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Mens Rea Lecture #1 - Law Teacher"Why I Want To Become A Nurse" Essays and recklessness Research Papers. I was born and raised in a small, under serviced community in Northern, Ontario called Muskoka. As a child I always had an . Crash Movie? interest in health care. Whether I was reading the oral pathology books of my fathers (a local oral surgeon) or playing doctor with my dolls and my fisher price doctor kit, I was always drawn to medicine and caldwell its ability to help people. Factors That Contribute Causes)? During my early years in Muskoka I was always encouraged to take a strong interest in the sciences, arts, and the natural world. I not only. Health , Health care , Health care provider 1356 Words | 4 Pages. Why do I want to be a Nurse ? I want to be a nurse because . Caldwell Recklessness? I enjoy being around people in tekanan kerja guru their times of need and I get internal satisfaction by serving those that need help. I remember when I was just a kid and I played with my cousin that we were both nurses , I grew up saying I wanted to be a nurse and that is when I realized my passion for caldwell recklessness nursing. I believe that the cure for many of the people's ailments is not just in medicine, it is in the care that they receive as patients in hospitals and. Hospital , Need , Nurse 307 Words | 4 Pages. MY FIRST TRIP ABROAD It was on a Monday morning, the 1st day of December, 2010. Was Louis Riel Born? I had spent two years preparing and caldwell recklessness saving money for tekanan kerja this . Caldwell Recklessness? memorable day. I was going to free essays 123, be my best moment after my wedding day. The whole village where I was born “Makupa”led by our local chief Mr. Caldwell Recklessness? Ndoto, my brothers, sisters members of the Clergy both young and old men and women, no wanted to miss that memorable opportunity of escorting me to Jomo Kenyatta international Airport. One would have thought that there was. Capital punishment , Jomo Kenyatta , Jomo Kenyatta International Airport 980 Words | 3 Pages. Why I Want To Become An Accountant. Why I want to become an accountant. Crash Movie? Composing. Why I want . to caldwell, become an accountant? Have you ever been in the accounting department? I have been in where was louis born the accounts. Everywhere numbers and digits, and small and large, very different, but in the end all agree with each other. Accounting! Surprisingly interesting. Mayakovsky Accountant - responsible profession. It requires a mathematical mind, here it is all very logical, exactly. Caldwell? The main principle of accounting - rigid logic. Some people believe that. Accountancy , Accountant , Accountants 759 Words | 2 Pages. Coke and Pepsi I am writing about coke and Pepsi and what are the differences between the two The problem no one really knows much of . a difference between the two and I would like to establish The differences between the two and the similarities between the two, this has been investigated before But I want to form my own opinion and take a theoretical guess to how and why these carbonated Drinks are similar and why they are different. Most people say it’s because one is sweeter. Caffeine , Carbon dioxide , Carbonated water 695 Words | 4 Pages. Becoming a Nurse Essay Opportunities in Nursing My decision to pursue a career in free essays 123 nursing came from recklessness my personal and professional . experiences. When I was 13 years of age, I took care of my elderly grandma who had been suffering from guru Alzheimer's disease. I knew that the disease was incurable but I did all to help grandma cope with her daily problems. I learned a lot from that experience. From that time I have dreamed to recklessness, become a highly qualified, experienced, and very competent nurse . I want to work. Florence Nightingale , Health care , Medicine 1149 Words | 3 Pages. Before I Become a Pediatric Nurse. Future When I was a little girl, I would pretend that I was a nurse or even a doctor. Free Essays 123? . I treated my teddy bears as if they were my patients from the doctor’s office, I would bandage up their broken legs and make sure they were not sick. When my mom was getting sick, I was helping my sister take care of our mother. Recklessness? Then, I started to take care of my mom by myself, because my sister had to do a lot of runs. Every day I came home from school, I would go and make sure my mom was okay. I would make sure. Academic degree , Associate's degree , Bachelor of Science 1714 Words | 4 Pages. nature to want what I don’t have-nurturing parents. My parents worked very hard to provide a better life that they never had. Was Louis Born? . I and recklessness three of my brothers were grown up with unhappy childhood. We never had time to free essays 123, play with friends, go to the park or even get any gift on our birthday ….All of us had to work after school to recklessness, help my parents earn more money for food and others basic shelters. When I was in the middle school I had to do all of the housework and trading in where was louis born the market for foods. I believed. Happiness , United States 1510 Words | 4 Pages. seasons, I too have prepared for the study of medicine through variously themed ¡°seasons¡± in my life. During high school, for example, . I focused my activities on serving the recklessness, various communities of which I am a part. The Persistence Of Memory Parody? After joining Mt. Olivet SDA Church, I became involved with the community of caldwell recklessness Williamsville, New York -- participating in an anti-drug rally and health fair, leading local public speaking events, singing in church choirs at nursing homes, and visiting hospitalized church members. I was. Ethics , General practitioner , Medicine 969 Words | 3 Pages. years, I can remember my English teachers asking things like what do I want to be when I grow up? . What to you want to study in college? As a child I would give a quick sentence or a couple of words. I would say that I wanted to of memory parody, be a cop, a firefighter ,or a chef. As a teenager, I was expected to caldwell recklessness, contemplate and free essays 123 compile a three page written paper . My answers varied each and every year from wanting to be a teacher, a chef , to a social worker. I can remember many kids saying they wanted to become a nurse. Experience , Family , Lebanon, Tennessee 858 Words | 2 Pages. JUDY BRADY I Want a Wife (1971) Judy Brady’s essay became an instant classic when it appeared in 1971 in the premier issue . Caldwell? of the feminist magazine Ms. Crash Movie? As you read, analyze the definitions of “husband” and “wife” that Brady uses, and consider why this essay became so powerful in the 1970s. I belong to that classification of people known as wives. I am A Wife. And, not altogether incidentally, I am a mother. Not too long ago a male friend of recklessness mine appeared on tekanan the scene fresh from a recent. Arrangement , Courteney Cox , Economics terminology 1165 Words | 3 Pages. Why Should I Want to Become a Teacher? Why I became a Teacher? When I was unfulfilled, working in the profession of social work, I decided . that I would need to help others for my job. That was in 2007. I quit my job and did something that I had never done before. I started hiking the Appalachian Trail by myself. After thinking about what goals I had, it hit me: teaching. As a teacher you will influence youth to make a difference in caldwell recklessness their lives. That is of memory parody, when I thought about the example that my mother had been for students at her. Certified teacher , Education , High school 1031 Words | 3 Pages. “ Why I Want to caldwell, Be a Teacher” First of where was louis born all, I love kids and it has always been my dream and passion . to become an educator. Recklessness? For most people, the word teacher is tropical rainforest, defined as someone who is responsible for informing or teaching someone something. But not everyone would have the same meaning or image for a teacher. Teachers have a very important role of shaping the recklessness, lives of kerja young children and caldwell preparing them to become productive citizens in of memory our community and with these types of recklessness responsibilities teachers. Childhood , Education , Educational psychology 868 Words | 3 Pages. Kish WHY I WANT TO BE A NURSE The field of nursing has long interested me because . I find myself compassionate about tekanan providing care to sick people. I think that the field of nursing may serve as a way for me to help individuals especially during their most difficult times such as illness and accidents. I am aware that the training required to become a nurse is challenging. I am still willing to undergo such challenging training in order to enhance my greatest capabilities as a nurse . Recklessness? I am excited. Florence Nightingale , Health care , Health care provider 485 Words | 2 Pages. In this page I will be sharing with you my decision to crash movie, home educate my children. I have broken it down into two parts as it has . become a rather long post! I didn’t realise that I had so much to say. It would have been a lot longer if I had included all the finer details. Sit back and relax as I talk to you about recklessness my decision to home educate. I truly believe that I am being led in free essays 123 this direction by the Lord. I remember this time last year sitting in my car, parked on the side road reading a book. Alternative education , Growing Without Schooling , Homeschooling 1624 Words | 4 Pages. Why I Want To Become A Civil Engineer. Why I decided to major in Civil Engineering? Last Year around this time, I did not know the answer to this question . Caldwell Recklessness? myself. I was confused when it came to choosing a career. Parody? I still had the caldwell recklessness, questions in my mind when I was asked to of memory, write this five-page paper. Then, I got a job at an engineering firm, a firm that involves the construction of caldwell recklessness buildings, roads, and bridges. They also deal with storm and drainage sewers. As I looked into crash movie engineering, I decided that I liked many of the characteristics. Academic degree , Civil engineer , Civil engineering 1221 Words | 4 Pages. Why I Want to be a Fire Fighter Being a Firefighter today is a demanding and dangerous job. From mixed views of . the profession from the caldwell, public, all should respect what danger a firefighter faces day in that contribute causes) and day out. Being a firefighter is caldwell recklessness, more than just putting out fires. They have many more calls such as EMS and car accidents not including all the false calls. What possibly could drive this writer to crash movie, risk his life day in and day out for people he doesn’t even know? Well this writer will be a future. College , Fire , Fire department 976 Words | 3 Pages. Why I want to be a nurse ? I firmly believe that choosing the right profession, the recklessness, . Where Was Louis Riel Born? one that I will be good at is essential to my personal happiness, and well being. Although, my path on choosing a nursing as a carrier wasn’t always clear to me, my school advisers have been pointing me to the nursing since High School. Recklessness? According to the adviser and free essays 123 carrier test my personality will suite me well in a nursing carrier. However, influenced by the family members growing up I was fixed on becoming. Health , Health care , Health care provider 603 Words | 2 Pages. name is Colby Bean, I was born and raised in caldwell recklessness maine. I live in where was louis a town called Hartland, its a small town so there is really nothing . to do, when i was younger I used to play sports but the only one i really got into was basketball but the recklessness, problem with only playing one sport is that you only play for a few months out of the year. So I decided that I had to find something to do for the seven to eight months that I wasn't playing basketball. So in decided to start watching movies, I started with some classics. Actor , Educational years , Fifth grade 1324 Words | 3 Pages. Why do I want to become a nurse : Ever since I had use of reason, . Riel Born? I always dreamt of becoming a Doctor. When I was only 4 years old, I asked for my first microscope. When I was around 8 years old, I asked for my first chemistry set. When I was only caldwell recklessness, 9 years old, I gave my Grandmother her insulin shot. All these contributed for me to kerja guru, be interested in the medical field. But what made me change my mind to become an recklessness RN instead of an MD? Well, as years have prolonged and I have grown up, I have been. Childbirth , Emotion , Family 579 Words | 2 Pages. I would love to be a nurse someday because it has many attractive qualities. The qualities that accompany The field of nursing . and which i consider essential to me include the crash movie, scientific aspect to method, being an active member of the caldwell, health care team, and becoming a patient advocate. When I was thirteen, I saw all different kinds of people in poverty, may it be infants, children, elderly people and even disabled people. My aunt, who lived in Mexico, got diagnosed with cancer and crash movie my family and I . Family , Florence Nightingale , Health 886 Words | 2 Pages. Why I decided to become a nurse . Growing up I always thought I would . someday be a nurse . It was a dream that I always had. Knowing that it would be hard for mom and dad to afford, I considered enlisting into the army to get school and recklessness training paid for. As high school graduation got closer, I decided to "take a break" from school. So, I didn't go to free essays 123, college or enlist. When I started running low on funds, I decided to go to training to become a certified nurse's aide (cna). It didn't. Acupressure , Certified Nursing Assistant , Healthcare occupations 545 Words | 2 Pages. expected Gini to take over that task---after all, he couldn’t wear wrinkled clothes to his new job, could he? Poking fun at recklessness, the responsibilities involved in . marriage is similar to the attitude presented in Judy Brady’s 1971 essay, " Why I Want a Wife." In " Why I Want a Wife," Brady offers hypothetical criteria for an ideal wife in a satirical commentary on how the work of wives is born, often taken for granted. Caldwell? The humor of the essay lies in that becoming (i.e causes) its structure: on recklessness the surface it seems to accept the criteria. Irony , Jonathan Swift , Marriage 2941 Words | 7 Pages. doctors in the United States. Of Memory Parody? And I could be one of recklessness them. They treat people when they are sick or hurt. They give advice to patients to help . keep them from getting sick. They bandage knees, prescribe medicine, sew up cuts. Kerja? They bring new babies into the world and comfort older people who are sick or dying. And what made me go into recklessness this career was that I always wanted to do something in medicine. And I thought that why not become a M.D. And medicine is something I love to do. Characteristics- . Anatomy , Health care , Medical school 1023 Words | 3 Pages. Licensed practical nurse has slowly faded into the background; the duties once performed now removed from the scope of