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Quote a song in an essay

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Anti-Communist Propaganda: Reed Crandall. Reed Crandall’s illustration of the Soviet Union Leader Nikita Khrushchev, demonstrates the hatred of communism from an American standpoint during the Cold War. The result of World War II left the United States and the Soviet Union as two superpowers with profound economic and political differences. Therefore political and military tension brewed between the quote in an essay, superpowers. However, the on science, two superpowers would never engage in battle but were both victims of quote a song essay proxy wars and propaganda. Crandall’s illustration of dissertation online jobs Khrushchev is an a song in an essay example of anti-communist propaganda in the US. One thing that I have learned from this time period of this picture is that the Soviet Union was shady and seen as untrustworthy. Both of the two larger gentlemen in black portray a sense of buy a dissertation online dishonesty. Khrushchev, the quote essay, man with two faces looking in opposite directions with a dove and an olive branch in one hand and a missile in the other, clearly depicts someone who is “two-faced”. Someone who is two-faced is hypocritical and help, deceitful.

The dove with an olive branch symbolizes peace whereas the missile symbolizes war and conflict. Quote! Need essay sample on Anti-Communist Propaganda: Reed Crandall ? We will write a custom essay sample specifically for you for only $12.90/page. Khrushchev is facing both the dove and missile which implies that he is custom help, hypocritical and unbalanced. Moreover, the a song, left part of his face is facing the western front which suggests that the western side of the globe, the US, sees Khrushchev as an enemy due to the missile in his hand. The left part of his face faces the eastern front, which is comprised of Russia, China, and Vietnam, which suggests that the eastern front sees Khrushchev a peaceful leader due to the dove in his other hand. Another thing I noticed was that Khrushchev is stepping on a paper with the word “Treaty” peeking out from under his foot.

This says that Khrushchev and on science, the Soviet Union did not honor treaties. The second larger gentleman on a song the right side of the picture is seen giving a poorer, less-clothed, skinny man a bag of money while hiding a whip behind his back. This is another example of the Soviet Union being shady. Furthermore, the text in the boxes provided by Crandall further explains America’s distrust with the essay, Soviet Union during the Cold War era. During this time, America was certainly afraid of the Domino Theory that ommunism would spread throughout the world and a song in an, eventually land in write, the US. However, the government used propaganda to alleviate some of the fear with anti-communism cartoons as well as promoting the idea that the communistic philosophies of the Soviet Union could lead to destruction. The skeleton behind the fat man is a symbol of death.

The cracks in the ground and rubble are a symbol of destruction and war. In addition, the broken Roman columns with “Culture” inscribed at the top is also a clear indicator of the destruction of culture if Communism reached the US. The woman lying face down suggests that she is dead and the soldier with a gun is bleeding down the side of his face. Quote A Song! This entire picture is filled with evidence of destruction that could be the result of Communism. The text boxes further prove the destructiveness of communism. Essays On Macbeth's Character Foil! For example, Crandall writes, “We have seen in this series of stores the way in which Russia’s leaders have followed the teachings of Marx and in an, Lenin. Behind them, they have left a bloody trail. ” Crandall implies that the teachings of Marx and Lenin result in a “bloody trail” which is Communism. In the last text box, Crandall writes, “In its wake, Communism as left a trail of murders, lies and misery of a kind never before seen in the history of the world. ” Crandall’s message for write an essay your in french, the readers becomes obvious that communism breeds all kinds of evils that could be extremely devastating and a song, destructive.

If the thought of communism in character, the US scared the essay, citizens, the industries, thought of world domination by the Soviet Union truly put fear in the US citizens as Crandall explains that “…behind all this talk is one goal: world domination by any means. During this time, American citizens were constantly aware of the domino theory and led up to a worst case scenario of the Soviet Union The Soviet Union strived for world domination which is indicated by the map of the world that spreads across the a song, entire picture. A map of the world would be needed for world domination. In addition, the chains and shackles lying on the ground implies that the essay on science and politics, Soviet Union wants to imprison and capture the world. Furthermore, the diversity of culture would no longer exist if a nation desired world domination.

This is portrayed by quote in an the damaged Roman columns with the word “Culture” written at the top. The domino theory could have led to world domination but something of essay that caliber is highly unlikely, but during this time, Americans really thought about world domination by a song in an the Soviet Union. From this time period, it seems as if America was very influenced with Christian ideologies. Americans believed that God chose to side with them to essay and politics go against the Soviet Union and in an essay, communism. This is proved blatantly by the title “The Godless Communism. ” In addition, Crandall writes, “It is truly the historical writing, work of the devil. Here he explicitly says that Communism is the work of the Devil which is the enemy of a song in an God. From the picture, there is a broken cross, a destroyed church, and perhaps a beaten bible that portrays “The Godless Communism. ” According to on science the broken bible, cross and church, the picture presents the viewer with a fact that Communists detested Christianity. Moreover, Christian ideologies were significant in influencing America as Americans saw Communism as a work of the Devil and that empowered them to work “with” God to fight Communism.

A larger theme that this picture fits into is how Americans always have an ideology of quote a song good or bad. Americans have an innate tendency to take sides on various things such as sports players like Kobe Bryant and LeBron James, or political entities like the Populist and the Progressives, and assignment, even phone operating systems like Apple and Android. Americans tend to fight for what they believe in and will defend their beliefs in in an, an argument that may provoke their beliefs. For example, most people think Kobe Bryant is a better basketball player than LeBron James because of the fact that Kobe has won 4 more NBA Championships than LeBron. Another theme this picture portrays is the use of propaganda to evoke a certain side of your school in french opinion; that it was used to promote the idea that America and it’s predominant belief in Christianity is good and that the Soviet Union, Nikita Khrushchev, and communism is bad. The government uses propaganda to influence the attitude of an audience to choose a side by only showing only one side of an quote in an argument. In other times, like WWII, propaganda was used to essay and politics encourage women to join the war effort by building planes, tanks, and becoming nurses which transformed women’s roles during that era. This picture also portrays the theme of the involvement of Christianity in American life.

The belief of Christianity in America helped promote the idea that Communism was the quote a song in an essay, work of the devil as Crandall illustrates. Historical Fiction Essay! In essence, communism has helped Christianity become a predominant belief system in America. For example, Americans believed in a song in an essay, Christianity as they did not want to be considered communist. This cartoon tells a lot about American culture during the time of the Cold War; that Americans believed Nikita Khrushchev and the Soviet Union were destructive, deceitful, and hypocritical, and developed a predominant belief in Christianity. Americans also had an ideology of good and bad which is exemplified by the American belief that Christianity was good and Communism was bad.

In addition propaganda helped promote these ideas through cartoons.

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Should essays and quote other “open-ended”-type questions retain a place in written summative assessment in clinical medicine? © Hift; licensee BioMed Central. Essay On Science! 2014. Published: 28 November 2014. Written assessments fall into two classes: constructed-response or open-ended questions, such as the essay and a number of variants of the short-answer question, and selected-response or closed-ended questions; typically in the form of multiple-choice. It is widely believed that constructed response written questions test higher order cognitive processes in a manner that multiple-choice questions cannot, and consequently have higher validity. An extensive review of the in an essay literature suggests that in summative assessment neither premise is evidence-based.

Well-structured open-ended and multiple-choice questions appear equivalent in their ability to assess higher cognitive functions, and performance in buy a dissertation, multiple-choice assessments may correlate more highly than the open-ended format with competence demonstrated in clinical practice following graduation. In An Essay! Studies of construct validity suggest that both formats measure essentially the same dimension, at least in mathematics, the physical sciences, biology and medicine. The persistence of the open-ended format in summative assessment may be due to the intuitive appeal of the belief that synthesising an answer to an open-ended question must be both more cognitively taxing and similar to actual experience than is selecting a correct response. I suggest that cognitive-constructivist learning theory would predict that a well-constructed context-rich multiple-choice item represents a complex problem-solving exercise which activates a sequence of cognitive processes which closely parallel those required in clinical practice, hence explaining the cooper high validity of the quote in an essay multiple-choice format. The evidence does not support the cooper inc case solution proposition that the open-ended assessment format is superior to the multiple-choice format, at least in exit-level summative assessment, in terms of quote in an essay either its ability to fiction test higher-order cognitive functioning or its validity. A Song In An! This is explicable using a theory of mental models, which might predict that the multiple-choice format will have higher validity, a statement for which some empiric support exists.

Given the superior reliability and cost-effectiveness of the multiple-choice format consideration should be given to phasing out essay on science and politics open-ended format questions in a song, summative assessment. Whether the same applies to non-exit-level assessment and formative assessment is a question which remains to be answered; particularly in essay on science, terms of the educational effect of essay testing, an area which deserves intensive study. Learning and the stimulation of learning by assessment. Modern definitions of about school learning, such as that attributed to Siemens: “Learning is a continual process in which knowledge is transformed into something of meaning through connections between sources of information and quote a song the formation of useful patterns, which generally results in something that can be acted upon appropriately, in a contextually aware manner” [ 1 ],[ 2 ] essentially stress two points: firstly, that learning requires a much deeper, effortful and industries inc case study purposeful engagement with the material to be learned than the acquisition of factual knowledge alone; secondly, that learned knowledge does not exist in a vacuum; its existence is inferred from a change in the learner’s behaviour. This has led transfer theorists to postulate that knowledge transfer is the basis of all learning, since learning can only be recognised by observing the a song essay learner's ability to display that learning later [ 3 ],[ 4 ]. It is now generally accepted that all cognition is built on domain-specific knowledge [ 5 ]. Content-light learning does not support the ability to help transfer knowledge to new situations and a comprehensive store of quote in an essay declarative or factual knowledge appears essential for transfer [ 4 ]. Furthermore, a high order of understanding and contextualization must accompany the declarative knowledge if it is to be successfully applied later. Where transfer – in other words, the successful application of knowledge to dissertation online jobs new situations – has been shown, the common factor appears to be deep learning, and the abstraction of general principles [ 6 ]-[ 8 ]. Miller’s pyramid of assessment of clinical skills, competence and performance [ [ 15 ] ]. Assessment is central to the educational process, and has benefits beyond that of measuring knowledge and competence alone; principally in directing and stimulating learning, and in quote in an, providing feedback to teachers and learners [ 17 ]. Recent research supports a critical role for assessment in consolidating learning, and strengthening and facilitating memorisation and recall.

There is accumulating evidence that the process of stimulating recall through testing enhances learning and retention of essay and politics learned material. This has been termed the testing effect , and several hypotheses have been put forward to explain it, including increased cognitive effort, conceptual and semantic processing, and increased attention to the properties distinguishing the learnt item from similar items, which strengthens the relationship between the cue which triggers the memory and a song in an essay the memory item itself [ 18 ],[ 19 ]. It appears to be principally the act of retrieving information from memory which strengthens knowledge and knowledge retention [ 20 ],[ 21 ], irrespective of whether retrievable is covert or overt [ 22 ]. Importantly, high-level questions appear to stimulate deeper conceptual learning and better learning retention then those pitched at a lower level [ 23 ]. Critical Foil! A number of strategies have been proposed to exploit this in educational practice, including those recently summarised for use in medical education [ 24 ]. Quote In An Essay! This is in essays character, a sense related to quote a song in an essay the “generation effect”, where it has been shown that spontaneously generating information as opposed to learning it passively improves subsequent recall [ 18 ],[ 19 ]. Assessment in educational practice. It is essay writing, accepted that standards of assessment are inherently variable. There is therefore an obligation, in summative assessment, to ensure that assessment meets certain minimum criteria [ 25 ]. Achieving this in the individual instance is challenging, given the wide range of skills and knowledge to be assessed, marked variation in the knowledge of assessment of quote a song essay those who must assess and the highly variable environments in which the assessment takes place. Critical On Macbeth's! There is quote a song essay, now an extensive literature on assessment, in terms of research, guidelines and recommendations [ 26 ],[ 27 ]. Importantly, modern approaches recognise that no single form of assessment is suitable for every purpose, and stressed the need for programmatic assessment , which explicitly recognises that assessment is study solution, best served by a careful combination of a range of instruments matched to a particular purpose at each stage of the a song in an essay learning cycle, such as for formative, diagnostic or summative purposes [ 25 ],[ 26 ],[ 28 ].

Despite the fiction essay writing proliferation of assessment methodologies which attempt to test the competence of medical students directly, such as OSCE, OSPE, case-based assessment, mini-CEX and workplace-based assessment, written assessments remain in widespread use. Much of the knowledge base required by the clinician is not necessarily testable in the performance format. Additionally, in quote essay, comparison with most practical assessment formats, written tests are easier to organize and deliver, requiring little more than pen and paper or a computer, a venue, question setters and markers who need not be physically present. In general, all forms of essay on science written assessment may be placed into one of two categories. Constructed response or open-ended questions include a variety of written formats in which the student is required to generate an answer spontaneously in response to a question. The prototypical example is the quote a song in an essay essay.

There are many variants including short answer questions (SAQ), mini-essay questions, single-word and single-sentence questions and the modified essay question (MEQ). The selected-response or closed-ended format is typified by write about your school in french, the multiple-choice question (MCQ) assessment, where candidates select the most appropriate answer from a list of options rather than generating an answer spontaneously. Many variants of the multiple-choice format have been used: current best practice recommends the use of one-best-answer (of three, four or five possible answers), and extended matching item (EMI) formats [ 29 ]. In this debate I shall use the in an term open-ended when referring to the constructed-response format, and multiple-choice as a synonym for the selected-response format. All high-stakes assessments should meet an adequate standard in custom, terms of quality and fairness, as measured by a number of quote a song parameters, summarised recently in a consensus statement [ 30 ]. Principal among these are the classic psychometric parameters of reproducibility (reliability or consistency; that a result would not essentially change with retesting under similar conditions), and validity or coherence, which I describe in inc case, detail below. Other important measures by a song, which assessments should be judged are equivalence (assessments administered at different institutions or during different testing cycles produce comparable outcomes), feasibility (particularly in terms of efficiency and cost effectiveness), educational effect (the student who takes the assessment is thereby motivated to undertake appropriate learning), catalytic effect (the assessment provides outcomes that, when fed back into the educational programme, result in better teaching and inc case learning) and acceptability to both teachers and quote in an learners. It is generally accepted that the multiple-choice format, in contrast to the open-ended format, has high reliability and is efficient, a consequence primarily of wide sampling, and to on science and politics a lesser extent, of its objectivity. In support of the open-ended format, it has been widely held that this format is a song, superior at testing higher cognitive levels of knowledge and buy a dissertation jobs has greater validity. This belief is in an essay, intuitively appealing and appears to represent the viewpoint of many of those involved in medical assessment, including those with extensive knowledge and experience in medical education. In an attempt to gain the best of inc case study solution both formats, there has been a shift from the prototypical essay towards newer formats comprising a larger number of short, structured questions, a development intended to retain the perceived benefit of the open-ended question with the superior reliability of the MCQ.

Thus the two formats are generally seen to be in tension, MCQ being significantly more reliable, the open-ended format having greater validity. In this debate I will compare the performance of the a song open-ended format with MCQ in summative assessment, particularly in final exit examinations. I draw attention to the large body of cooper industries inc case study solution evidence which supports the view that, in summative assessment, the multiple-choice format is quote a song essay, intrinsically able to provide all the value of the open-ended format and does so more reliably and cost effectively, thus throwing into question the justification for the inclusion of the open-ended format in summative assessment. I will suggest a hypothesis as to why the multiple-choice format provides no less information than the open-ended format, a finding which most people find counter-intuitive. A critical concept is that assessment is not only of learning, but also for learning [ 27 ],[ 31 ]. In the first case, the purpose of historical essay writing assessment is to determine whether that which is required to be learnt has in fact been learnt. In the second case, it is acknowledged that assessment may in itself be a powerful driver for learning at quote essay the cognitive level. This is supported by a body of evidence indicating the powerful effect of assessment on strengthening memorisation and recall [ 20 ],[ 22 ],[ 23 ]. In this debate I concentrate primarily on summative assessment in its role as assessment of learning ; one must however remain aware that those methods of study solution assessment best suited to essay such summative assessment may not be identical to those best suited to assessment for learning ; indeed, it would be surprising if they were.

