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How do GPs identify a need for palliative care in their patients? An interview study. Little is known about how GPs determine whether and when patients need palliative care. Little research has been done regarding the assumption underpinning Lynn and Adamson’s model that palliative care may start early in dissertations the course of the disease. This study was conducted to explore how GPs identify a need for palliative care in obesity cause and effect essays patients. A qualitative interview study was performed among 20 GPs in the Netherlands. GPs reported that a combination of several signals, often subtle and not explicit, made them identify a need for palliative care: signals from patients (increasing care dependency and not recuperating after intercurrent diseases) and signals from relatives or reports from communication dissertations, medical specialists. GPs reported differences in how they identified a need for palliative care in cancer patients versus those with other diseases.
In cancer patients, the obesity need for palliative care was often relatively clear because of a relatively strict demarcation between the development communication dissertations curative and palliative phase. Ib Tok Essay 2005. However, in development communication dissertations patients with e.g. COPD or in the very old, GPs' awareness of palliative care needs often arises gradually, relatively late in the disease trajectory. GPs consider the diagnosis of a life-threatening illness as a key point in the disease trajectory. However, this does not automatically mean that a patient needs palliative care at that point. GPs recognize a need for cause essays, palliative care on the basis of various signals. Development Communication. They do not support the idea underlying Lynn and ib tok 2005, Adamson’s model that palliative care always starts early in the course of the disease. Electronic supplementary material. The online version of this article (doi: 10.1186/1471-2296-14-42 ) contains supplementary material, which is available to development, authorized users.
Today, relevant policy makers and other experts are increasingly aware that palliative care is a broader concept than terminal care [ 1 ]. Ib Tok 2005. In 2003, a 'model' of palliative care was introduced by Lynn and Adamson [ 2 ] that underlined the necessity of an early start of palliative care. Initially, curative, disease-modifying and life-prolonging treatments may be given alongside palliative treatments, with a gradual shift to an emphasis on palliation. Development Dissertations. However, a previous study in the Netherlands indicated that in practice the shift from curative and life-prolonging treatments towards palliation often occurs at a late stage in the disease trajectory [ 3 ], suggesting that sometimes GPs or other relevant professionals only recognize patients' need for essay scholarships, palliative care late in the disease trajectory. However, timely recognition may be important in order to enable advance care planning and communication dissertations, prevent crisis situations and essay scholarships, unnecessary care transitions or hospital admissions. Nowadays there is also an increasing awareness that palliative care is communication dissertations not only for patients with incurable cancer but also for patients with COPD, heart failure or dementia, for instance. Word Problems Worksheets. GPs' recognition of a need for communication dissertations, palliative care may be different for cancer patients than for patients with other diseases since disease trajectories vary [ 4 , 5 ]. Lynn and binding oxford, Adamson have described three common disease trajectories [ 2 ]. First, there is a trajectory often seen in cancer patients, characterized by development a relatively short period of evident decline, a rather clear demarcation between the curative and palliative stages and a foreseen death. Bag Book Report. In contrast, the disease trajectory of patients with heart failure or COPD is often characterized by long-term limitations, intermittent exacerbations and remissions, resulting in a relatively sudden death.
In older people there is often a prolonged gradual deterioration towards death. Various disease trajectories can therefore be distinguished that may be related to variations in the timing and nature of the recognition of a patient's need for palliative care. However, few studies have been conducted to development, date on bag book report GPs’ recognition of their patients’ need for palliative care [ 6 ]. The scarcity of research literature on GPs’ recognition of a need for palliative care is remarkable, since GPs often have a long 'history' with the patient and development communication, family and also play a pivotal role in palliative care. In the Netherlands, for example, palliative care is mainly provided by ‘general’ health care professionals, like the GP and ib tok essay 2005, home care professionals, to guarantee that this care is accessible for everyone who is in need of it. Hence, palliative care is integrated into the regular healthcare system, in which GPs function as gatekeepers for specialized care services and as family doctors. Considering GPs’ pivotal role in palliative care this qualitative study was conducted to explore how GPs recognize a need for palliative care in various patient groups.
How do GPs recognize a need for development, palliative care? Does this recognition generally arise in the diagnosis stage or in later stages of the disease trajectory? Are there any differences in the timing and nature of GPs' recognition of the need for bag book report, palliative care between cancer patients and communication dissertations, non-cancer patients? In the Netherlands, all GPs have had mandatory postgraduate GP training after their basic medical training. Thesis Oxford. GPs were recruited in several ways. First, GPs who had participated in a previous survey about palliative care in general practice had been asked whether they were also willing to be interviewed. Secondly, GPs were recruited by ‘snowball sampling’ and via the researchers’ personal networks. Purposive sampling was conducted to development communication, guarantee variation in background characteristics such as age, gender, experiences with palliative care, degree of international scholarships urbanization and kind of practice.
Recruitment of GPs stopped after data saturation was reached (i.e. Communication. no additional themes relevant for answering the research questions emerged during additional interviews and subsequent data analysis). According to Dutch law, approval by a medical ethics committee is not needed for non-experimental interview data involving competent adults. The anonymity of the GPs was strictly preserved throughout the data entry and analysis process. All GPs were given verbal and written information about the aim and scope of the bag book report interviews and all GPs gave written informed consent. All interviews were conducted by the first author (SC), who was supported and accompanied in the first two interviews by communication dissertations the second author (AF). The interviews were performed at the GP’s practice or home, at an appropriate moment for mental block writing, the GP. The interview questions were compiled by development communication the four authors (one medical doctor/PhD student, two professors and one assistant professor in palliative care) and refined on the basis of block writing recommendations by the steering committee (two GPs and one professor in communication and dissertations, education of math worksheets family medicine). The interviews were semi-structured using a topic list with open interview questions (see the development dissertations Additional file 1 ). The interviews were audio taped, transcribed verbatim and rendered anonymous. As usual in qualitative research, data analysis started after the bag book report initial interviews were conducted as part of a cyclical process of data collection – data analysis – new data collection, et cetera. Each interview was transcribed literally and development dissertations, read and reread, keeping the research questions in mind.
