . . . . a. Production of beta-lactamase.
. . Essays! . . . b. Alteration of penicillin binding proteins. . . . . . c. Increased efflux pumps. . Essay Statement! . Collapse Communism! . . . d. Low tissue bioavailability. 3. True/False: Nasopharyngeal and throat cultures are useful in determining etiology of bacterial pneumonia. 4. True/False: Lobar consolidation on chest x-ray provides conclusive evidence for bacterial pneumonia. 5. Which factor does not appear to desk clerk no experience affect the etiology of pneumonia?
. . Communism Essays! . . Essay Statement! . Essays! b. Vaccination status. . . . . . c. Current antibiotic use. 6. The most common cause of bronchiolitis is: . . . . . a. Respiratory syncytial virus. . . . . . b. Human Metapneumovirus. 7. True/False: Bronchiolitis may initially present with apnea and minimal respiratory symptoms. 8. Treatment of bronchiolitis should include all of the following except: a. Supplemental oxygen for infants with hypoxia. b. Intravenous fluids and close monitoring of nutritional status. c. Good handwashing. Essay! d. Antibiotics. 9. True/False: Corticosteroids and bronchodilators are highly efficacious therapies for RSV bronchiolitis. Pneumonia case presenting with abdominal pain: Yamamoto LG. Abdominal Pain with a Negative Abdominal Examination. Collapse Communism! In: Yamamoto LG, Inaba AS, DiMauro R (eds).
Radiology Cases In Pediatric Emergency Medicine, 1994, volume 1, case 3. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v1c03.html. Staph pneumonia case: Yamamoto LG, Young LL. Tachypnea and Abdominal Pain. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1995, volume 2, case 5. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v2c05.html. Series of pediatric chest radiographs: Yamamoto LG. Test Your Skill In Reading Pediatric Chest Radiographs. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1995, volume 3, case 20. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v3c20.html.
Another series of pediatric chest radiographs: Yamamoto LG. Test Your Skill In Reading Pediatric Chest Radiographs. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1996, volume 4, case 5. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v4c05.html. 1. Graham NMH. The Epidemiology of to buy research papers Acute Respiratory Infection in Children and Adults: A Global Perspective.
Epidemiol Rev 1990;12:149-178. 2. Essays! National Center for Health Statistics. National Vital Statistics report (www.cdc.gov) 2001;49(1):14. 3. Age Of Reason! Dixon RE. Economic Costs of Respiratory Tract Infections in the United States. Communism Essays! Am J Med 1985;78(6B): 45-51.
4. Excellent Essay Writing! Miller MA, Ben-Ami T, Daum RS. Chapter 39-Bacterial Pneumonia in Neonates and communism essays Older Children. In: Taussig LM, Landau LI (eds). Pediatric Respiratory Medicine, first edition. Exam Essay Rubrics! 1999, St. Louis: Mosby, pp. Communism Essays! 595-664. 5. Red Convertible Symbolism! Dowell SF, Kupronis BA, Zell ER, Shay DK. Mortality From Pneumonia in Children in the United States, 1939 Through 1996. N Engl J Med 2000;342(19):1399-1407.
6. Bradley JS. Management of Community-Acquired Pediatric Pneumonia in collapse communism essays an Era of Increasing Antibiotic Resistance and Conjugate Vaccines. Pediatr Infect Dis J 2002;21(6):592-598. 7. Rubrics! Nohynek H, Valkeila E, Leinonen M, Eskola J. Erythrocyte Sedimentation Rate, White Blood Cell Count and Serum C-reactive Protein in Assessing Etiologic Diagnosis of Acute Lower Respiratory Infections in Children. Pediatr Infect Dis J 1995;14(6): 484-490.
8. Nelson J. Community-Acquired Pneumonia in Children: Guidelines for Treatment. Pediatr Infect Dis J 2000;19(3):251-253. 9. Heiskanen-Kosma T, Korppi MN, Jokinen C, et al. Etiology of Childhood Pneumonia: Serologic Results of a Prospective, Population-Based Study. Pediatr Infect Dis J 1998;17(11):986-991. 10. McIntosh K. Community-Acquired Pneumonia in Children. N Engl J Med 2002;346(6);429-437. 11. Ruuskanen O, Mertsolon J. Childhood Community-Acquired Pneumonia.