For the first part of the 20 th century, written assessment in jobs, medicine consisted largely of essay-writing [ 30 ]. Multiple-choice assessment was developed for psychological testing by Robert Yerkes immediately before the First World War and then rapidly expanded for the testing of army recruits. Yerkes was interested in quote a song essay, assessing learning capacity—not necessarily human—and applied it to buy a crows [ 32 ] and pigs [ 33 ] as well as psychiatric patients and mentally challenged subjects, a group among whom it was widely used for a number of years thereafter [ 34 ],[ 35 ]. Application to educational assessment has been credited to Frederick J. Kelly in 1914, who was drawn to it by a song in an essay, its efficiency and objectivity [ 36 ]. Throughout its history, the multiple-choice format has had many detractors. Their principal arguments are that closed-ended questions do not stimulate or test complex constructive cognitive processes, and that if the inc case study solution ability to construct rather than choose a correct answer is not actively assessed, there is a potential that it will be neither taught nor learnt [ 37 ]-[ 41 ]. As Rotfield has stated: Students proudly show off their high grades, from multiple-choice exams, as if their future careers will depend on knowing which choice to make instead of discerning which choices exist [ 42 ]. Self-evidently competence demands more complex cognitive processes than factual recall alone. In An Essay! The ability to invoke these higher levels of cognition is clearly a skill which should be explicitly assessed. Is multiple-choice assessment inherently unable to do so, as its detractors have claimed? The belief that open-ended questions test high-order cognitive skills whereas multiple-choice questions do not and that therefore by write about school in french, inference open-ended questions evoke and test a reasoning process which is more representative of real-life problem-solving than multiple-choice, is a song, a serious concern which I address in this review. We begin however with a comparison of the essay on science and politics two formats in terms of reproducibility and feasibility. Reliability and efficiency of a song open-ended and multiple-choice question formats.

Wider sampling greatly increases reproducibility, compensating as it does for unevenness in fiction essay, a candidate’s knowledge, varying quality of questions and even the personality of examiners [ 43 ],[ 44 ]. A Song In An Essay! That the fiction essay writing reproducibility of the multiple-choice format is much higher than that of the open-ended format is in an essay, borne out in numerous studies comparing the two formats [ 45 ]-[ 47 ]. Recognition of these shortcomings has led to the design of inc case study open-ended-formats specifically intended to increase reproducibility and objectivity, while maintaining the supposed advantages of this format in terms of validity. A widely used format in essay, medical assessment is the cooper industries modified essay question (MEQ) . A Song! The format is critical essays character foil, of a clinical scenario followed by a series of quote in an essay sequential questions requiring short answers. This was expressly designed to an essay about your bridge a perceived gap between multiple-choice and SAQ as it was believed that it would prove better at in an essay testing high-order cognitive skills than multiple-choice while allowing for more standardised marking than the critical character foil standard open-ended question [ 45 ]. Yet where these have been compared with multiple-choice, the advantage of the multiple-choice format remains. Quote A Song! A large number of questions and multiple markers are required in order to provide acceptable reliability for MEQs and essay questions [ 45 ]. Even for well-constructed MEQ assessments, studies have shown poor inter-rater reliability. Thus in an MEQ paper in a final undergraduate medical exit examination marked in writing, parallel by several assessors, statistically significant differences between the quote scores of the different examiners were shown in 50% of the questions, as well as significant differences in write your school, the median scores for a song essay, the examination as a whole [ 47 ]. Nor were these differences trivial; a substantial difference in outcome in terms of inc case likelihood of failure were shown. This is cause for concern. Schuwirth et al . have stressed the necessity for interpreting reliability in terms of outcome, particularly in quote in an essay, terms of pass/fail misclassification, and not merely in terms of cooper industries study numeric scores such as Cronbach’s alpha [ 27 ]. Quote! In this and other such studies the open-ended questions were of the highest possible quality practically achievable, typically MEQ's carefully prepared by custom, skilled question writers working in a song in an essay, teams, reviewed for appropriateness and scored using an about analytic scoring scheme designed to minimise inter-rater variability. These conditions do not hold for quote a song in an essay, the standard essay-question or SAQ paper where the reliability will be much lower, and the contrast with multiple-choice correspondingly greater [ 47 ]. Open-ended items scored on a continuum, such as 0-100%, have much lower inter-rater reliability than those scored against write in french a rigid marking schedule. A Song Essay! Therefore the discrepancy in custom, reliability for the graded essay marked on a continuum versus multiple-choice is much larger than it is for more objectively scored open-ended formats. In contrast to the open-ended question format, the multiple-choice is objective and allows multiple sampling of a subject.

The result is high reproducibility. Furthermore it substantially reduces the potential for a song in an, a perception of examiner bias, and thus the essay on science opportunity for legal challenge by quote essay, the unsuccessful candidate [ 48 ]. The multiple-choice format is efficient. Lukhele et al . studied a number of national university-entrance examinations which included both multiple-choice items and essay questions [ 49 ]. They found that 4-8 multiple-choice items provided the same amount of information as a single essay, and that the essay’s efficiency in providing information about the candidate’s ability per minute of testing was less than 10% of that of an average multiple-choice item. For a middle-level examinee, approximately 20 times more examination time was required for an essay to obtain the same information as could be obtained from a multiple-choice assessment. They reported that a 75-minute multiple-choice assessment comprising 16 items was as reliable as a three-hour open-ended assessment.

Though the relative gain in efficiency using multiple-choice in essay, preference to essay questions varies according to subject, it is an invariable finding [ 49 ]. Though the initial development of an multiple-choice assessment is quote essay, labour-intensive, this decreases with increasing experience on and politics, the part of item-writers, and decreases further once a question bank has been developed from which questions can be drawn for re-use. The lower efficiency of the quote in an open-ended question is not restricted to examination time but also the requirement for cooper industries, grading by examiners. Typically an quote a song in an essay open-ended test requires from historical, 4 to 40 times as long to administer as a multiple-choice test of equivalent reliability [ 50 ]. In one study, the cost of marking the open-ended items was 300 times that of the quote a song essay multiple-choice items [ 49 ]; the relative cost of scoring the papers may exceed a factor of 1000 for a large examination [ 50 ]. The multiple-choice format thus has a clear advantage over open-ended formats in terms of reproducibility, efficiency and cost-effectiveness. Why then are open-ended questions still widely used? Principally this is because of a belief that essay-type questions, SAQ and their variants test higher-order cognitive thinking in a manner that MCQ cannot, and consequently have higher validity. Write An Essay About Your School! It has been repeatedly stated that the quote in an essay MCQ format is limited in buy a dissertation online jobs, its ability to test deep learning, and is suitable for quote in an essay, assessing facts only, whereas open-ended questions assess dynamic cognitive processes such as the strength of interconnected rules, the essays foil use of the mental models, and the mental representations which follow [ 37 ]-[ 39 ]; in short that open-ended questions permit the assessment of logical and reasoning skills in a manner that multiple-choice does not [ 40 ],[ 41 ]. Is there evidence to support these assertions? The ability to test higher-order cognitive skills. The revised Bloom's taxonomy of learning [ 9 ]-[ 12 ] is quote in an essay, helpful in evaluating the level of cognition drawn upon by an assessment (Figure 1 ). By convention, assessment questions targeting the first two levels, are regarded as low-level questions, the third level as intermediate, and the fourth to sixth levels as high-level. Those who understand the principles underlying the setting of high-quality multiple-choice items have no difficulty in accepting that multiple-choice is capable of assessing high-order cognition [ 10 ],[ 13 ],[ 14 ]. The shift from true-false questions, (which in buy a online jobs, order to avoid ambiguity frequently test factual information only) to the one-best-answer and EMI formats have facilitated this [ 29 ]. Indeed, there exist well-validated instruments specifically designed to assess critical thinking skills and to measure their development with progress through college-level educational programs, which are entirely multiple-choice based, such as the California Critical Thinking Skills Test [ 51 ],[ 52 ]. Schuwirth and quote Van der Vleuten [ 48 ] make a distinction between context-rich and context-free questions.

In clinical assessment, a context-rich question is typically presented as a case vignette. Information within the vignette is on science and politics, presented to candidates in its original raw format, and they must then analyse, interpret and evaluate this information in order to provide the answer. The stimulus reflects the question which the candidate must answer and is therefore relevant to the content of the question. An example of a final-year question in Internal Medicine is shown in essay, the following example. Such a question requires analysis ( What is the underlying problem? ), application ( How do I apply what I know to the treatment of this patient? ) and evaluation ( Which of several possible treatments is the most appropriate? ), none of buy a dissertation online which can be answered without both knowledge and understanding. Thus 5 of Bloom’s 6 levels have been tested.

Example of a context-rich multiple-choice item in internal medicine. Platelet concentrate infusion. None of the options offered are obviously unreasonable or easily excluded by the candidate who attempts to shortcut the a song in an essay cognitive processes required in answering it by searching for clues in the options themselves. All have a place in the therapy of patients presenting with a variety of similar presentations. Answering this item requires: Analysis . In order to answer this item successfully, the candidate will have to recognise (1) that this patient is highly likely to be HIV-positive (given the lymphadenopathy, evidence of oral candidiasis and the high local prevalence of HIV), (2) that the critical on macbeth's presentation is suggestive of immune thrombocytopenic purpura (given the epistaxis, skin manifestations and very low platelet count), (3) that other commonly-seen concomitant features such as severe bacterial infection and extensive esophageal candidiasis are excluded by a number of negative findings. Evaluation . In An Essay! Further, in order to answer this item successfully, the candidate will have to (1) consider the differential diagnosis for the principal components of the clinical vignette and, by process of critical essays evaluation, decide which are the most likely; (2) decide which of the diagnoses require treatment most urgently, (3) decide which form of therapy will be most appropriate for quote a song essay, this. Knowledge, understanding and application . It is utterly impossible to “recognise” the correct answer to this item without having worked through this process of write school analysis and evaluation, and quote a song in an essay the knowledge required to answer it must clearly be informed by deep learning, understanding and buy a dissertation online jobs application.

Hence five of the six levels of Bloom’s taxonomy have been tested. Furthermore it would appear an eminently reasonable proposition that the candidate who correctly answers this question will indeed be able to manage such a patient in practice, hence implying structural validity. Though guessing has a 20% chance of a song in an essay providing the critical foil correct answer, this will be eliminated as a factor by assessing performance across multiple such items and applying negative marking to incorrect answers. As a general conclusion, it would appear that the open-ended format is not inherently better at assessing higher order cognitive skills than MCQ. The fundamental determinant is the quote essay way in which the question is historical essay writing, phrased in order to in an stimulate higher order thinking; if phrased inappropriately, the open-ended format will not perform any better than MCQ. A crucial corollary is that in comparing formats, it is essential to essays on macbeth's character ensure that MCQ questions crafted to elicit high order thinking (particularly those which are context-rich) are compared with open-ended questions crafted to the same level; it is quote a song essay, inappropriate to custom assignment help compare high-order items in a song in an essay, one format with low order items in the other. Cooper Study! Several studies have investigated the effect of the stimulus on thought processes in a song essay, the open questions and historical have shown that the stimulus format is more important than the response format . Scores on questions in open-ended format and multiple-choice format correlate highly (approaching 100%) for context-rich questions testing the same material. In contrast, low correlations are observed for different content using the a song same question format [ 48 ]. In response to the low objectivity and reliability of the custom assignment classic essay-type questions, modified open-ended formats have evolved which typically combine short answers, carefully crafted questions and rigid marking templates. Yet this increase in reliability appears to come at a significant cost to the presumed advantage of the open-ended format over the multiple-choice format in quote in an, testing higher orders of cognition. Feletti and Smith have shown that as the number of items in the open-ended examination increases, questions probing high-order cognitive skills tend to be replaced by essay, questions requiring factual recall alone [ 46 ]. Hence as accuracy and reliability increase, any difference between such an assessment and quote essay a multiple-choice assessment in terms of other indicators tends to disappear; ultimately they converge on an essay, an essentially identical assessment [ 47 ],[ 49 ].

Palmer and Devitt [ 45 ] analysed a large number of quote a song in an essay multiple-choice and MEQ questions used for summative assessment in a clinical undergraduate exam. The examination was set to a high standard using appropriate mechanisms of review and quality control. Yet they found that more than 50% of both MEQ items and MCQ items tested factual recall while multiple-choice items performed better than MEQ in the assessment of higher-order cognitive skills. They reported that the modified essay question failed in its role of consistently assessing higher cognitive skills whereas the multiple-choice frequently tested more than mere recall of essay on science knowledge”. In a subsequent study of a rigorously prepared and controlled set of exit examinations, they reported that the proportion of quote questions testing higher-level cognitive skills was lower in the MEQ paper then in assignment, the MCQ paper. More than 50% of the multiple-choice items assessed higher level cognition, as opposed to just 25% of the MEQ items. The problem was compounded by quote in an essay, a higher frequency of cooper industries item-writing flaws in the MEQ paper, and flaws were found in the marking scheme in 60% of the quote a song in an MEQ's. The authors conclude that “The MEQ paper failed to achieve its primary purpose of assessing higher cognitive skills” [ 47 ]. We therefore appear to school in french be dealing with a general rule: the more highly open-ended questions are structured with the intention of quote a song essay increasing reliability, the more closely they converge on an equivalent multiple-choice question in custom assignment help, terms of performance, thus negating any potential advantage of the open-ended format over the closed-ended [ 53 ]; indeed they appear frequently to underperform MCQ items in the very area in which they are believed to a song essay hold the advantage. Thus the shift to these newer forms of assessment may actually have had a perverse effect in cooper industries inc case study solution, diminishing the potential for the open-ended assessment to evaluate complex cognitive processes.

This does not imply that open-ended items such as SAQ, MEQ and key-feature assessments, particularly those designed to assess clinical reasoning, are inherently inferior to quote essay MCQ; rather it is a warning that there is a very real risk in practice of “dumbing-down” such questions in historical fiction, an attempt to improve reliability, and empiric observations suggest that this is quote a song in an essay, indeed a consequence frequently encountered even in carefully crafted assessments. Combining multiple-choice and open-ended tests in the same assessment, in the belief that one is improving the strength of the cooper industries study assessment, leads to an overall less reliable assessment than is constituted by the multiple-choice section on its own [ 49 ], thus causing harm rather than adding benefit [ 50 ]. The second argument, frequently advanced in support of the open-ended format, is that it has greater validity; that spontaneously recalling and reproducing knowledge is a better predictor of the student’s eventual ability to handle complex problems in real-life then is the ability to select an answer from a list [ 54 ]. Indeed, this argument is a song, intuitively highly appealing. The case for fiction essay, the retention of open-ended questions in in an, medical undergraduate and postgraduate assessment largely rests on validity, with the assumption that asking the candidate to describe how they would diagnose, investigate and treat a patient predicts future clinical competence more accurately than does the ability to select the right response from a number of options [ 55 ],[ 56 ]. The question of validity is central. If the open-ended format is genuinely of higher validity than the inc case study solution multiple-choice format, then there is a strong case for retaining essay-type questions, SAQ and MEQ in the assessment protocol.

If this contention cannot be supported, then the quote a song justification for retaining open-ended items in summative assessment may be questioned. Is the contention true? Essentially, this may be explored at assignment two levels. The first is to correlate outcomes between the two formats. Quote In An Essay! The second is to perform appropriate statistical analysis to historical essay writing determine whether these formats are indeed testing different dimensions or “factors”.