practice. The LPN's are . being forced to either return to school to obtain an ADN, BSN, or MSN in rainforest order to continue working in the nursing field or remain stagnant and caldwell have no hope of tekanan career advancement has created a rise in the LPN to caldwell, RN-BSN programs now offered. This paper will allow you to see this journey through the eyes of the tropical rainforest environment, LPN. Caldwell Recklessness? As a Licensed practical nurse on the team, we. Certified Nursing Assistant , Healthcare occupations , Licensed practical nurse 1265 Words | 4 Pages. In " Why I Want a Wife," Brady offers hypothetical criteria for an ideal wife in a satirical commentary on free essays 123 how the . Recklessness? work of wives is often taken for granted. The humor of the was louis riel, essay lies in its structure: on the surface it seems to accept the criteria it puts forth, while the meaning actually operates in the recognition that the caldwell, narrator is being sarcastic. That Contribute Refugees Causes)? Using writing as one of her tools for activism, Judy (Syfers) Brady has established herself as a supporter of the caldwell recklessness, women’s movement since she. Irony , Jonathan Swift , Marriage 2263 Words | 5 Pages. Why I Want to Be an Mdical Assisant. Why Do I Want To Be A Medical Assistant You already know that the . health care industry is growing at an accelerated rate. Baby boomers are getting older, and more and more people need medical help.As the baby boomers grow older, they will require more medical attention. According to becoming causes), the U.S. Department of Labor, more than 3.6 million jobs created between 2004 and 2014 will be in the health care industry. And 8 out of caldwell recklessness 20 occupations projected to grow. Health , Health care , Health care provider 1151 Words | 4 Pages. For my career I would like to be a pediatrician . Kerja Guru? I would . like to caldwell recklessness, be a pediatrician because I love to work with kids . I think they are very adorable and they interest me and I love to help them in there needs . A pediatrician is a child's physician who provides Preventive health maintenance for healthy children , Medical care for children who are acutely or chronically ill . pediatricians focus on babies, children, adolescents. Body mass index , College , High school 1105 Words | 3 Pages. BECOMING A TEACHER Page 1 Why I would want to be a Teacher Jamie Croneberger Grand Canyon University- EDU . 310 August 16th, 2012 BECOMING A TEACHER Page 2 I want to become a teacher because I , one day, ant to free essays 123, open up my own Day Care Center where I can teach and help the toddlers and recklessness babies learn and where was louis riel born grow before they start in Pre- Kindergarten. I have always wanted to help younger kids ever since I had my son Anthony and caldwell recklessness my daughter Kaitlynn. I am having trouble finding a decent. Certified teacher , Education , High school 1216 Words | 4 Pages. Analysis: Why I Want A Wife by Judy Brady 1. What is the tone of the essay? Is she serious? The tone in where the . essay is caldwell recklessness, casual, humorous, sarcastic, and sometimes ironic. The author lists multiple jobs which a wife does and is expected by many to do in many instances. 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Emotion , Form of the Good , Navy 997 Words | 3 Pages. ENG101 9A EXAMPLE 22 SEPTEMBER 2010 Why I Want to be a Nurse In the caldwell recklessness, short time my mother was . alive, she had such an amazing influence on my life. She taught me so much about care and compassion and what being a nurse was all about. She believed that nursing was a profession that you must feel in your heart. It was her way of giving back to the community as well as doing something she truly loved. Though becoming a nurse was not always in my mindset, I know that deep down that is crash movie, truly the career. 2002 albums , A Teenager in Love , Need 484 Words | 2 Pages. career that can make you feel proud and accomplished, and it is a career in which I have a lot of respect for. In order to caldwell, be a firefighter you . must be in shape, prepared, experienced, and ready to deal with your job emotionally as well as physically. 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Bureau of caldwell Labor Statistics , Medicine , Occupational Outlook Handbook 685 Words | 3 Pages. Running head: WHY DO I WANT AN MBA? 1 Why Do I Want An MBA? Sandra . R. Tropical Rainforest? Schubert MGT/521- Management December 10, 2010 Edward Darley Running head: WHY DO I WANT AN MBA? 2 Why Do I Want An MBA? A Master’s in Business Administration (MBA) degree not only opens many doors of opportunity for the possessor of the degree, it also increases one’s potential for earning higher salaries and developing a better career path. Caldwell Recklessness? Along with the prestige this degree brings, increased responsibilities. Better , Business school , Management 1108 Words | 4 Pages. ------------------------------------------------- why i want to crash movie, become a doctor . Caldwell Recklessness? ------------------------------------------------- I think that wanting to become a doctor is almost something people are born with. 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Human body , Infant , Life 664 Words | 2 Pages. " Why I Want a Wife" Judy Brady "According to the dictionary, a wife is a "woman married to a man." But, as many . women know, a wife is much more: coo, housekeeper, nutritionist, chauffeur, friend, sex partner, valet, nurse , social secretary, ego-builder, and caldwell more. Rather than complains why she herself would like to have a wife. I belong to that classification of people known as wives. I am a Wife. And, not altogether incidentally, I am a mother. Not too long ago a male friend of mine appeared. Need 1075 Words | 3 Pages. Why I Want to Be a Police Officer. WHY I WANT TO BE A POLICE OFFICER Why I Want To Be a Police Officer . Career Choices in where born Criminal Justice Dr. Darwin L. Driggers, Ybor Campus October 11, 2011 Why I Want To Be a Police Officer For as long as I can remember I have wanted to be a police officer. 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Why I want To Be A Nurse By: Lourdes Ocasio I walked off the school . bus; it was a beautiful summer day. The sun was shining and the birds were singing, but inside my house it was dark, a cloud had moved over caldwell us. I slowly made my way to the door, expecting my mother to greet me but instead my sister opened the door, something was wrong, I knew instantly. When I walked in there sat my three year old little brother playing with his toys in the family room and my parents were sitting. 2007 singles , English-language films , Family 804 Words | 2 Pages. I heard the familiar sound of the front door closing gently. My father was returning from rainforest environment work as a barber. Although he begins his day at 5:00 . a.m. every morning, he usually returns at around 7:00 p.m. Recklessness? I never really questioned his schedule when I was a child, but as I entered high school I wondered how my dad could work so hard every day of the week and still enjoy what he does. 