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Meaning of immaturity

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How to Write an Evidence-Based Clinical Review Article. JAY SIWEK, M.D., and MARGARET L. GOURLAY, M.D., Georgetown University Medical Center, Washington D.C. DAVID C. SLAWSON, M.D., University of Virginia Health System, Charlottesville, Virginia. ALLEN F. SHAUGHNESSY, PHARM.D., Harrisburg Family Practice Residency, Harrisburg, Pennsylvania. Am Fam Physician. 2002 Jan 15;65(2):251-258.

Traditional clinical review articles, also known as updates, differ from systematic reviews and meta-analyses. Updates selectively review the of immaturity medical literature while discussing a topic broadly. Nonquantitative systematic reviews comprehensively examine the medical literature, seeking to identify and synthesize all relevant information to formulate the best approach to diagnosis or treatment. Sudan Current Event. Meta-analyses (quantitative systematic reviews) seek to answer a focused clinical question, using rigorous statistical analysis of pooled research studies. This article presents guidelines for of immaturity writing an evidence-based clinical review article for what sparked the industrial revolution American Family Physician . First, the topic should be of common interest and relevance to family practice. Include a table of the continuing medical education objectives of the review. Of Immaturity. State how the literature search was done and what is a include several sources of evidence-based reviews, such as the meaning of immaturity Cochrane Collaboration, BMJ's Clinical Evidence , or the InfoRetriever Web site. Where possible, use evidence based on clinical outcomes relating to morbidity, mortality, or quality of life, and studies of primary care populations.

In articles submitted to American Family Physician , rate the level of evidence for key recommendations according to the following scale: level A (randomized controlled trial [RCT], meta-analysis); level B (other evidence); level C (consensus/expert opinion). Finally, provide a table of key summary points. American Family Physician is particularly interested in receiving clinical review articles that follow an evidence-based format. Clinical review articles, also known as updates, differ from event systematic reviews and meta-analyses in important ways.1 Updates selectively review the medical literature while discussing a topic broadly. An example of meaning of immaturity such a topic is, #x201c;The diagnosis and treatment of myocardial ischemia.#x201d; Systematic reviews comprehensively examine the medical literature, seeking to study, identify and synthesize all relevant information to formulate the best approach to diagnosis or treatment. Meaning Of Immaturity. Examples are many of the enron systematic reviews of the Cochrane Collaboration or BMJ's Clinical Evidence compendium.

Meta-analyses are a special type of systematic review. They use quantitative methods to analyze the literature and of immaturity seek to answer a focused clinical question, using rigorous statistical analysis of guilty pooled research studies. Of Immaturity. An example is, #x201c;Do beta blockers reduce mortality following myocardial infarction?#x201d; The best clinical review articles base the discussion on existing systematic reviews and what is a communism meta-analyses, and incorporate all relevant research findings about the management of a given disorder. Meaning Of Immaturity. Such evidence-based updates provide readers with powerful summaries and what is a communism sound clinical guidance. In this article, we present guidelines for writing an evidence-based clinical review article, especially one designed for continuing medical education (CME) and incorporating CME objectives into of immaturity its format. This article may be read as a companion piece to a previous article and accompanying editorial about reading and evaluating clinical review articles.1 , 2 Some articles may not be appropriate for in the an evidence-based format because of the nature of the meaning topic, the slant of the article, a lack of sufficient supporting evidence, or other factors. We encourage authors to what the industrial, review the literature and, wherever possible, rate key points of evidence.

This process will help emphasize the summary points of the meaning of immaturity article and strengthen its teaching value. Choose a common clinical problem and avoid topics that are rarities or unusual manifestations of disease or that have curiosity value only. Whenever possible, choose common problems for sparked the industrial revolution which there is new information about diagnosis or treatment. Emphasize new information that, if valid, should prompt a change in clinical practice, such as the recent evidence that spironolactone therapy improves survival in patients who have severe congestive heart failure.3 Similarly, new evidence showing that a standard treatment is no longer helpful, but may be harmful, would also be important to report. For example, patching most traumatic corneal abrasions may actually cause more symptoms and delay healing compared with no patching.4. When searching the of immaturity literature on Need Body, your topic, please consult several sources of evidence-based reviews (Table 1) . Look for pertinent guidelines on the diagnosis, treatment, or prevention of the disorder being discussed. Incorporate all high-quality recommendations that are relevant to of immaturity, the topic. When reviewing the first draft, look for all key recommendations about diagnosis and, especially, treatment. Try to ensure that all recommendations are based on the highest level of evidence available. If you are not sure about the source or strength of the recommendation, return to schapelle corby guilty, the literature, seeking out the basis for the recommendation.

Some Sources of Evidence-Based Medicine. Agency for Healthcare Research and Quality (AHRQ), formerly known as the Agency for Health Care Policy and Research (AHCPR): Clinical Guidelines and meaning Evidence Reports* The AHRQ Web site includes links to the National Guideline Clearinghouse, Evidence Reports from the AHRQ's 12 Evidence-based Practice Centers (EPC), and Preventive Services. The AHCPR released 19 Clinical Practice Guidelines between 1992 and1996 that were not subsequently updated. American College of Physicians Journal Club (ACPJC) ACP Journal Club evaluates evidence in individual articles. Commentary by ACP author offers clinical recommendations. Corby. Access to the online version of ACPJC is a benefit for members of the ACP-ASIM, but will be open to of immaturity, all until at least the end of 2001. Features short evaluations/discussions of individual articles dealing with evidence-based clinical practice.

Centre for sudan Evidence Based Medicine (CEBM) The University of Oxford/Oxford Radcliffe Hospital Clinical School Web site includes links to CEBM within the Faculty of Medicine, a CATbank (Critically Appraised Topics), links to of immaturity, evidence-based journals, and EBM-related teaching materials. Center for Research Support, TRIP Database. The AHRQ began the Translating Research into Practice (TRIP) initiative in 1990 to implement evidence-based tools and information. The TRIP Database features hyperlinks to the largest collection of EBM materials on the internet, including NGC, POEM, DARE, Cochrane Library, CATbank, and individual articles. A good starting place for communism an EBM literature search. Clinical Evidence , BMJ Publishing Group* Searches BMJ's Clinical Evidence compendium for up-to-date evidence regarding effective health care. Lists available topics and describes the supporting body of meaning of immaturity evidence to date (e.g., number of relevant randomized controlled trials published to date).

Concludes with interventions #x201c;likely to be beneficial#x201d; versus those with #x201c;unknown effectiveness.#x201d; Individuals who have received a free copy of Clinical Evidence Issue 5 from the United Health Foundation are also entitled to free access to the full online content. Cochrane Database of Systematic Reviews* Systematic evidence reviews that are updated periodically by the Cochrane Group. The Industrial. Reviewers discuss whether adequate data are available for the development of EBM guidelines for diagnosis or management. Database of Abstracts of Reviews of Effectiveness (DARE)*

Structured abstracts written by University of York CRD reviewers (see NHS CRD). Meaning Of Immaturity. Abstract summaries review articles on diagnostic or treatment interventions and discuss clinical implications. Effective Health Care* Bi-monthly, peer-reviewed bulletin for medical decision-makers. Based on systematic reviews and synthesis of research on communism, the clinical effectiveness, cost-effectiveness and meaning of immaturity acceptability of health service interventions. Bimonthly publication launched in 1995 by the BMJ Publishing Group. Article summaries include commentaries by clinical experts. Subscription is required.

Evidence-Based Practice Newsletter (including JFP Patient-Oriented Evidence that Matters [POEM])* This JFP newsletter features up-to-date POEM, Disease-Oriented Evidence (DOE), and current tests approved for Category 1 CME credit. Subscription required. Includes the InfoRetriever search system for the complete POEMs database and six additional evidence-based databases. Subscription is required. Institute for Clinical Systems Improvement (ICSI)* ICSI is an independent, nonprofit collaboration of health care organizations, including the of immaturity Mayo Clinic, Rochester, Minn.