Sem Resp Infect 1999;14(2):163-172. 12. McCraken, GH Jr. Etiology and Treatment of Pneumonia. Pediatr Infect Dis J 2000;19(4):373-377. 13. Korppi M, Kiekara O, Heiskanen-Kosma T, Soimakallio S. Comparison of Radiological Findings and Microbial Aetiology of communism Childhood Pneumonia. Ap World Exam! Acta Paediatr 1993;82: 360-363. 14.
Overturf GD, Committee on Infectious Diseases, American Academy of Pediatrics. Collapse Communism! Technical Report: Prevention of Pneumococcal Infections, Including the Use of Pneumococcal Conjugate and essay rubrics Polysaccharide Vaccines and Antibiotic Prophylaxis. Pediatrics 2000;106(2):367-376. 15. Brook I, Finegold SM. Bacteriology of Aspiration Pneumonia in Children. Pediatrics 1980;65(6):1115-1120. 16.
Laurenzi GA, Potter RT, Kass EH. Bacteriologic Flora of the Lower Respiratory Tract. N Engl J Med 1961;265:1271-1278. 17. Green GM, Kass EH.
The Role of the Alveolar Macrophage in the Clearance of essays Bacteria from the Lung. J Exp Med 1964;119:167-175. 18. Tuomanen EI, Austrian R, Masure HR. Pathogenesis of Pneumococcal Infection. Desk Cover Letter No Experience! N Engl J Med 1995(19);332:1280-1284. 19. Collapse Essays! Wildin SR, Chonmaitree T, Swischuk LE.
Roentgenographic Features of Common Pediatric Viral Respiratory Tract Infections. Am J Dis Child 1988;142:43-46. 20. Hart CA, Duerden BI. Excellent! Respiratory Infections. J Med Microbiol 2002;51:903-914. 21. Whitney CG, Farley MM, Hadler J, et al.
Increasing Prevalence of Multidrug-Resistant Streptococcus Pneumoniae in the United States. N Engl J Med 2000;343(26):1917-1924. 22. Grossman LK, Wald ER, Nair P, Papiez J. Roentgenographic Follow-Up of Acute Pneumonia in Children. Pediatrics 1979(1);63:30-31. 23. Hall CB.
Respiratory Syncytial Virus and Parainfluenza virus. N Engl J Med 2001;344(25):1917-1928. 24. Communism! Greenough A. Symbolism Essay! Respiratory Syncytial Virus Infection: Clinical Features, Management, and Prophylaxis. Essays! Curr Opin in symbolism essay Pulm Med 2002;8:214-217. 25. Communism! Jartti T, van den Hoogen B, Garofalo RP, et al.
Metapneumovirus and Acute Wheezing in Children. Lancet 2002;360:1393-1394. 26. Patel H, Platt RW, Pekeles GS, Ducharme FM. A Randomized Controlled Trial of the Effectiveness of rubrics Nebulized Therapy with Epinephrine Compared with Albuterol and Saline in Infants Hospitalized for Acute Viral Bronchiolitis. J Pediatr 2002(6);141:818-824.
27. Hollman G, Shen G, Zeng L, et al. Helium-Oxygen Improves Clinical Asthma Scores in Children with Acute Bronchiolitis. Crit Care Med 1998;26(10):1731-1736. 28. Martinon-Torres F, Rodriguez-Nunez A, Martinon-Sanchez JM. Heliox Therapy in Infants with Acute Bronchiolitis. Pediatrics 2002(1);109:68-73.
29. Beasley JM, Jones SEF. Continuous Positive Airway Pressure in Bronchiolitis. Collapse! British Medical Journal 1981;283:1506-1508. 30.
Soong W, Hwang B, Tang R. Continuous Positive Airway Pressure by Nasal Prongs in Bronchiolitis. Pediatr Pulmonol 1993;16:163-166. 31. Bisgaard H for the Study Group on Montelukast and Respiratory Syncytial Virus. A Randomized Trial of Montelukast in Respiratory Syncytial Virus Postbronchiolitis. Am J Respir Crit Care Med 2003;167:379-383. 32. Halsey NA, Abramson JS, Chesney PJ, et al.
American Academy of essay writing Pediatrics: Prevention of Respiratory Syncytial Virus Infections: Indications for collapse communism, the Use of Palivizumab and Update on the Use of websites papers RSV-IGIV. Pediatrics 1998;102(5):1211-1216. 33. Bruhn FW, Mokrohisky ST, McIntosh K. Apnea Associated with Respiratory Syncytial Virus Infection in Young Infants. J Pediatr 1977;90:382-386.
34. Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B. Respiratory Syncytial Virus Bronchiolitis in collapse communism Infancy is an Important Risk Factor for Asthma and Allergy at Age 7. Excellent! Am J Respir Crit Care Med 2000;161:1501-1507. Answers to collapse communism questions. 1.c. Overall, viruses cause the majority of pneumonias in children; however, the incidence of viral pneumonia decreases with age, becoming less common in older children and adolescents.
4.False. Focus Statement! Lobar pneumonias are more likely to be of bacterial etiology, but this is not definitive since some lobar pneumonias will still be viral.
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The Collapse of Communism in Eastern Europe and the USSR
Guidelines for writing a literature review. by Helen Mongan-Rallis. Last updated: November 21, 2014. [Note: For these guidelines, in some sections I have quoted directly some of the the steps from: Galvan, J. (2006). Writing literature reviews: a guide for students of the behavioral sciences (3rd ed.) . Glendale, CA: Pyrczak Publishing. ] A literature review is not an annotated bibliography in which you summarize briefly each article that you have reviewed.
While a summary of the collapse, what you have read is contained within the literature review, it goes well beyond merely summarizing professional literature. It focuses on a specific topic of interest to you and red convertible essay, includes a critical analysis of the relationship among different works, and relating this research to collapse your work. It may be written as a stand-alone paper or to essay provide a theoretical framework and rationale for a research study (such as a thesis or dissertation). These guidelines are adapted primarily from Galvan (2006). Galvan outlines a very clear, step-by-step approach that is collapse, very useful to excellent use as you write your review.
I have integrated some other tips within this guide, particularly in collapse suggesting different technology tools that you might want to consider in helping you organize your review. In the sections from age of reason enlightenment, Step 6-9 what I have included is the outline of those steps exactly as described by Galvan. I also provide links at the end of this guide to resources that you should use in order to search the communism, literature and as you write your review. In addition to using the step-by-step guide that I have provided below, I also recommend that you (a) locate examples of writing literature reviews in your field of study and communism essays, skim over these to get a feel for what a literature review is and how these are written (I have also provided links to a couple of essay statement examples at the end of collapse essays these guidelines (b) read over other guides to writing literature reviews so that you see different perspectives and approaches: Some examples are: Read through the red convertible, links provided below on APA guidelines so that you become familiar with the common core elements of communism essays how to write in APA style: in particular, pay attention to general document guidelines (e.g. font, margins, spacing), title page, abstract, body, text citations, quotations. It will help you considerably if your topic for your literature review is the one on which you intend to do your final M.Ed. project, or is in some way related to the topic of your final project. However, you may pick any scholarly topic.
Step 3: Identify the ap world rubrics, literature that you will review : Familiarize yourself with online databases (see UMD library resource links below for help with this), identifying relevant databases in your field of study. Using relevant databases, search for literature sources using Google Scholar and also searching using Furl (search all sources, including the Furl accounts of other Furl members). Some tips for identifying suitable literature and narrowing your search : Start with a general descriptor from the collapse, database thesaurus or one that you know is already a well defined descriptor based on past work that you have done in this field. You will need to experiment with different searches, such as limiting your search to descriptors that appear only in the document titles, or in both the document title and in the abstract. Redefine your topic if needed: as you search you will quickly find out if the topic that you are reviewing is too broad. Try to narrow it to a specific area of interest within the broad area that you have chosen (remember: this is merely an symbolism essay introductory literature review for Educ 7001). Communism. It is focus statement, a good idea, as part of your literature search, to look for existing literature reviews that have already been written on collapse communism essays, this topic. As part of websites papers your search, be sure to identify landmark or classic studies and theorists as these provide you with a framework/context for your study. Collapse Communism. Import your references into your RefWorks account (see: Refworks Import Directions for symbolism essay, guide on how to collapse essays do this from different databases).
You can also enter references manually into RefWorks if you need to. Once you have identified and enlightenment essay, located the articles for your review, you need to analyze them and organize them before you begin writing: Overview the articles : Skim the articles to get an idea of the general purpose and content of the article (focus your reading here on the abstract, introduction and communism, first few paragraphs, the conclusion of each article. Tip: as you skim the articles, you may want to front desk clerk cover letter no experience record the collapse communism, notes that you take on each directly into RefWorks in the box for User 1. You can take notes onto age of reason, note cards or into a word processing document instead or as well as using RefWorks, but having your notes in RefWorks makes it easy to organize your notes later. Group the articles into categories (e.g. into essays, topics and subtopics and chronologically within each subtopic). Once again, it's useful to enter this information into focus statement, your RefWorks record. You can record the essays, topics in the same box as before (User 1) or use User 2 box for the topic(s) under which you have chosen to place this article. Take notes : Decide on the format in which you will take notes as you read the articles (as mentioned above, you can do this in RefWorks.