In accordance with the guidelines for qualitative analysis of Dierckx de Casterle [ 7 ], the bag book report first author (SC) subsequently made narrative interview reports describing the main findings from each interview. The second author (ALF) did the same for half of the interviews. The pairs of narrative interview reports for the same interview were compared and discussed in relation to development, the research questions. In addition, the first author (SC) systematically coded the interview transcripts, initially by ‘open coding’, which means identifying, naming and ib tok essay 2005, categorizing relevant themes found in the transcripts. This was followed by ‘axial coding’.
Axial coding involves looking for connections between categories of codes. Ultimately, ‘selective coding’ was carried out whereby a core concept (viz. subtle signals from patients) was determined [ 8 ]. Development Communication. The coding process was supported by the Atlas.ti program [ 9 ]. This software program sorts relevant fragments and links these to other fragments with the same codes within a single interview and in other interviews. The code book was discussed and agreed upon with the block essay writing second author (AF). Development Communication Dissertations. Results from the interim and final analyses were reported and discussed during meetings with the other co-authors. Overview of bag book report participants’ characteristics. Working hours per week. Practice location area. GPs’ views on the start of palliative care.
GPs mainly associate palliative care with a relatively circumscribed period of a few weeks or months in which incurably ill people need a great deal of physical, psychosocial and spiritual care. Development. Some GPs add that they realize palliative care may start years before death in essay the case of certain chronic diseases such as COPD or heart failure. However, the development immediate association is still with a limited period at the end of life in which the patients (and often their close relatives) make increasing demands on the GP, care needs become more intensive, and contacts become more frequent. (GP 10, male): ‘Well, I think my feeling is that the palliative phase starts when the care needs start to get more intensive. Mental Block Essay. So when you notice that contact isn’t just once every three months… just asking hey, how’s it going, if that shifts to more intensive care, where your help is demanded on a more regular basis or where you feel perhaps I should pop in more often to keep an development communication eye on things, to my mind that is a kind of start to the palliative phase.’ While GPs do see palliative care as more than just terminal care, and some are clearly familiar with Lynn and Adamson’s model (see introduction), that is essays not sufficient reason for them to start using the term palliative care right from the moment of diagnosis. Nevertheless, GPs do see the diagnosis phase as an important phase, and they offer support to the patient and relatives to development dissertations, cope with the diagnosis.
However, GPs feel there is little to be gained from seeing this as the start of palliative care, especially as many people with cancer, for example, will eventually recover. Patients are often not yet dependent on mental essay writing healthcare in the early stage of a life-threatening disease, and in such situations GPs feel it does not make sense to talk of development communication dissertations ‘palliative care’. (GP 19, female) ‘Well yes… if it really is about people with COPD or people with heart failure and so on - and I think these are mainly the people we are talking about, or people with muscular conditions - even though you know someone is eventually going to die from this there is a long period before dying, you can say it’s really a chronic disease. You know they will eventually die from it. Mental Block Essay. I find it difficult to say whether you should call that entire period palliative care. Well… as I said, well we discussed it earlier when I said that I’m not thinking about that, I don’t start offering different care because it’s suddenly called palliative care or chronic care. Because you always try just to make things as comfortable as possible for the patient. So perhaps the label applied to it is just not so important. That's my feeling… why should you call it that?’ It is development dissertations often not the diagnosis but a combination of generally subtle signals that prompts GPs to consider palliative care needs. These signs come initially from the patient, frequently in combination with reports by cause and effect essays other care professionals and development dissertations, close relatives.
We explain the bag book report different signs below. Changes in development dissertations self-care abilities and international, care dependency. The recognition of a need for palliative care is often a gradual process steered by a combination of development communication dissertations signals. One key signal is international scholarships a reduction in a patient’s self-care ability, in the sense that it costs a patient an increasing amount of effort to look after himself. Often, a patient also becomes increasingly bedridden and dependent on care by relatives and professionals. The care needs addressed to the GP also become more frequent and more intense. A patient who always used to come to development communication dissertations, the GP practice may suddenly request a home visit. Two GPs describe increasing healthcare demands in the interview excerpts below. (GP 3, male): ‘It starts when the care need increases.’ Interviewer: ‘Could you explain that?’ ‘Well, as a patient you obviously try to keep to your old lifestyle as much as possible’. And if you have to ib tok 2005, give that up and communication, ask for help because you can no longer manage to eat or sleep or because of the pain, that is the point when you can give a patient support.’ (GP 1, female): ‘Yes, there are different kinds of palliative care.
And the real palliative care is the final stage as it were, because then more care is needed from the people around them or from outside. And if someone becomes progressively dependent on others. Ib Tok 2005. I think that this… is so for development communication, various activities of daily living, that they can no longer do themselves.’ Not recuperating fully after an additional condition, such as bladder infection, is also a signal for GPs that they need to thesis oxford, monitor this patient particularly closely. Development Communication. Normally people should be back to normal, but the anticipated recovery never happens or is ib tok only partial, and this is a signal for GPs that their patients are ‘sliding’ into the palliative phase. (GP 4, female): ‘These are people who sometimes don’t recuperate after a particular condition as you expect - hey, I treated that bladder inflammation and… so it is partly a case of development communication expectations and knowing that if I treat that condition they should recuperate after a certain period. Then someone should be back to normal, but look, they’re not. And that’s often the start.’ Social changes are also a signal for GPs that there is word a need for palliative care, for development communication, example if people become withdrawn, less focused on contacts beyond their close relatives and no longer get pleasure from hobbies or going out. Life becomes more ‘existential’ in the sense that they concentrate on the people and binding oxford, things that are most important to them, and focus on closure and dissertations, taking leave of life.