Validity is an quote a song indicator of how closely the assessment actually measures the quality it purportedly sets out to test. It is on science, self-evident that proficiency in many domains, including clinical practice, requires not only the quote essay ability to recall factual knowledge, but also the critical essays ability to generate and test hypotheses, integrate knowledge and apply it appropriately as required. Modern conceptualisations of validity posit a single type; namely construct validity [ 57 ]-[ 59 ]. This is quote in an essay, based on the premise that ultimately all validity rests on write an essay about your, the fidelity with which a particular assessment reflects the underlying construct, “intangible collections of abstract concepts and principles which are inferred from behaviour and explained by educational or psychological theory” [ 60 ]. Construct validity is then defined as a process of investigation in which the constructs are carefully delineated, and evidence at a song in an essay multiple levels is sought which supports a valid association between scores on that assessment and the candidate's proficiency in terms of essays character foil that construct. For example, five types of quote a song in an evidence have been proposed which may provide support for such an association [ 60 ],[ 61 ], namely content, the assignment response process, internal structure, relationship to other variables and quote in an consequences. In this discussion we highlight the relevant to the last two methods; convergent correlations between the two forms of assessment, and essay on science the impact of test scores on later performance, particularly that requiring problem-solving under conditions encountered in the work situation. This “is particularly important to those employers more interested in quote essay, hiring competent workers than good test takers” [ 62 ]. Direct comparisons of the open-ended and multiple-choice formats. Numerous studies have assessed the correlation of scores between the two formats. If scores are highly correlated, the two formats are essentially measuring the same thing in which case, in terms of assignment validity, there is no advantage of one over the other.

With few exceptions, studies indicate that scores on the two forms of in an assessment are highly correlated. Norman et al. compared the two formats prospectively and dissertation showed a strong correlation between the in an essay two sets of on macbeth's character foil scores [ 63 ]. A similar result was found by Palmer et al. Quote! who suggested that the two types of examination were essentially testing similar characteristics [ 47 ]. Critical Foil! Similarly Norcini et al. found that written patient management problems and multiple choice items appeared to quote essay be measuring essentially the same aspects of clinical competence, though the multiple-choice items did so more efficiently and with greater reliability [ 17 ]. Similar results have been obtained in fields as diverse as economics and marketing [ 64 ],[ 65 ]. In general correlations between the cooper industries two formats are higher when the questions in each format are specifically designed to be similar (stem-equivalent), and lower where the a song in an essay items in the two formats differ. About Your School! However, the difference is not great: in a meta-analysis, Rodriguez found a correlation across 21 studies of 0.92 for quote essay, stem-equivalent items and 0.85 across 35 studies for non-stem-equivalent items. The scores may not always be identical, but they are highly correlated [ 53 ],[ 65 ]. Factor analysis: do the formats measure more than one construct? Identification of the essay and politics actual constructs measured in an assessment has proved challenging given the lack of congruence between the simple cognitive assumptions on quote a song in an essay, which testing is often based and the very complex cognitive nature of the constructs underlying understanding [ 66 ]. A number of studies have used confirmatory factor analysis and on science and politics principal component analysis to determine whether the constructs tested by the two formats lie along a single dimension or along two or more divergent dimensions. Bennett et al . compared a one factor model with a two factor model to examine the in an essay relationship of the open-ended and closed-ended formats and found that in general the single factor provided a better fit. This suggests that essentially the cooper inc case solution two formats are testing the same thing [ 67 ]. Similarly Bridgeman and Rock found, using a principal components model, that both formats appeared to load on the same factor, implying that the open-ended format was not providing information on a different dimension [ 68 ]. Thissen and Wainer found that both formats could largely be ascribed to a single shared factor but did find some specific open-ended factors for a song in an essay, which only the open-ended items contributed [ 69 ]. Though Lissitz et al . [ 70 ] quote a study by JJ Manhart, which found a two-factor model generally more appropriate than a one factor model, this study has not been published and study solution the significance of the divergence cannot be assessed. In a study of quote essay high school assessments using confirmatory factor analysis, Lissitz et al. showed a correlation of 0.94 between the two formats in the domains of algebra and biology; a two-factor model provided a very slight increment over a one-factor model in terms of fit. In the case of an English language assessment the correlation was lower at 0.74 and a two-factor model provided a better fit.

In a test of essays on macbeth's foil US government, intermediate results were found with the correlation of quote a song in an essay 0.83 and a slight superiority of a two-factor model. This suggests that the addition of open-ended items in biology and algebra provided little further information beyond the multiple-choice items, whereas in other domains—English and government—the two formats are to some degree measuring different constructs [ 70 ]. Indeed, the literature in general suggests that differences in format appeared to be of little significance in the precise sciences such as biology and mathematics, but may have some relevance in fields such as history and languages, as suggested by Traub and Fisher [ 71 ]. In summary, there is little evidence to support the belief that the custom help open-ended format is essay, testing dimensions which the historical essay writing multiple-choice format cannot [ 53 ],[ 70 ],[ 72 ]. Construct validity was specifically assessed by Hee-Sun et al . [ 73 ], who attempted to measure the depth of understanding among school-level science students revealed by multiple-choice and short written explanatory answers respectively. In An! They reported that students who showed higher degrees of knowledge integration were more likely to score highly on multiple-choice, though the reverse did not hold true. They suggested that the multiple-choice items were less effective in distinguishing adjacent grades of assignment understanding as opposed to distinguishing high-performance from a song in an essay, low performance, a finding similar to that of Wilson and Wang [ 74 ] and on macbeth's Ercikan et al . [ 75 ]. Unfortunately the generalisability of these results is limited since the multiple-choice items were poorly standardised, both in quote a song in an, format and in difficulty, and the circumstances under which the dissertation online testing was conducted were essentially uncontrolled.

Lukhele et al . performed a rigorous analysis of high-quality university placement exams taken by thousands of candidates [ 49 ]. They found that both formats appeared to be measuring essentially the same construct. There was no evidence to suggest that the open-ended and multiple-choice questions were measuring fundamentally different things—even in areas as divergent as chemistry and history. Quote A Song In An! Factorial analysis suggested that there were two variant dimensions reflected in the scores of the multiple-choice and open-ended sections, one slightly more related to multiple-choice and the other to the open-ended format. However these were highly correlated, whatever the factor is that is essay on science, specifically measured by a song in an, the open-ended format, multiple-choice would measure it almost as well. Thus for all practical purposes, in cooper industries solution, such summative assessments, multiple-choice assessments can satisfactorily replace open-ended assessments. Stylized depiction of the contrasting ability of the presumed open-ended and essay multiple-choice formats to assess recognition and recall as opposed to write about in french higher forms of quote a song essay cognitive learning. Ideally, multiple-choice and dissertation jobs open-ended questions would measure two different abilities (such as recall/recognition versus reasoning/application) – this may be shown as two divergent axes (shown on left). The error variance associated with each type of question is indicated by the shaded blocks, and quote is much greater for the open-ended question, given its inherent lower reliability. In practice, it appears that the two axes are closely aligned, implying that the two types of questions are measuring essentially the same thing (shown on right).

What little additional information the fiction open-ended question might be giving (as shown by a slight divergence in axis) is offset by its wide error variance, which in in an, effect overlaps the information given by the multiple-choice question, thus significantly reducing the value of custom help any additional information it provides. In summary, where studies have suggested that the open-ended format is measuring something that multiple-choice does not (particularly in quote essay, older studies), the help effect has tended to be minimal, or possibly explicable on methodological grounds, or indefinable in terms of what is actually being measured. In contrast, methodologically sound studies converge on the conclusion that the difference in validity between the two formats is trivial. This is the conclusion drawn by Rodriguez in a meta-analysis of 21 studies [ 53 ]. Demonstrating an quote a song in an essay essential similarity for the two formats under the conditions of summative assessment does not necessarily mean that they provide identical information. It is possible and indeed likely that open-ended questions may make intermediate steps in thinking and understanding visible, thus serving a useful role in diagnostic as opposed to help summative assessment [ 73 ],[ 75 ],[ 76 ]. Such considerations are particularly useful in using assessment to guide learning rather than merely as a judgment of competence [ 77 ]. In summative assessment at a stage prior to final exit from a programme, and particularly in formative assessment, the a song in an essay notion of assessment for learning becomes important; and considerations such as the generation effect and the potentiation of memory recall by testing cannot be ignored. Interestingly, a recent publication suggests that multiple-choice format testing is as effective as SAQ-format testing in on science, potentiating memorisation and recall [ 23 ], thus supporting the contention that well-crafted MCQ and a song in an essay open-ended questions are essentially stimulating the same cognitive processes in the learner. Some authors have raised the critical on macbeth's character concern that students may constitutionally perform differentially on the two forms of assessment, and might be disadvantaged by a multiple-choice assessment should their strengths lie in the open-ended format. Studies in this area have been reassuring. Bridgeman and Morgan found that discrepant results were not predictive of poor academic performance as assessed by other parameters [ 78 ]. In An Essay! Ercikan et al . reported that discrepancies in the outcome between open-ended and multiple-choice tests were largely due to the low reliability of the open-ended component and custom assignment help inappropriate testing strategies [ 75 ]. A study which correlated the two formats with each other and with other measures of student aptitude showed a high degree of correlation and a song was unable to identify students who clearly had a propensity to perform consistently better on help, one format than the other [ 79 ]. Thus the belief that some students are constitutionally more suited to quote essay open-ended questions than to write your in french multiple-choice would appear to be unfounded.

An important question is whether the quote a song format of assessment effects the type of buy a dissertation online learning students use in preparation for a song in an, it. As early as 1971, Hakstian suggested that anticipation of custom assignment a specific form of examination did not result in any change in the amount or type of preparation, or any difference in performance in quote, subsequent testing [ 80 ]. Custom! He concluded as follows: “The use of various types of a song essay tests to historical essay foster various kinds of study and a song essay learning, although widely advocated would seem to be a practice based on intuitive appeal, but not convincingly supported by empirical research. In particular, the contention that the superiority of the essay examination is its ability to promote more desirable study methods and higher performance on tasks requiring organisation, and deeper comprehension analysis of information should be re-evaluated in light of the evidence in the present study of online jobs no differences between groups in terms of study methods, the in an essay essay examination, or items from the online jobs higher levels of the cognitive domain”. In fact, the relationship between assessment format and learning styles remains ill-defined. Though some studies have suggested that students tended to make more use of surface learning strategies in preparation for a song, MCQ and deeper learning strategies in essay on science and politics, preparation for open-ended questions [ 81 ],[ 82 ], other studies have failed to show such an association [ 80 ],[ 83 ]. Some studies have even failed to show that deep learning approaches correlated with better performance in applied MCQ’s and a written course project, both of which required high level cognitive performance [ 84 ],[ 85 ], though, a significant finding was that a surface learning strategy appeared deleterious for both factual and applied MCQ scores [ 85 ]. Indeed, a review of the literature on learning strategies suggests that the a song essay notion that one or other assessment format consistently calls forth a particular learning strategy is writing, simplistic, and much of the evidence for this may have been misinterpreted [ 86 ]. The student’s choice of learning style appears to be dependent on multiple interacting and to some extent, confounding factors, most importantly the student’s innate learning motivation and preferred learning strategy. This is however subject to a song modification by other factors, particularly the student’s own perception of whether the assessment is directed at custom assignment assessment of factual knowledge or of understanding, a perception which may frequently not coincide with the intentions of the examiner [ 87 ]. Individual differences in learning strategy probably outweigh any other consideration, including the assessment format, though this is not constant and students will adapt their preferred learning strategy according to their perception of the requirement for a particular assessment [ 88 ]. A further study has suggested that the approach to learning the student brings into the course is the strongest predictor of the learning style they will employ subsequently and, irrespective of the instructor’s best efforts, the only factor significantly correlated with the change in learning style is a change in the student’s perception of the cognitive demands of the assessment. Thus students are frequently strategic in their choice of quote essay learning strategy, but the strategies may be misplaced [ 87 ]. Jobs! The student’s academic ability may be relevant; one study has shown that more academically able science students correctly identified the MCQ as requiring deep knowledge and adopted an appropriate learning strategy, whereas less able students interviewed the assessment as principally a test of recall and used a counter-productive surface-learning strategy. Hadwin et al . have stressed the major influence of context on choice of assessment strategy [ 88 ]. There is for example evidence that students will modify their strategy according to whether the essay assessment is perceived as a final examination or as an interim assessment, irrespective of format [ 81 ]. So-called construct-irrelevant factors such as female gender and increasing maturity tend to correlate with selection of a deep learning strategy [ 85 ] independent of assessment format, while the association of anxiety and other emotional factors with a particular assessment will impair performance and thus operate as a confounding factor [ 89 ],[ 90 ]. In discussing their results, Smith and Miller stated that “Neither the and politics hypothesis that multiple-choice examination will promote student use of surface strategy nor the hypothesis that essay examination will promote student use of deep strategy were supported” [ 91 ]. As a general conclusion, it would appear valid to say that current evidence is insufficient to suggest that the open-ended format should be preferred over MCQ or vice versa on the grounds that it promotes more effective learning strategies. It is quote a song, also important to be aware that open-ended assessments may bring confounding factors into buy a online jobs, play, for example testing language mastery or skills rather than the intended knowledge domain itself [ 70 ], and hand-written answers also penalise students with poor writing skills, low writing speeds and poor handwriting [ 65 ].

In comparison with the multiple-choice format, is the open-ended format superior in predicting subsequent performance in a song, the workplace? This has been assessed and the answer, surprisingly, is that it may be less predictive. Rabinowitz and Hojat [ 92 ] correlated the single MEQ assessment and historical fiction essay five multiple-choice assessments written at the conclusion of a series of six clerkships with performance after graduation. In An Essay! Results in multiple-choice assessment consistently demonstrated the highest correlations with subsequent national examination scores and with objective assessments of performance in the workplace. And Politics! The MEQ questions showed the lowest correlation. Wilkinson and Frampton directly compared an assessment based on a song in an essay, long and write an essay about your short essay-type questions with a subsequent assessment protocol containing short essay questions and two multiple-choice papers [ 56 ], correlating these with performance in the subsequent internship year using robust rating methodologies. They found no significant correlation between the scores of the open-ended question protocol and assessments of performance in the workplace after graduation. In contrast they found that the combination of the SAQ paper and two multiple-choice papers showed a highly significant correlation with subsequent performance. This study showed that the predominant use of multiple-choice in the assessment resulted in a significant improvement in the structural validity of the assessment in comparison with essay-type questions alone. It was unable to answer the question as to whether the quote essay open-ended questions are necessary at all since the multiple-choice component was not compared with the performance rating independently of the essay questions. These authors conclude that that the change from the open-ended format to the multiple-choice format increased both validity and reliability.

Recommendations from the your school in french literature. Wainer and Thissen stated that: “We have found no evidence of any comparison of the efficacy of the two formats (when a particular trait was specified and skilled item writers then constructed items to quote a song in an essay measure it) in which the multiple-choice item format was not superior” [ 50 ]. Lukhele et al . Assignment Help! concluded: “Thus, while we are sympathetic to… the arguments… regarding the advantages of open-ended format, we have yet to see convincing psychometric evidence supporting them. We are awash in evidence of their drawbacks”, and further, “… We are forced to essay conclude that open-ended items provide this information in on science and politics, more time at greater cost than the multiple-choice items. This conclusion is surely discouraging to a song in an essay those who feel that open-ended items are more authentic and, hence, in some sense, more useful than multiple-choice items. It should be” [ 49 ]. Palmer et al . have suggested that the MEQ should be removed from the exit examination [ 47 ]. Given that MEQ's are difficult to write to a high standard and in writing, such a way that they test high-order cognitive skills, and quote a song in an given the time required and the subjectivity in marking, their use does not represent an efficient use of essay and politics resources. Indeed, they state “… MEQ's often do little more than test the candidate's ability to quote a song in an recall a list of critical essays on macbeth's facts and frustrate the examiner with a large pile of quote in an essay papers to your in french be hand-marked”. They conclude there is no good measurement reason for including open-ended items in the high-stakes assessment, given that the quote in an MEQ performed poorly in terms of testing high-order thinking in comparison with the fiction essay multiple-choice despite considerable effort to produce quality questions.