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Also how the tools of communication is tropical rainforest environment, affective towards. Communication , Ethics , Health care provider 940 Words | 3 Pages. Why I Want to Execute Traning Bond. WHY I WANT TO EXCUTE A TRAINING BOND Knowledge is power and knowledge, once imparted, cannot be . retrieved.Organizations make very important investments in its people ’s knowledge by way of trainings, and asexpected from caldwell recklessness any investment, returns in form of improved work quality, increased productivity, lowerturnaround times, higher profits and/ or a larger market share are expected.Signing a training bond is predominantly conceived to be a form of rainforest environment legalized and consented ‘ employeeslavery ’ . Bond , Charlie Chaplin , Finance 843 Words | 3 Pages. Introduction Why I became a nurse . Caldwell? As a child I was taught many good values. My mother had a . Of Memory? strong belief in God and she preached her beliefs to the family. 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Within the process of teaching, I hope to crash movie, find. Education , Knowledge , Lesson plan 851 Words | 2 Pages. Cordon Whaley January 18, 2013 Why do I want to teach? I always wanted to become . a teacher. The main reason for this is that I want to do something to help the community, and give back some of the privileges that I enjoyed. Some of recklessness these privileges included a great education, and factors contribute becoming caring teachers. Everyone has gotten to where they are in life because they had a teacher. By definition, a teacher is someone who gives instruction and caldwell communicates skills. The lives most impacted by teachers are. Education , Future , Need 427 Words | 2 Pages. Why I Want to Pursue a Degree in Ece. Essay One: Why I Want To Pursue a Degree In ECE Angelina D. The Persistence Of Memory? Lewis MOC @ Wilmington EDU 305 Early . Recklessness? Childhood Education June 7, 2011 2 Ever since I was a little girl, I’ve known what I wanted to do. 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Doctor , Doctor of Medicine , Hospital 5355 Words | 13 Pages. Philosophy of Education / Why I want to recklessness, become a teacher? Philosophies vary from time to time . because we live in a world that moves at a very fast pace, and we have to move our ideas with it. I have pursued a BA in Communications and a MA in Secondary Education with a concentration in educational technology. Now, I teach with my English minor, and I absolutely love it. Tekanan Guru? As an educator, I want prepare students not only for college, but for the world we live in caldwell recklessness today. My philosophy of education. 21st century , Academic degree , Education 499 Words | 2 Pages. language. Being good at kerja, English, i can travel to caldwell recklessness, any place or any country which i like. English is commonly spoken throughout . much of the world due to Great Britian’s expansion during the crash movie, colonial age. 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Who I Want to be When I am Older Every human historically and caldwell recklessness presently, thrives for the same thing, success. . Some seek it through monetary values, while others perceive success as the amount of power one possesses. Ralph Waldo Emerson however, offered a new perspective of the was louis born, meaning of success. He claimed, “To laugh often and caldwell much, to win the respect of free essays 123 intelligent people and the affection of caldwell children… to factors becoming, leave the world a better place, to know one life has breathed easier because you have lived. Albert Einstein , American philosophers , Concord, Massachusetts 1030 Words | 3 Pages.
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Recklessness - The Student RoomFirst published: 9 December 2004 Full publication history DOI: 10.1111/j.1471-1842.2004.00543.x View/save citation Cited by (CrossRef): 4 articles Check for updates. Alison Alborz, National Primary Care Research and Development Centre, 5th Floor, Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. E-mail: email@example.com. Objectives: To develop methods to facilitate the ‘systematic’ review of evidence from a range of methodologies on diffuse or ‘soft’ topics, as exemplified by ‘access to health care’. Data sources: Twenty-eight bibliographic databases, research registers, organizational websites or library catalogues. Caldwell Recklessness! Reference lists from identified studies. Contact with experts and free essays 123, service users. Current awareness and caldwell recklessness, contents alerting services in the area of learning disabilities. Review methods: Inclusion criteria were English language literature from 1980 onwards, relating to people with learning disabilities of free essays 123 any age and all study designs. The main criteria for assessment was relevance to Guillifords’ model of access to recklessness health care which was adapted to the circumstances of people with learning disabilities. Selected studies were evaluated for born scientific rigour then data was extracted and the results synthesized. Quality assessment was by an initial set of ‘generic’ quality indicators. This enabled further evidence selection before evaluation of findings according to specific criteria for qualitative, quantitative or mixed-method studies. Results: Eighty-two studies were fully evaluated. Five studies were rated ‘highly rigorous’, 22 ‘rigorous’, 46 ‘less rigorous’ and nine ‘poor’ papers were retained as the sole evidence covering aspects of the recklessness guiding model. The majority of studies were quantitative but used only descriptive statistics. Most evidence lacked methodological detail, which often lowered final quality ratings. Conclusions: The application of a consistent structure to quality evaluation can facilitate data appraisal, extraction and synthesis across a range of was louis born methodologies in diffuse or ‘soft’ topics. Synthesis can be facilitated further by using software, such as the microsoft ‘access’ database, for managing information. The evidence base to inform methods for carrying out systematic reviews is developing rapidly. Caldwell! The Health Technology Assessment programme has funded a number of studies to further our understanding of the application of aspects of the factors that contribute becoming (i.e systematic review process. 1–4 The growth of the Cochrane Methodology Register, 5 which conducts and monitors this research, also reflects the development of this subject. This is the second of two papers on literature review methodology in caldwell, diffuse subject areas. Crash Movie! The first focused on identification of relevant literature. 6 This paper describes an approach to the evaluation of quality across research employing different methods, used for a review of a ‘diffuse’ topic—‘access to recklessness health care’. As the amount of published research evidence increases exponentially, syntheses of evidence are an important resource in informing decision making by policy makers, practitioners and crash movie, health service users. 7 The evaluation of literature described here was part of caldwell a literature review funded by factors that contribute to persons becoming (i.e causes), the National Co-ordinating Centre for caldwell Service Delivery and Organization research programme (NCCSDO), which has itself produced guidance on riel, methods for researching the recklessness organization and becoming refugees causes), delivery of caldwell health services. 8 The purpose of review in this context is to summarize the available evidence to inform decision-making within health care services, while identifying areas where research is lacking. It is against rainforest environment, this background of increased commissioning of caldwell literature reviews in diffuse topics 9 that the role of the librarian in the systematic review process is now being highlighted. 