GPs also often get signals from international scholarships, close relatives. Development Dissertations. A partner or other close family member will often report deterioration in bag book report the patient’s situation or say that the burden of care is becoming very heavy and that they need to discuss matters. (GP 9, male): ‘Yes, or the family carers for example. Communication Dissertations. They may well be the thesis biggest source. You see the family carer, who often ends up dealing with most of the demands for help and care, and development communication, they say, well, I’m finding it a bit too much, I’m finding the going too tough, I need someone I can discuss things with now and then. And you see the family carers are often just as pleased with a GP who visits regularly as the patients themselves are. So they also play an important part.’
Another signal for GPs that a patient may require palliative care is bag book report a message from the medical specialist that cure is not, or no longer, a possibility. This is also the point at which the medical specialist refers the patient back to their GP, who once again becomes the primary treating physician. Interviewer: ‘If you now think more generally about patients who require palliative care, how do you recognize their need for development communication, that care?’ (GP 3, male): ‘The need that arises or comes automatically if people are discharged from hospital or if they say there is nothing more we can do for you. That’s really when it begins…’ The home care organization may also sound the alarm.
For instance, the thesis oxford district nurse may phone the GP to development communication, say there are problems with the patient, the family is overburdened and essay, something needs to development dissertations, be done. A signal like that in combination with other signals alerts a GP and makes them feel there is essay a need for palliative care. Differences in development recognition of palliative needs for bag book report, different conditions. GPs mention differences in the recognition of a need for development dissertations, palliative care depending on the conditions people are suffering from. There is international often a relatively clear demarcation between the curative and palliative phases for cancer patients, as a medical specialist will say curative treatment is no longer possible. An additional factor is that the diagnosis of cancer is often experienced as a ‘bombshell' by dissertations the patient, their close relatives and sometimes even the GP. Even if GPs feel that palliative care does not automatically start with the diagnosis, in ib tok 2005 the case of cancer everyone is aware of the real chance that the patient will die.
As a result, the option of development communication palliative care is on top of mind at an earlier stage than is the case for many chronic diseases. (GP 10, male): ‘Usually it’s the case that as soon as they have had the diagnosis, people start to think this could well mean I die and I am still so young. Or fine, I’ve had a good life, I have to die of 4th grade math problems something… but at communication any rate they’ll be aware they might die when they get the diagnosis. So that’s a totally different process. So I feel these people often… of math word worksheets course they sometimes also get the shock of seeming to have completely recovered and development communication, then they collapse again. But of essay course often people… the communication dissertations attempts at a cure don’t work out and they gradually get reconciled to the idea. And then it’s a very clear process, then they are thinking about it. And for you as a doctor… these are very intensive things… but I do think there is a certain clarity.’
GPs explain that it is often more difficult to problems, predict how other chronic, ultimately terminal conditions will progress compared with cancer. Development Dissertations. People with COPD, heart failure or Parkinsonism are often still being treated by a medical specialist in essay the final stages. They do not have a clear point where the medical specialist says there are no more treatment options. In the excerpt below, a GP explains how he often gradually becomes aware of a need for palliative care. (GP 9, male): ‘Well, as I said, it is relatively somewhat easier with cancer patients because then you often get a message from the hospital that the communication dissertations curative treatment has failed, so then you know that from that moment on these people are officially palliative. Problems. Although certainly at first we often don’t get that involved. And in the case of COPD or heart failure and so on it’s more of a question of noticing at development communication dissertations a particular point, well, we seem to be doing palliative things, without it being an explicit decision, but more that you… yes, there comes a point where the policy gradually changes… and there comes a point when you realize, yes, we really are giving palliative care.’ GP also frequently have the feeling with very old people that the patients often shift slowly and gradually to ‘a palliative process’. They describe this as a natural development, the ‘circle of life’.
A GP explains: (GP 8, male): ‘But after they get to 85 or so, lots of people are finished with life, or no longer see it as a real… yes, as a diversion that they are going to die or that it is coming to an end. Thesis Binding. They're finished with life, so dying is a very natural thing. And then you don’t have so much of an explicit feeling of now we are going to development dissertations, opt for palliative care.’ GPs recognize a need for palliative care on the basis of various, often subtle signals. An important signal is a rise in a patient’s care dependency, in the sense of an increasing need for 4th grade math word problems worksheets, help in daily functioning and a growing reliance on family members and development communication dissertations, professionals. Scholarships. In addition, not recovering after intercurrent diseases may be a signal that there is a need for development dissertations, palliative care. These signals are often accompanied by reports by family members, home care professionals and medical specialists. Thus, GPs also take into account the patients’ context and environment when recognizing palliative care needs. Remarkably, GPs did not mention psychosocial or spiritual problems among the initial signals that a patient was in need of palliative care, although they did consider psychosocial and spiritual support as elements of palliative care. We found differences between recognizing palliative care needs among patients with cancer, patients with other chronic diseases and the very old, who often deteriorate slowly.
In cancer patients, the demarcation between the curative and palliative phases is 4th grade problems often relatively clear for GPs. In the case of these patients, the medical specialist informs the GP when curative treatments are not an option or have been stopped. Then the patient is referred from the medical specialist to communication, the GP and obesity cause essays, a palliative care policy is started. This makes it relatively easy for GPs to development dissertations, demarcate the math need for palliative care. However, in patients with chronic diseases such as COPD and heart failure, the course of the disease is often less predictable and communication, patients continue to bag book report, be treated both by a medical specialist in the hospital and their GP. Development. Consequently, recognition of the need for palliative care often arises gradually.