Schuwirth and quote essay Van der Vleuten too have suggested that there is no justification for the use of SAQ in assessment, since the stimulus of most SAQ can also be applied with multiple-choice. They recommend that SAQ should not be used in any situation except where the spontaneous generation of the answer is essay and politics, absolutely essential. Furthermore, they believe that there is little place for a song in an, context-free questions in medical assessment as the context-rich stimulus approximates clinical practice more closely [ 48 ]. Why does the open-ended format persist in medical assessment? Hence the evidence suggests that in written summative assessment the multiple-choice format is no less able to test high-order thinking than open-ended questions, may have higher validity and is superior in essays on macbeth's foil, reliability and cost-effectiveness. Remarkably this evidence extends as far back as 1926 [ 53 ],[ 93 ], and the reasons underlying the quote in an essay persistence of the open-ended format in assessment are of essay some interest. I suggest a number of factors.

Studies bear out the common-sense expectation that questions designed to test factual knowledge only—irrespective of whether these are presented as open-ended or in multiple-choice format—do not test the same level of reasoning as more complex questions [ 94 ]. Indeed, a recurring finding in quote essay, the literature is that the so-called deficiencies of the multiple-choice format lie more with the quality of the individual question item (and by inference, with the write school question-setter), than with the format per se . Quote A Song Essay! This leads to a self-fulfilling prophecy: examiners who do not appreciate the versatility of the multiple-choice format set questions which only test low-order thinking and not surprisingly achieve results which confirm their bias. Industries Study Solution! Palmer et al. state that criticism of multiple-choice as being incapable of testing high-order thinking is in fact criticism of a song poorly written questions, and on macbeth's that the quote in an essay same criticism can be directed at open-ended assessments [ 45 ]. There is indeed evidence that stem-equivalent items tend to historical fiction essay writing behave similarly, irrespective of whether the item is quote a song essay, phrased as an open-ended question or in MCQ format. It is therefore essential that in making comparisons, the items compared are specifically crafted to write about school in french assess the a song essay same order of cognition. As Tanner has stated, any assessment technique has its limitations; those inherent in multiple-choice assessment may be ameliorated by careful construction and thoughtful analysis following use [ 95 ]. Second, it would appear that many educators are not familiar with much of the historical fiction essay writing literature quoted in this discussion. The most persuasive material is found in the broader educational literature, and though there are brief references in the medical education literature to some of the studies to which I have referred [ 47 ],[ 48 ], as well as a few original studies performed in the medical assessment context [ 17 ],[ 45 ],[ 47 ],[ 63 ], the issue does not appear to have enjoyed prominence in quote essay, debate and has had limited impact on actual assessment practice. In their consensus statement and recommendations on research and assessment, Schuwirth et al. stress the need for cooper inc case solution, reference beyond the a song in an essay existing medical education literature to critical essays on macbeth's relevant scientific disciplines, including cognitive psychology [ 27 ]. In the teaching context, it is remarkable how the a song essay proposition that the assignment help open-ended format is more appropriate in testing the knowledge and skills ultimately required for quote a song essay, the workplace has been repeatedly and uncritically restated in the literature in the absence of compelling evidence to dissertation support it. Third is the counter-intuitiveness of this finding.

Indeed, the proposition that the open-ended format is more challenging than MCQ is intuitively appealing. Furthermore, there is the “generation effect”; experimental work has shown that spontaneous generation of information, as opposed to reading enhances recall [ 18 ],[ 19 ]. Although this applies to quote essay learning rather than to fiction writing assessment, many teachers implicitly attribute a similar but reversed process to the act of recall, believing that spontaneous recall is more valid than cued recall. However, validity at face value is an unreliable proxy for true validity, and quote a song essay the outcome in practice may contradict what seems intuitively correct [ 48 ]. As the literature on learning increases, it has become apparent that evidenced-based practice frequently fails to assignment help coincide with the intuitive appeal of a particular learning methodology. Examples include the observation that interleaved practice is more effective than blocked practice and distributed practice is more effective than massed practice in promoting acquisition of quote a song skills and historical fiction writing knowledge [ 21 ]. There is a need for assessment to be evidence-based; to an extent assessment would appear to lag behind learning and in an essay teaching methodology in this respect. Rohrer and Pashler have suggested that underutilisation of cooper inc case study solution learning strategies shown to a song in an essay be more effective than their traditional counterparts, such as learning through testing, distributed practice and interleaved practice, remain so because of “the widespread (but erroneous) feeling that these strategies are less effective than their alternatives” [ 21 ]. Fourth and study perhaps most defensible is concern that there is much that as yet remains unknown about the nature of assessment; particularly seen from the a song viewpoint of assessment for learning, and given very interesting new insights into the cognitive basis of memorisation, recall and reasoning, a field which is as yet largely unexplored, and may be expected to have a significant impact on the choice of assessment format. Essay Writing! For diagnostic purposes, the open-ended format may hold value, since it is better able to expose the students intermediate thinking processes and therefore allow precise identification of learning difficulties [ 72 ]. Newer observations such as the quote generation effect [ 18 ],[ 19 ], the testing effect [ 20 ],[ 23 ], the preassessment effect, where the act of preparation for an assessment is custom help, itself a powerful driver of learning [ 96 ], and the post-assessment effect, such as the quote a song effect of feedback [ 96 ] are clearly important; were it to dissertation online jobs be shown that a particular format of assessment, such as the open-ended question, was superior in driving learning, then this would be important information which might well determine the choice of assessment. Quote A Song Essay! At this point however no such reliable information exists. Critical Essays On Macbeth's Character Foil! Preliminary work suggests that MCQ items are as effective as open-ended items in promoting the testing effect [ 23 ]. None of these considerations are as yet sufficiently well supported by experimental evidence to argue definitively for the inclusion of open-ended questions on the basis of their effect on learning, though the possibility clearly remains. Furthermore, this debate has concentrated on high-stakes, summative exit assessments where the in an essay learning effects of assessment are presumably less important than they are at other stages of learning. Certainly, open-ended assessment remains appropriate for those domains not well-suited to multiple-choice assessment such as data gathering, clinical judgement and professional attitudes [ 92 ] and may have value for a particular question which cannot be presented in any other format [ 48 ]. Cooper Study! Though the evidence is less compelling, open-ended items may be superior in distinguishing between performances of candidates occupying the two extremes of quote a song performance [ 75 ].

Cognitive basis for on macbeth's foil, the observation. The need for assessment of research to move beyond empiric observations to quote a song studies based on a sound theoretical framework has recently been stressed [ 27 ],[ 96 ]. There is as yet little written on the reasons for the counter-intuitive finding that MCQ is as valid as open-ended assessments in predicting clinical performance. Cooper Industries Inc Case Study! I suggest that the observation is highly compatible with cognitive-constructivist and a song in an situated learning theory, and in particular the theory of conceptual change [ 97 ]. Write About Your In French! Fundamental to this theory is the concept of mental models. These are essentially similar to schemas, but are richer in that they represent knowledge bound to situation and context, rather than passively stored in the head [ 98 ]. Mental models may therefore be thought of as cognitive artifacts constructed by an individual based on his or her preconceptions, cognitive skills, linguistic comprehension, and perception of the problem, which evolve as they are modified through experience and in an essay instruction [ 99 ]. Conceptual change is postulated to school in french represent the quote a song essay mechanism underlying meaningful learning, and is a process of progressively constructing and organizing a learner’s personal mental models [ 100 ],[ 101 ]. Assignment! It is a song in an, suggested that an effective mental model will integrate six different aspects: knowledge appropriately structured for a particular domain (structural knowledge), pathways for solving problems related to the domain (procedural knowledge), mental images of the system, associations (metaphors), the ability to know when to activate mental models (executive knowledge), and assumptions about the problem (beliefs) [ 102 ]. Therefore increasing proficiency in any domain is associated not just with an enlarging of store of knowledge and experience, but also with increasing complexity in the extent to which knowledge is organised and an essay your the manner in which it is stored and accessed [ 103 ], particularly as complex mental models which may be applied to problem-solving [ 104 ]. A counterpart in the domain of medical expertise is the hierarchy of constructs proposed by Schmidt et al . elaborated causal networks, knowledge encapsulation and illness scripts [ 105 ],[ 106 ]. Conceptual change theory has a clear relationship to our current understanding of quote in an expertise, which is postulated to emerge where knowledge and concepts are linked as mental representations into propositional networks which allow rapid processing of information and industries the omission of intermediate steps in reasoning [ 107 ],[ 108 ]; typically the expert’s knowledge is grouped into discrete packets or chunks, and manipulation of these equates to the manipulation of a large amount of information simultaneously without conscious attention to any individual component [ 104 ]. In comparison with non-experts, the representations of experts are richer, more organised and abstract and in an are based on help, deep knowledge; experts also recognise the conditions under which use of particular knowledge is appropriate [ 109 ]. As Norman has stated, “expert problem-solving in medicine is a song essay, dependent on (1) prior experiences which can be used in routine solution of problems by pattern recognition processes and (2) elaborated conceptual knowledge applicable to the occasional problematic situation ” [ 110 ]. The processes of building expertise and that of constructing mental models are essentially parallel [ 99 ]. Therefore any form of assessment intended to measure proficiency must successfully sample the candidate’s organisation of and access to knowledge, and your in french not just content knowledge alone [ 99 ],[ 111 ]. I have reviewed the empirical evidence which suggests that the quote a song multiple-choice format is indeed predictive of proficiency, which provides important evidence that it is essay and politics, valid. This is explicable in terms of mental models. An alternative view of a mental model is as an internal representation of a system that the learner brings to bear in a problem-solving situation [ 103 ],[ 104 ],[ 112 ]. The context-rich written assessment [ 48 ] is quote, essentially an essay and politics exercise in complex problem-solving, and essay fits the definition of problem-solving as “cognitive processing aimed at accomplishing certain goals when the solution is unknown” [ 103 ],[ 113 ]. Zhang has introduced the concept of custom assignment a “distributed cognitive task”: a task requiring that information distributed across both the essay internal mind and the external environment is processed [ 114 ]. If we extend Zhang’s concept of external representation to include a hypothetical patient, the subject of the write about in french clinical vignette, who represents the class of all such patients, then answering the context-rich multiple-choice item may be seen as a distributed cognitive task. The candidate must attempt to call forth an appropriate mental model which permits an effective solution to the complex problem. Quote A Song! In a sequence of events which parallels that described by Zhang, the candidate must internalise the information provided in the vignette, form an accurate internal representation (an equivalent concept is that of the problem space, a mental representation of the about your school in french problem requiring solution [ 115 ]); this in turn activates and interacts with the relevant mental models and is followed by quote in an, externalization: the return of the product of the interaction of internal representation and mental model to the external environment, and essay the selection of a solution. In effect a relationship has been defined between environmental information, activation of higher level cognition and externalisation of internal representations [ 114 ].

Assessment items which require complex problem-solving call on mental models appropriate to that particular context, and the item can only quote a song be answered confidently and custom assignment correctly if the mental model is essay, present at the level of proficiency. There is therefore no such thing as the student with generic expertise “in answering multiple-choice questions”, which explains the findings of Hakstian [ 80 ], Bridgeman and Morgan [ 78 ], Ercikan et al. [ 75 ] and Bleske-Rechek et al . [ 79 ], none of whom found convincing evidence for the existence of a class of student with a particular skill in answering multiple-choice questions. Recent observations that retrieval of knowledge improves retention, and may be enhanced in critical essays, the learning process by frequent testing [ 20 ],[ 21 ], and in particular a recent publication summarising four studies performed in an authentic learning environment which demonstrates that that testing using MCQ format is as effective as SAQ testing [ 23 ], supports the hypothesis that the MCQ format engages with high order cognitive processes, in both learning and retrieval of memory. This is further supported by their finding that high-level test questions stimulate deeper conceptual learning and quote essay better learning retention then do low-level test questions [ 23 ]. In summary, the your school multiple-choice item is testing the quote essay integrity and appropriateness of the candidate’s mental models, and in on science, doing so, is in fact assessing proficiency. If the item is designed to quote a song essay test factual recall only then it will fail for this purpose, since it is the solution of a complex problem which tests the strength of the mental model and the cognitive processes which interact with it.

Yet even a low-quality assessment based on factual recollection will correlate significantly with proficiency. Firstly, all mental models are based on industries inc case study solution, a foundation of structural knowledge. Quote Essay! The subject with sound mental models must therefore possess a good knowledge base. Secondly, possessing effective and appropriate mental models facilitates the retention and recall of knowledge [ 103 ]. Not surprisingly therefore, even on a fact-based assessment, good students will correctly recall the information and excel; students with deficient mental models, are less likely to be able to recall the information when needed. This is supported by the work of Jensen et al . [ 116 ] who found that high order questions stimulated deep conceptual understanding and retention, and historical fiction essay writing correlated with higher performance on both subsequent high order assessment items and low-order assessment items. Quote! Indeed, recognition and recall are highly correlated [ 50 ]. There is evidence that the cognitive processes evoked by the multiple-choice format are not influenced by cueing [ 117 ], though the reasons for the frequent observation that MCQ scores are higher than those for equivalent open-ended item assessments raise concern that cueing may yet have a role [ 118 ]. An Essay About! However, where the stem and options have been well-designed?particularly such that the essay distractors all appear attractive to the candidate without the requisite knowledge? cueing should not be an issue [ 29 ],[ 48 ], and the common argument that it is easier to recognize an industries study answer than it is to generate it spontaneously would appear not to a song essay hold true. Problem-solving skills are poorly generalizable [ 41 ]. This is explicable in that mental models are essentially domain-specific, representing a particular set of knowledge and circumstances, but the actual process of developing them is highly dependent on domain-general processes including metacognition, self-regulation and cognitive flexibility [ 99 ].

I suggest that the problem with many assessments in fiction, the MEQ format is that they are essentially linear. By requiring the candidate to think one step at a time, the assessment effectively misses the crux of the quote a song in an essay problem-solving process, which is to look at and respond to a complex problem in its entirety, and not stepwise. The context-rich vignette-based multiple-choice item by contrast presents a complex problem which must be holistically assessed. Thus it requires a form of cognitive processing which mirrors that associated with actual proficiency. Hybrid formats such as key feature assessments in effect also break down the clinical reasoning process into a sequence of sequential steps; whether this is regarded as a drawback will depend on the relative importance ascribed to decision-making at critical points in the decision tree and assignment global assessment of a problem viewed holistically. This is a critical area for in an essay, future research in custom, clinical reasoning.

Educators who mistrust the multiple-choice format have tended to concentrate on the final, and cognitively the least important, step in this whole process: the quote in an selection of a particular option as the answer, while ignoring the complex cognitive processes which precede the selection. Character Foil! Indeed, in a good assessment, the candidate is not “selecting” an a song answer at all. They recognise the external representation of a problem, subject the internalised representation to high level cognitive processing, and then externalise the product as a solution [ 119 ], which (almost as if coincidentally) should coincide with one of the options given. The multiple-choice format is by cooper inc case solution, no means unlimited in its capacity to test higher-order thinking. The literature on problem-solving stresses the importance of highly-structured complex problems, characterised by unknown elements with no clear path to quote a song essay the solution and indeed a potential for there to be many solutions or even no solution at all [ 99 ]. The standard multiple-choice item by help, definition can only have one solution. Thus, though it may be context-rich, it is limited in its complexity.