Web site includes the ICSI guidelines for preventive services and disease management. National Guideline Clearinghouse (NGC) Comprehensive database of evidence-based clinical practice guidelines from government agencies and health care organizations. Describes and compares guideline statements with respect to objectives, methods, outcomes, evidence rating scheme, and major recommendations. National Health Service (NHS) Centre for Reviews and Dissemination (CRD) Searches CRD Databases (includes DARE, NHS Economic Evaluation Database, Health Technology Assessment Database) for EBM reviews.

More limited than TRIP Database. Primary Care Clinical Practice Guidelines. University of California, San Francisco, Web site that includes links to NGC, CEBM, AHRQ, individual articles, and organizations. U.S. Preventive Services Task Force (USPSTF)*

This Web site features updated recommendations for clinical preventive services based on guilty, systematic evidence reviews by the U.S. Preventive Services Task Force. EBM = evidence-based medicine . *#x2014; These Web sites are AAFP-approved sources of meaning of immaturity systematic evidence reviews. When these sources are used to prepare continuing medical education clinical content according to what is a communism, guidelines issued by the AAFP Commission of meaning of immaturity Continuing Medical Education, the content will qualify for the special designation of evidence-based CME. See the case study AAFP Web site for additional information about preparing evidence-based CME . Some Sources of meaning of immaturity Evidence-Based Medicine. Agency for Healthcare Research and Quality (AHRQ), formerly known as the Agency for Health Care Policy and Research (AHCPR): Clinical Guidelines and Evidence Reports* The AHRQ Web site includes links to the National Guideline Clearinghouse, Evidence Reports from the AHRQ's 12 Evidence-based Practice Centers (EPC), and Preventive Services. The AHCPR released 19 Clinical Practice Guidelines between 1992 and1996 that were not subsequently updated.

American College of Physicians Journal Club (ACPJC) ACP Journal Club evaluates evidence in individual articles. Commentary by ACP author offers clinical recommendations. Access to the online version of ACPJC is a benefit for members of the Need Positive ACP-ASIM, but will be open to all until at least the end of of immaturity 2001. Features short evaluations/discussions of individual articles dealing with evidence-based clinical practice. Centre for Evidence Based Medicine (CEBM) The University of Oxford/Oxford Radcliffe Hospital Clinical School Web site includes links to CEBM within the case Faculty of of immaturity Medicine, a CATbank (Critically Appraised Topics), links to evidence-based journals, and EBM-related teaching materials. Center for case Research Support, TRIP Database.

The AHRQ began the Translating Research into Practice (TRIP) initiative in 1990 to implement evidence-based tools and meaning of immaturity information. What Sparked The Industrial Revolution. The TRIP Database features hyperlinks to the largest collection of EBM materials on the internet, including NGC, POEM, DARE, Cochrane Library, CATbank, and individual articles. A good starting place for meaning of immaturity an EBM literature search. Clinical Evidence , BMJ Publishing Group* Searches BMJ's Clinical Evidence compendium for up-to-date evidence regarding effective health care. Lists available topics and describes the supporting body of evidence to date (e.g., number of Teens Positive relevant randomized controlled trials published to date). Meaning Of Immaturity. Concludes with interventions #x201c;likely to be beneficial#x201d; versus those with #x201c;unknown effectiveness.#x201d; Individuals who have received a free copy of Clinical Evidence Issue 5 from the United Health Foundation are also entitled to free access to the full online content. Cochrane Database of Systematic Reviews*

Systematic evidence reviews that are updated periodically by the Cochrane Group. Reviewers discuss whether adequate data are available for is a the development of EBM guidelines for diagnosis or management. Database of meaning Abstracts of Reviews of Effectiveness (DARE)* Structured abstracts written by University of York CRD reviewers (see NHS CRD). Abstract summaries review articles on diagnostic or treatment interventions and discuss clinical implications. Effective Health Care* Bi-monthly, peer-reviewed bulletin for medical decision-makers. Based on systematic reviews and synthesis of research on Need Positive Body Essays, the clinical effectiveness, cost-effectiveness and acceptability of health service interventions.

Bimonthly publication launched in 1995 by of immaturity the BMJ Publishing Group. Article summaries include commentaries by clinical experts. Subscription is case, required. Evidence-Based Practice Newsletter (including JFP Patient-Oriented Evidence that Matters [POEM])* This JFP newsletter features up-to-date POEM, Disease-Oriented Evidence (DOE), and tests approved for Category 1 CME credit.

Subscription required. Includes the of immaturity InfoRetriever search system for the complete POEMs database and six additional evidence-based databases. Renaissance. Subscription is required. Institute for Clinical Systems Improvement (ICSI)* ICSI is an of immaturity, independent, nonprofit collaboration of health care organizations, including the Mayo Clinic, Rochester, Minn.

Web site includes the ICSI guidelines for what the industrial revolution preventive services and of immaturity disease management. National Guideline Clearinghouse (NGC) Comprehensive database of evidence-based clinical practice guidelines from government agencies and health care organizations. Describes and sparked revolution compares guideline statements with respect to objectives, methods, outcomes, evidence rating scheme, and major recommendations. National Health Service (NHS) Centre for Reviews and Dissemination (CRD) Searches CRD Databases (includes DARE, NHS Economic Evaluation Database, Health Technology Assessment Database) for meaning EBM reviews.

More limited than TRIP Database. Primary Care Clinical Practice Guidelines. University of enron case study California, San Francisco, Web site that includes links to NGC, CEBM, AHRQ, individual articles, and of immaturity organizations. U.S. Teens Need Essays. Preventive Services Task Force (USPSTF)* This Web site features updated recommendations for meaning of immaturity clinical preventive services based on systematic evidence reviews by Teens Positive Body the U.S. Preventive Services Task Force.

EBM = evidence-based medicine . *#x2014; These Web sites are AAFP-approved sources of systematic evidence reviews. When these sources are used to prepare continuing medical education clinical content according to guidelines issued by the AAFP Commission of Continuing Medical Education, the content will qualify for the special designation of evidence-based CME. See the meaning AAFP Web site for additional information about sudan preparing evidence-based CME . In particular, try to find the meaning answer in an authoritative compendium of evidence-based reviews, or at least try to find a meta-analysis or well-designed randomized controlled trial (RCT) to support it. Corby. If none appears to be available, try to of immaturity, cite an authoritative consensus statement or clinical guideline, such as a National Institutes of Health Consensus Development Conference statement or a clinical guideline published by a major medical organization. Corby. If no strong evidence exists to support the meaning of immaturity conventional approach to managing a given clinical situation, point this out in the text, especially for key recommendations.

Keep in mind that much of traditional medical practice has not yet undergone rigorous scientific study, and high-quality evidence may not exist to support conventional knowledge or practice. Patient-Oriented vs. Disease-Oriented Evidence. With regard to types of is a evidence, Shaughnessy and Slawson5 #x2013; 7 developed the concept of Patient-Oriented Evidence that Matters (POEM), in distinction to Disease-Oriented Evidence (DOE). POEM deals with outcomes of importance to patients, such as changes in morbidity, mortality, or quality of life. DOE deals with surrogate end points, such as changes in laboratory values or other measures of meaning of immaturity response. Although the Teens Need Positive results of DOE sometimes parallel the results of POEM, they do not always correspond (Table 2) .2 When possible, use POEM-type evidence rather than DOE. When DOE is the only guidance available, indicate that key clinical recommendations lack the of immaturity support of outcomes evidence.

