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book report on gangs Published: January 29, 1967. n 1965 the Sample Resume, Attorney General of the State of California distributed a report on the Hell's Angels Motorcycle Club to law enforcement agencies throughout the state, urging that all measures be taken to contain the menace of this elite outlaw organization. According to Custom Essays Custom Writing Service, the Lynch report, the 450 members of the Sample Resume, club had a record of 874 felony arrests, 300 felony convictions, more than 1,000 misdemeanor convictions. The report held that there would have been an even more extensive record, but for the Angels' practice of 10 New Formatted Business | Templates, intimidating witnesses. The criminal actions listed by Sample College Resume, the Lynch report ranged from the Formatted Proposals | Templates, terrorization of Sample Of A College, rural communities to 7+ Ledger Template - Bookletemplate.org, the theft of Resume, motorcycle parts. Included were detailed charges of attempted murder, assault and battery, malicious destruction of property, narcotics violations and sexual aberrations. Investigating officers further reported that both club members and female associates seem badly in need of a bath. Film Invoice | Invoice Template. It was a picture of College, alarming menace.

Depraved hoodlums--unmanageable, incorrigible, vindictive and Essay Excellent Custom Writing Service organized--roamed the Sample Resume, California highways in stripped down Harley-Davidson motorcycles. They were dressed like pirates, with full beards, a ring in one ear, shoulder-length hair, an embroidered winged skull on the backs of their sleeveless denim jackets, Iron Crosses on their chests, swastikas on their helmets. These weren't the 7+ Ledger, teen-agers of the Sample Of A, usual urban gang, but adults, ranging in 7+ Ledger Template - Bookletemplate.org age from the Sample Of A, early 20's to the mid-40's. They could strike anywhere in 7+ Ledger Template the state, and they didn't fear the police. Sample Resume. The underground in which they were lords seemed dark, rancid, impenetrable.

Hunter Thompson entered this terra incognita to become its cartographer. Dental Nurse Resume. Manager Resume. For almost a year, he accompanied the Hell's Angels on College Resume, their rallies. Formatted Business | Templates And Samples. He drank at their bars, exchanged home visits, recorded their brutalities, viewed their sexual caprices, became converted to their motorcycle mystique, and was so intrigued, as he puts it, that I was no longer sure whether I was doing research on the Hell's Angels or being slowly absorbed by them. At the conclusion of his year's tenure the ambiguity of Sample Of A, his position was ended when a group of Angels knocked him to 7+ Ledger - Bookletemplate.org, the ground and stomped him. Without denying that the Angels are violent, unpredictable and dangerous, Thompson regards the Lynch report as vastly exaggerating their menace and Of A College misrepresenting their life in | Template crime.

There was a certain pleasure, he writes, in sharing the Angels' amusement at Resume the stir they created. According to - Bookletemplate.org, Thompson, the membership is in the neighborhood of Sample Of A College, 100, not 450 as the Essay Essays Service, report claimed. Sample College. The failure to get convictions had less to do with the intimidation of witnesses than with the Performance | Mytemplate.co, baselessness of the complaints. Police harassment was responsible for the large number of Sample Of A, misdemeanor convictions. Thompson, noting the relatively insignificant part the Angels play in California crime statistics, is amused at the disproportionate publicity they have secured. Template. He argues that publicity saved the club from extinction. Prior to the Lynch report, club fortunes were on the wane. Resume. The Lynch report called the Angels to the attention of national media and with the publicity breakthrough they again flourished. Thompson, in Dental Nurse Manager Examples a tone of exuberant irony reminiscent of Mencken, comments, In a nation of Sample College Resume, frightened dullards there is a shortage of Film Invoice Template Template 2017, outlaws.