Furthermore, in the case of the ‘oldest old’ where physical and bag book report, cognitive functions often deteriorate steadily, GPs experience the development communication dissertations gradual decline as the normal course of life. Therefore, recognition of the need for palliative care also arises gradually. This finding is in line with the research of Shipman et al. [ 10 ]. Mental. According to development, this research, prominent concerns included difficulties with prognosis and the availability of bag book report adequate support for development, patients with advanced non-malignant disease. Currently, experts like Lynn and Adamson consider the palliative phase as a care continuum which starts early in the course of ib tok a life-threatening illness [ 1 , 2 , 11 , 12 ]. Development Communication Dissertations. Dutch GPs also consider the obesity cause and effect diagnosis stage as an important stage in the patient’s disease trajectory. Dissertations. However, they do not necessarily see the diagnosis as the starting point for essay 2005, palliative care. Although GPs may give support at the time of the diagnosis, they do not call it palliative care as long as cure is dissertations still a possibility or as long patients are not care-dependent. Obesity. They see no added value in talking about ‘palliative care’ when cure is still an option or when the patient does not need much care. GPs often do give emotional support around the diagnosis, but they do not want to designate this as palliative care.
Some of them also indicated that the word ‘palliative’ in dissertations communication with a patient who is still living life to the full, is essay 2005 also not a very useful term. So far, little empirical research had been conducted regarding the assumption that palliative care should start early in the course of the disease. Our research seeks to close this gap. Most previous palliative care research has focused exclusively on patients with cancer [ 13 , 14 , 15 ]. A strength of this study is that it also focuses on development dissertations GPs’ experiences with people with chronic non-cancerous conditions. This study was based on qualitative interviews providing 'rich' detailed data on subjective experiences and essay, views. Qualitative methods are recommended when research topics are relatively unexplored and no structured measurement instruments are available, as was the case in our study. However, qualitative designs have limitations regarding generalizability and external validity. Since a non-random purposive sample of Dutch GPs was involved in the study, it cannot automatically be concluded that this provides a representative picture of all GPs in the Netherlands.
For instance, some overrepresentation can be expected of GPs with above-average interest in and experience with palliative care. Moreover, there may be limitations concerning the generalizability of the findings to other countries. Cross-national research shows that the Netherlands is known to be a country where doctors communicate relatively openly about development dissertations end-of-life issues [ 16 ]. Therefore, it can be expected that patients in thesis oxford other countries will be very unlikely to dissertations, communicate palliative care needs at an earlier stage than in this study. Implications for research and thesis binding, practice. Future quantitative research among a random sample of Dutch GPs as well as cross-national research is recommended to development communication dissertations, get a more complete and generalizable picture of how GPs recognize that a patient is in need of palliative care. It is cause and effect recommended that future research should include both GPs with considerable experience of palliative care and GPs with less experience. In addition, it would be interesting to combine and compare multiple perspectives in a future study: those of the patients, the dissertations family members, the GPs and of other professional caregivers. Finally, we recommend further research on the identification of palliative care needs in the ‘oldest old’ in particular, who often suffer from complex co-morbidity and mental essay writing, show a steady decline up to death. Further research on this group of elderly people is development communication dissertations important because this non-cancer group has not received much attention so far in palliative care research. This study indicated that GPs prefer to avoid the term 'palliative' as long as they have not received signals from the patient that he/she is in need of palliative care or if curative treatments are still possible. Discussions are recommended on the use of the bag book report term 'palliative' or options for development communication, alternative terms, for instance in the training and 4th grade, education of healthcare professionals.
The education and training of GPs could also include further discussion of what attitude GPs should take in palliative care. It is known from other recent research that Dutch GPs in general have a reactive rather than a proactive attitude in communication the interaction with their patients [ 17 ]. GPs assume that patients themselves should say what kind of support they need and what kind of problems they have. GPs do not want to patronise their patients or give care that is not needed. However, in general patients will not ask explicitly and clearly for palliative care in the early stages of the disease trajectory, which makes it even more important for GPs to initiate discussions on evolving care needs. A more proactive approach with the GP taking initiatives for advance care planning, may result in a better match with patients’ and family members’ existing and evolving care needs. We recommend further research into the conditions, stages and specific patient categories for which it would be better for GPs to opt for a proactive (rather than reactive) approach in patients with progressive diseases. GPs recognize a need for palliative care on the basis of essay scholarships various signals. They do not support the idea underlying Lynn and development, Adamson’s model that palliative care always starts early in the course of the ib tok essay 2005 disease. This work was supported by the Netherlands Organization for Health Research and Development (ZonMw; grant number 11510010). The authors declare that they have no competing interests. SJJC and AF drafted this manuscript in dissertations cooperation with YE and LD.
AF, YE and LD were responsible for the design of this study. Mental Writing. SJJC and AF were involved in the data collection. SJJC, AF, YE and LD were involved in the analysis and/or interpretation of the data. All authors read and approved the development communication dissertations manuscript. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Susanne JJ Claessen 1 Email author Anneke L Francke 1 2 Yvonne Engels 3 Luc Deliens 1 4 1. Obesity Cause Essays. EMGO Institute for Health and Care Research, Department of Public and Occupational Health Expertise Center Palliative Care VUmc VU University medical center (VUmc) Amsterdam The Netherlands 2. Dissertations. NIVEL, Netherlands Institute for ib tok 2005, Health Services Research Utrecht The Netherlands 3. Department of development communication Anesthesiology, Pain and Palliative Medicine Radboud University Nijmegen Medical Centre Nijmegen The Netherlands 4. Essay Scholarships. End-of-life Care Research Group Ghent University Vrije Universiteit Brussel Brussels Belgium. .RIS Papers Reference Manager RefWorks Zotero. .BIB BibTeX JabRef Mendeley. .RIS Papers Reference Manager RefWorks Zotero.
.BIB BibTeX JabRef Mendeley. Over 10 million scientific documents at development communication your fingertips. 2017 Springer International Publishing AG. Part of block essay Springer Nature.
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Every person’s experience is unique, so you’ll need to choose a template that best reflects and promotes your skills and experiences.Our templates are built to be customizable to any industry and are great for any of the 3 resume formats. The fact is, the web is filled with so many fantastic and creative template designs that there is undoubtedly something for you out development dissertations, there. Cause And Effect Essays! We are proud of the designs we’ve created, and have seen that they are effective at dissertations, landing interviews. Mental Block Writing! But we’re not finished yet — we’ll be adding template designs to this page extensively in the near future. If you feel like creating your own, that’s fine too. Readability is king when creating a good template — it is the most important factor, followed by how the dissertations resume itself is structured to showcase your best experiences and conceal your negative ones.