Here is an example of how the latter situation might appear in the text: #x201c;Although prostate-specific antigen (PSA) testing identifies prostate cancer at an early stage, it has not yet been proved that PSA screening improves patient survival.#x201d; (Note: PSA testing is an example of DOE, a surrogate marker for is a the true outcomes of of immaturity importance#x2014;improved survival, decreased morbidity, and improved quality of life.) Antiarrhythmic drug X decreases the case incidence of PVCs on meaning, ECGs. Antiarrhythmic drug X is associated with an corby, increase in mortality. POEM results are contrary to DOE implications. Antihypertensive drug treatment lowers blood pressure. Antihypertensive drug treatment is of immaturity, associated with a decrease in mortality. POEM results are in concordance with DOE implications. Screening for prostate cancer.

PSA screening detects prostate cancer at an early stage. Whether PSA screening reduces mortality from prostate cancer is currently unknown. Although DOE exists, the important POEM is currently unknown. DOE = disease-oriented evidence; POEM = patient-oriented evidence that matters; PVCs = premature ventricular contractions; ECGs = electrocardiograms; PSA = prostate-specific antigen . Adapted with permission from Shaughnessy AF, Slawson DC. Getting the most from is a communism review articles: a guide for readers and writers. Am Fam Physician 1997;55:2155#x2013;60 . Antiarrhythmic drug X decreases the incidence of PVCs on ECGs.

Antiarrhythmic drug X is associated with an of immaturity, increase in mortality. POEM results are contrary to DOE implications. Antihypertensive drug treatment lowers blood pressure. Antihypertensive drug treatment is sparked, associated with a decrease in mortality. POEM results are in concordance with DOE implications. Screening for prostate cancer. PSA screening detects prostate cancer at an early stage. Whether PSA screening reduces mortality from prostate cancer is currently unknown. Although DOE exists, the important POEM is currently unknown. DOE = disease-oriented evidence; POEM = patient-oriented evidence that matters; PVCs = premature ventricular contractions; ECGs = electrocardiograms; PSA = prostate-specific antigen . Adapted with permission from meaning Shaughnessy AF, Slawson DC.

Getting the most from review articles: a guide for readers and writers. Need Body. Am Fam Physician 1997;55:2155#x2013;60 . Evaluate the strength and validity of the of immaturity literature that supports the discussion (see the following section, Levels of Evidence). Schapelle Corby Guilty. Look for meaning meta-analyses, high-quality, randomized clinical trials with important outcomes (POEM), or well-designed, nonrandomized clinical trials, clinical cohort studies, or case-controlled studies with consistent findings. In some cases, high-quality, historical, uncontrolled studies are appropriate (e.g., the evidence supporting the efficacy of Papanicolaou smear screening). Avoid anecdotal reports or repeating the hearsay of conventional wisdom, which may not stand up to the scrutiny of scientific study (e.g., prescribing prolonged bed rest for low back pain). Look for studies that describe patient populations that are likely to be seen in primary care rather than subspecialty referral populations. Shaughnessy and Slawson's guide for enron case writers of clinical review articles includes a section on information and validity traps to avoid.2. Readers need to know the strength of the evidence supporting the meaning key clinical recommendations on diagnosis and treatment. Many different rating systems of varying complexity and clinical relevance are described in the medical literature.

Recently, the third U.S. Preventive Services Task Force (USPSTF) emphasized the sparked importance of rating not only the study type (RCT, cohort study, case-control study, etc.), but also the study quality as measured by meaning internal validity and the quality of the entire body of evidence on schapelle corby guilty, a topic.8. While it is important to appreciate these evolving concepts, we find that a simplified grading system is more useful in AFP . We have adopted the following convention, using an of immaturity, ABC rating scale. Criteria for enron case high-quality studies are discussed in several sources.8 , 9 See the of immaturity AFP Web site (www.aafp.org/afp/authors) for additional information about levels of evidence and see the accompanying editorial in this issue discussing the potential pitfalls and limitations of any rating system. Level A (randomized controlled trial/meta-analysis): High-quality randomized controlled trial (RCT) that considers all important outcomes. High-quality meta-analysis (quantitative systematic review) using comprehensive search strategies. Level B (other evidence): A well-designed, nonrandomized clinical trial. A nonquantitative systematic review with appropriate search strategies and study well-substantiated conclusions. Meaning. Includes lower quality RCTs, clinical cohort studies, and case-controlled studies with non-biased selection of study participants and consistent findings. Other evidence, such as high-quality, historical, uncontrolled studies, or well-designed epidemiologic studies with compelling findings, is also included. Level C (consensus/expert opinion): Consensus viewpoint or expert opinion.

Each rating is in the renaissance, applied to a single reference in the article, not to meaning, the entire body of evidence that exists on a topic. Renaissance. Each label should include the letter rating (A, B, C), followed by the specific type of study for that reference. For example, following a level B rating, include one of these descriptors: (1) nonrandomized clinical trial; (2) nonquantitative systematic review; (3) lower quality RCT; (4) clinical cohort study; (5) case-controlled study; (6) historical uncontrolled study; (7) epidemiologic study. Here are some examples of the meaning way evidence ratings should appear in the text: #x201c;To improve morbidity and mortality, most patients in in the renaissance congestive heart failure should be treated with an angiotensin-converting enzyme inhibitor. [Evidence level A, RCT]#x201d; #x201c;The USPSTF recommends that clinicians routinely screen asymptomatic pregnant women 25 years and younger for meaning chlamydial infection. [Evidence level B, non-randomized clinical trial]#x201d; #x201c;The American Diabetes Association recommends screening for the industrial diabetes every three years in all patients at high risk of the disease, including all adults 45 years and meaning of immaturity older. [Evidence level C, expert opinion]#x201d; When scientifically strong evidence does not exist to sudan, support a given clinical recommendation, you can point this out in the following way: #x201c;Physical therapy is traditionally prescribed for of immaturity the treatment of adhesive capsulitis (frozen shoulder), although there are no randomized outcomes studies of this approach.#x201d; The introduction should define the topic and enron case purpose of the review and describe its relevance to family practice. The traditional way of meaning of immaturity doing this is to discuss the epidemiology of the condition, stating how many people have it at one point in time (prevalence) or what percentage of the sudan event population is expected to develop it over a given period of time (incidence). A more engaging way of meaning doing this is to indicate how often a typical family physician is likely to schapelle corby guilty, encounter this problem during a week, month, year, or career. Emphasize the key CME objectives of the review and summarize them in a separate table entitled #x201c;CME Objectives.#x201d; The methods section should briefly indicate how the literature search was conducted and what major sources of evidence were used. Ideally, indicate what predetermined criteria were used to include or exclude studies (e.g., studies had to be independently rated as being high quality by an established evaluation process, such as the Cochrane Collaboration).

Be comprehensive in trying to identify all major relevant research. Critically evaluate the quality of research reviewed. Avoid selective referencing of only information that supports your conclusions. If there is controversy on a topic, address the full scope of the controversy. The discussion can then follow the typical format of a clinical review article.

It should touch on one or more of the meaning of immaturity following subtopics: etiology, pathophysiology, clinical presentation (signs and symptoms), diagnostic evaluation (history, physical examination, laboratory evaluation, and diagnostic imaging), differential diagnosis, treatment (goals, medical/surgical therapy, laboratory testing, patient education, and follow-up), prognosis, prevention, and patronage in the future directions. The review will be comprehensive and balanced if it acknowledges controversies, unresolved questions, recent developments, other viewpoints, and any apparent conflicts of interest or instances of bias that might affect the strength of the evidence presented. Emphasize an evidence-supported approach or, where little evidence exists, a consensus viewpoint. In the meaning of immaturity absence of a consensus viewpoint, you may describe generally accepted practices or discuss one or more reasoned approaches, but acknowledge that solid support for corby these recommendations is lacking. In some cases, cost-effectiveness analyses may be important in deciding how to meaning, implement health care services, especially preventive services.10 When relevant, mention high-quality cost-effectiveness analyses to help clarify the costs and health benefits associated with alternative interventions to achieve a given health outcome. Highlight key points about diagnosis and treatment in the discussion and include a summary table of the key take-home points. Schapelle. These points are not necessarily the same as the key recommendations, whose level of evidence is rated, although some of them will be. Use tables, figures, and illustrations to highlight key points, and meaning present a step-wise, algorithmic approach to diagnosis or treatment when possible. Rate the evidence for key statements, especially treatment recommendations. What Sparked. We expect that most articles will have at most two to four key statements; some will have none. Rate only those statements that have corresponding references and base the rating on the quality and level of of immaturity evidence presented in in the the supporting citations.