The underworld Thompson reveals to Sample Of A College, us is a more familiar terrain than the Fair Custom Essays Excellent, shadowy nightmare world of the Lynch report. He doesn't find an effective criminal conspiracy, nor does he see an organization ground in Nazi ideology. He draws a picture of desperate men, without status and-- despite their motorcycles--without mobility. He traces their origins to the Okies and Arkies and hillbillies who migrated to California during the Depression. He finds the literary prototype of their ancestor in the protagonist of Sample Of A Resume, Nelson Algren's A Walk on Dental Staff Resume. Manager Resume, the Wild Side, Dove Linkhorn. Sample Of A. Most Angels are uneducated. Only one Angel in 7+ Ledger Template 10 has steady work; Motorcycle outlaws are not much in demand on the labor market. The world demands skills they have no chance of Resume, acquiring; They are out of the One Page Wedding Design, ball game and they know it. Sample Of A Resume. They have no future; In a world increasingly geared to specialists, technicians, and fantastically complicated machinery, the Hell's Angels are obvious losers, and 10 New And Samples it bugs them.

They survive in College various ways. According to Template, Thompson, a few have steady work, some pander, some steal, some live off their ladies. Sample Of A. Some are married and faithful to Resume | Template Design, their wives. Others have a predilection for gang love. What they share is Of A Resume a guiding concern to be righteous Angels and Design a love for Sample Resume motorcycles. An Angel is quoted as saying, We don't lie to each other. Of course that don't go for outsiders because we have to fight fire with fire. Thompson describes the One Page Wedding Design, attitude of a Hell's Angel to outsiders as follows: To him they are all the Resume, same--the running dogs of whatever fiendish conspiracy has plagued him all these years. He knows that somewhere behind the Crew | Template, moat, the Sample Of A, Main Cop has scrawled his name on a blackboard in the Big Briefing Room with a notation beside it: 'Get this boy, give him no peace, he's incorrigible, like an Business Proposals | Templates And Samples egg-sucking dog.' Mounted on his bike, he assumes a dignity he often lacks on College, foot. Science Excellent Custom Writing. The high-speed trip described by Sample Of A College, Thompson is One Page akin to Of A, the psychedelic trip made on LSD.

The Angel has small chance of Production Invoice Template, assuming the College, role of hero save in a fantasy trip. Most Angels. . . are well enough grounded in the eternal verities to know that very few of the toads in Dental Staff Nurse Manager Resume this world are Charming Princes in disguise. Sample College. The others are simply toads, and no matter how many magic maidens they kiss or rape, they are going to stay that way. Program Template. Vindictive at Sample Of A College Resume being toads, they invert the Formatted Business | Templates, ethic of Of A Resume, Prince Charming. Formatted Business Proposals | Templates And Samples. The initiation ceremony of an Sample Resume Angel centers on 10 New | Templates And Samples, the defiling of Resume, his new uniform and emblem. 7+ Ledger. A bucket of dung and urine will be collected during the meeting, then poured on Sample College, the newcomer's head in a solemn baptismal. They never wash their soiled colors. They mock the courtly love of Dental Nurse Resume. Resume Examples, Prince Charming with gang love. Instead of the gentlemanly duel they subscribe to the principle of All on Of A Resume, One. They don't seek justice in dispensing punishment.

Rather, the response is always one of total retaliation. If a man gets wise, mash his face. If a woman snubs you, rape her. Free Employee. This is the Of A, thinking, if not the reality, behind the Fundamental Chapter 7 - Ppt Download, whole Angel's act. Sample. The Angel rejects precautions, whether riding a motorcycle or entering a brawl. They inhabit a world in which violence is as common as spilled beer. Performance Form | Mytemplate.co. The Angel has been injured so often that he is indifferent to Of A Resume, pain. This casual acceptance of bloodletting is a key to the terror they inspire in the squares. . Film Crew | Template Design. . Sample Of A College Resume. . Analysis Chapter 7 - Ppt Download. It is Of A College a simple matter of Film Invoice Template, having been hit or stomped often enough to Of A, forget the ugly panic that nice people associate with a serious fight. The reality behind the Angel's whole act is that most of the damage is One Page Program Template | Template inflicted on themselves. Sample Resume. An average of four die violently each year.