It is difficult however to imagine how a practically achievable open-ended written assessment might perform better. In order to quote a song essay accommodate complexity, the question would essentially have to critical essays on macbeth's be unstructured—thereby eliminating all the structured short-answer progeny of the essay format, such as MEQ. In order to permit the candidate to freely demonstrate the application of all his or her mental resources to a problem more complex than that permitted by a multiple-choice vignette, one would in a song in an essay, all probability require that the candidate is afforded the opportunity to develop an extensive, unstructured and essentially free-ranging, essay-length response; marking will be inherently subjective and cooper industries solution we are again faced with the problem of narrow sampling, subjectivity and low reliability. In effect the choice would then lie between an quote a song in an essay assessment comprising one or two unstructured essay length answers with low objectivity and reliability, and a large number of highly reliable multiple choice items which will effectively test high-order problem-solving, but will stop short of a fully complex situation. Perhaps this is a restatement of the assertion that “measuring something that is not quite right accurately may yield far better measurement than measuring the right thing poorly” [ 50 ], the situation depicted in Figure 3 . Expected performance in a well-structured context-rich multiple-choice assessment requiring complex problem-solving. Knowledge lacks structure and is essentially context-free. Concepts and relationships are of poor quality. The candidate will be unable to industries study solution identify or contextualise the problem. His or her ability is effectively limited to answering items which require factual recall only— provided they possess that knowledge. Situated knowledge is present but cannot be prioritised appropriately for the problem.

Though the problem may be recognised, the candidate will be unable to represent it internally or activate a mental model with sufficient fidelity for problem-solving. Is able to quote a song extract the key elements from the problem and possesses many or most of the concepts required for application to the problem, but the relationship between these may not yet be fully mature. The candidate will recognise the problem and respond appropriately to it, but may struggle to prioritise and evaluate elements appropriately because of the immature relationships between concepts. Immediately recognises the problem and online is able to accommodate it fully in a mental model which permits a solution. Will recognise the problem, identify, evaluate and a song in an prioritise all the elements necessary for a solution, thus arriving at the correct answer. Understands and responds to the situation intuitively, using tacit knowledge arising from extensive experience. Is able to on macbeth's character foil answer the question intuitively with minimal analysis or thinking.

The first column comprises the quote a song in an essay stages of learning proposed by Dreyfus and cooper industries study solution Dreyfus [ 16 ]; in this context, we shall regard stage of learning as synonymous with level of proficiency or expertise, which is a measure of the a song effectiveness of problem-solving skill. The second column contains descriptors for each stage chosen for their relevance to complex problem-solving posed by a well-constructed context-rich multiple-choice item. Dissertation Jobs! The third column contains a description of the quote a song essay likely performance on that item of a candidate at that stage of proficiency. The relationship between proficiency and performance in essay and politics, a complex multiple-choice item is in in an essay, fact remarkably direct. The debate may also be reformulated to incorporate the appropriateness of learning. Deep learning is characterised by an understanding of the cooper study meaning underlying knowledge, reflection on the interrelationships of items of information, understanding of the application of knowledge to everyday experience, integration of information with prior learning, the in an essay ability to differentiate between principle and example and the organisation of knowledge into critical on macbeth's character foil, a coherent, synthetic structure [ 99 ],[ 100 ]—essentially an quote in an essay alternative formulation of the mental model. One can thus argue that the buy a online candidate who possesses deep knowledge has, by the very fact of that possession, demonstrated that they have the quote a song in an sort of comprehensive and intuitive understanding of the on science subject—in short, the appropriate mental models as described by Jonassen and Strobel [ 97 ],[ 101 ]—to allow the information to be used for problem-solving. Correspondingly, the weak student lacks deep knowledge, and quote this will be exposed by a well-constructed multiple-choice assessment, provided that the essay items are written in a manner which explores the higher cognitive levels of learning. Therefore, if candidates demonstrate evidence of extensive, deeply-learned knowledge, and the ability to quote in an essay solve complex problems, be it through the medium of essays on macbeth's character foil multiple-choice assessment or any other form of assessment, then it is quote in an, safe to assume that they will be able to apply this knowledge in practice. This accounts for write an essay your school, the extensive correlation noted between multiple-choice performance, performance in quote a song essay, open-ended assessments, and tests of subsequent performance in an authentic environment. The argument that open-ended questions do not test higher order cognitive skills, and consequently lack validity, is on science, not supported by quote in an, the evidence.

Some studies may have been confounded by the unfair comparison of high-order items in one format with low-order items in another. This cannot be discounted as partly responsible for the discrepancies noted in some of the work I have referenced, such as that of Hee-Sun et al . [ 73 ], yet where the cognitive order of the items have been carefully matched, a number of careful studies suggest that, particularly in about your school in french, science and medicine, the two modalities assess constructs which though probably not identical, overlap to the extent that using both forms of assessment is redundant. Given the advantage of the a song essay multiple-choice format in reliability, efficiency and cost-effectiveness, the suggestion that open-ended items may be replaced entirely with multiple-choice items in summative assessment is one which deserves careful consideration. This counter-intuitive finding highlights our lack of understanding of the cognitive processes underlying both clinical competence and its assessment, and industries inc case solution suggests that much further work remains to be done. Despite the MCQ format’s long pedigree, it is clear that we understand little about the quote essay cognitive architecture invoked by this form of assessment. The need for a greater role for theoretical models in assessment research has been stressed [ 27 ],[ 96 ]. As illustrated in historical essay writing, this debate, medical teaching and a song essay assessment must be based on a solid theoretical framework, underpinned by on macbeth's character, reliable evidence. Hard evidence combined with a plausible theoretical model - which must attempt to quote in an explain the observations on the basis of cognition - will provide the strongest basis for the identification of effective learning and assessment methodologies. That the multiple-choice format demonstrates high validity is due in part to the observation that well-constructed, context-rich multiple-choice questions are fully capable of assessing higher orders of cognition, and that they call forth cognitive problem-solving processes which exactly mirror those required in practice. On a theoretical basis it is even conceivable that the multiple-choice format will show superior performance in assessing proficiency in contrast with some versions of the historical fiction open-ended format; there is indeed empirical evidence to quote a song in an essay support this in practice [ 56 ],[ 92 ]. Paradoxically, the open-ended format may demonstrate lower validity than well-written multiple-choice items; since attempts to improve reliability and reduce objectivity by writing highly focused questions marked against critical on macbeth's character standardised, prescriptive marking templates frequently “trivialize” the question, resulting in some increase in reproducibility at quote the expense of write an essay about your school in french a significant loss of validity [ 120 ]. A Song In An! Indeed, I have argued that, based on an understanding of critical on macbeth's character human cognition and quote a song in an essay problem-solving proficiency, context-rich multiple-choice assessments may be superior in assessing the very characteristics which the proponents of the open-ended format claim as a strength of that format. Though current evidence supports the essay writing notion that in summative assessment open-ended items may well be redundant, this conclusion should not be uncritically extrapolated to situations where assessment for learning is important, such as in formative assessment and in summative assessment at early and intermediate stages of the quote essay medical programme given that conclusive evidence with respect to the learning effects of the two formats is as yet awaited.

The author was solely responsible the buy a dissertation online jobs literature and writing the article. RJH is currently Dean and Head of the School of Clinical Medicine at the University of KwaZulu-Natal, Durban, South Africa. Quote In An! He studied at the University of buy a dissertation Cape Town, specialising in Internal Medicine and quote a song in an subsequently hepatology, before moving to historical fiction essay writing Durban as Professor of Medicine. He has a longstanding interest in medical education, and specifically in the cognitive aspects of quote essay clinical reasoning, an area in which he is currently supervising a number of research initiatives. Modified essay question. Short answer question. Objective structured clinical examination. The author would like to thank Dr Veena Singaram for fiction essay writing, her insightful and challenging appraisal of the manuscript. Authors' original submitted files for images. The author declares that he has no competing interests. Siemens G: Connectivism: Learning as Network-Creation. [ http://www.elearnspace.org/Articles/networks.htm ] Siemens G: Connectivism: A learning theory for the digital age.

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Surveillance Definitions of Infections in Long-Term Care Facilities: Revisiting the quote McGeer Criteria. You can always find the topics here! Select the topics that are inaccurate. The moving wall represents the time period between the help last issue available in JSTOR and the most recently published issue of a journal. Moving walls are generally represented in essay, years. In rare instances, a publisher has elected to have a zero moving wall, so their current issues are available in JSTOR shortly after publication. Note: In calculating the moving wall, the current year is not counted. For example, if the help current year is 2008 and a journal has a 5 year moving wall, articles from the year 2002 are available. Terms Related to the Moving Wall Fixed walls: Journals with no new volumes being added to the archive. Absorbed: Journals that are combined with another title.

Complete: Journals that are no longer published or that have been combined with another title. Surveillance Definitions of Infections in Long-Term Care Facilities: Revisiting the quote in an essay McGeer Criteria. Infection surveillance definitions for long-term care facilities (ie, the McGeer Criteria) have not been updated since 1991. An expert consensus panel modified these definitions on the basis of custom assignment, a structured review of the literature. Significant changes were made to the criteria defining urinary tract and respiratory tract infections.

New definitions were added for a song in an essay norovirus gastroenteritis and Clostridum difficile infections. When McGeer and colleagues proposed the first set of infection surveillance definitions specifically for use by long-term care facilities (LTCFs), their intent was to provide standardized guidance for infection surveillance activities and research studies in critical essays on macbeth's foil, nursing homes and similar institutions. 1 These definitions were adapted from existing surveillance definitions (such as those of the Centers for Disease Control and Prevention [CDC] National Nosocomial Infection Surveillance) that are used in quote a song essay, acute care hospitals and with modifications determined by consensus discussions among infectious diseases physicians, geriatricians, and infection control nurses with experience in critical on macbeth's character, LTCFs, 1,2 using an unstructured review of the limited literature available at the time. These consensus definitions, also known as the McGeer Criteria, have not been validated or updated despite their ongoing use by infection prevention and control programs and in research studies of nursing homes. The original surveillance definitions 1 were specifically developed for use in quote a song in an, LTCFs with older adults who required (1) supervision and care for impaired cognition, (2) assistance with activities of historical essay writing, daily living (ADLs), or (3) skilled nursing care, such as the a song in an use of indwelling devices (eg, urinary catheters or enteral feeding tubes). At the time the McGeer Criteria were developed, these facilities rarely provided intravenous therapy or had on-site laboratory or radiology services for about your school in french the diagnosis of new clinical problems. Now, 20 years later, these definitions should still be applied in skilled nursing facilities and in an, nursing homes that care for the postacute and frail elder populations, as well as in other long-term residential care environments that deliver medical and write about your, skilled nursing services if appropriate clinical and diagnostic evaluations can be provided. However, the McGeer Criteria were not designed for use in long-term acute care hospitals, acute inpatient rehabilitation facilities, or pediatric LTCFs.

In March 2009, members of the essay Society for Healthcare Epidemiology of America (SHEA) Long-Term Care Special Interest Group (LTCSIG) agreed that the surveillance definitions of infections in LTCFs should be updated in historical fiction essay writing, light of (1) a substantial increase in the body of in an, evidence-based literature about infections in the elderly in LTCF settings, (2) the availability of improved diagnostics for infection surveillance, (3) the buy a dissertation online jobs changing populations of patients who are cared for in nonhospital settings, and (4) the updated acute care hospital surveillance definitions of the CDC’s National Healthcare Safety Network (NHSN). The process of updating the essay McGeer Criteria included an evidence-based structured review of the literature in essay on science and politics, addition to consensus opinions from industry leaders including infectious diseases physicians and epidemiologists, infection preventionists, geriatricians, and public health officials. We systematically reviewed the definitions of clinical syndromes that commonly occur in LTCF residents, including respiratory tract infections (RTIs), urinary tract infections (UTIs), skin and soft tissue infections (SSTIs), and in an essay, gastrointestinal (GI) tract infections. Because of a lack of recent, relevant research pertaining to systemic infections (bloodstream infections [BSIs] and unexplained febrile episodes), revisions to the definitions in these categories were not pursued. Specific criteria for defining nasal and otic infections have been removed; categorizing these events should be based on evaluation by a clinical provider.

Oropharyngeal and conjunctival infections were included with SSTIs as mucosal infections. Dissertation Online Jobs. For the infection surveillance definitions of in an essay, each clinical syndrome undergoing revision, a team of SHEA LTCSIG members was assigned to review the custom help literature and provide updated surveillance criteria. The definitions were reviewed, modified where appropriate on quote a song in an the basis of the review, and approved by about school the LTCSIG and a panel of outside reviewers selected by the SHEA Board of Directors. First we searched for relevant guidelines, using Medline, National Guideline Clearinghouse, Cochrane Health Technology Assessment, National Institutes of Health Consensus Development, and essay, the US Preventative Services Task Force. On the basis of a review of those guidelines, each team developed a series of key questions. Examples of these key questions are “What is the utility of examination of urine for pyuria for the diagnosis of symptomatic urinary tract infection?” and “What is the about your in french diagnostic accuracy of pulse oximetry for nursing home pneumonia?” These key questions further guided the quote a song evidence review used to revise the existing surveillance criteria. Next, a search of the primary literature was performed, using Medline, CINAHL, Embase, Cochrane Systematic Reviews, and the Cochrane Controlled Clinical Trials Registry. Examples of key search terms include the following: nursing home, long-term care, aged, skilled nursing facility, older adults, elderly, fever, healthcare-associated infection, pneumonia, influenza, respiratory tract infection, functional impairment, confusion, leukocyte count, pulse oximetry, urinary tract infection, bacteriuria, urine culture, gastroenteritis, diarrhea, Clostridium difficile , norovirus, cellulitis, soft tissue infection, pressure ulcer, scabies. A line listing of assignment help, articles that met the search criteria and were included in the final analyses is available upon request from the authors.

A reference was included if it was (1) relevant to key questions; (2) a systematic review, meta-analysis, or primary research report; and quote essay, (3) written in English. For each clinical syndrome, a standardized evidence table was prepared that summarized the data from industries inc case study, each relevant article. Quote In An. Information on the type(s) of historical essay, LTCF and in an essay, the specific resident population(s) was included in the evidence tables. The strategy for review of the literature by asking key questions and summarizing the evidence was based on a standard methodology developed by the CDC’s Healthcare Infection Control Practices Advisory Committee and the University of Pennsylvania Center for Evidence-Based Practice. Cooper Industries Inc Case Study. 3 When evidence was limited or unavailable to inform changes to a song in an the definitions, expert consensus guided any modifications. Most of the studies we evaluated were small observational or uncontrolled case series that primarily addressed questions related to buy a jobs the utility of signs and symptoms for the purpose of quote essay, diagnosing infection in an essay about your school, older people. The majority of these studies did not clearly address questions about the utility of 1 or more clinical findings in the context of infection detection and surveillance in LTCFs or other healthcare facilities. Quote Essay. Because the evidence was generally indirect and judged to critical on macbeth's character foil be of low quality, a decision was made to not grade proposed additions or changes in clinical parameters according to standardized methods that are typically applied to recommendations and guidelines. The criteria that define infections for surveillance purposes were selected to increase the essay likelihood that the fiction writing events captured by quote a song in an essay application of the definitions are true infections.

Presentations of infection in older residents of LTCFs may be atypical, so failure to dissertation jobs meet surveillance definitions may not fully exclude the quote in an essay presence of infection. For this reason, the surveillance definitions presented here may not be adequate for assignment help real-time case finding, diagnosis, or clinical decision making (eg, antibiotic initiation). Separate clinical guidelines address early identification of infections and a song essay, appropriate initiation of antibiotic therapy in LTCF residents, 4,5 which are both important for impacting resident outcomes. The syndromes included here represent a variety of clinically relevant infections that can occur in the LTCF population. Surveillance should be performed for infections for which there are clear strategies that can be implemented for prevention and custom assignment, control of transmission (Table 1). However, for completeness and quote a song, consistency with the inc case original surveillance definitions, 1 several infections that may occur because of underlying host factors rather than transmission within the facility have also been included in this document, so that both infection prevention programs and research studies have a standard set of criteria. Given the limited infection prevention and control resources that are currently available in most LTCFs, surveillance activities may need to target those infections in a facility that have the most potential for quote a song essay prevention. In addition, some infections are associated with a high likelihood of transmission and help, development of outbreaks (eg, norovirus, influenza, group A Streptococcus , acute viral hepatitis). For these infections, identification of even a single case in a LTCF should trigger a more intensive investigation. 6,7. 1. Quote. Evidence of transmissibility in a.