Use primary sources (original research, RCTs, meta-analyses, and systematic reviews) as the basis for determining the level of evidence. In other words, the supporting citation should be a primary research source of the information, not a secondary source (such as a nonsystematic review article or a textbook) that simply cites the original source. Meaning Of Immaturity. Systematic reviews that analyze multiple RCTs are good sources for determining ratings of evidence. The references should include the most current and important sources of support for key statements (i.e., studies referred to, new information, controversial material, specific quantitative data, and Teens Need Body Images Essays information that would not usually be found in meaning most general reference textbooks). Generally, these references will be key evidence-based recommendations, meta-analyses, or landmark articles. Although some journals publish exhaustive lists of reference citations, AFP prefers to include a succinct list of key references. (We will make more extensive reference lists available on our Web site or provide links to your personal reference list.)

You may use the following checklist to ensure the completeness of your evidence-based review article; use the source list of enron study reviews to meaning, identify important sources of evidence-based medicine materials. Checklist for an Evidence-Based Clinical Review Article. The topic is common in family practice, especially topics in is a communism which there is new, important information about diagnosis or treatment. The introduction defines the topic and the purpose of the meaning of immaturity review, and describes its relevance to family practice. A table of CME objectives for schapelle corby the review is included. The review states how you did your literature search and of immaturity indicates what sources you checked to ensure a comprehensive assessment of relevant studies (e.g., MEDLINE, the Cochrane Collaboration Database, the Center for Research Support, TRIP Database). Several sources of evidence-based reviews on the topic are evaluated (Table 1) . Where possible, POEM (dealing with changes in morbidity, mortality, or quality of life) rather than DOE (dealing with mechanistic explanations or surrogate end points, such as changes in laboratory tests) is used to support key clinical recommendations (Table 2) . Studies of patients likely to be representative of those in primary care practices, rather than subspecialty referral centers, are emphasized. Studies that are not only what statistically significant but also clinically significant are emphasized; e.g., interventions with meaningful changes in absolute risk reduction and low numbers needed to treat. Meaning. (Seehttp://www.cebm.net/index.aspx?o=1116.)11. The level of evidence for key clinical recommendations is labeled using the following rating scale: level A (RCT/meta-analysis), level B (other evidence), and level C (consensus/expert opinion). Acknowledge controversies, recent developments, other viewpoints, and any apparent conflicts of interest or instances of bias that might affect the enron case study strength of the of immaturity evidence presented. Highlight key points about diagnosis and treatment in the discussion and include a summary table of key take-home points.

Use tables, figures, and illustrations to enron study, highlight key points and present a step-wise, algorithmic approach to diagnosis or treatment when possible. Emphasize evidence-based guidelines and primary research studies, rather than other review articles, unless they are systematic reviews. The essential elements of meaning of immaturity this checklist are summarized in Table 3 . Essential Steps in Writing an Evidence-Based Clinical Review Article. Choose a common, important topic in family practice. Provide a table with a list of continuing medical education (CME) objectives for the review. State how the literature search and reference selection were done. Use several sources of evidence-based reviews on the topic. Rate the level of evidence for key recommendations in the text. Provide a table of schapelle corby guilty key summary points (not necessarily the same as key recommendations that are rated). Essential Steps in Writing an Evidence-Based Clinical Review Article.

Choose a common, important topic in family practice. Provide a table with a list of continuing medical education (CME) objectives for the review. State how the literature search and reference selection were done. Use several sources of evidence-based reviews on the topic. Rate the level of evidence for key recommendations in the text. Provide a table of key summary points (not necessarily the same as key recommendations that are rated).

Read the of immaturity full article. Get immediate access, anytime, anywhere. Choose a single article, issue, or full-access subscription. Earn up to 6 CME credits per issue. Already a member or subscriber? Log in. Get Full Access. Includes: Immediate, unlimited access to all AFP content More than 130 CME credits per year Access to the AFP app Print delivery option. Access This Issue. Includes: Immediate access to event, this issue CME credits in this issue. Access This Article.

JAY SIWEK, M.D., is professor and chair of the Department of Family Medicine at Georgetown University Medical Center, Washington, D.C. He is also editor of American Family Physician. A graduate of Georgetown University School of Medicine, Dr. Meaning Of Immaturity. Siwek completed his family practice residency at enron case study Middlesex Hospital in of immaturity Middletown, Conn. Schapelle Corby. . MARGARET L. GOURLAY, M.D., is currently the American Family Physician Medical Editing Fellow at Georgetown University Medical Center. A graduate of Rush Medical College, Chicago, she completed a residency in family medicine at the University of meaning California, San Diego, Medical Center. DAVID C. SLAWSON, M.D., is the B. Lewis Barnett, Jr. professor of renaissance family medicine at the University of meaning Virginia Health System in Charlottesville, Va. Teens Positive Images. He is director and founder of the of immaturity Center for Information Mastery and serves as section editor for The Journal of Family Practice POEMs. What Is A Communism. Dr. Slawson is meaning of immaturity, a graduate of the University of Michigan School of Medicine, Ann Arbor, Mich., and he completed postdoctoral training in family medicine at the University of Virginia. ALLEN F. Patronage. SHAUGHNESSY, PHARM.D., is director of research and meaning of immaturity associate director of the Harrisburg Family Practice Residency, Harrisburg, Pa. Guilty. He completed his doctorate and of immaturity fellowship training at the Medical University of South Carolina, Charleston.

Address correspondence to enron case study, Jay Siwek, M.D., Department of Family Medicine, Georgetown University Medical Center, 215 Kober-Cogan Hall, 3750 Reservoir Rd. NW, Washington DC 20007 (e-mail:afp@family.georgetown.edu). Reprints are not available from the meaning authors . The authors thank Ted Ganiats, M.D. for a helpful review and conceptual contributions to the manuscript . The authors indicate that they do not have any conflicts of interest. Sources of funding: none reported . 1. Siwek J. Reading and evaluating clinical review articles. Am Fam Physician . 1997;55:2064,2069#x2013;70,2072. . 2. Enron. Shaughnessy AF, Slawson DC. Getting the meaning of immaturity most from review articles: a guide for readers and writers. Am Fam Physician . 1997;55:2155#x2013;60. 3. Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, et al. for the Randomized Aldactone Evaluation Study Investigators.

The effect of spironolactone on Teens Need Body Images, morbidity and mortality in patients with severe heart failure. N Engl J Med . 1999;341:709#x2013;17. 4. Flynn CA, D'Amico F, Smith G. Of Immaturity. Should we patch corneal abrasions? A meta-analysis. J Fam Pract . 1998;47:264#x2013;70. 5. Slawson DC, Shaughnessy AF, Bennett JH.

Becoming a medical information master: feeling good about not knowing everything. J Fam Pract . 1994;38:505#x2013;13. 6. Shaughnessy AF, Slawson DC, Bennett JH. Becoming an information master: a guidebook to the medical information jungle. J Fam Pract . 1994;39:489#x2013;99. 7. Schapelle. Slawson DC, Shaughnessy AF. Becoming an information master: using POEMs to change practice with confidence.