The easy acceptance of Science Essay Custom Essays Custom Service, violence lends to Thompson's account a cartoon quality. We observe Angels brutalizing themselves and others and Sample College Resume somehow we expect them to 7+ Ledger, recover as quickly as the cartoon cat and mouse. It's not that Thompson doesn't give us a vivid picture of brawls and orgies. Of A. His language is brilliant, his eye is Essays Service remarkable, and Sample Of A College his point of view is Employee Form Template | Mytemplate.co reminiscent of Huck Finn's. He'll look at anything; he won't compromise his integrity. Somehow his exuberance and innocence are unaffected by what he sees. Dirty Ed is laid flat by a two-foot lead pipe, but he gets up and Sample Of A College Resume drives away on his motorcycle. Nurse Resume. Manager. Terry the Sample Of A College, Tramp is stomped by 7+ Ledger Template, the Diablos, a rival gang, but he still manages to Sample Of A College Resume, make the Labor Day run.

We see a mass assault on a compliant lady during a party; the dancing continues. A 7- foot Negro invades the Angel clubroom. He is Dental Nurse Manager Resume Examples Resume overwhelmed, cast down, kicked in College the face and belly, dumped in the parking lot. He gets up and walks to Dental Staff Nurse Examples Resume, the ambulance. During Thompson's last interview with a group of Sample, Angels, he is suddenly struck from behind, then from all sides. He is Science Fair Essays Excellent Writing knocked down and stomped. He is Sample Of A College Resume almost done in Crew Resume | Template by a vicious swine trying to get at me with the stone held in Of A a two-handed Godzilla grip. Film Production Template | Invoice Template 2017. He gets to a hospital unaided. Sample Of A Resume. Because the Hell's Angels have lacked a focus for Resume | Template Design their hostility, their violence has been undirected.

However, those who observe the trappings--the swastikas and Sample College Resume Iron Crosses--have wondered if there might not be in Film them the Sample Of A College, raw material out of which Brown Shirts are made. Free Employee Performance Form. This suspicion seemed confirmed when, in the fall of 1965, a group of Hell's Angels attacked an anti-war rally at the Oakland-Berkeley boundary, an assault which put them into direct conflict with the radical left in neighboring Berkeley. Sample Resume. The attack was an One Page Program | Template awful shock to those who had seen the Hell's Angels as pioneers of the human spirit, but to anyone who knew them it was entirely logical. The Angels' collective viewpoint has always been fascistic. They insist and seem to Of A College Resume, believe that their swastika fetish is no more than an anti-social joke, a guaranteed gimmick to Employee Evaluation Form | Mytemplate.co, bug the squares, the taxpayers--all those they spitefully refer to College, as 'citizens.' . . . If they wanted to be artful about bugging the squares they would drop the swastika and decorate their bikes with the hammer and sickle. That would really raise hell on the freeways. . . hundreds of Communist thugs roaming the countryside on big motorcycles, looking for trouble. However, the threat to Film | Invoice Template 2017, disrupt all future anti-war demonstrations didn't materialize. A visit from poet Allen Ginsberg and novelist Ken Kesey served to pacify the Sample, Angels and Template - Bookletemplate.org there has been no recent sign of political direction. Sample. Hunter Thompson has presented us with a close view of Performance Template | Mytemplate.co, a world most of us would never dare encounter, yet one with which we should be familiar. Of A College Resume. He has brought on stage men who have lost all options and are not reconciled to the loss. They have great resources for Employee Performance violence which doesn't as yet have any effective focus.

Thompson suggests that these few Angels are but the vanguard of College Resume, a growing army of disappropriated, disaffiliated and Fundamental Analysis Ppt Download desperate men. There's always the risk that somehow they may force the wrong options into Of A College, being.

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How to Write an Evidence-Based Clinical Review Article. JAY SIWEK, M.D., and MARGARET L. Sample Of A College Resume! GOURLAY, M.D., Georgetown University Medical Center, Washington D.C. DAVID C. SLAWSON, M.D., University of Virginia Health System, Charlottesville, Virginia. ALLEN F. SHAUGHNESSY, PHARM.D., Harrisburg Family Practice Residency, Harrisburg, Pennsylvania. Am Fam Physician. Production | Invoice Template 2017! 2002 Jan 15;65(2):251-258.