2. Processes available to fiction essay writing prevent. acquisition of quote a song in an essay, infection. 3. Clinically significant cause of morbidity. 4. Historical Essay Writing. Specific pathogens causing serious. Pneumonia, urinary tract infection, gastrointestinal tract infections including Clostridium difficile , and skin and soft tissue infections. Any invasive group A Streptococcus infection, acute viral hepatitis, norovirus, scabies, influenza. Associated with hospitalization and functional decline in LTCF residents. A single laboratory-confirmed case should prompt further investigation. 1. Infections with limited transmissibility.

in a healthcare setting. 2. Infections with limited preventability. definitions should be applied in quote a song essay, LTCF. surveillance (may apply to only specific. For infection surveillance purposes, infections should be attributed to a LTCF onset if (a) there is no evidence of an incubating infection at the time of admission to the facility (on the basis of an essay your, clinical documentation of appropriate signs and symptoms and not solely on screening microbiologic data) and (b) onset of quote a song in an, clinical manifestation occurs 2 calendar days after admission. Although debate exists about the use of this time frame to determine a LTCF onset for C. Essay Writing. difficile infections, 8 it is consistent with acute care infection surveillance reporting and surveillance methodology, and there is currently no evidence to support changing this standard for LTCFs. As outlined in essay, the original McGeer Criteria, 3 important conditions should be met when applying these surveillance definitions: 1. All symptoms must be new or acutely worse. Many residents have chronic symptoms, such as cough or urinary urgency, that are not associated with infection; however, a new symptom or a change from baseline may be an indication that an and politics infection is developing. 2. Alternative noninfectious causes of signs and symptoms (eg, dehydration, medications) should generally be considered and quote a song essay, evaluated before an historical essay writing event is deemed an infection. 3. Identification of infection should not be based on quote a song in an essay a single piece of historical essay, evidence but should always consider the clinical presentation and any microbiologic or radiologic information that is available.

Microbiologic and radiologic findings should not be the sole criteria for defining an event as an infection. Similarly, diagnosis by a physician alone is quote a song not sufficient for a surveillance definition of infection and custom assignment, must be accompanied by documentation of compatible signs and symptoms. The feasibility of implementation and the validity of these surveillance definitions would benefit from further assessment in different types of LTCFs. As with the original article by McGeer and colleagues, 1 these definitions have not been tested in advance of their publication. Data from quote a song in an essay, a French study demonstrated that application of the original surveillance definitions underestimated the custom help number of nursing home–associated infections when compared with provider diagnoses of infection. 9 This finding highlights the need for a song future studies to determine the sensitivity and specificity of historical essay writing, criteria used within the surveillance definitions and to validate their application in this setting.

Constitutional Criteria for Infection. In an effort to standardize terminology across the quote a song in an essay clinical syndromes defined in this article, we agreed on common definitions for fever, acute change in mental status, and acute functional decline (Table 2). The definition of fever was changed from a temperature of greater than 38°C (100.4°F), as in the original McGeer Criteria, to a definition consistent with the 2008 Infectious Diseases Society of America (IDSA) guideline for evaluating fever and infection in older adults residing in LTCFs: either (1) a single oral temperature greater than 37.8°C (100°F) or (2) repeated oral temperatures greater than 37.2°C (99°F) or rectal temperatures greater than 37.5°C (99.5°F) or (3) a single temperature greater than 1.1°C (2°F) over baseline from any site. 4 The rationale for this recommendation includes: 1. Fiction Essay Writing. A desire to maintain consistency across different guidelines. 2. Recognition that although the IDSA guideline is based on data from small numbers of participants in studies performed nearly 2 decades ago, no recent evidence has provided any rationale to modify them. 3. The lower threshold will increase sensitivity for a song in an essay detecting infection given the greater likelihood of a lower febrile response in essay on science, the elderly. 10,11.

Although both the IDSA guideline and the original McGeer Criteria note that “worsening mental or functional status” can be a nonspecific manifestation of acute infection in quote a song in an essay, an elderly resident of a LTCF, 1,4 there are relatively few studies that have defined a standard assessment of mental status or functional change in the context of critical essays foil, acute infection. Quote A Song. Mehr et al, in assignment, their prospective study involving 36 nursing homes and 2,334 episodes of pneumonia in 1,474 residents, showed that residents with either probable or possible pneumonia were more likely to be somnolent and confused when compared with those with no pneumonia. 12 Lim and MacFarlane 13 compared 397 patients with community-acquired pneumonia (CAP) with 40 patients who had nursing home–acquired pneumonia and in an, found that the patients with nursing home–acquired pneumonia were more likely to be confused when compared with patients who had CAP. Integrated into the recently released Minimum Data Set (MDS), version 3.0, is an assessment of delirium that is based on essay and politics the confusion assessment method (CAM) criteria. 14,15 In order to standardize an assessment of acute mental status across LTCFs, the CAM criteria are adopted here for the definition of acute confusion or altered mental status (Table 3).

For similar reasons, the definition of essay, acute functional decline is historical fiction also based on a song in an essay changes in ADLs according to the scoring system in MDS 3.0. Cooper. 16. Criteria are adapted from a study by Lim and MacFarlane. 13. Relative to the original surveillance definitions, 1 few changes were made to the definitions of quote, RTIs, which include 4 subcategories: (1) common cold syndromes or pharyngitis, (2) influenza-like illness, (3) pneumonia, and (4) lower RTI (Table 4). No changes were made to industries inc case study the definitions of cold syndromes or pharyngitis. must be present) 1. Runny nose or sneezing. 2. Stuffy nose (ie, congestion) 3. Sore throat or hoarseness or difficulty in swallowing.

5. Swollen or tender glands in the neck (cervical. 2. At least 3 of the in an following influenza-like illness subcriteria. b. New headache or eye pain. c. Myalgias or body aches. d. Malaise or loss of appetite. f. New or increased dry cough.

1. Interpretation of a chest radiograph as demonstrating. pneumonia or the presence of a new infiltrate. 2. At least 1 of the following respiratory subcriteria. a. Fiction Writing. New or increased cough. b. New or increased sputum production. c. Quote A Song In An Essay. O 2 saturation 94% on room air or a reduction in O 2. saturation of 3% from baseline. d. New or changed lung examination abnormalities. e. Pleuritic chest pain.

f. Respiratory rate of ?25 breaths/min. 3. At least 1 of the constitutional criteria (see Table 2) all 3 criteria must be present) 1. Chest radiograph not performed or negative results for. pneumonia or new infiltrate. 2. At least 2 of the respiratory subcriteria (a–f) listed in.

section C above. 3. At least 1 of the constitutional criteria (see Table 2) The only change to the definition of influenza-like illness was the assignment help removal of seasonal restrictions for quote in an the identification of this infection. In the essay on science and politics past, seasonal influenza activity in quote a song in an essay, the United States typically peaked in fiction, January or February. However, on occasion, seasonal influenza activity has extended into May. In 2009, the H1N1 influenza A virus strain caused increased hospitalization, morbidity, and mortality from influenza-related illnesses during the summer months. 17 Because of increasing uncertainty surrounding the timing of the essay start of influenza season, the peak of influenza activity, and the length of the cooper season, “seasonality” is no longer a criterion to a song essay define influenza-like illness. Changes to the surveillance definitions of pneumonia and lower RTI were made to on macbeth's character increase the specificity of the criteria. A Song Essay. Several recent studies have used at least 1 respiratory and 1 constitutional sign or symptom, along with radiographic findings, to define pneumonia. 13 The definition of lower RTI requires the presence of 2 respiratory criteria and custom, 1 constitutional sign or symptom without radiographic findings that is suggestive of pneumonia.

The respiratory signs and symptoms are unchanged in this article from the original criteria except for the addition of oxygen saturation in the lower RTI and pneumonia definitions, because of quote a song in an essay, increased access to pulse oximeters in cooper industries study solution, most facilities. Given that the in an initial respiratory examination of a LTCF resident who has suspected pneumonia is rarely performed by buy a jobs a physician, the literature was reviewed to determine the role of a physical examination by a nurse or paramedic in predicting pneumonia. Mehr et al 12 demonstrated that a nurse’s assessment for quote a song in an the presence of crackles and the absence of wheezing was highly predictive of identifying radiographic evidence of pneumonia. Ackerman and Waldron 18 retrospectively reviewed 244 ambulance reports of breathing difficulty to determine whether paramedic physical examinations, patient history, and custom assignment, clinical judgment correlated with emergency room physician diagnoses. In that study, the classification of respiratory disease included aspiration, asthma, chronic obstructive pulmonary disease, dyspnea, pleurisy, pneumonia, and upper respiratory tract infection (URI). In An. The paramedic respiratory diagnoses had a sensitivity of 71% (range, 58%–82%) and a specificity of custom, 94% (range, 89%–96%). These 2 studies suggest that nonphysician assessments can assist with the determination of pneumonia, and therefore we retained in a song in an, our definitions the criterion of abnormal findings on lung examination. The structure of the new pneumonia and lower RTI definitions should facilitate surveillance by buy a online segregating criteria into 3 categories (radiography results, respiratory signs or symptoms, and constitutional criteria) and explicitly requiring the exclusion of alternative explanations for quote in an respiratory signs or symptoms such as congestive heart failure, atelectasis, and jobs, other noninfectious respiratory conditions. The definitions for quote in an UTI presented here differ substantially from the original surveillance definitions 1 for both (A) residents without an indwelling catheter and (B) residents with an indwelling catheter (Table 5).

The revised definitions take into account the low probability of UTI in residents without indwelling catheters if localizing symptoms are not present, as well as the need for microbiologic confirmation for diagnosis. 19. 1 and 2 must be present) 1. At least 1 of the following sign or symptom subcriteria. a. Acute dysuria or acute pain, swelling, or tenderness of. the testes, epididymis, or prostate. b. Fever or leukocytosis (see Table 2) and at least 1 of the. following localizing urinary tract subcriteria. i. Acute costovertebral angle pain or tenderness.

ii. Suprapubic pain. iii. Gross hematuria. iv. New or marked increase in incontinence. v. New or marked increase in urgency. vi. Historical Fiction Essay. New or marked increase in frequency. c. In the absence of a song in an essay, fever or leukocytosis, then 2 or more. of the following localizing urinary tract subcriteria.

i. Suprapubic pain. ii. Gross hematuria. iii. New or marked increase in incontinence. iv. New or marked increase in urgency. v. New or marked increase in frequency. 2. One of the following microbiologic subcriteria.

a. At least 10 5 cfu/mL of no more than 2 species of. microorganisms in a voided urine sample. b. At least 10 2 cfu/mL of any number of organisms in a. specimen collected by in-and-out catheter. Urine specimens for culture should be processed as soon as possible, preferably within 1–2 h. Essay On Science And Politics. If urine specimens cannot be processed within 30 min of collection, they should be refrigerated. Refrigerated specimens should be cultured within 24 h. and 2 must be present)

1. At least 1 of the following sign or symptom subcriteria. a. Fever, rigors, or new-onset hypotension, with no. alternate site of infection. b. Either acute change in mental status or acute functional. decline, with no alternate diagnosis and a song in an, leukocytosis. c. New-onset suprapubic pain or costovertebral angle pain. d. Buy A Jobs. Purulent discharge from around the catheter or acute. pain, swelling, or tenderness of the testes, epididymis,

2. A Song In An Essay. Urinary catheter specimen culture with at least. 10 5 cfu/mL of any organism(s) Urinary catheter specimens for culture should be collected following replacement of the essay catheter (if current catheter has been in place for 14 d). Pyuria does not differentiate symptomatic UTI from asymptomatic bacteriuria. Absence of pyuria in diagnostic tests excludes symptomatic UTI in residents of long-term care facilities. cfu, colony-forming units. For residents without an indwelling catheter, the clinical criterion “acute dysuria” and quote, the urinary tract subcriteria are derived from Loeb et al’s 5,20 consensus criteria, which require localizing genitourinary findings and have been validated in a prospective randomized trial showing efficacy and safety. The criterion “acute pain, swelling, or tenderness of the testes, epididymis, or prostate” was added by expert consensus during the review.

Fever or leukocytosis plus 1 localizing urinary tract subcriterion or the cooper inc case presence of 2 or more new or increased localizing urinary tract subcriteria could be used to in an meet the jobs definition for symptomatic UTI. Acute change in in an essay, mental status and change in on science and politics, the character of the urine (eg, change in color or odor) were each independently associated with bacteriuria (?10 5 colony-forming units [cfu]/mL) plus pyuria (?10 white blood cells per high-power field) in a prospective study of in an, LTCF residents with clinically suspected UTI; 21 however, these 2 symptoms are frequently demonstrated in write about school, the presence of asymptomatic bacteriuria 22 due to a song in an other confounding clinical conditions, such as dehydration. Other nonspecific signs and custom assignment help, symptoms (eg, falls) without localizing lower urinary tract findings were not associated with bacteriuria plus pyuria. For residents with an indwelling catheter, the first clinical criterion, “fever, rigors, or new-onset hypotension with no alternate site of infection” is a song essay consistent with the essays on macbeth's criteria of in an essay, Loeb et al. 5 Localizing urinary tract symptoms for custom residents with an indwelling catheter include “new-onset suprapubic pain,” “costovertebral angle tenderness,” and “purulent discharge from around the catheter.” “Acute pain, swelling, or tenderness of the testes, epididymis, or prostate” is included for both catheterized and a song in an, noncatheterized men as recognized complications of UTI in males, particularly when an write indwelling urinary catheter is present. 23 The additional criterion “acute change in mental status or acute functional decline with no alternate diagnosis and leukocytosis” has been included.

Acute mental status change and functional decline are nonspecific manifestations of many conditions including hypoxia, dehydration, and adverse effects of medication. The additional requirement of concomitant leukocytosis, a marker of a song in an essay, a systemic inflammatory reaction, provides support that the clinical deterioration has an infectious etiology. However, symptomatic UTI in the catheterized resident should always be a diagnosis of exclusion in the absence of localizing urinary tract findings. A positive urine culture is necessary for diagnosis of UTI 4 and is applied in study, the revised surveillance definitions for both subcategories (residents without and a song in an, with an critical foil indwelling catheter). A Song. For individuals without an indwelling catheter, at least 10 5 cfu/mL of assignment, no more than 2 species of microorganisms is the recommended quantitative count from a voided specimen, and for a specimen collected by in an in-and-out catheterization it is at least 10 2 cfu/mL of any number of cooper industries solution, organisms. Although a small proportion of female residents in LTCFs who have UTI have voided specimens with quantitative counts of quote, less than 10 5 cfu/mL, these specimens were usually evidence of contamination. 24 Before urine samples for culture are obtained from individuals with a chronic indwelling catheter (in place for more than 14 days), the original urinary catheter should be replaced and the specimen should be obtained from the new catheter.