Patient-oriented evidence that matters. J Fam Pract . Of Immaturity. 2000;49:63#x2013;7. 8. Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM, et al. In The Renaissance. Methods Work Group, Third U.S. Preventive Services Task Force. Current methods of the U.S. Preventive Services Task Force. A review of the process. Am J Prev Med . 2001;20(3 suppl):21#x2013;35. 9. CATbank topics: levels of evidence and grades of of immaturity recommendations. Retrieved November 2001, from: http://www.cebm.net/.

10. Saha S, Hoerger TJ, Pignone MP, Teutsch SM, Helfand M, Mandelblatt JS. for what sparked the industrial revolution the Cost Work Group of the Third U.S. Meaning Of Immaturity. Preventive Services Task Force. The art and in the renaissance science of incorporating cost effectiveness into evidence-based recommendations for clinical preventive services. Am J Prev Med . 2001;20(3 suppl):36#x2013;43. 11. Of Immaturity. Evidence-based medicine glossary. Retrieved November 2001, from: http://www.cebm.net/index.aspx?o=1116. Copyright © 2002 by the American Academy of Family Physicians. This content is owned by study the AAFP. Of Immaturity. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.

This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in guilty any medium, whether now known or later invented, except as authorized in writing by meaning the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests. This page will be removed from your Favorites Links. Are you sure? Want to use this article elsewhere? Get Permissions. MOST RECENT ISSUE. Access the revolution latest issue of American Family Physician.

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250 Word Essay Essays and Research Papers. ?Ismael Salgado March 25, 2014 English 250 FE Professor Klein One Night Stands and Regret Sex is meaning of immaturity, considered a taboo up until we become . college students. We have people whom want to remain chaste until marriage, we have people whom want to have experimental encounters with as many people as they can in college, and then there are people whom would only consider having sexual relations with their significant other. College parties are wild and what is a communism, it is guaranteed that at least 5 couples will end up. Age of consent , Casual relationship , Casual sex 1051 Words | 4 Pages. ? Ambiguous Words Essay Question: “Southerners maintained that secession was the ultimate expression of democracy, while . Lincoln claimed it was rejection of democracy. How did they explain and justify their principles.” On December 20, 1860, the Confederacy was born when South Carolina seceded from the federal Union. The Union and the Confederacy severely clashed in meaning of immaturity, their views on the Constitution; the South felt that individual states should have the right to nullify. American Civil War , Confederate States of America , North Carolina 979 Words | 8 Pages. one needs to Teens Need Positive Images understand the origin of meaning of immaturity words . Case Study? Etymology, according to Yule(2006) is “the study of the origin and history of a . Meaning Of Immaturity? word ” (p.35). This process is used in the evolution of schapelle corby words today, the internet is the building block of this process.

The internet is a catalyst for a number of new words that have become normal in everyday language. This has raised some fundamental questions about the nature of such words being included in the dictionary. This essay will argue that although change is inevitable. English language , Etymology , French language 1231 Words | 4 Pages. in a more accurate way. WELL, that is how I feel about what I write.

Since coming home for the summer, I’ve revisited old papers and essays . for of immaturity further refinement and current, fine tweaking just because I think it’s fun (and because I’m a perfectionist, whoops). So some of the essays I post are more loved and tended to than others, but today I am posting the of immaturity first essay I wrote for the Nonfiction Writing class I took this past spring at KU. Teens Need Body? It’s come a long way since then, and I’m certain I will pay it. Microsoft Word , Political correctness , Word 2077 Words | 6 Pages. Of Immaturity? Mark G. Event? Period 6 01.24.12 AP Literature Othello Words Essay The word “heaven” is one of the most frequently . used words in the play Othello. Throughout the play, the word is used in various forms with numerous connotations, often including multiple ones in a single incident. “Heaven” is used in the first few acts mostly as a “power or majesty of meaning heaven, or as God”(“Heaven” Def. 7a). The people refer to the heavens as a God or a divine being, such as when Cassio says “Oh, let the heavens Give him.

Connotation , Dictionary , English language 887 Words | 3 Pages. the Usage of the “N” Word When discussing the definition, effects, and the history behind the “N” word , it is interesting how . this word has managed to change over schapelle guilty, time from having a descriptive meaning, to a negative connotation, and to a positive controversial meaning. That is why there are those who believe that the “N” word should and should not be used, and there are those that believe that only some (or the accepted ones) should use it in order to avoid conflicts. This essay will go over some. Meaning? Black people , Hip hop , Hip hop music 918 Words | 3 Pages. The Odyssey Translations Essay WORD. ?The Odyssey Translations Essay The Odyssey is an epic poem, written in classical Greek, describing Odysseus's adventures in Teens Positive Body Essays, his ten year . attempt to return to Ithaca after the of immaturity Trojan War. Since this 2,500 year old book was written, there have been several English translations that are believed to schapelle guilty be the closest interpretations to the original version of meaning of immaturity The Odyssey. Alexander Pope, Emile V. Enron Case? Rieu, Robert Fitzgerald, and Robert Fagles each wrote a translation of meaning of immaturity his own.

These translations are read. Aeneid , Cyclops , Homer 865 Words | 3 Pages. ?Assignment The student should complete a brief essay analysing the use of technologies to enhance your own learning and teaching. This should . Sudan Current? also include the benefits and limitations of meaning of immaturity using technology in learning and event, teaching. (400 words minimum) Technology has moved on in leaps and meaning of immaturity, bounds within the current event last thirty years and can be a great benefit but may also be frustrating for some that do not understand how to use it. From my own perspective the internet (computers, tablets and phones) has helped. Learning 916 Words | 2 Pages. The 500- word Essay : Some Thoughts Gordon Thompson The 500- word length is consistent with many other kinds of . professional writing, from blogs to meaning book reviews. Teens Positive Images Essays? Moreover, if you want to capture and meaning of immaturity, hold your audience's attention, the three-section statement maximizes your opportunity. The statements below provide ideas on how you might successfully write. The short essays for this seminar have several goals. 1. They provide you with an opportunity to explore a topic we have covered in our discussions.

English passive voice , Essay , Grammar 1108 Words | 3 Pages. 800 Word Essay Food, health and medical technologies have a large impact on Positive Body Essays individuals and of immaturity, communities today and in the . future. Throughout this paper, discussion will involve the issues that society faces regarding food and what the industrial, health and of immaturity, how we can create a healthier and safer world for Need Positive Body Images our future. Meaning? The food industry has a large impact on individuals and Teens Essays, will affect wider communities in the future. The rush of today’s society has pushed food production to become more commercialized with prepackaged/premade. Meaning Of Immaturity? Fast food , Food , Health 826 Words | 3 Pages. 346). In his essay , “Slurring Spanish,” Luis Rodriguez highlights the difficulties of sudan bilingual speakers, specifically Spanish speakers, in meaning, . America. He concentrates on current event the challenges that Spanish speakers face in school from having English forced as the language to be spoken at all times, moreover Rodriguez points out two Spanish-speaking students that experienced the hardships of bilingual speakers in an “English Only” education system. Although Luis Rodriguez could have written his essay in meaning, his native.

Bilingual education , English language , French language 1061 Words | 4 Pages. ?2000 Word Essay on Disrespecting an NCO by SPC BUTLER On November 21, I received a negative counseling for disrespecting a Non . Commissioned Officer, though it was warranted by a series of events I didn’t agree with I should have found a more appropriate way to voice my concerns. The online dictionary defines disrespect as an expression of lack of respect and a fashion that is generally disrespectful and contemptuous. I define disrespect as putting one down verbally, physical or emotionally. Sudan Current Event? In. Corporal , Non-commissioned officer , Officer 2059 Words | 3 Pages. A Definition Essay on the Word Romance.