10. Literature reviews that examine services must place the research evidence in context. To this end, the review included a consultation (described in the first paper 6 ) to gather evidence on barriers to, and facilitators of, access to health care for people with learning disabilities. The challenges in developing systematic review methods include how to incorporate evidence using different research methodologies into a single review 11 and how to kerja include different types of ‘knowledge’, such as that gathered from consultation, generated to meet the need of stakeholders. Caldwell! 12 We felt it was important to discriminate between different types of where born ‘evidence’ and ‘knowledge’ as research evidence, in itself, is of limited value unless stakeholders are able to translate it into their own context and use it to support their practice or decision making. Only when this translation has taken place can research evidence be said to have become ‘knowledge’ either tacitly or formally within organizations. Caldwell Recklessness! Different types of evidence are recognized as being more or less valid, depending on of memory, their quality and caldwell recklessness, the purpose for which they were gathered. The consultation exercise gathered non-written forms of evidence and was designed to capture the where was louis tacit and recklessness, experiential knowledge of service users. Identification of where was louis riel born evidence context is one area where the caldwell librarian can make a significant contribution to the review process. The concept of ‘access to health care’ is multi-faceted with barriers and facilitators operating both outside and across health services. Capturing the available evidence, therefore, required identification of kerja guru literature across a range of disciplines, as well as consideration of its concern to a range of stakeholders. Details of the model of caldwell recklessness access used and search strategy are given in the previous paper. 6 The full report is available on the SDO website. 13. There are two ways in which the rationale for the methods employed in this review differed from a systematic review of effectiveness. Firstly, it was deemed inappropriate to adopt criterion for study design, or ‘hierarchy of evidence’ 14 because research evidence on diffuse topics is likely to reflect a plurality of methods and approaches, in keeping with their multi-faceted nature. Crash Movie! We, therefore, made no value judgements about the relative merits of caldwell recklessness qualitative vs. quantitative method, but reasoned that it was possible and justifiable to not limit evidence to a particular methodological approach or study type. Secondly, as a key purpose of the review was to identify gaps in the evidence base and practical interventions to promote ‘access’, it was important not to exclude research solely on the basis of poor methodological quality. It was acknowledged that such research could be substantive in illuminating the underpinning model, or ‘innovative’ in terms of potential for future service development. Tropical Rainforest Environment! A conscious decision was therefore made to balance the ‘signal’ of a publication (i.e. our judgement of its potential value to illuminating access to health care for people with learning disabilities) against its ‘noise’ or poor methodological quality. 15. Quality evaluation tool development. Critical appraisal of the literature in this review draws on a number of established criteria 16,17 and caldwell, approaches. 18–20 There is some agreement on the most important elements of research that embody methodological and epistemological quality that should be appraised to establish the credentials of evidence. In diffuse topics, many titles and/or abstracts retrieved are inadequate, there can be an extensive grey literature and, almost certainly, use of a wide range of methodologies. Tropical Environment! It is, therefore, preferable to use a parsimonious tool that provides opportunities to caldwell recklessness decide further analysis is unproductive. The quality evaluation tool described here was designed to of memory parody incorporate the multifarious nature of caldwell research evidence on of memory parody, ‘access to health care’ and provide two opportunities for data rejection before appraisal of findings and caldwell recklessness, final quality rating. Quality evaluation tool summary. Use of the tool is dependent on rainforest environment, an adequate appreciation of the recklessness issues denoting rigour in qualitative and quantitative research. These are alluded to in the description of this tool, however, the kerja reader is recommended to see the caldwell work of Popay, Rogers and Williams 18 and Mays and Pope 19 regarding evaluation of qualitative research, and Gomm 21 for a discussion of the issues affecting quality in quantitative research. Phase 1—paper identifiers and assessment of relevance. Fields—author(s), title, source, year, study type. Paper identifiers (noted above) were recorded for every paper. Those not relevant to our model on examining the the persistence full text were discarded and the reason noted. Full details of selection criteria are given in the first paper. 6. Phase 2—evaluation of methodological rigour. Part 1. Method—fields: design, aims, participants, instruments. Methodological details were recorded for remaining papers. The design and other details informed assessment of caldwell recklessness methodological quality, and enabled the reviewer to interpret the findings in context during synthesis. Adequate description of methodological detail in research papers is crucial to evaluation of quality. 22. Part 2. Methodological quality indicators—fields: clarity of aims, appropriateness of design, clarity of context/setting description, sampling adequacy, data collection technique adequacy, data analysis techniques adequacy. These indicators were applied to both quantitative and qualitative papers as they have been identified as central to guru methodological rigour in both types of research. 18,19,21. It is caldwell recklessness a prerequisite of any piece of rigorous research that the aim of the study, hypothesis or research question is clearly stated as this is the yardstick against which findings are considered. The design of the study should then be capable of providing evidence to answer the question, support or refute the hypothesis. The reader is unable to adequately assess the tropical extent to recklessness which findings provide answers to research questions without knowledge of the context within which the research was conducted. That To Persons Refugees (i.e Causes)! Settings may exert significant influence on outcomes. For example, interviews conducted in participants’ own homes may allow more reflective and caldwell recklessness, open comment than those either conducted in the high street or in the presence of an authority figure such as their manager, doctor or teacher. Issues of sampling also have a bearing on research outcome. In quantitative research, considerations of statistical power 23 often mean that large numbers of participants must be included in order to detect statistically significant effects. In qualitative research, the absolute number of that contribute to persons participants is less significant than the range 18 whose experiences reflect different perspectives on the research subject and therefore allow a more considered analysis of the topic. Methods used to collect data also influence outcome. Face-to-face interview, telephone interview, postal survey, using structured, semi-structured or grounded questioning/interviewing will all produce data, but with varying levels of detail. Data collection must be appropriate to the aims of the caldwell recklessness study and its participants. Data analysis, therefore, whether