25 Again, a small number of individuals with symptomatic UTI may have lower counts, but a value of at least 10 5 cfu/mL is recommended for increased specificity for surveillance criteria, 26 and it is also consistent with current NHSN acute care definitions for symptomatic UTI. 27 Repeat urine cultures following treatment as a “test of cure” are not recommended because of the high prevalence of asymptomatic bacteriuria in the LTCF population. A diagnosis of UTI can be made without localizing urinary tract symptoms if a blood culture isolate is the same as the organism isolated from the urine and critical on macbeth's character, there is no alternate site of infection. This secondary BSI provides definitive evidence of the existence of systemic infection; in the absence of an alternate source, a UTI becomes the presumptive diagnosis. Skin, Soft Tissue, and Mucosal Infections. Consistent with the original surveillance definitions, 1 this section includes definitions for (A) skin (cellulitis/soft tissue/wound) infections, (B) scabies, (C) fungal oral/perioral and skin infections (fungal mucocutaneous infections), (D) herpesvirus skin infections, and (E) conjunctivitis (Table 6). In An Essay. The review of the literature revealed that because diagnoses of write your school, infections of the skin, soft tissue, and mucous membranes are heavily dependent on essay clinical criteria, developing definitions with specificity is challenging. Additionally, there was no original research literature that described the validation of a surveillance definition for soft tissue infections. following criteria must be present) 1. Pus present at a wound, skin, or soft tissue site. 2. New or increasing presence of at cooper study solution, least 4 of the following.

sign or symptom subcriteria. a. Heat at the affected site. b. Redness at quote essay, the affected site. c. Swelling at the affected site. d. Tenderness or pain at the affected site. e. Serous drainage at the affected site. f. One constitutional criterion (see Table 2) 1. A maculopapular and/or itching rash. 2. At least 1 of the custom assignment help following scabies subcriteria. a. Quote A Song In An Essay. Physician diagnosis. b. Laboratory confirmation (scraping or biopsy)

c. Epidemiologic linkage to a case of scabies with. 1. Oral candidiasis (both criteria a and buy a, b must be present) a. Presence of raised white patches on inflamed mucosa or. plaques on oral mucosa. b. Diagnosis by a medical or dental provider. 2. Fungal skin infection (both criteria a and in an, b must be. a. Characteristic rash or lesions. b. Either a diagnosis by a medical provider or a laboratory- confirmed fungal pathogen from a scraping or a. Dermatophytes have been known to cause occasional infections and rare outbreaks in the LTCF setting.

1. Herpes simplex infection (both criteria a and b must be. a. Buy A Dissertation Online Jobs. A vesicular rash. b. Either physician diagnosis or laboratory confirmation. 2. Herpes zoster infection (both criteria a and b must be. a. Quote A Song. A vesicular rash. b. Either physician diagnosis or laboratory confirmation. 1. Write In French. Pus appearing from 1 or both eyes, present for at least. 2. New or increased conjunctival erythema, with or. 3. Quote. New or increased conjunctival pain, present for at least.

For wound infections related to surgical procedures, LTCFs should use the Centers for Disease Control and Prevention’s National Healthcare Safety Network Surgical Site Infection criteria and report these infections back to the institution where the original surgery was performed. The original definitions for SSTIs include clinical but not microbiological criteria, whereas the definitions used by NHSN for infection surveillance include a laboratory component. 27 At this time, there is insufficient evidence to support changing the criteria. However, for LTCF residents who have undergone recent surgical procedures, it would be appropriate to utilize the on macbeth's character foil NHSN criteria for defining surgical site infections. The review of the literature did not identify studies describing the quote in an essay validation of a surveillance definition for scabies. A criterion for identification of an epidemiological linkage to a known case has been added to the definition because (a) residents with scabies, particularly heavily infested residents, are highly infectious and (b) skin scraping, which remains the historical dominant diagnostic test, has low sensitivity. Quote. 28. The original surveillance definitions of fungal mucocutaneous infections, including those caused by Candida species, require diagnosis by a physician or dentist. 1 Definitions of mucocutaneous candidiasis are based on vague clinical descriptions, and there is insufficient basis for changing the an essay about your criteria; however, a description of a song essay, typical lesions has been added to increase the specificity of the definition. Although fungal skin infections other than mucocutaneous candidiasis are rare, the original definition for these required both a maculopapular rash and write about school, either physician diagnosis or laboratory confirmation.

The minor change in the definition substitutes “characteristic rash or lesions” for “maculopapular rash,” since dermatophyte lesions may be macular. 29 No data were found to essay support revisions in the definitions of herpesvirus skin infections (herpes simplex and herpes zoster) or conjunctivitis. Gastrointestinal Tract Infections. This section includes infection definitions for (A) gastroenteritis, (B) norovirus gastroenteritis, and (C) C. difficile infection (Table 7). The general surveillance definition for write in french gastroenteritis was unchanged from that proposed in the original surveillance definitions. Quote A Song Essay. 1 Two new surveillance definitions have been added: (a) criteria for fiction writing determining the presence of norovirus gastroenteritis and (b) criteria for C. difficile infection. These new GI infection definitions were developed because it is quote in an now recognized that norovirus is highly transmissible, causing frequent and often large outbreaks in healthcare institutions including LTCFs, 30 and C. difficile is the major infectious cause of healthcare-associated and on macbeth's, antibiotic-associated diarrhea, contributing to quote a song in an essay significant morbidity and online, mortality among elderly institutionalized individuals. 31,32.

1. Diarrhea: 3 or more liquid or watery stools above what is. normal for the resident within a 24-h period. 2. Vomiting: 2 or more episodes in a 24-h period. 3. A Song. Both of the study solution following sign or symptom subcriteria. a. A stool specimen testing positive for a pathogen (eg,

Salmonella , Shigella , Escherichia coli O157?H7, Campylobacter species, rotavirus) b. At least 1 of the following GI subcriteria. iii. Abdominal pain or tenderness.

1. At least 1 of the following GI subcriteria. a. Diarrhea: 3 or more liquid or watery stools above what. is normal for the resident within a 24-h period. b. Vomiting: 2 or more episodes of in a 24-h period. 2. A stool specimen for which norovirus is positively detected. by electron microscopy, enzyme immunoassay, or.

molecular diagnostic testing such as polymerase chain. 1. One of the following GI subcriteria. a. Diarrhea: 3 or more liquid or watery stools above what. is normal for the resident within a 24-h period. b. Presence of toxic megacolon (abnormal dilatation of the. large bowel, documented radiologically) 2. One of the following diagnostic subcriteria. a. Quote. A stool sample yields a positive laboratory test result for. C. difficile toxin A or B, or a toxin-producing C. difficile organism is identified from a stool sample.

culture or by assignment a molecular diagnostic test such as PCR. b. Quote A Song. Pseudomembranous colitis is identified during. endoscopic examination or surgery or in. histopathologic examination of a biopsy specimen. The gastroenteritis criteria were deemed appropriate and adequate for identifying sporadic or outbreak-associated cases of GI infection caused by common bacterial enteric pathogens. A minor change in historical fiction essay writing, the definition of diarrhea substitutes “liquid or watery stools” for “loose or watery stools,” since the concept of liquid stools (ie, conforming to the shape of the specimen collection container) is quote in an consistent with other surveillance definitions for on science diarrheal illness. 27,33 Additionally, the definition of diarrhea as “3 or more stools above what is a song in an essay normal for a resident in a 24-hour period” was standardized across GI infections to simplify surveillance activity. The definition for norovirus gastroenteritis requires the presence of dissertation jobs, both a compatible clinical presentation and a laboratory confirmation with detection of the infectious agent by one of several accepted laboratory methods. This definition is based on numerous descriptions of norovirus outbreaks and studies of the a song clinical manifestations of buy a dissertation online jobs, norovirus gastroenteritis in healthcare settings.

34 The norovirus definition can be used to identify either sporadic or outbreak-associated cases. However, sporadic cases would require laboratory confirmation, whereas outbreak cases may not if either a subset of cases involved in the outbreak have laboratory-confirmed diagnosis or the “Kaplan Criteria” are met. 35 The Kaplan Criteria, which have been useful in identifying outbreaks of acute gastroenteritis due to norovirus, 36 provide a surveillance definition to detect a presumed norovirus-like outbreak in a LTCF even in quote, the absence of historical fiction essay writing, laboratory confirmation. C. difficile has been associated with severe, life-threatening disease, especially in the elderly, and infection with this organism can be acquired or transmitted in LTCFs. 32 C. difficile infection may be endemic in some healthcare facilities, as well as a cause of outbreaks. A Song In An. Consequently, it is recommended that surveillance for C. difficile infection should be done in custom assignment help, LTC settings. 31 Surveillance should include prompt clinical and quote a song essay, appropriate laboratory evaluation of LTCF residents who have antibiotic-associated diarrhea or an cooper industries study acute diarrheal illness that is not otherwise explained. A surveillance definition for C. difficile infection is proposed that includes clinical and a song in an, microbiology laboratory test criteria. Importantly, because LTCF residents may be colonized with this organism, tests for C. difficile or its toxins should be performed only on diarrheal (liquid) stool specimens, unless ileus is and politics suspected. Laboratory surveillance of asymptomatically colonized residents or repeat testing for the presence of C. difficile toxins following treatment is not recommended.

31,32 The proposed definition includes criteria for determining whether the C. difficile infection is a primary episode or whether it represents a recurrence (relapse or reinfection). Published recommendations for quote a song in an surveillance for C. difficile infection have also attempted to determine the setting in which the infection was likely to have been acquired; 33 however, there is controversy about how to apply these attribution criteria in LTCFs. 8. The original surveillance definitions included BSI and unexplained febrile episodes in this section. 1 However, there has been scant literature to better define approaches to the diagnosis or routine surveillance of these clinical entities in LTCFs. In 2008, the IDSA guideline did not recommend performing blood cultures as part of the evaluation for infection in “most” residents in critical essays character foil, LTCFs, but they qualified this by a song essay saying that in facilities with quick access to laboratory facilities, physicians available to respond to results, and capacity to administer parenteral antibiotics, diagnostic blood cultures would be appropriate.

4. There have been limited studies assessing the utility and reliability of blood cultures in LTCFs. In 2005, Mylotte 37 reviewed several studies evaluating nursing home–associated BSI. Solution. Only 1 reported on the total numbers of blood cultures obtained during the study period, 38 and 1 reported the proportion of quote a song essay, contaminated blood cultures (“false positives”). 39 None of the studies in the review had data more recent than from 2000. Since the critical essays on macbeth's character Mylotte review, a single study from quote a song essay, Israel has reported on results from blood cultures performed on samples from a multilevel geriatric facility over critical character, a 2-year period from quote a song in an essay, 2002 to 2004. Historical Fiction. 40 In this study, 252 (15.8%) of 1,588 cultures had positive results, which indicates an quote a song essay incidence of BSI of 0.46 per 1,000 resident-days.

The study did not provide data on episodes of suspected contaminated cultures. Buy A Dissertation Online Jobs. However, in a cohort of 100 bacteremic residents, only 58% had received adequate empiric antibiotic therapy and the mortality rate was 34%, compared with 13% in nonbacteremic matched controls. The incidence of BSI and the prevalence of positive cultures were much higher in this study compared with earlier studies, suggesting that those LTCFs with the capacity to perform blood cultures and respond to results should include blood cultures in the diagnostic evaluation of infection. Given the limited evidence addressing the effectiveness of blood cultures in LTCFs, we did not attempt to propose a revised surveillance definition for BSI. Instead, consideration should be given to an application of the NHSN criteria for central line–associated BSI in those LTCFs who care for residents with indwelling vascular catheters including peripherally inserted central catheters (PICCs) and hemodialysis catheters. 27. These infection surveillance definitions for LTCFs update the consensus definitions proposed by McGeer et al, incorporating evidence published over the interim 20 years. The majority of quote a song in an essay, definitions and criteria were retained with only minor revisions except for those for UTI, where the criteria were made more specific, and GI infection, where 2 new infections were added to the surveillance definitions (norovirus and online jobs, C. difficile ). These updated definitions are intended to serve as a national standard for infection surveillance in quote a song, LTCFs. Because they are implemented in this setting, feedback from providers and efforts to validate the definitions will guide subsequent modifications as appropriate.

Nimalie D. Stone and Suzanne F. Bradley (co–project leaders), Lindsay E. Nicolle, Andrew E. Buy A Dissertation Jobs. Simor, Philip W. Smith, Kurt B. Stevenson; Gastrointestinal Writing Group : Andrew E. Simor (group leader), Muhammad S. Ashraf, Carolyn V. Gould, Taranisia MacCannell, Preeti N. Malani; Respiratory Tract Infection Writing Group : Mark Loeb and quote in an, Lona Mody (co–group leaders), Christopher Crnich, Joseph P. Mylotte, Steven J. Schweon; Skin and Soft Tissue Writing Group : Philip W. Smith (group leader), Jennifer Calder, Kent Crossley, Mary-Claire Roghmann; Urinary Tract Infection Writing Group : Lindsay E. Nicolle (group leader), Paul J. Drinka, Ebbing Lautenbach, Manisha Juthani-Mehta; Fever and Delirium Standards Subcommittee : Suzanne F. Bradley, Kent Crossley, Paul Drinka, Preeti Malani, Lona Mody, Lindsay Nicolle, Mary-Claire Roghmann, Nimalie D. Stone. SHEA Long-Term Care Special Interest Group. Kurt B. Stevenson (chair; Ohio State University Hospitals, Columbus, OH), Nimalie D. About Your. Stone (vice-chair; Centers for Disease Control and Prevention, Atlanta, GA), Muhammad S. Ashraf (East Carolina University, Greenville, NC), Suzanne F. Bradley (University of Michigan Medical School and Geriatric Research Education and Clinical Center [GRECC], VA Ann Arbor Healthcare System, Ann Arbor, MI), Mike Brown (Evergreen Hospital Medical Center, Kirkland, WA), Chris Cahill (California Department of Public Health [retired], Richmond, CA), Jennifer Calder (New York Medical College, Valhalla, NY), Christopher J. Crnich (University of Wisconsin and William S. Quote A Song In An Essay. Middleton VA Medical Center, Madison, WI), Kent Crossley (University of Minnesota and Minneapolis VA Medical Center, Minneapolis, MN). Solution. Paul J. Drinka (Medical College of Wisconsin, Milwaukee, WI), Jon P. Furuno (Oregon State University, Portland, OR), Rosemary Ikram (Christchurch, New Zealand), Jennie Johnstone (McMaster University, Hamilton, ON), Manisha Juthani-Mehta (Yale University School of essay, Medicine, New Haven, CT), Keith S. Kaye (Wayne State University School of Medicine, Detroit, MI), Ebbing Lautenbach (University of Pennsylvania School of Medicine, Philadelphia, PA), Donna R. Lewis (Atlanta Veterans Affairs Medical Center, Atlanta, GA), Mark Loeb (McMaster University, Hamilton, ON), Anurag N. Malani (St. Joseph Mercy Hospital, Ypsilanti, MI), Preeti N. Malani (University of online, Michigan Medical School and GRECC, VA Ann Arbor Healthcare System, Ann Arbor, MI), James Marx (University of Phoenix, San Diego, CA), Allison McGeer (University of Toronto School of quote a song in an essay, Medicine, Toronto, ON), Lona Mody (University of Michigan Medical School and GRECC, VA Ann Arbor Healthcare System, Ann Arbor, MI), Joseph P. Mylotte (University at Buffalo School of historical fiction writing, Medicine and Biomedical Sciences, Buffalo, NY), Lindsay E. Nicolle (University of Manitoba, Winnipeg, MB), Joseph F. A Song In An. Perz (Centers for Disease Control and Prevention, Atlanta, GA), Chesley Richards (Centers for Disease Control and Prevention, Atlanta, GA), Mary-Claire Roghmann (University of Maryland School of Medicine and Baltimore VA Medical Center, Baltimore, MD), Brenda J. Roup (Maryland Department of Health and Mental Hygiene, Baltimore, MD), Steven J. Schweon (Pleasant Valley Manor Nursing Home, Stroudsburg, PA), Joseph Segal (Drake Center, Cincinnati, OH), Andrew E. Simor (University of Toronto School of Medicine, Toronto, ON), Michael R. Inc Case. Spence (Kalispell Regional Medical Center, Kalispell, MT), Philip W. Smith (University of Nebraska Medical Center, Omaha, NE), Lauri D. Thrupp (University of in an essay, California, Irvine, CA), Kavita Trivedi (California Department of an essay about school, Public Health, Richmond, CA), Constanze Wendt (University of Heidelberg, Heidelberg, Germany). These definitions have been endorsed by the American Medical Directors Association, the Association of Medical Microbiology and Infectious Disease–Canada, the Association for Professionals in Infection Control and Epidemiology, the Community and Hospital Infection Control Association–Canada, and the National Association of quote in an essay, Directors of Nursing Administration in Long Term Care. Special thanks to historical writing Malinda McCarthy and Elizabeth Bolyard from the Centers for Disease Control and Prevention for their administrative and organizational support of a song in an, this writing project. Potential conflicts of interest. All authors report no conflicts of interest relevant to this article. All authors submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and the conflicts that the historical fiction essay editors consider relevant to this article are disclosed here. Special thanks to quote a song essay Malinda McCarthy and industries study, Elizabeth Bolyard from the Centers for Disease Control and Prevention for a song in an their administrative and organizational support of this writing project.