The Attraction of meaning Romance Romance: the word the puts the art in heart, the word describes the actions that take place to imprint . your name in a girls head, the word that everyone thinks about when two people are madly in love with one another. The Oxford English Dictionary tells the enron case study word came from 1497 from a time when chivalry was the key to love. Meaning? In this time, the word meant to be chivalrous, but in modern times to romance someone is to “put your moves on them” to schapelle corby dazzle someone with your personality. English language , French language , Kid Rock 925 Words | 3 Pages. ?One word essay : HARMONY Confucius once said “Let the states of equilibrium and Harmony exist in perfection, and meaning of immaturity, a happy order . will prevail throughout heaven and earth, and all things will be nourished and sudan current, flourish.” Harmony is defined as the state of being in agreement or concord. Singapore is a bustling metropolis and a multi-racial society, where people of different ethnic groups co-exist and lived harmoniously. Singapore has thrived rapidly because of our openness to international trade. Ethnic group , Race 916 Words | 4 Pages. your own opinion. Give reasons for your answer and include any relevant examples from your own knowledge or experience. Meaning Of Immaturity? You should write at least . 250 words . Many people wonder about advertisement. Some people think that it has negative impact in our life.

However, others said it has been playing as positive effect on this world. This is not an easy essay to be answered, but I will look at this issue. Advertising is all around us, it is an unavoidable part of Teens Images Essays everyone’s life. Some people say that. Addition , Advertising , Essay 1200 Words | 4 Pages. Words are powerless when looked at individually but they have the potential for good or evil, when someone who can properly use them to his . or her advantage. That is what Nathaniel Hawthorne quote means, and I fully agree with him. An example of words being used for evil could be a dictator trying to convince his people that he is best for meaning the country.

An example of revolution words being used for good could be a civil rights activist trying to persuade people to get along and to treat everyone with respect. Core issues in ethics , Evil , God 1292 Words | 4 Pages. on the use of “forbidden words ” in meaning of immaturity, the media, the individual responsibility of using curse words has increased. In this research . Teens Need Positive Images Essays? I have found that the use of curse words has heightened some people’s sensitivity to these words . Meaning? Children are the most affected and the parents are not far behind. Schapelle Corby Guilty? The use of curse words in meaning of immaturity, our media has changed our perspective; children and teens use them sometimes on the daily basis, but is this change a good thing? The common curse words , some starting with S’s and. Curse , Fuck , Minced oath 1426 Words | 5 Pages. ne. pas negative form, Descartes' extraordinary fondness for multiple negatives and the desire of many translators to render his words . exactly into English and you commonly get a text which is constructed of double, treble and at least one octuple negative. This does not make for easy reading.

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Cloud computing , Google , Joni Mitchell 871 Words | 5 Pages. stories, news articles, and enron case, especially essays begin with good hooks because a writer is meaning of immaturity, often judged within the first few sentences. Just as . the news tries to stimulate our fears by announcing a “danger in our water supply,” a writer must try to bring the reader from his or her world into the world of the patronage in the essay . This is done with a few choice words at the beginning of the essay : the infamous hook. Meaning? It is not easy to think of sudan current how to make someone want to read an meaning essay about a novel. Schapelle Guilty? It’s not even easy to. Essay , Good and evil , Human 609 Words | 3 Pages. Centre for Language Study Pre-Sessional Course A 2013 WRITING TASK 4: Assessed Essay WRITING TASK 4 is your assessed essay . and you will need to write an essay of 1200-1400 words . This is the same length as the essay in WRITING TASK 3. WRITING TASK 4 will form 80% of your mark for writing on the Pre-Sessional course. Of Immaturity? Please select a title from the list here: 1. What? Discuss the impact a particular theory has had on your area of of immaturity study in terms of application, use and renaissance, limitations.

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essay to meaning of immaturity do good Read the topic and sample essay, then study the comments. Click on the highlighted text for comments about academic writing conventions; click on the notes in the margin for enron, commentary on of immaturity the essay. Birth rates are falling in developed countries. There is one simple reason for this - young people nowadays are just too selfish and too self-centred to have children.

And this is particularly true of women. To what extent do you agree with this view? Support your argument with relevant readings and evidence. Countries in sudan current, the developed world have seen a big shift in attitudes to population growth. Several generations ago, it was generally believed that too many babies were being born, and that societies should try to reduce their populations. Nowadays, however, the concern is the of immaturity reverse - that birthrates are falling too low and that urgent action is schapelle needed to meaning of immaturity encourage people to have more children. But what are the causes of this trend?

And how much are the attitudes and lifestyles of young people to blame? This essay will consider a number of explanations for the so-called baby crash. My argument will be that to hold young people responsible is neither valid nor helpful. The best explanation, I believe , is to be found in the condition of increased economic insecurity faced by the young. The birth rate has fallen dramatically in many parts of the revolution world. To take several examples, in Europe in 1960, the meaning total fertility rate (TFR) was about case study, 2.6 births per female, but in 1996 it had fallen to meaning of immaturity 1.4 (Chesnais, 1998) . In many Asian countries, similar declines have been experienced. Japan now has a birthrate of only about 1.3, and Hong Kong#039;s has fallen to below 1.0 (Ichimura and Ogawa, 2000) . A TFR of patronage in the below 2.0 means that a country#039;s population is not replaced, and thus there is a net population decline. This ageing of the of immaturity population has the potential to create serious problems. Fewer children being born means that in the long term, a smaller proportion of the populace will be economically productive, whilst a larger proportion will be old and what revolution, economically dependent - in the form of pension, health care and other social services.

Most experts agree that these greying societies will not be able escape serious social and meaning, economic decline in the future (Chesnais, 1998). So what are the causes of this trend and what can be done to stop it? One common approach has been to lay the blame on young people and their supposedly self-centred values. It is argued that in developed societies, we now live in a post-materialist age, where individuals do not have to be so concerned about basic material conditions to survive (McDonald, 2000a). Thus people, especially the young, have become more focussed on the values of self-realisation and the satisfaction of personal preferences, at the expense of traditional values like raising a family. A strong version of this view is put forward by Japanese sociologist, Masahiro Yamada (cited in Ashby, 2000) . Patronage In The Renaissance? He uses the term parasite singles to refer to grown children in their 20s and 30s who have left school and are employed, but remain unmarried and continue live at meaning of immaturity home with their parents. These young people are spoilt, he says, and interested only in sparked the industrial revolution, their own pleasure - mainly in the form of shopping. According to Yamada , it is of immaturity this focus on self, more than any other factor, that is responsible for Japan#039;s languishing birth rate (Ashby, 2000). In other developed countries, there is a similar tendency for the young to guilty remain at home enjoying a single lifestyle - and a similar tendency for older people to interpret this as selfishness (McDonald, 2000a). But is it reasonable to attribute the baby crash to the pleasure-seeking values of the young? The problem with this view is that whenever young people are surveyed about their attitudes to family, not only do they say they want to have children, they also express preferences for family sizes that are, on average, above the replacement level (McDonald, 2000a).

As an example, McDonald quotes an Australian study that found that women aged 20-24 expected to have an average of 2.33 children in their lifetime. Findings like this suggest that the values of the young are not at meaning of immaturity all incompatible with the idea of having a family. It seems then that, as young people progress through their twenties and thirties, they encounter obstacles along the way that prevent them from fulfilling their plans to schapelle corby guilty be parents. Some conservative thinkers believe the meaning of immaturity main obstacle is the changed role and status of women (eg. Norton, 2003). According to this view, because young women now have greater educational and career opportunities than in patronage, previous generations, they are finding the of immaturity idea of family and motherhood less attractive.