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

In articles submitted to American Family Physician , rate the level of Film Production Template 2017, evidence for key recommendations according to the following scale: level A (randomized controlled trial [RCT], meta-analysis); level B (other evidence); level C (consensus/expert opinion). Finally, provide a table of College Resume, key summary points. American Family Physician is particularly interested in Program Design receiving clinical review articles that follow an evidence-based format. Sample Of A College! Clinical review articles, also known as updates, differ from systematic reviews and meta-analyses in important ways.1 Updates selectively review the Nurse Resume. Examples medical literature while discussing a topic broadly. An example of such a topic is, #x201c;The diagnosis and treatment of myocardial ischemia.#x201d; Systematic reviews comprehensively examine the Sample Of A medical literature, seeking to identify and Science Excellent Custom Writing, synthesize all relevant information to Resume, formulate the best approach to diagnosis or treatment. Examples Resume! Examples are many of the systematic reviews of the Cochrane Collaboration or BMJ's Clinical Evidence compendium.

Meta-analyses are a special type of Of A, systematic review. They use quantitative methods to analyze the literature and seek to answer a focused clinical question, using rigorous statistical analysis of pooled research studies. An example is, #x201c;Do beta blockers reduce mortality following myocardial infarction?#x201d; The best clinical review articles base the | Template Design discussion on College Resume, existing systematic reviews and meta-analyses, and incorporate all relevant research findings about the management of a given disorder. Such evidence-based updates provide readers with powerful summaries and Film Crew Resume, sound clinical guidance. In this article, we present guidelines for writing an evidence-based clinical review article, especially one designed for continuing medical education (CME) and Sample College, incorporating CME objectives into its format. This article may be read as a companion piece to a previous article and 7+ Ledger - Bookletemplate.org, accompanying editorial about reading and evaluating clinical review articles.1 , 2 Some articles may not be appropriate for an evidence-based format because of the Of A nature of the topic, the slant of the article, a lack of sufficient supporting evidence, or other factors. Fair Essay Custom Essays Excellent Service! We encourage authors to review the literature and, wherever possible, rate key points of evidence.

This process will help emphasize the summary points of the article and strengthen its teaching value. Choose a common clinical problem and avoid topics that are rarities or unusual manifestations of disease or that have curiosity value only. Whenever possible, choose common problems for which there is new information about Resume, diagnosis or treatment. Film Resume | Template! Emphasize new information that, if valid, should prompt a change in clinical practice, such as the recent evidence that spironolactone therapy improves survival in patients who have severe congestive heart failure.3 Similarly, new evidence showing that a standard treatment is College no longer helpful, but may be harmful, would also be important to report. For example, patching most traumatic corneal abrasions may actually cause more symptoms and delay healing compared with no patching.4. When searching the literature on your topic, please consult several sources of evidence-based reviews (Table 1) . Look for pertinent guidelines on the diagnosis, treatment, or prevention of the Film Design disorder being discussed. Incorporate all high-quality recommendations that are relevant to the topic. When reviewing the first draft, look for all key recommendations about diagnosis and, especially, treatment. Try to Of A Resume, ensure that all recommendations are based on 7+ Ledger Template, the highest level of evidence available. If you are not sure about the source or strength of the recommendation, return to the literature, seeking out the basis for the recommendation.

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

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

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

Structured abstracts written by Film Production Invoice | Invoice Template 2017, University of York CRD reviewers (see NHS CRD). Abstract summaries review articles on diagnostic or treatment interventions and discuss clinical implications. Effective Health Care* Bi-monthly, peer-reviewed bulletin for Sample Of A, medical decision-makers. Based on Dental Staff Nurse Resume. Nurse Manager Examples, systematic reviews and synthesis of research on the clinical effectiveness, cost-effectiveness and acceptability of health service interventions. Bimonthly publication launched in 1995 by the BMJ Publishing Group. Article summaries include commentaries by clinical experts. Subscription is required.

Evidence-Based Practice Newsletter (including JFP Patient-Oriented Evidence that Matters [POEM])* This JFP newsletter features up-to-date POEM, Disease-Oriented Evidence (DOE), and Of A College Resume, tests approved for Category 1 CME credit. 7+ Ledger! Subscription required. Includes the InfoRetriever search system for the complete POEMs database and six additional evidence-based databases. Subscription is required. Institute for Clinical Systems Improvement (ICSI)* ICSI is an independent, nonprofit collaboration of Sample Of A Resume, health care organizations, including the Mayo Clinic, Rochester, Minn.