conducted on environment, conclusion of data collection, as in much quantitative research, or concurrently, as is common in qualitative research, needs to caldwell be appropriate to the sample, type of data collected and the question it is the persistence of memory parody trying to answer. Part 3. Caldwell Recklessness! Review organisers—fields: area of model, age group, severity of tropical rainforest environment disability. Details were recorded of which aspects of the model were covered in the paper, participants’ age group and disability range. The review aimed to caldwell recklessness reflect differences in access to health care across the lifespan and any effect severity of disability had on access. These details were recorded at this point to aid decisions on the usefulness of including the paper where the indicators showed the study to where riel born be lacking rigour. The remaining analysis was differentiated by method, however, the overall structure for each section was consistent. Part 1. Key findings. Findings from the research paper, relevant to the review topic, were recorded. Part 2. Evaluation of findings by method. Whether the findings connected with existing bodies of knowledge, or generated new research evidence, was considered and formed the ‘knowledge indicator’. Such connections were considered to signify rigour by positioning the findings within the wider evidence base. This involved reflection on the findings and their relation to evidence cited in the introduction to the paper, as well as other ‘bodies of knowledge’ that the caldwell recklessness reviewer became aware of through the process of review. Quantitative studies were assessed with respect to the aim of the research and particularly whether confounding may offer an alternative explanation to the findings and whether there had been attempts to control for, recognize and address, confounding. 20 Confounding occurs where statistical significance, or association, is crash movie apparent between an recklessness, independent and dependent (or outcome) variable, but may in fact be attributable to guru a third factor, or variable, that is related to caldwell both. For example, research may demonstrate a statistical relationship between socio-economic status (SES) and computer literacy amongst 8-year-old children. Further investigation may suggest that an of memory parody, intermediate factor—access to a computer—may mediate the relationship between SES and caldwell, computer literacy. The research is therefore confounded, as it is unclear whether SES relates to free essays 123 aptitude or opportunity differences between the caldwell recklessness children. Qualitative research was assessed using established standards 18,19 with particular consideration given to the validity and adequacy of studies. This was judged through theoretical and conceptual adequacy—clarity of description, logic of crash movie analysis, imagination in interpretation, coherence, fairness, honesty—and transferability of findings. For both types of study, consideration was given to recklessness its policy relevance—the extent that the rainforest environment study addresses issues of concern to practitioners and policy makers and empowers service users. Part 3. Notes—idiomatic translation. The quality evaluation tool uses a heuristic approach to the exploration of the literature, rather than rigid criteria. It was designed to include idiomatic translation of findings, to place the study within the wider literature. Notes were therefore made on the focus of the research and its fit within the model of access guiding the review, along with other relevant concerns. The literature reflected a wide range of themes, disciplines and paradigms, which represented forms of narrative and therefore issues of caldwell recklessness audience, language and knowledge. Free Essays 123! This is in keeping with literature synthesis as a form of ethnography where the synthesiser identifies key metaphors and concepts in order to caldwell recklessness understand competing ‘world views’ of a topic. 24 This section guided final synthesis. Mixed method studies underwent both types of evaluation for their component parts. Final consideration was given to whether these met quality criteria and were adequately integrated. Part 4. Final quality rating. Taking all the above factors into account, studies were allocated a quality rating as described below. 1 Highly rigorous—all or most quality indicators met including knowledge indicator. 2 Rigorous—main quality indicators met including knowledge indicator. 3 Less rigorous—some lack of methodological detail but knowledge indicator met. 4 Poor—lack of methodological detail and/or knowledge indicator not met. Two researchers were involved in factors contribute refugees, reviewing literature but, given that over 800 papers were identified as potentially relevant and there was a timescale of 1 year, it was not possible for both researchers to review every paper. It was therefore important to ensure that the tool provided a firm structure through which a thorough review would be conducted consistently. The tool was piloted on a sample of six qualitative, quantitative, and caldwell, mixed-method papers, to allow reviewer familiarization and evaluate its capacity to rainforest environment capture the dimensions of the publications to caldwell recklessness be assessed. Comparisons were made between three sets of completed assessments and discrepancies discussed. A further three sets of papers were then completed in light of these discussions to ensure compatibility between the reviewers in application of the tool. The pilot phase was brief, but considered adequate, as the reviewers were not expected to conduct their reviews in environment, isolation. They were able to meet to discuss and learn from discrepancies and generate a consistent method for dealing with future cases. The co-location of the reviewers was an important factor in being able to conduct data extraction and evaluation in this way. As a result of the pilot exercise, some amendments were made to the tool to extend the number of options for caldwell recklessness classifying the literature by type, design, age group and disability range. The number of coding boxes for identifying the areas of the model explored by factors that contribute to persons (i.e, the publication were also increased from three to five. The tool was then converted into a database format using Microsoft ‘Access’ software. Recklessness! The evaluation of all remaining papers was carried out by entering data directly onto the database. Application of the evaluation tool. The tool facilitated ‘funnelling’ of environment literature, 22 that is stages of manual scanning and filtering search results to compensate for the lower level of specificity occurring in diffuse topic searches. The process is caldwell recklessness illustrated in Fig. 2 below. Funnelling of references. *Discarded studies were methodologically poor and tekanan kerja, covered areas of model where more rigorous studies were identified, or they applied to health care in the USA. Stage 1—initial inclusion/exclusion. Stage 1 funnelling was completed during the search phase where inclusion/exclusion criteria were applied to records retrieved from databases (titles and abstracts). Of the 2221 records screened, 839 appeared to meet our criteria. This stage was deliberately over inclusive because we did not wish to exclude relevant papers/publications because of obscure titling or inadequate abstracts (see first paper 6 ). Implementation of ‘quality evaluation’ therefore began in earnest with the caldwell consideration of guru these 839 records. Twelve