You may have read on the Internet that it’s inappropriate to use a resume template. You’ll hear these arguments: 1. It shows you’re lazy and uncreative, and unable to ib tok essay design your own. Wrong, it shows you’re efficient. (Creating your own is fine, too.) 2. Since your experience is development communication dissertations, unique, a resume template won’t cut it. Wrong again. Your experience is personally unique, but you still generally fall into pattern that many other people have traveled before. 3. The hiring manager will be tired of looking at that resume template design because a lot of other people use it.
That hiring manager should be fired. It’s the content of thesis, your resume that matters, not the aesthetic (unless it’s not readable.) We hope that clears up any misconceptions you may have had. We invite you to scroll back to communication the top and choose from obesity and effect, one of our many resume libraries, and start writing. cover letter for nursing. Should i include collegiate sports in my resume? And if so where? It depends how much professional experience you have. If you are a recent college grad, then it is dissertations, acceptable to essay 2005 include on communication your resume. Good luck on the job hunt! Good luck on the job hunt!
If the jobs are relevant to international scholarships the ones you are applying for, then you can go as far back as you like. With regards to your military experience, check out our military to civilian resume guide: https://resumegenius.com/blog/go-shooting-guns-coffee-runs. Any of the templates in library 2 would be suitable for manufacturing careers. Best of luck! I’ve worked in the same industry for development dissertations the past 13 years. Multiple employers with jobs lasting two to three years each. Ib Tok Essay! The jobs have been similar, so the experience looks a bit repetitive. I need to development dissertations find a template that highlights my experience without getting bogged down in ib tok essay 2005, the chronology, Any suggestions? It provides ample space for your professional experience, while also highlighting your top qualifications. Development! Good luck on math problems worksheets the job hunt! hi resume genius.. i need template resume that suitable for development trainer and coach.. can u suggest to me with template is obesity cause essays, suitable.. #128578;
I had a job for communication dissertations 7 years and during that time I wore many hats, Executive Admin, Purchasing, Vendor Management, Project Coordination, etc. How would I write that on my resume? Perhaps the Company name and then all the related roles under that and the times I did those jobs? I was always the Executive Admin, but I did other jobs during that period. Yes, your suggestion is bag book report, correct. Start with the company name and included the related jobs with their own bullet points underneath.
Good luck! Consider trying the ‘Job Hopper’ or the ‘Executive.’ They should able to fit all your jobs nicely. Ive never had a job so what should I use? Most of the templates above would suit your situation, but we suggest trying the development communication dissertations Career Changer template because it emphasizes skills over the dates of your professional experience. (https://resumegenius.com/resume-templates/career-level-life-situation-templates#career-changer-templates) Best of luck! We suggest using the ‘Gatsby’ Template. Good luck with grad school! As far as style, we suggest our ‘Professional’ template.
In terms of format, if you want to include your restaurant experience, then you might want to mental essay consider using a functional format:https://resumegenius.com/resume-formats/functional-samples-writing-guide. Hope this helps! We suggest using our ‘Entry-Level’ template. Communication! Good luck with the thesis binding oxford internship! Good Day Resume Genius.I’m a midwife by profession an has worked in a military hospital for development communication dissertations 16 years in KSA. I’m trying to apply as a home based ESL educator and an email respondent . Since I’m from the 4th grade medical profession, I’m having difficulty in choosing the perfect resume.The skill I know is more on the medical.,clerical which involes data entry for development appointments and summary, interpreter and my part time informal english lessons to native speaking arabs. What template should I use? Try the ‘Murray’ template.
Good luck! Hello. Which is good for cabin crew applicant? I have no many work experience in service. So i want to obesity essays highlight the other things. Thanks #128578; Take a look at development communication, our Flight Attendant resume sample: https://resumegenius.com/resume-samples/flight-attendant-resume-example You can download it and input your own information. Which template would you recommend for mental essay writing a career in education?
Check out our teacher resume samples: https://resumegenius.com/resume-samples/teacher-resume-example You can download them and input your own experience. Try using the communication dissertations ‘Freeman’ template. Best of luck on the promotion! Hi! What resume template would you recommend for ib tok 2005 a college freshman trying to apply for a competitive summer program with the USDA and development communication, South Dakota State University? Sound like the ‘Entry-Level’ template would be a good fit for what you’re trying to math problems worksheets do. Good luck with the summer program. Hi! Which resume template would you recommend for someone trying to dissertations tap into the finance and accounting market.
Looking for an entry-level position. You should go with the ‘Entry-Level’ template. Scholarships! Good luck with the job hunt. I have worked 32+ years as a nurse, the last 4 years taking care of my elderly father and online work. Now seeking to dissertations get back into the job market for obesity and effect essays extra income, not necessarily in the health field, just to earn some income and communication, socialize. What resume do you suggest? Try the ‘Job Hopper’ template. Oxford! Good luck with your job search! Hi! What resume template would you recommend for a 9th grader trying to apply for a doctor (any)??
Apparently, resume making and interviewing is our project for the fourth quarter this year. I couldn’t find any clear examples on the web, and development, I was hoping you could help me out and effect, with what template I should use.. Try using the ‘Elegant 2.0’ template. Good luck on your project. Yes, if you click the development communication View all Resume Designs button and obesity essays, click the download link for development the template pack of your choice. If you’ve never written a resume before, I’d recommend checking out and effect essays, our “How to development Write a Resume” guide to get a clearer idea (it’s much more comprehensive than any answer I can give here). https://resumegenius.com/how-to-write-a-resume.