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

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

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

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

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

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

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

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

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

More limited than TRIP Database. Primary Care Clinical Practice Guidelines. University of California, San Francisco, Web site that includes links to Free Evaluation, NGC, CEBM, AHRQ, individual articles, and organizations. U.S. Of A Resume! Preventive Services Task Force (USPSTF)* This Web site features updated recommendations for clinical preventive services based on systematic evidence reviews by the U.S. Preventive Services Task Force.

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

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

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

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

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

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

Recently, the third U.S. Sample Of A! Preventive Services Task Force (USPSTF) emphasized the importance of Program Template, rating not only the study type (RCT, cohort study, case-control study, etc.), but also the Of A Resume study quality as measured by internal validity and the quality of the entire body of Science Fair Essay Excellent Custom Service, evidence on a topic.8. While it is important to Of A College Resume, appreciate these evolving concepts, we find that a simplified grading system is more useful in AFP . We have adopted the following convention, using an ABC rating scale. Criteria for high-quality studies are discussed in Science Service several sources.8 , 9 See the AFP Web site (www.aafp.org/afp/authors) for College Resume, additional information about levels of evidence and see the accompanying editorial in Film Invoice Template Template 2017 this issue discussing the potential pitfalls and Sample, limitations of any rating system. Level A (randomized controlled trial/meta-analysis): High-quality randomized controlled trial (RCT) that considers all important outcomes. High-quality meta-analysis (quantitative systematic review) using comprehensive search strategies. Level B (other evidence): A well-designed, nonrandomized clinical trial. A nonquantitative systematic review with appropriate search strategies and well-substantiated conclusions. Includes lower quality RCTs, clinical cohort studies, and case-controlled studies with non-biased selection of study participants and consistent findings. Other evidence, such as high-quality, historical, uncontrolled studies, or well-designed epidemiologic studies with compelling findings, is also included. Level C (consensus/expert opinion): Consensus viewpoint or expert opinion.

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

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

It should touch on one or more of the following subtopics: etiology, pathophysiology, clinical presentation (signs and symptoms), diagnostic evaluation (history, physical examination, laboratory evaluation, and diagnostic imaging), differential diagnosis, treatment (goals, medical/surgical therapy, laboratory testing, patient education, and follow-up), prognosis, prevention, and future directions. The review will be comprehensive and balanced if it acknowledges controversies, unresolved questions, recent developments, other viewpoints, and any apparent conflicts of interest or instances of bias that might affect the strength of the Template evidence presented. Emphasize an evidence-supported approach or, where little evidence exists, a consensus viewpoint. In the absence of a consensus viewpoint, you may describe generally accepted practices or discuss one or more reasoned approaches, but acknowledge that solid support for Sample, these recommendations is lacking. In some cases, cost-effectiveness analyses may be important in deciding how to implement health care services, especially preventive services.10 When relevant, mention high-quality cost-effectiveness analyses to help clarify the costs and health benefits associated with alternative interventions to Wedding | Template Design, achieve a given health outcome. Sample Of A College Resume! Highlight key points about diagnosis and treatment in the discussion and include a summary table of the key take-home points. These points are not necessarily the same as the 7+ Ledger - Bookletemplate.org key recommendations, whose level of evidence is Sample Of A College Resume rated, although some of them will be. Use tables, figures, and illustrations to highlight key points, and present a step-wise, algorithmic approach to 7+ Ledger, diagnosis or treatment when possible. Rate the evidence for key statements, especially treatment recommendations. We expect that most articles will have at most two to four key statements; some will have none. Rate only those statements that have corresponding references and base the Sample Of A College rating on the quality and level of evidence presented in the supporting citations.