of the 839 ‘relevant’ publications identified were unobtainable. The reviewers considered the full text of recklessness remaining publications. After recording paper identifiers, confirmation was sought that the paper addressed one or more of the areas of the model adopted for the research. Any publication where the tropical rainforest environment assessor was unsure or doubtful was discussed jointly to agree a status. Six hundred and forty-four publications did not address ‘access’ as defined by our criteria and were abandoned. Stage 3—methodological quality evaluation. Twenty-four of the 183 publications confirmed relevant were reviews. These were read to ensure that papers we had failed to identify were included. Methodological rigour was poor on many of the remaining papers. The audiences for these publications were often practitioners, and evidence cited based on very small samples or anecdotes of experience. A few studies surviving to this stage addressed access to caldwell the insurance-based health care system in the USA and were therefore not included. Papers were read fully and assessed against a ‘generic’ set of methodological quality indicators as described above. This involved considering the crash movie background to the investigation, its aims in relation to caldwell these issues, and the appropriateness of the methodological and rainforest environment, analytical techniques employed. The areas of the model of ‘access’ covered in the study, age groups and disability range were recorded and used to organize the review in synthesis. Recklessness! These items were valuable for free essays 123 highlighting ‘gaps’ in research. Papers which scored well on these ‘generic’ quality indicators, and/or those that applied to recklessness areas of the free essays 123 model for which no more rigorous literature was identified, proceeded to a detailed evaluation of their findings based on study design. Poor quality papers had their limitations made explicit. Stage 4—method specific quality evaluation. Eighty-two studies were considered of adequate quality and relevance to the ‘access’ model including 15 qualitative, 62 quantitative and caldwell, five mixed-method studies. These proceeded to the final stage of evaluation of findings according to specific quality criteria. The data extraction and quality evaluation process included evaluation of the literature using both literal and idiomatic techniques. Contribute! 24 That is, the main details of each paper were transcribed literally (word for word) from the original text onto the quality evaluation pro-forma to accurately represent original findings. These were then evaluated in light of the criteria for the study type, as described above and, using idiomatic translation, comments were added on the quality, paradigms and approaches used, comparisons with previously reviewed literature and relationship to the model. Idiomatic translation identifies the underlying ‘meaning’ of the text, from recklessness its literal meaning, and has been highlighted as a precursor for synthesizing and interpreting qualitative literature into a new construction or dialectic. That To Persons Becoming Refugees (i.e! 24 Diffuse literature review needs to recognize competing ‘world views’ and evaluate their relevance to the model employed. This translation means that reviewer perspectives, along with the substance of the literature, are reflected in recklessness, synthesis of findings. Refugees (i.e! This is a feature of literature review in more diffuse, ‘soft’ topics. Final ratings are shown in Fig. 2. Many papers evaluated failed to attain higher ratings as a result of caldwell lack of detail on the methodology, which made judgements on confounding, representativeness and transferability difficult. The nature of the topic meant that statistical analysis in the vast majority of quantitative papers was merely descriptive. Rainforest Environment! Statistical considerations were therefore not critical to evaluation and recklessness, many of the papers rated ‘less rigorous’ were considered adequate in terms of the soundness of the data on which conclusions were based. Use of a Microsoft ‘Access’ database to manage information generated by data extraction and evaluation proved invaluable. Where Was Louis Born! It allowed the reviewer to extract data easily according to areas of the model underpinning the literature review. Equally important, in the light of evidence from the consultation exercise, it enabled us to describe the distribution of the evidence across the model and hence identify ‘gaps’. Time and effort in converting the hard copy pro-forma to a database format were more than repaid at this stage. The type of literature evaluation described here is increasingly being commissioned to inform decision making on caldwell recklessness, future priorities for research, and to assess the impact of policy 9,25 from a stakeholder perspective. This has implications for the research infrastructure, of which librarians are part, in terms of the persistence of memory capacity and skills to caldwell respond. Librarians are familiar with literature across a range of methods and disciplines and are therefore well placed to contribute to the evaluation of literature, particularly in identifying and categorizing the different narratives that converge in a diffuse topic. Identifying the underlying assumptions, or ontology, on which research is based draws on tropical rainforest environment, traditional librarian skills of classifying the literature. The evaluation phase of the literature review required the authors to focus on caldwell recklessness, the content of the evidence gathered during which the the persistence parody librarian identified and categorized the variety of ‘world views’ 24 reflected. Caldwell Recklessness! This facilitated the mapping of the free essays 123 literature. Quantitative papers using parametric statistics, although a small proportion of the studies using this methodology, were evaluated by the first author who has the necessary skills in this area. Critical appraisal of quantitative research and statistical methods has been identified as a skills gap among health librarians. To contribute effectively to all stages of the systematic review process, and provide an caldwell, evidence-based service, it is important that skills are developed in the persistence of memory, this area. 26. The quality appraisal tool was devised by the first author, drawing on her research experience. However, ensuring the tool was ‘fit for purpose’ required further development work during the pilot phase as the tool was applied to a variety of literature. Librarians have done a good deal of caldwell recklessness work in assisting research users to where riel born identify and apply the caldwell recklessness plethora of quality evaluation tools and checklists available, through the Critical Appraisal Skills Programme 27 (CASP). Crash Movie! They can extend this role by contributing to the development and piloting of quality appraisal tools, by recklessness, using their extensive knowledge of the literature, and by further testing and applying these tools in subsequent literature reviews. To this end, participating in all stages of a literature review, from the funding proposal to the dissemination of findings, can provide a vehicle for developing the role of the librarian in the health services context. At the same time, their developing research skills will enable them to conduct research both on the services they provide and, as a member of a team, on kerja, research projects. Implications for caldwell recklessness systematic review methods. Literature reviews of diffuse concepts require additional stages of manual sieving, or ‘funnelling’ data, as final criteria for inclusion only emerge after examining the full range of available literature. 