Hit us up with any follow-up questions after giving that a read we’ll see if we can help further! Good luck! Hey there Margaret, In order to best understand which template works, it’s a good idea to check out which resume format fits your particular needs; then you can take it from thesis, there. https://resumegenius.com/resume-formats. All of the templates were created by professional resume writers, so it’s hard to go wrong with any of them — it just depends on your preference. Good luck! It really depends on what job you’re applying for. Since you have substantial work experience, try quantifying that in communication dissertations, your resume (think: any numbers that a hiring manager can look at and better understand what you accomplished during your time working there). International! Check out development, this page and choose the one you find most fitting, that should be a good start: https://resumegenius.com/resume-formats. Good luck on the job hunt!
Hey there hbil036, This way, you can focus on your skills qualifications critical to the job application. As an aside, you may want to look into whether you’re qualified to get back into accounting after that many years outside of the field. I understand that some regulations and rules change over the years — it may just be a matter of taking a test or updating your certifications, but I’m not certain. If that doesn’t seem to be a problem then go with the binding oxford functional resume for sure. Good luck on the job hunt! If you are lacking in communication, major experience, I’d recommend using a reverse chronological format for your resume. Our “Classic” template on mental essay writing this page should do the trick: https://resumegenius.com/resume-templates/ Good luck at the job fair! I recommend you first check out our internship resume sample page: https://resumegenius.com/resume-samples/internship-resume-example. Afterwards, feel free to choose any format – just use a comprehensive education section instead of a professional experience section, and communication dissertations, you should be good. Good luck landing that internship!
There are tons of errors throughout. See why. How to essay writing Modify and Maximize your Resume Template. Need a resume template? Feel free to development download one, but be sure to make small modifications to unlock your. Would You Rather Work for a Man or a Woman? Do people still care whether they work for thesis oxford a man or woman, or do most people simply look for a nice job.
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Analysis of Masters of War, by Bob Dylan Essay. The 1960’s was also a major time in dissertations which social classes were at war with one another. The young and the old were large factors in this time period. Bag Book Report. In this time period the battle for development communication dissertations, Civil Rights fought as well. Obesity Cause Essays. During this time period East and West Germany separated with the development dissertations construction of the thesis binding oxford Berlin Wall (Harris 8-9). Communication Dissertations. Mainly in this time period was the mass spread of culture.
The 1960’s are said to be the thesis binding oxford decade that is development communication dissertations, defined by the artists and obesity cause and effect essays opinions that made up the decade (Miller 1). Many people were speaking out against the government’s decisions and rebelling against them in their works of art, such as music. Additionally, in dissertations this time period the Civil Rights movement took place and 4th grade math worksheets the races Some fans called Dylan leader of development dissertations, protest-song era of early sixties. In 1965, Dylan shocked the fans with a mixture of folk, rock, folk-rock, protest songs, electric blues, and Nashville style country. He was screaming freedom through songs such as Like a Rolling Stone and obesity and effect Mr. Tambourine Man when all that seemed to dissertations work was war. Even in his album Another Side of Bob Dylan, a lot of his poetry is printed and ib tok 2005 simply by reading it, one can feel his spirit, his when the war had not yet started, but was used, a couple years later, as a protest song against the war. “Blowin’ in development the Wind” starts with a couple of bag book report, questions: How many roads must a man walk down Before you call him a man? Yes, 'n' how many seas must a white dove sail Before she sleeps in the sand? Yes, 'n' how many times must the cannon balls fly Before they're forever banned?
He asks the first couple of questions so he can put the last question, the one that has to do with war, in the same old Dylan left his hometown of Hibbing in the fall of 1959 for college at the University of Minnesota, Minneapolis. This would be his first taste of the big city and the life that awaited him. The sight and sounds of the big city opened many new vistas for the young Dylan and he took advantage of his situation by development communication dissertations studying the roots of contemporary rock. He began to listen to the works of folk pioneers like Hank Williams, Robert Johnson, and ib tok Woody Guthrie. At the same time Dylan was Bob Dylan's lyrics that evening were dated.
But, no doubt to his great dismay, they were no more less relevant on development dissertations, this evening in 1991 then they were when he wrote them in the midst of ib tok essay, then President Lyndon Johnson's controversial deployment of American troops to Vietnam. The audience that evening wasn't watching some fly-by-night hipster playing senseless fluff. They were caste in the shadow of the most prophetic musical figure of the last fifty years. A man whose inner fire forged a new musical To do this day, there are still no records to be found of development communication, how Dylan really crashed while he was riding his motorcycle near his Woodstock, New York home. There are numerous stories that have been circulating around for years, such as he lost his balanced or that he slipped on an oil slick. Regardless, whatever happened on his motorcycle in oxford that summer changed his life forever. In a 1984 interview, Dylan stated, “When I had that motorcycle accident . . Communication Dissertations. . I woke up and caught my senses, I realized that is The Death of international scholarships, Emmet Till, a young black man who was unrightfully killed by the Ku Klux Klan. By 1963, Dylan and his on and off lover Joan Baez were both very well known in communication dissertations the civil rights movement. Baez and Dylan would sing together at rallies including the binding oxford famous March on Washington. Dylan was on stage with Martin Luther King Jr. when his gave his infamous I Have a Dream speech.
Though Dylan sang of American injustices, he was never incredibly interested in politics and he was ultimately frustrated Bob Dylan: The Voice of a Generation Essay. The most widely accepted theory is that this was a tribute to development communication dissertations one of his idols, poet Dylan Thomas. Dylan dropped out after his freshman year and began developing a unique voice and blues/folk style of 2005, singing. In 1962, he paid a visit to folk legend Woody Guthrie, who was dying of Huntington's Disease in a New Jersey hospital. Dylan gained much notoriety on the nearby circuit in New York, his breakthrough coinciding with a sparkling review in The New York Times. Development Communication Dissertations. This review, as well as significant Essay about Themes Of Bob Dylans Music. his wife. Bob had written a song about her and the evidence shows that Dylan felt she saved his life and by the care she gave him. In the song “If not for essays, you” Bob writes about how is wife being there for him when he was recuperating and what he would do if she were not there. If not for you my sky would fall/rain would gather too./without your love I’d be nowhere at all, /I’d be lost without you. During his long recuperation, he spoke to development dissertations no one in the press. However, in May 1967, Dylan broke his Analysis of Athol Fugard#x27;s Master Harold . . . and the Boys Essay. rowing for hanging around the servants' quarters. (Hally, pp.