You can also do this using a Word Processor, or a concept mapping program like Inspiration (free 30 trial download), a data base program (e.g. Age Of Enlightenment. Access or File Maker Pro), in an Excel spreadsheet, or the collapse communism essays, old-fashioned way of using note cards. Be consistent in how you record notes. Define key terms: look for differences in the way keys terms are defined (note these differences). Note key statistics that you may want to websites research use in the introduction to your review.
Select useful quotes that you may want to include in your review. Important : If you copy the exact words from an article, be sure to cite the communism, page number as you will need this should you decide to red convertible symbolism use the quote when you write your review (as direct quotes must always be accompanied by collapse essays, page references). To ensure that you have quoted accurately (and to save time in note taking), if you are accessing the article in a format that allows this, you can copy and paste using your computer edit -- copy -- paste functions. Note: although you may collect a large number of quotes during the note taking phase of papers your review, when you write the review, use quotes very sparingly. The rule I follow is to quote only when when some key meaning would be lost in communism essays translation if I were to statement paraphrase the original author's words, or if using the original words adds special emphasis to a point that I am making. Note emphases, strengths weaknesses: Since different research studies focus on different aspects of the issue being studied, each article that you read will have different emphases, strengths. and weaknesses. Your role as a reviewer is to evaluate what you read, so that your review is not a mere description of different articles, but rather a critical analysis that makes sense of the collection of articles that you are reviewing. Critique the research methodologies used in essays the studies, and distinguish between assertions (the author's opinion) and actual research findings (derived from ap world exam, empirical evidence). Identify major trends or patterns: As you read a range of articles on your topic, you should make note of trends and patterns over collapse, time as reported in the literature.
This step requires you to synthesize and websites to buy, make sense of what you read, since these patterns and trends may not be spelled out in the literature, but rather become apparent to you as you review the big picture that has emerged over communism essays, time. Your analysis can make generalizations across a majority of front desk studies, but should also note inconsistencies across studies and over time. Identify gaps in essays the literature, and reflect on writing, why these might exist (based on the understandings that you have gained by reading literature in this field of communism study). These gaps will be important for you to address as you plan and write your review. Identify relationships among studies: note relationships among studies, such as which studies were landmark ones that led to subsequent studies in the same area. You may also note that studies fall into different categories (categories that you see emerging or ones that are already discussed in the literature). When you write your review, you should address these relationships and different categories and websites research papers, discuss relevant studies using this as a framework. Collapse Essays. Keep your review focused on your topic: make sure that the articles you find are relevant and directly related to your topic. As you take notes, record which specific aspects of the article you are reading are relevant to essay your topic (as you read you will come up with key descriptors that you can record in communism your notes that will help you organize your findings when you come to write up your review). If you are using an electronic form of note taking, you might note these descriptors in a separate field (e.g. in RefWorks, put these under User 2 or User 3; in exam rubrics Excel have a separate column for each descriptor; if you use Inspiration, you might attach a separate note for key descriptors. Evaluate your references for currency and coverage: Although you can always find more articles on your topic, you have to decide at what point you are finished with collecting new resources so that you can focus on communism, writing up your findings.
However, before you begin writing, you must evaluate your reference list to ensure that it is up to date and ap world essay rubrics, has reported the most current work. Typically a review will cover the last five years, but should also refer to any landmark studies prior to this time if they have significance in shaping the direction of the field. Essays. If you include studies prior to the past five years that are not landmark studies, you should defend why you have chosen these rather than more current ones. Step 5: Summarize the literature in excellent essay writing table or concept map format. Galvan (2006) recommends building tables as a key way to communism help you overview, organize, and summarize your findings, and suggests that including one or more of the tables that you create may be helpful in your literature review. If you do include tables as part of your review each must be accompanied by an analysis that summarizes, interprets and essay, synthesizes the literature that you have charted in the table. You can plan your table or do the collapse, entire summary chart of your literature using a concept map (such as using Inspiration) You can create the table using the table feature within Microsoft Word, or can create it initially in Excel and then copy and paste/import the the Excel sheet into Word once you have completed the table in Excel.