22 A high level of wastage would then seem to be an unavoidable feature of this type of was louis riel review as many references initially obtained as of potential, or undeterminable, relevance are later discarded on examining the full text. The evaluation of the recklessness literature was an intense, iterative process, reflecting the developing literature around quality assessment in qualitative research, which suggests that further criteria refinement may be necessary during evaluation as qualitative research incorporates a wide range of techniques and approaches. 28. The development and the persistence, piloting of the quality appraisal tool was of necessity a rapid process. Caldwell! Time limitations also meant the literature had to be divided between the two authors. However, ongoing consultation was conducted as necessary. Given more time, each paper could have been evaluated by both assessors. This would have enhanced the factors that contribute becoming (i.e causes) scientific validity of the review findings by enabling calculation of inter-rater reliability, and further assessment of the evaluation tool. A common practice in literature review, particularly within short timescales, is for reviewers to take the lead on specific pieces of the caldwell recklessness overall work, which are later assembled and honed into a complete review. The advantage of researchers reviewing the full range, as opposed to the persistence parody carving out discreet areas of the literature, is the depth of knowledge acquired around the topic. As quality appraisal progressed, the reviewers’ understanding of the literature and its relationship to caldwell the model of ‘access to health care’ deepened and they were therefore able to feed this more rounded or ‘holistic’ view into the synthesis. The authors plan to further test and develop the tool and would encourage other researchers and practitioners involved in reviewing different types of evidence to provide feedback on its use. In this regard, the section of the evaluation tool entitled ‘Area(s) of the model’ was specific to the research project described here. However, this section is interchangeable and could be replaced with criteria from models or frameworks underpinning any review through which the evidence is to be organized. Finally, this literature review adopted a relativist approach congruent with the multi-faceted nature of health care service delivery, recognizing that human activity reveals a wide range of subjective perspectives and the persistence of memory parody, narratives. Caldwell Recklessness! Unlike traditional systematic reviewing, therefore, all methodological perspectives and types of publication were considered valid. Consequently, the findings of this review challenge conventional ways of delivering health services by where, identifying both the recklessness ‘thick’ and ‘thin’ descriptions 29 of kerja guru contextual factors that may result in failure to gain access to services by people with learning disabilities. The authors believe that the value of this approach to literature review is demonstrated by the range and depth of publications identified and gaps in knowledge highlighted. They suggest that it is caldwell possible to conduct such reviews systematically, although they do not constitute a ‘systematic review’ in the traditional sense. We thank our colleagues Angela Swallow and Caroline Glendinning, all those who participated in the consultation exercise and the NCC SDO for funding this project. A full report of the project is available from the NCC SDO website at: http://www.sdo.lshtm.ac.uk/access.htm. The full quality evaluation tool is available on the NPCRDC, University of the persistence Manchester website at: http://www.npcrdc.ac.uk/publications/Quality%20Evaluation%20Tool.doc. • Participating in the evaluation phase of a literature review is a valuable role that provides skill development opportunities for health librarians. • Traditional librarian skills of caldwell recklessness organizing and classifying information can assist in rainforest, identifying and mapping underlying themes and components in literature reviews of diffuse topics. • Librarians need training in both qualitative and recklessness, quantitative methods, and tropical, evaluation of research quality to participate in research and become evidence-based practitioners. Issue online: 9 December 2004 Version of record online: 9 December 2004. 1 Moher, D. , Pham, B. Caldwell Recklessness! , Lawson, M. L. & Klassen, T. P. The inclusion of reports of randomised trials published in languages other than English in parody, systematic reviews . Health Technology Assessment 2003 , 7 , 1 – 90 . CrossRef | PubMed | CAS 2 Sutton, A. , Abrams, K. , Jones, D. , Sheldon, T. & Song, F. Systematic reviews of recklessness trials and other studies . Health Technology Assessment 1998 , 2 , 1 – 276 . PubMed | CAS | Web of Science® Times Cited: 2 3 Song, F. Crash Movie! , Eastwoood, A. , Gilbody, S. , Duley, L. & Sutton, A. Caldwell! Publication and related biases . Health Technology Assessment 2000 , 4 , 1 – 115 . PubMed 4 Egger, M. , Juni, P. , Bartlett, C. Crash Movie! , Holenstein, F. & Sterne, J. How important are comprehensive literature searches and the assessment of recklessness trial quality in systematic reviews? Empirical study . Health Technology Assessment 2003 , 7 , 1 – 76 . PubMed | CAS 5 The Cochrane Methodology Register . In: The Cochrane Library . The Persistence Of Memory Parody! Issue 2. Chichester, UK: John Wiley & Sons, Ltd, 2004 . Caldwell! 6 McNally, R. & Alborz, A. Developing methods for systematic reviewing in health services delivery and organisation: an the persistence, example from a review of access to health care for caldwell recklessness people with learning disabilities. I. Identifying the literature . Health Information and the persistence of memory, Libraries Journal 2004 , 21 , 182 – 93 . Recklessness! Wiley Online Library | PubMed 7 Boaz, A. , Ashby, D. & Young, K. Systematic reviews: what have they got to offer evidence based policy and practice? ESRC UK Centre for tropical Evidence Based Policy and Practice: Working Paper 2. London: ESRC UK Centre for Evidence Based Policy and Practice, Queen Mary, University of London, 2002 . 8 Fulop, N. , Allen, P. , Clarke, A. & Black, N. (eds). Studying the Organisation and Delivery of Health Services Research Methods. London: Routledge, 2001 . 9 Grayson, L. & Gomersall, A. 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London: Social Care Institute for Excellence, 2004 : 1–83. 13 Alborz, A. , McNally, R. , Swallow, A. & Glendinning, C. From the cradle to the grave . A Literature Review of Access to Health Care for People with Learning Disabilties. The Persistence! Manchester: National Primary Care Research and Deevlopment Centre, University of caldwell Manchester, 2003. Available from: http://www.sdo.lshtm.ac.uk/access.htm. 14 Sackett, D. L. , Richardson, W. S. , Rosenberg, W. Parody! & Hayes, R. Caldwell Recklessness! B. Evidence Based Medicine: How to Practice and where was louis, Teach EBM. New York: Churchill Livingstone, 1997 . 15 Edwards, A. Caldwell! , Russell, I. & Stott, N. Rainforest Environment! Signal versus noise in recklessness, the evidence base for medicine: an alternative to hierarchies of evidence? Family Practice 1998 , 15 , 322 . CrossRef | Web of Science® Times Cited: 22 16 University of Salford, Health Care Practice Research and Development Unit. 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