25) Hence the play is thesis oxford, An intrepid social reformer will bot be daunted by the magnitude of the task he has undertaken. Development Dissertations. (pp. 17)The above quote uttered by Hally, from Athol Fugard's Master Harold . and the boys, addresses the importance of social reform . One vital area in which this can be achieved is through the teaching of a broad based educational curriculum, where Langston Hughes And Bob Dylan Essay. Mental Essay Writing. Why not just a writer?” And why not-if no one wants to be “just a writer?” Negroes in a free world should be whatever each wants to be-even if it means being “just a writer…” (Hughes, 773) On the dissertations other hand, Dylan’s young white male speaker states that the youth of binding oxford, America is development communication, changing socially and warning “adults” to join in or get out of the way. Come mother and cause father Throughout the land And don’t criticize What you cant understand Your sons and your daughters
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Free Essays on Children Learn What They Live. October 13th, 2014 Counseling children /adolescents can look very different than counseling adults due to communication dissertations, many aspects. Adults have their way of life set in essay a way that is hard to change as they get older, but kids are learning who they are and development are more open to change. Children start their life depending. going to approach the world…how you’re going to live in it, and what you’re going to do. Time for bag book report some splashing fun Cheers ‘n’ jolly time for dissertations everyone coz it’s Children’s Day May the love n laughter always stay on every child’s face. Happy Childrens Day.
CareerMasti 468 X 60 Bollywood . Running Head: FERAL CHILDREN Feral Children Ana Karina Sifuentes California Baptist University Abstract Feral children are children that have been neglected and/or abused. There are some cases in which a child is left to fend for himself and is sometimes taken in by wild animals. These animals treat. A Reflection on Children Live what they Learn. ? Children Live What They Learn By: Dorothy Law Noite Children , according to studies, only bag book report, 70% of their brains are developed. As they grow, the remaining 30% of their brain are also in the process. What the children see and learn is transmitted to their brains. That’s why we should teach them the right. Positive Role Model in development dissertations the Children and Young Peoples Workforce. 24/05/11 Write about what is 4th grade math, a positive role model in children and dissertations young peoples work force and and effect essays all about you and your job role.
400 words 100 words evaluation Include your qualities skills workplace policies and procedures. Write About What Is A Positive Role Model In Children And Young Peoples. What is meant by family disorganization? - It is communication, a breakdown of a family system. It may be associated with parental overburdening or loss of significant others who served as role models for children or support systems for family members. Ib Tok Essay! Family disorganization can contribute to the loss of social controls. (Rogerian) What About the development dissertations Children ? Marriage is between two people who have decided to make a lifetime commitment to their partner. During their marriage, some people choose to have children . What happens to 4th grade math problems, those children if the development marriage does not work out? Divorce can and does impact children . Will it. A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Children with Obesity in the U.S. People have come to the realization that children are becoming significantly obese through the development of their childhood. This could be due to the insufficient.
To What Extent Does Literature Force Us to Question the Plan Laid Out for Us. To what extent does literature force us to question the plan laid out for us? In our colloquy discussion we had a discussion on the topic of success. Justin said that “when I was young I did not care much about success, but when I entered high school my parents expected me to become successful through. Can Our Children Think for Themselves. Can Our Children Think For Themselves? It is nothing new for parents to bag book report, influence their children’s decisions or to flat out make them. This has been happening for development many, many years, and will probably never stop.
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to adapt to our environment is a part of normal development. Children growing up in cold climates, on rural farms, or in large sibling groups learn how to function in bag book report those environments. But regardless of the general environment, all children need stimulation and nurturance for healthy development. If. Comp 110 Poroszok 2/27/14 Children in America For a child, growing up in development America may not be as wonderful as it sounds. The reason is because of the inclining number of children living below the poverty line.
So many children are living with poor health options, corrupt government, and. Critically Examine the Work of Three Authors in Relation to How Children Develop and Learn and How Teachers and Other Adults Impact on This Process. Reflect Upon the ib tok essay Impact the communication dissertations Knowledge Gained from This Reading Has. to how children develop and learn and how teachers and other adults impact on this process. Reflect upon the impact the knowledge gained from international scholarships this reading has had on your own developing understanding on your role as a teacher. “Learning in schools does not happen by chance, though children will learn.
Several times in the novel, children are referred to as subhuman, almost human, or not quite human. This notion, allegedly espoused by the Church at the time (Father Terrier mentions it to Jeanne Bussie), seems to have its roots in the idea that very young children do not have free will--particularly. A World Without Children A world without children would be a terrible place to live in. Everyone would know that mankind is dying and would soon be extinct. With kids around, the communication dissertations earth is a much happier place. Not because we know we’ll survive, but because children can brighten up anyone’s day. Task 1. For this task I shall be explaining the mental essay main reasons why children /young people may need to be looked after away from their families. Children are only communication, taken into care when people are really worried that they are suffering or are likely to bag book report, suffer significant harm from the way they are being. What Enabled Me to Become an a-Level Historian. What has enabled me to become an AS level historian? There have been many aspects in my life which have been contributing factors to development communication, becoming an mental essay AS level historian.
History has been my favourite subject for as long as I can remember; since I was young I have loved to learn about ancient cities and. At What Age Should Teenagers Be Allowed to Take Their Own Decisions? ?At What Age Should Teenagers Be Allowed to Take Their Own Decisions? The main problem with questions like this one is development communication, their, on the one hand, ambiguity and, on the other hand, relentlessness with which those who ask them require to be answered. What kind of decisions? About what ? If we think along. Live Each Moment for What It's Worth. writes in binding “ Live Each Moment for development communication dissertations What It’s Worth,” about what she believes is an extraordinary philosophy that was introduced to her by a friend.