Potential conflicts of interest. All authors report no conflicts of interest relevant to industries inc case study solution this article. A Song Essay. All authors submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and the conflicts that the dissertation online editors consider relevant to this article are disclosed here. JSTOR is part of quote a song in an, ITHAKA, a not-for-profit organization helping the academic community use digital technologies to fiction preserve the scholarly record and to advance research and teaching in in an, sustainable ways. 2000-2017 ITHAKA. All Rights Reserved.

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9th grade essays Writing standards for ninth and tenth grades define the quote a song in an essay knowledge and skills needed for about your school, writing proficiency at these grade levels. By understanding 9th and 10th grade writing standards, parents can be more effective in quote a song in an, helping their children meet grade level expectations. What is 9th and assignment help 10th Grade Writing? In grades nine and ten, students plan, draft, and in an complete written compositions on a regular basis. Ninth grade and industries inc case tenth grade students practice all forms of writing and are expected to a song in an, produce error-free essays that demonstrate their awareness of cooper solution, audience and purpose. Students edit their essays for clarity, engaging language, and the correct use of the quote in an conventions and mechanics of standard American English. An emphasis is cooper study solution placed on writing coherent and focused essays that convey a well-defined perspective and quote a song essay tightly reasoned argument. What Writing Standards Measure.

Academic standards are very specific, detailing every aspect of what students are expected to learn in each grade. Organized into five key areas, writing standards focus on: writing process, writing purposes (what students write), writing evaluation, writing conventions (grammar, usage, and mechanics), and research/inquiry for writing. The following writing standards represent what states* typically specify as benchmarks in solution, writing proficiency for grade nine and grade ten. Grades 9 and 10: Writing Process. Writing standards for all grades focus on the writing process as the primary tool to help students become independent writers. In grades 9 and 10, students are expected to use each phase of the process as follows: Prewriting: Students in 9th and 10th grades use prewriting strategies to a song in an essay, generate ideas, develop voice, and plan their writing. Students generate ideas from custom assignment, multiple sources (e.g., brainstorming, discussion, research materials), and use strategies and tools (e.g., technology, spreadsheets, diagrams, outlines) to develop a personal organizational style. Students make a plan for writing that addresses purpose, audience, controlling idea, logical sequence, and a timeframe for completion. Drafting: In ninth grade and tenth grade, students develop drafts, alone and collaboratively, by organizing and reorganizing content.

Drafts establish a controlling thesis that conveys a clear and distinctive perspective on the subject and employ a logical organizational pattern with substantial and relevant supporting details. In ninth and tenth grades, students are expected to maintain a consistent tone and focus and use precise language, action verbs, sensory details, appropriate modifiers, and the active rather than the passive voice. Students analyze the language techniques of professional authors, (e.g., figurative language, denotation, connotation), to establish a personal style, demonstrating a command of language with confidence of in an essay, expression. Revising: In 9th grade and 10th grade, students revise selected drafts by custom assignment improving the logic and coherence of the organization and controlling perspective, and developing meaningful relationships among ideas. Other revision techniques used by ninth- and tenth-graders include checking the in an accuracy of supporting details, (e.g., facts, statistics, expert opinions, definitions) and working on the precision of word choice, voice, and tone to critical character, suit the occasion, audience, and purpose.

Editing: Students edit their writing to ensure standard usage, varied sentence structure, and appropriate word choice. Ninth- and tenth graders also proofread for appropriateness of organization, content, style, and language conventions, using resources and reference materials (e.g., dictionary, thesaurus). Publishing: Using technology, students in grades nine and ten publish their work frequently in a format appropriate to purpose (e.g., for display, multimedia). Published pieces use such design techniques as margins, tabs, spacing, and columns, as well as graphics (e.g., drawings, charts, graphs). Use of technology: Ninth grade and tenth grade students use advanced publishing software and graphic programs to a song in an essay, support aspects of creating, revising, editing, and publishing texts. Grades 9 and 10: Writing Purposes. In grades nine and ten, students write in a variety of forms for various audiences and purposes (e.g., to explain, inform, analyze, entertain, reflect, persuade).

Students exercise the rhetorical strategies of narration, exposition, persuasion, and description to produce essays of at custom, least 1,500 words each. A Song Essay. Specifically, writing standards for 9th and 10th grades stipulate that students write in the following forms: Narrative/Creative: Ninth and tenth grade students write in a variety of narrative, expressive, and reflective forms, including biographical and autobiographical narratives and short stories. In these essays, students relate a sequence of events and buy a dissertation jobs communicate the quote in an significance of the events through concrete sensory details (e.g., sights, sounds, smells), and the explicit actions and gestures of the characters. Ninth- and an essay about your in french tenth-graders develop the plot or events further by creating dialogue and interior monologues to depict the characters’ feelings and locating scenes and quote a song in an essay incidents in specific places. Students are expected to use literary devices and make effective use of descriptions of appearance, images, shifting perspectives, and sensory details. In addition, students learn to pace the presentation of actions to school in french, accommodate changes in time and mood.

Expository: Students in 9th and 10th grades write a variety of expository essays, including analytical essays, research reports, and essays that speculate on the causes and effects of a situation. A Song In An. Students assemble evidence in support of a thesis, including information on all relevant claims and perspectives, and compose introductory, body, and concluding paragraphs. Historical Essay. Expository essays in quote essay, these grades should address readers’ potential misunderstandings, biases, and expectations, and make distinctions between the relative value and significance of specific data, facts, and ideas. In writing expository essays, ninth- and tenth-graders are expected to convey information and technical terms from primary and secondary sources, accurately and coherently, as well as integrate quotations and citations into the text while maintaining the flow of ideas. Students also incorporate visual aids into their expository essays, using technology to organize information on charts, maps, and graphs. Persuasive: Students in ninth and tenth grades write persuasive essays that structure ideas and write an essay arguments in a sustained and logical fashion. Quote A Song Essay. Persuasive essays in these grades should use specific rhetorical devices to support assertions (e.g., appeal to logic through reasoning; appeal to emotion or ethical belief; relate a personal anecdote, case study, or analogy). Ninth- and tenth-graders are expected to clarify and on science defend positions with precise and relevant evidence, including facts, expert opinions, quotations, and expressions of commonly accepted beliefs and logical reasoning. Students should also refute opposing arguments by addressing readers’ concerns, counterclaims, biases, and expectations. Responses to Literature: Ninth and tenth grade students are expected to demonstrate a comprehensive grasp of the significant ideas of literary works.

Students should support their ideas through accurate and detailed references to the text or to other works, and a song in an essay show an understanding of the stylistic devices used and the effects created. Students should also identify and assess the impact of perceived ambiguities, nuances, and complexities within the cooper industries study solution text. Business Documents: Students in grade nine and grade ten write a variety of business and work-related documents, including business letters, memos, emails, speaker introductions, resumes, applications, and cover letters for applications. The goal of business writing in these grades is to provide clear and purposeful information and address the intended audience appropriately. Students strive to highlight central ideas and pay attention to vocabulary, tone, and style by considering the nature of the relationship with, and the knowledge and interests of the a song essay recipient. Your School In French. Ninth- and tenth-graders are expected to follow a conventional style with page formats, fonts, and spacing that enhance readability and impact. Technical Documents: Students in 9th grade and 10th grade write technical documents (e.g., how-to-manuals, procedures, assembly directions, meeting minutes) with the quote in an essay goal of reporting information and conveying ideas logically and correctly. Critical Essays On Macbeth's Foil. Students are expected to quote in an essay, offer detailed and write school accurate specifications and include scenarios, definitions, and essay examples to aid comprehension (e.g., a troubleshooting guide). Technical documents in these grades should also anticipate readers’ problems, mistakes, and misunderstandings. Ninth- and tenth-graders may also be asked to buy a dissertation, write detailed travel directions and design an accompanying graphic using the cardinal and ordinal directions, landmarks, streets and a song in an essay highways, and distances.

Grades 9 and 10: Writing Evaluation. Ninth and tenth grade students evaluate the writing of others, as well as their own writing. Students make suggestions to improve writing and assess their own writing for critical foil, both mechanics and content. In grades nine and ten, students are expected to respond productively to quote a song in an essay, peer reviews of their own work. Writing standards recommend that each student keep and write about your review a collection of his/her own written work to quote a song in an essay, determine its strengths and weaknesses and to set goals as a writer. Grades 9 and 10: Written English Language Conventions. Students in ninth and tenth grades are expected to produce legible work that shows a command of standard English conventions, including accurate spelling, punctuation, and capitalization.

In particular, writing standards for grades nine and ten specify these key markers of proficiency: —Understand sentence construction, including parallel structure, subordination, and proper placement of modifiers. —Compose increasingly more involved sentences that contain clauses (e.g., main and subordinate) and phrases (e.g., gerunds, participles, absolutes, and infinitives) in their various functions, as well as the correct use of fragments for effect. —Exhibit proper English usage and control of grammar, paragraph and sentence structure, diction, and syntax. —Demonstrate control over grammatical elements such as subject-verb agreement, pronoun-antecedent agreement, consistency of verb tenses, comparative and superlative adjectives and adverbs, and possessives. —Use appropriate manuscript requirements, including title page presentation, pagination, spacing and margins, and integration of source and support material (e.g., in-text citation, use of direct quotations, paraphrasing) with appropriate citations. Character. —Identify and correctly use the mechanics of punctuation, including commas, colons, semicolons, apostrophes, hyphens, quotation marks, italics or underscoring, and ellipses. —Ninth- and tenth-graders pay particular attention to capitalization of names of academic courses and proper adjectives. — Use knowledge of quote essay, spelling rules, orthographic patterns, generalizations, prefixes, suffixes, and roots, including Greek, Latin, and dissertation jobs Anglo-Saxon root words. —Understand foreign words commonly used in quote, English (e.g., laissez faire, croissant). About Your. —Students use fluent and legible handwriting skills. A Song In An. Grades 9 and 10: Research and inc case solution Inquiry. In ninth and tenth grades, students use appropriate research methodology and a variety of print and electronic sources to gather information for research papers and other writing assignments. Students use writing as a research and learning tool in the following ways: Use writing to discover, organize, and support what is a song known and what needs to be learned about a topic. Use clear research questions and suitable research methods (e.g., library, electronic media, personal interview) to elicit and present evidence from primary and secondary sources. Synthesize information from multiple sources and identify complexities and discrepancies in the information and the different perspectives found in each medium (e.g., almanacs, microfiche, news sources, in-depth field studies, speeches, journals, technical documents). Represent information in a variety of ways such as graphics, conceptual maps, and learning logs. Use appropriate conventions for documentation in the text, notes, and essay on science bibliographies by adhering to those in style manuals (e.g., Modern Language Association Handbook, The Chicago Manual of Style). Analyze strategies that writers in different fields use to compose. Use writing as a study tool to clarify and remember information.

Ninth and Tenth Grade Writing Tests. Quote A Song Essay. In many states, students in grades nine and ten take standardized writing assessments, either with pencil and paper or on on science and politics a computer. While tests vary, students are typically given questions about grammar and quote a song in an essay mechanics, as well as timed essay-writing exercises in which they must write an essay in response to a writing prompt. On 9th and 10th grade essay writing tests, students demonstrate their ability to produce an effective composition for a specific purpose, as well as their command of the on science and politics conventions of spelling, capitalization, punctuation, grammar, usage, and sentence structure. A Song. In some states, students’ revising and cooper industries inc case solution editing skills are tested with multiple-choice questions on reading passages.

Students are asked to indicate how a particular sentence might be corrected or improved or how the quote essay organization or development of a paragraph might be strengthened. Tests may also require students to proofread for correct punctuation, capitalization, word choice, and spelling. Another type of question asks students to write a summary statement in response to a reading passage. In addition, 9th and 10th grade students are given classroom-based writing tests and writing portfolio evaluations. State writing assessments are correlated to state writing standards.

These standards-based tests measure what students know in relation to what they’ve been taught. If students do well on school writing assignments, they should do well on and politics such a test. Educators consider standards-based tests to be the most useful as these tests show how each student is meeting grade-level expectations. Quote Essay. These assessments are designed to pinpoint where each student needs improvement and help teachers tailor instruction to fit individual needs. State departments of education usually include information on writing standards and writing assessments on their websites, including testing guidelines and write in french sample questions. Writing Test Preparation. Quote. The best writing test preparation in ninth and tenth grades consists of encouraging your student to write, raising awareness of the written word, and offering guidance on writing homework. Talk about writing and share appropriate articles and historical fiction writing books with your child. Students learn to write effectively when they write more often. Suggest keeping a journal, writing movie reviews for the family, or writing the procedures for using a new piece of home equipment.

Any writing is valuable practice. By becoming familiar with 9th and 10th grade writing standards, parents can offer more constructive homework support. Remember, the best writing help for kids is not to correct their essays, but offer positive feedback that prompts them to use the strategies of writing process to revise their own work. Time4Writing Online Writing Courses Support 9th and 10th Grade Writing Standards. Time4Writing is an quote a song essay excellent complement to cooper study, ninth and tenth grade writing curriculums. Developed by classroom teachers, Time4Writing targets the fundamentals of quote in an, writing.

Students build writing skills and deepen their understanding of the writing process by working on essay on science standard-based, grade-appropriate writing tasks under the individual guidance of a certified teacher. Writing on a song in an essay a computer inspires many students, even reluctant writers. Learn more about Time4Writing online courses for ninth and tenth grades. *K-12 writing standards are defined by critical on macbeth's character foil each state. A Song Essay. Time4Writing relies on a representative sampling of state writing standards, notably from Florida, Texas, and California, as well as on the standards published by nationally recognized education organizations, such as the National Council of Teachers of English and essay and politics the International Reading Association.

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Essay On The Element Neon Essays and Research Papers. Neon Essay Neon is probably one of the most interesting elements , in my opinion. The name . “ neon ” is a song in an, derived from the Greek word for “new”. I chose to do neon because most of us encounter neon on solution a daily basis as opposed to other elements such as pure gold or silver. Our world is much more colorful as a result of neon . A Song In An Essay? The symbol of Neon is Ne. Inc Case Solution? It is also in group 18 of the periodic table so it is classified as a noble gas. The atomic number of quote in an essay Neon is on science, 10. Neon is the 10th element on the periodic. Chemical element , Electron configuration , Gas 1000 Words | 3 Pages.

? Neon is a chemical element found on quote a song in an essay the periodic table. Essays On Macbeth's? Neon is also known as Ne. Neon’s atomic number is a song in an essay, . 10. Neon has an atomic mass of historical essay 20.179 amu. Neon is a colorless, odorless monatomic gas under standard conditions, with about two-thirds the density of air. Neon was the second of three rare gases to essay, be discovered in the air in 1898, and was immediately recognized as a new element from its bright red emission spectrum.

Neon's name is derived from Greek words meaning new one. Neon is chemically. Argon , Atom , Chemical element 2073 Words | 4 Pages. ELEMENTS OF ESSAY 1. Thesis: your main insight or idea about on science a text or topic, and in an, the main proposition that your . Historical Fiction? essay demonstrates. It should be true but arguable (not obviously or patently true, but one alternative among several), be limited enough in scope to a song, be argued in a short composition and with available evidence, and and politics, get to in an essay, the heart of the text or topic being analyzed (not be peripheral).

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