The advantage of using Excel is that it enables you to sort your findings according to a variety of factors (e.g. sort by date, and then by author; sort by methodology and then date) Examples of tables that may be relevant to front cover letter no experience your review: Definitions of key terms and essays, concepts. Research methods Summary of research results. Step 6: Synthesize the literature prior to writing your review. Using the ap world, notes that you have taken and essays, summary tables, develop an outline of your final review. The following are the age of reason enlightenment essay, key steps as outlined by Galvan (2006: 71-79) Consider your purpose and voice before beginning to write. In the case of this Educ 7001 introductory literature review, your initial purpose is to provide an collapse essays overview of the essay, topic that is of interest to you, demonstrating your understanding of key works and concepts within your chosen area of focus. Collapse. You are also developing skills in reviewing and writing, to provide a foundation on which you will build in subsequent courses within your M.Ed. and ultimately in your final project. In your final project your literature review should demonstrate your command of your field of study and/or establishing context for a study that you have done.
Consider how you reassemble your notes: plan how you will organize your findings into a unique analysis of the picture that you have captured in your notes. Exam Essay Rubrics. Important: A literature review is not series of annotations (like an annotated bibliography). Galvan (2006:72) captures the essays, difference between an annotated bibliography and red convertible symbolism essay, a literature review very well: . in communism essays essence, like describing trees when you really should be describing a forest. In the case of a literature review, you are really creating a new forest, which you will build by using the trees you found in the literature you read. Create a topic outline that traces your argument: first explain to front desk clerk letter the reader your line or argument (or thesis); then your narrative that follows should explain and justify your line of argument. You may find the program Inspiration useful in mapping out your argument (and once you have created this in a concept map form, Inspiration enables you to convert this to a text outline merely by clicking on the outline button). Collapse Essays. This can then be exported into a Microsoft Word document. Reorganize your notes according to rubrics the path of your argument Within each topic heading, note differences among studies.
Within each topic heading, look for obvious gaps or areas needing more research. Communism Essays. Plan to describe relevant theories. Plan to discuss how individual studies relate to and advance theory Plan to to buy research papers summarize periodically and, again near the end of the review Plan to collapse essays present conclusions and implications Plan to suggest specific directions for future research near the end of the review Flesh out your outline with details from your analysis. Step 7: Writing the review (Galvan, 2006: 81-90) Identify the front clerk no experience, broad problem area, but avoid global statements Early in the review, indicate why the topic being reviewed is important Distinguish between research finding and other sources of information Indicate why certain studies are important If you are commenting on the timeliness of a topic, be specific in describing the collapse essays, time frame If citing a classic or landmark study, identify it as such If a landmark study was replicated, mention that and indicate the enlightenment, results of the replication Discuss other literature reviews on your topic Refer the reader to other reviews on issues that you will not be discussing in details Justify comments such as, no studies were found. Avoid long lists of nonspecific references If the communism essays, results of ap world previous studies are inconsistent or widely varying, cite them separately Cite all relevant references in communism the review section of thesis, dissertation, or journal article. Step 8: Developing a coherent essay (Galvan, 2006: 91-96)
If your review is long, provide an overview near the beginning of the review Near the beginning of a review, state explicitly what will and excellent essay, will not be covered Specify your point of view early in the review: this serves as the thesis statement of the collapse communism essays, review. Aim for a clear and cohesive essay that integrates the key details of the symbolism essay, literature and communicates your point of view (a literature is not a series of annotated articles). Use subheadings, especially in collapse essays long reviews Use transitions to excellent essay writing help trace your argument If your topic teaches across disciplines, consider reviewing studies from each discipline separately Write a conclusion for the end of the collapse essays, review: Provide closure so that the path of the age of reason enlightenment essay, argument ends with a conclusion of collapse essays some kind. How you end the review, however, will depend on your reason for writing it. Red Convertible. If the review was written to stand alone, as is the case of a term paper or a review article for collapse, publication, the conclusion needs to make clear how the material in the body of the review has supported the front desk, assertion or proposition presented in the introduction.
On the other hand, a review in a thesis, dissertation, or journal article presenting original research usually leads to the research questions that will be addressed. Collapse Communism Essays. Check the flow of your argument for age of reason essay, coherence. Galvan, J. (2006). Collapse. Writing literature reviews: a guide for students of the behavioral sciences ( 3rd ed.). Glendale, CA: Pyrczak Publishing.