Thus, educated middle class women are delaying marriage and childbirth or even rejecting motherhood altogether. It is claimed that women#039;s improved status - which may be a good thing in itself - has had the unfortunate consequence of threatening population stability. But there are several problems with this argument. For one, the lowest TFRs in Europe are found in Spain and Italy (around 1.2), both more traditional, male-oriented societies, which offer fewer opportunities to Teens Body Images women. In comparison, Sweden which has been a leading country in advancing the rights of women enjoys a higher TFR (1.6 in meaning, 1996) - even though it is still below replacement. Chesnais (1998: p. 99) refers to this contrast as the feminist paradox and concludes that empowerment of women [actually] ensures against a very low birth rate (my emphasis) . Another problem with trying to link improved education levels for women to low birth rates is schapelle guilty that fertility in developed countries seems to be declining across all education and class levels. In a recent survey of meaning of immaturity Australian census data, Birrell (2003) found that, whereas the non-tertiary-educated group was once very fertile, its rate of partnering is now converging towards that of tertiary educated women. We can summarise the discussion to this point as follows: Young people today, in spite of what#039;s said about their values, still express a desire to have children. However, few end up having as many as they say they would like.

The improved education and career opportunities for women does not seem to be the decisive factor in reducing the number of children that a woman has. These conclusions suggest that there must be something else involved. Many writers are now pointing to a different factor - the economic condition of study young people and their growing sense of insecurity. Peter McDonald (2000a) in his article #039;Low fertility in Australia: Evidence, causes and policy responses#039; discusses some of the things that a couple will consider when they are thinking of having a child. One type of thinking is what McDonald calls Rational Choice Theory, whereby a couple make an assessment of the relative costs and benefits associated with becoming a parent. In traditional societies, there has usually been an economic benefit in having children because they can be a source of meaning of immaturity labour to help the family. Sparked The Industrial Revolution? In developed societies, however, children now constitute an economic cost, and so, it is argued, the benefits are more of a psychological kind - for example, enjoying the meaning status of being a parent, having baby who will be fun and what communism, will grow up to love you, having offspring who will carry on meaning the family name etc. Event? The problem, McDonald suggests, is meaning that for many couples nowadays the economic cost can easily outweigh any perceived psychological benefits. McDonald (2000b) discusses another type of decision-making - Risk Aversion Theory - which he says is also unfavourable to the birth rate.

According to this theory, when we make important decisions in our lives life, if we perceive uncertainty in our environment, we usually err on the side of safety in current, order to avert risk. Meaning? McDonald points to a rise in sudan current event, economic uncertainty which he thinks has steered a lot of young people away from life-changing decisions like marriage and parenthood: Jobs are no longer lifetime jobs. There is a strong economic cycle of booms and busts. Geographic mobility may be required for employment purposes (McDonald, 2000: p.15).

Birrell (2003) focuses on of immaturity increased economic uncertainty for men. Referring to the situation in Australia, he discusses men#039;s reluctance to form families in terms of perceived costs and risks: Many men are poor - in 2001, 42 per cent of men aged 25-44 earnt less than $32,000 a year. Only two-thirds of men in this age group were in full-time work. Young men considering marriage could hardly be unaware of the risks of marital breakdown or the long-term costs, especially when children are involved (Birrell, 2003: p.12).

And Yuji Genda (2000) in Japan, responding to what Yamada#039;s analysis of parasite singles, argues that the failure of young Japanese to leave home and start families is not due to self-indulgence, but is an understandable response to meaning increasingly difficult economic circumstances. Genda (2000) notes that it is the communism young who have had to bear the brunt of the decade long restructuring of the Japanese economy, with youth unemployment hovering around 10% and a marked reduction in of immaturity, secure full-time jobs for the young. Young people around the world seem to have an increasing perception of case study economic uncertainty and contemplate something their parents would have found impossible - a decline in living standards over their lifetime. According to a 1990 American survey, two thirds of of immaturity respondents in patronage renaissance, the 18-29 age group thought it would be more difficult for meaning, their generation to live as comfortably as previous generations (cited in Newman, 2000: p.505). Furthermore, around 70% believed they would have difficulty purchasing a house, and around 50% were worried about their future.

Findings like these suggest that the younger generation may be reluctant to enron study have children, not because they have more exciting things to do, but because they have doubts about their capacity to provide as parents. If we accept that economics has played a significant role in young people choosing to of immaturity have fewer babies, then the key to reversing this trend is for governments to take action to remove this sense of insecurity. A number of policy approaches have been suggested. Some writers have focussed on the need for better welfare provisions for what is a, families - like paid parental leave, family allowances, access to child care, etc (Chesnais, 1998). Others have called for more radical economic reforms that would increase job security and raise the living standards of the young (McDonald, 2000b).

It is hard to know what remedies are needed. What seems clear, however, is that young people are most unlikely to of immaturity reproduce simply because their elders have told them that it is selfish to do otherwise. Castigating the Need Positive young will not have the effect of making them willing parents; instead it is likely to just make them increasingly resentful children. Ashby, J. (2000). Parasite singles: Problem or victims?

The Japan Times. Of Immaturity? 7/04/02. Birrell, B. What Sparked Revolution? (2003). Fertility crisis: why you can#039;t blame the meaning blokes. The Age 17/01/03 p. 14. Chesnais, J-C. (1998).

Below-replacement fertility in the European Union: Facts and current, Policies, 1960-1997. Review of Population and Social Policy, No 7, pp. Meaning? 83-101. Genda, Y. Enron? (2000). Meaning Of Immaturity? A debate on Japan#039;s Dependent Singles, Japan Echo, June, 2000, pp. 47-56. Ichimura, S. and N. Ogawa (2000). Policies to meet the challenge of an aging society with declining fertility: Japan and other East Asian countries. Paper presented at the 2000 Annual Meeting of the Population Association of America, Los Angeles, USA. McDonald, P. (2000a).

Low fertility in guilty, Australia: Evidence, causes and policy responses. People and Place, No 8:2. Meaning Of Immaturity? pp 6-21. McDonald, P. (2000b). The toolbox of public policies to impact on schapelle fertility - a global view. Paper prepared for the Annual Seminar 2000 of the European Observatory on Family Matters, Low Fertility, families and Public Policies, Sevilla (Spain), 15-16 September 2000. Norton, A. (2003). Student debt: A HECS on fertility? Issue Analysis No 3. Melbourne: Centre for Independent Studies. Newman, D. (2000). Sociology: Exploring the of immaturity architecture of everyday life.

California: Pine Forge. Notice what the question is asking students to do - in this case saying how much they agree with the #039;view#039; in sudan, the topic. What do you think? Is this a reasonable explanation for the declining birthrate? Hint: always spend some time looking over of immaturity, and thinking about an essay topic before you start your planning and reading for it. As part of this thinking, you should give some thought to what your position (argument) could be.

Notice how in the introduction, this student writer: introduces the what topic area in a general way (ie. declining birthrates) introduces the main issue to be covered in the essay (ie. why this is happening). Hint: there are many different ways you can begin an essay - if you are stuck, try beginning with i) and meaning, ii). In the last part of the introduction, the student introduces his argument. Notice how he disagrees with the sudan event explanation in the topic, and then offers an alternative explanation. Hint: in the introduction it is always a good idea to state what you intend to argue. In this paragraph, the of immaturity student considers the first part of the topic - that birth rates have fallen. What Sparked The Industrial? This is meaning of immaturity presented as background information. Notice how the revolution student begins the paragraph with a claim (that the meaning birth rate has fallen dramatically in many parts of the Teens Need Positive Body Essays world) and then supports this with relevant evidence (statistics from Europe and Asia). Hint: in your writing be aware when you are making claims - be aware also of the meaning of immaturity need to support them with some evidence.

After giving some background in paragraph 2, the student reminds the reader what the main issue is - why birthrates have declined? Notice also that the student has seen the sparked the industrial revolution issue as a #039;problem#039; - and of immaturity, asks What can be done about it? Hint: always be aware what the main issue is you are addressing in your work. This paragraph mainly summarises the ideas of those who think young people are to communism blame for declining birthrates. Of Immaturity? Notice how in the first part of the paragraph, these ideas are discussed in a general way. In the second part, the student focuses on patronage in the the ideas of a single writer (Yamada) as a specific example of this view. Hint: always try to find opportunities in your work to engage with the ideas of meaning individual writers.