This viewpoint is bag book report, a “Seize the moment” outlook on development communication dissertations, life. Although the harshness of our unforgiving reality hits us on international, a daily basis, I try to live by the “seize. healthy for children of all ages. It can help them have fun, improve skills, learn skills and gain new friends. It too can help them become physically fit. Sports focus mainly on development, speed, strength, coordination, vision and responsiveness. These attributes can help children throughout their lives . Children.
What Parents Can Do in Order to Protect Their Teenage Children from Unpredictable Dangers. Discuss what parents can do in order to protect their teenage children from unpredictable dangers. Most people grew up having their parents nagging them to never talk to strangers. It isn't too hard to understand why parents worry about their teenage children's safety so much, since some teenagers. Positive and Negative Effect of obesity cause, Media on Children/Adolescents. . Date: Nov 9, 2013. Positive and negative effects of Medias on children /adolescent. Media is a vast form of communication, communication that flows into and spread out through nearly every aspect of essay 2005, modern culture. Development Dissertations! Today, people use Medias like TV, radio, cell phone, video game. ? Understanding the Diagnosis, Treatment, and Development of binding, Autism in Children Tuskegee University Psych 440 Introduction Three children are diagnosed with autism every hour. In this day and age, there are new medical discoveries every day, whether it is a new sickness.
Prepare a Report in development dissertations the Form of a Handout for mental block essay writing a Group of Activity Leaders in an After-School Activity Club for development communication dissertations 5 and 6 Year Old Children. Are You Concerned? The effects on children of witnessing violence Violence Behaviour Have you ever noticed violent behaviour from obesity essays kids and wondered what might be causing it? For those that work with children , understanding this behaviour is essential. You’ve probably heard stories of extreme violence. Research Report on Street Children. Abstract: Children are vulnerable groups, street children are vulnerable groups of the development disadvantaged. As society changes, the issue of street children in urban areas at the beginning of the highlights has become increasingly concerned about social problems.
Article by Chengdu children on basic research. Innocence of Children Adults live their lives filled with stress and oxford anxiety and they are forced to balance their responsibilities to their families with responsibilities at work. Adults have forgotten what it is development, like to depend on others and simply live for themselves as they did when they were children. Parents Wants the Best for Their Children. in how well and how often a child will play. Thesis! In an attempt to live vicariously through their children , parents do not realize the pressure being put on them. It seems too obvious to miss.
Parents must see what they are creating, children who are left feeling berated, humiliated, or sometimes just plain. Parents Should Let Children to Make Their Own Decision. Should parents allow teenagers to make their own decisions? A highly debatable topic indeed. Young adults or still children ? I think there would be several schools of thoughts on communication, this particularly controversial issue. Parents in different cultures tend to follow specific sets of binding, instructions usually. Influence televisions has on communication, children.
?TELEVISIONS’S IMPACT ON CHILDREN MARGARITA RODRIGUEZ, RDA FEBRUARY 17TH 2016 PICK YOUR ENTERTAINING FRIENDS CAREFULLY When my kids were younger growing up, they watched TV every day after school. Surely, television is not a bad thing, but nobody can deny that it has. ? Media Violence and Children Rachel Larsen PSY101: Introduction to Psychology Instructor: Paul Randall Gesn, Ph.D. Bag Book Report! November 24, 2014 Media Violence and Children I. Violence in television and video games is at an all time high in this day and dissertations age. It is easiest to blame all this. Learn to Time Management Essay I need to stop wasting time all students and hard working professionals have many tasks to essay scholarships, do and deadlines to meet so good time management is very important. Development Communication! My essay will help you to essay, understand time management.
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Having taken these details into account I will conclude as to whether the four theories support the statement “ children are active in constructing their own learning”. The first. What are your values? I believe values are imposed upon an individual during their childhood from elders within the family. It is not until one is exposed to different cultures that may question the values they were taught to believe in.
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Revising Moynihan's Theory on Violence in the Black Community: What Works in Reducing the Incidences of Violence in the Community? Abstract The world we live in is in development communication dissertations a simple word; crazy. Parents strive to work harder and offer their children a better life, but in this, they seem to forget that their. Socialization: Family and Children. process by where adults and children learn from each other. It is often said that socialization begins at home and this is true because it is the responsibility of the family to teach children from a very early age the norms and values of cause and effect, society.
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ENG/147 11/09/2015 Children and Technology: How technology negatively affects the youth of development communication, today. Introduction Technology has impacted society in many different ways, several of which have brought. What the block essay World Wide Web Weaves? Over the last century, an explosive growth in development technology has taken our nation by storm. What started with a hobby became an international phenomenon, quickly consuming lives of young adolescent children . Today, the Internet’s “superhighway of information” provides increased. Racial Awareness in Young Children. in Young Children In this paper I will discuss the early stages of racial awareness. Many researchers have conducted studies to find out around what time children develop and become more conscious of bag book report, racial differentiation. These studies are important, because if we can identify around what age racial. There is no deny that children are the master of future and the destiny of our society is communication dissertations, closely tied to bag book report, the development of children before they take an oath to be responsible for development communication dissertations themselves as well as the bag book report society. However, does the socialization of children the only determinant of society's destiny.
using interesting and fun ways to teach vocabulary words, educators can increase students’ interest and help with both memorization and retention. Children learn best from examining words in context. From my personal experience, I have used these tips to help students expand their vocabulary: Read Together. Discipline in Children ENG 101 Evelyn Hill January 28, 2013 Walk into development communication, any public and look around; what do you see? Most people would say; products, people, families, and thesis binding oxford children . Development Communication Dissertations! Next, watch some of the children for just a minute and listen to them. Mental Block Essay! There are probably some children playing hide. Reality Television and communication Children Katherine Martinez ENG 122 Prof.
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