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

You may use the Crew | Template following checklist to ensure the completeness of your evidence-based review article; use the source list of reviews to identify important sources of College Resume, evidence-based medicine materials. Checklist for 7+ Ledger - Bookletemplate.org, an Evidence-Based Clinical Review Article. The topic is common in family practice, especially topics in which there is new, important information about Of A College, diagnosis or treatment. The introduction defines the topic and the purpose of the review, and describes its relevance to Film | Template, family practice. A table of College, CME objectives for the review is included. The review states how you did your literature search and indicates what sources you checked to - Bookletemplate.org, ensure a comprehensive assessment of relevant studies (e.g., MEDLINE, the Cochrane Collaboration Database, the Center for Research Support, TRIP Database). Several sources of Sample College Resume, evidence-based reviews on the topic are evaluated (Table 1) . Where possible, POEM (dealing with changes in morbidity, mortality, or quality of Science Fair Essay Essays Custom Writing Service, life) rather than DOE (dealing with mechanistic explanations or surrogate end points, such as changes in laboratory tests) is used to support key clinical recommendations (Table 2) . Studies of patients likely to be representative of those in primary care practices, rather than subspecialty referral centers, are emphasized. Studies that are not only statistically significant but also clinically significant are emphasized; e.g., interventions with meaningful changes in absolute risk reduction and Sample Of A Resume, low numbers needed to treat. (Seehttp://www.cebm.net/index.aspx?o=1116.)11. The level of evidence for | Template, key clinical recommendations is labeled using the following rating scale: level A (RCT/meta-analysis), level B (other evidence), and level C (consensus/expert opinion). Acknowledge controversies, recent developments, other viewpoints, and any apparent conflicts of interest or instances of Sample Of A College Resume, bias that might affect the strength of the evidence presented. Highlight key points about diagnosis and treatment in the discussion and include a summary table of key take-home points.

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

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

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

JAY SIWEK, M.D., is Sample College Resume professor and Dental Nurse Resume. Nurse Resume Resume, chair of the Department of Family Medicine at Georgetown University Medical Center, Washington, D.C. Sample Of A Resume! He is also editor of Essay, American Family Physician. A graduate of Georgetown University School of Medicine, Dr. College Resume! Siwek completed his family practice residency at Middlesex Hospital in Template - Bookletemplate.org Middletown, Conn. . MARGARET L. GOURLAY, M.D., is currently the American Family Physician Medical Editing Fellow at Georgetown University Medical Center. A graduate of Rush Medical College, Chicago, she completed a residency in family medicine at Of A Resume, the University of California, San Diego, Medical Center. DAVID C. SLAWSON, M.D., is the Design B. Lewis Barnett, Jr. professor of family medicine at Sample Of A Resume, the University of Virginia Health System in Charlottesville, Va. He is director and Science Fair Essays Excellent Custom Service, founder of the Center for Information Mastery and serves as section editor for The Journal of Family Practice POEMs. Sample Resume! Dr. Slawson is Program Template | Template a graduate of the University of Of A Resume, Michigan School of Medicine, Ann Arbor, Mich., and he completed postdoctoral training in family medicine at the University of Virginia. ALLEN F. SHAUGHNESSY, PHARM.D., is Program Template director of research and associate director of the Sample Resume Harrisburg Family Practice Residency, Harrisburg, Pa. He completed his doctorate and fellowship training at the Medical University of Custom Essays, South Carolina, Charleston.

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

The effect of spironolactone on morbidity and 7+ Ledger Template - Bookletemplate.org, mortality in patients with severe heart failure. N Engl J Med . 1999;341:709#x2013;17. 4. Flynn CA, D'Amico F, Smith G. Should we patch corneal abrasions? A meta-analysis. J Fam Pract . 1998;47:264#x2013;70. 5. College Resume! Slawson DC, Shaughnessy AF, Bennett JH.

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

Patient-oriented evidence that matters. J Fam Pract . 2000;49:63#x2013;7. 8. Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM, et al. Methods Work Group, Third U.S. Custom Essays Writing Service! Preventive Services Task Force. Of A! Current methods of the Template - Bookletemplate.org U.S. Preventive Services Task Force. A review of the process. Am J Prev Med . 2001;20(3 suppl):21#x2013;35. 9. CATbank topics: levels of Sample Of A College Resume, evidence and Free Employee Performance Form Template, grades of recommendations. Retrieved November 2001, from: http://www.cebm.net/.

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

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

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