The previous paragraph was concerned with summarising some ideas. Notice how in case, this new paragraph, the student provides a critique of these ideas. (Recall the student#039;s argument in the introduction: . to hold young people responsible is of immaturity neither valid nor helpful). Notice too that the student provides some supporting evidence for this critique - mainly from the work of McDonald. Hint: it is quite OK to criticise the ideas of schapelle guilty other writers - in fact many essay topics will specifically ask you to meaning do this. But if you are going to be critical, you need to provide good reasons for your critique. Recall that the topic suggested that young people were to blame for declining birthrates - and then went on to single out women. Enron Case? In this paragraph, the student takes up this gender issue.

Hint: aim to structure your essays so that all issues in the topic are covered - and in some logical sequence. In this paragraph the student seeks to dismiss the view that young women are to blame. (There are several problems with this argument).Notice that the student then goes on to explain these problems (For one. ; Another problem is that . ). Hint: the of immaturity providing of a well-organised critique is schapelle corby guilty something your lecturers will value highly in your work. Recall the second part of the student#039;s argument stated in the introduction: The best explanation is to be found in the condition of increased economic insecurity faced by the young. Of Immaturity? The student now elaborates on sparked the industrial revolution this part of the argument. Hint: remember that the argument is the key to meaning of immaturity any essay you write. Sudan Current? In the body of your essay, you need to of immaturity be sure that your argument comes through clearly. Providing evidence for the argument.

The student is arguing that economic insecurity experienced by young people is the Teens Need Positive Images main reason why the birthrate is in decline. Notice how in the rest of the essay, he seeks to support this argument with various forms of evidence. The student presents a range of evidence: several theories discussed by McDonald some research by Birrell comments by Genda results of a US survey. Hint: it is important to of immaturity have an argument in your essay. But it is equally important to provide support for revolution, what you are arguing. Meaning? Your essays will be judged mainly on your ability to Teens Body do these two things. There are a number of things happening in the conclusion. In the first sentence, the of immaturity student restates his argument - if we accept that. . Enron? He then goes on to discuss what could be done to deal with the problem.

In broad terms this is of immaturity a discussion of the implications of the students#039; argument. Notice also how the student mentions the negative implications of the blaming approach. Hint: a conclusion that only restates the argument can be a bit uninteresting. You might also like to consider the implications of your argument - but you should do this briefly. Think: I have argued for this position - so what might follow on from this. You may have noticed that this essay is quite tightly structured. Its paragraph structure can be set out thus: Introduction Background to is a issue Explanation point 1 - summary student#039;s critique Explanation point 2 - summary student#039;s critique Student#039;s alternative explanation - Evidence 1 - Evidence 2 - Evidence 3 Conclusion.

Hint: always try to map out meaning, a structure for your essay. Do this before you do too much writing. You may have noticed that the essay is free of spelling, typographical and Positive, grammatical errors. Hint: always read your work very carefully before you submit it. Avoid doing your editing on the screen. Always print out and edit from meaning of immaturity a hard copy. Note in the references section, you need to list all the texts you have referred to (cited) in the essay - not all the what sparked texts you have read, as some students mistakenly believe. Notice that the sample essay refers to a total of nine texts.

This is a good number, and indicates that the student has done a fair amount of reading. Hint: try to include a reference to most of the texts that you read for an essay - so that you can build up a reasonable list of references. Of course, all references have to be relevant to your argument. Notice how the student uses I in his essay: The best explanation, I believe, is. And in the previous sentence, another first person pronoun is used: My argument is that . Some students have the impression that they are not allowed to use these words in their written work. But in of immaturity, fact they can often be found in academic writing. In general, the best place to use them is in Teens, the introduction - when you are presenting your argument. But if you are concerned that it is not OK to use I, you can use other expressions - which avoid self-reference, but which mean much the same thing, e.g.

This essay will argue that . Remember though, that the really important issue is not the words you use to present your argument - but that your essay actually has a clear argument. Try to keep your paragraphs a reasonable length. (Most paragraphs in this essay are around 7-8 sentences long.) Citations are used to indicate the meaning source of the current event ideas you have used in your essay. Note that there are two main citation systems: the author-date system (also known as Harvard); the footnote system (also known as Oxford). In this essay, the author-date system has been used. (Always check which system is required in each of your subjects.) Citation 2 (Ichimura and Ogawa, 2000) Citations can be set out in a number of ways. Of Immaturity? One method is to present some information and then provide the citation immediately after it to enron case indicate the source.

These are known as #039;information-prominent#039; citations eg: Japan now has a birthrate of only about 1.3, and Hong Kong#039;s has fallen to below 1.0 (Ichimura and Ogawa, 2000). Other formats are considered further on. Citation 3 Masahiro Yamada (cited in Ashby, 2000) This citation means that the student is dealing with the ideas of meaning of immaturity Yamada, but actually read about them in Ashby#039;s text. Whilst you should make an effort to sudan event read ideas in their original form, this is meaning of immaturity not always possible.

In such cases, use the #039;cited in#039; format. When you are summarising the ideas of a writer, you need to use reporting expressions like the ones used here: He [Yamada] uses the term . According to Teens Positive Body Images Yamada. You use these to distance yourself from certain language. eg. when you are using an informal expression, or a term used by others that you don#039;t necessarily agree with. In this paragraph, the student wants to reject the view in the topic - that young people#039;s selfishness is to blame for meaning of immaturity, the declining birthrate.

Notice how he does this in a careful way, by using expressions like: Findings like this suggest that . It seems then that . Being careful about the current event way you express your claims is a distinctive feature of academic style. When you quote an author (like Chesnais here) you need to use quotation marks, and indicate the exact page number in the citation. Sometimes you may need to change the wording of the quote slightly so that it fits into your sentence. If you need to add/change any words, use [ ]; if you need to of immaturity delete words, use . (Whilst it is OK to change the wording of a quote, you must never change its sense.) Use italics when you want to emphasise a word. (When you do this in a quote, you need to guilty indicate that it is your emphasis.) It#039;s OK to use dot points in of immaturity, an essay (or numbered points here), but use them very sparingly. Citation 4 Peter McDonald (2000a) . discusses.

Notice how in some citations the author can be part of the what sentence: Peter McDonald (2000a) . discusses some of the things etc. This is known as an #039;author-prominent#039; citation and is very common in meaning, academic writing. Notice the use of reporting verbs in this citation type (discusses). Use #039;inverted commas#039; for sudan current event, the title of an article. Use italics for the title of a book. Notice some of the meaning of immaturity other reporting expressions used in the student#039;s summary of Peter McDonald#039;s ideas: . what McDonald calls. . McDonald points to . . which he thinks. It#039;s very important to make it clear to sparked the industrial your reader when one paragraph ends and a new one begins. In this paragraph (#9), there is meaning of immaturity some potential for confusion. Notice how the student has used indenting to Need Positive Body Essays make this clear.

Quotes of more than one sentence in length should be separated from the of immaturity main text. Schapelle Corby? Notice how these are indented and are in a slightly smaller font. Of Immaturity? Again you should indicate the page number. You only have to schapelle provide a separate list of references when you use the author-date system. Entries should be set out in alphabetical order. Each entry should generally be set out in the following order and format: Author family name, Initial. (date). Title.

Place: Publisher. It is becoming increasingly common for students to refer to of immaturity sources from the world wide web in patronage in the, their essays. In addition to providing author and title of site, you need to include: the URL for the site when you accessed the site. Although web references can be very useful, you obviously need to exercise some caution - there is a lot of junk around. Check all sites carefully to be sure the information provided has credibility (.edu and of immaturity, .org sites are generally the sudan current event more reliable). Problems?

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