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Features in a narrative essay

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First published: 9 December 2004 Full publication history DOI: 10.1111/j.1471-1842.2004.00543.x View/save citation Cited by (CrossRef): 4 articles Check for updates. Alison Alborz, National Primary Care Research and essay, Development Centre, 5th Floor, Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. E-mail: alison.alborz@man.ac.uk. Objectives:  To develop methods to facilitate the ‘systematic’ review of evidence from a range of methodologies on diffuse or ‘soft’ topics, as exemplified by ‘access to health care’. Data sources:  Twenty-eight bibliographic databases, research registers, organizational websites or library catalogues. Reference lists from identified studies. Contact with experts and service users. Current awareness and contents alerting services in the area of learning disabilities. Review methods:  Inclusion criteria were English language literature from 1980 onwards, relating to people with learning disabilities of any age and all study designs. The main criteria for assessment was relevance to Guillifords’ model of access to health care which was adapted to narrative essay, the circumstances of people with learning disabilities. Selected studies were evaluated for features in a essay, scientific rigour then data was extracted and the results synthesized. Essay? Quality assessment was by an initial set of ‘generic’ quality indicators. This enabled further evidence selection before evaluation of findings according to specific criteria for qualitative, quantitative or mixed-method studies. Results:  Eighty-two studies were fully evaluated. Five studies were rated ‘highly rigorous’, 22 ‘rigorous’, 46 ‘less rigorous’ and nine ‘poor’ papers were retained as the sole evidence covering aspects of the guiding model. The majority of studies were quantitative but used only descriptive statistics. Most evidence lacked methodological detail, which often lowered final quality ratings. Conclusions:  The application of a consistent structure to quality evaluation can facilitate data appraisal, extraction and synthesis across a range of methodologies in diffuse or ‘soft’ topics. In A? Synthesis can be facilitated further by using software, such as the microsoft ‘access’ database, for managing information. The evidence base to inform methods for carrying out proper essay systematic reviews is developing rapidly. Features In A Narrative? The Health Technology Assessment programme has funded a number of teaching narrative essay, studies to further our understanding of the application of aspects of the systematic review process. 1–4 The growth of the features essay, Cochrane Methodology Register, 5 which conducts and monitors this research, also reflects the development of this subject. This is the second of two papers on literature review methodology in diffuse subject areas. The first focused on identification of relevant literature. 6 This paper describes an approach to the evaluation of quality across research employing different methods, used for a review of a ‘diffuse’ topic—‘access to health care’. As the amount of published research evidence increases exponentially, syntheses of lee do the right, evidence are an important resource in informing decision making by policy makers, practitioners and health service users. 7 The evaluation of literature described here was part of a literature review funded by features narrative essay the National Co-ordinating Centre for Service Delivery and Organization research programme (NCCSDO), which has itself produced guidance on methods for researching the organization and delivery of health services. 8 The purpose of review in this context is to summarize the available evidence to inform decision-making within health care services, while identifying areas where research is lacking. It is against this background of increased commissioning of literature reviews in diffuse topics 9 that the berlin wall essay, role of the librarian in the systematic review process is now being highlighted. 10. Literature reviews that examine services must place the features essay, research evidence in context. To this end, the review included a consultation (described in the first paper 6 ) to gather evidence on orange business barriers to, and facilitators of, access to narrative essay, health care for research automated material system, people with learning disabilities. The challenges in developing systematic review methods include how to incorporate evidence using different research methodologies into a single review 11 and how to include different types of ‘knowledge’, such as that gathered from consultation, generated to meet the need of stakeholders. 12 We felt it was important to features in a narrative, discriminate between different types of ‘evidence’ and research material handling, ‘knowledge’ as research evidence, in features in a narrative, itself, is teaching narrative, of limited value unless stakeholders are able to translate it into their own context and use it to support their practice or decision making. Only when this translation has taken place can research evidence be said to have become ‘knowledge’ either tacitly or formally within organizations. Different types of evidence are recognized as being more or less valid, depending on their quality and the purpose for which they were gathered. The consultation exercise gathered non-written forms of evidence and was designed to capture the in a essay, tacit and experiential knowledge of service users. Identification of essay, evidence context is one area where the librarian can make a significant contribution to narrative, the review process. The concept of ‘access to health care’ is multi-faceted with barriers and facilitators operating both outside and across health services. Capturing the available evidence, therefore, required identification of literature across a range of disciplines, as well as consideration of its concern to a range of stakeholders. Details of the model of ransome, access used and search strategy are given in the previous paper. 6 The full report is available on the SDO website. 13. There are two ways in which the rationale for features in a essay, the methods employed in this review differed from a systematic review of effectiveness. Paper? Firstly, it was deemed inappropriate to adopt criterion for study design, or ‘hierarchy of evidence’ 14 because research evidence on diffuse topics is in a narrative, likely to reflect a plurality of methods and approaches, in lee do the right thing essays, keeping with their multi-faceted nature. We, therefore, made no value judgements about the relative merits of qualitative vs. quantitative method, but reasoned that it was possible and justifiable to not limit evidence to a particular methodological approach or study type. Secondly, as a key purpose of the review was to identify gaps in the evidence base and practical interventions to promote ‘access’, it was important not to exclude research solely on the basis of poor methodological quality. Features Essay? It was acknowledged that such research could be substantive in illuminating the underpinning model, or ‘innovative’ in terms of potential for future service development. A conscious decision was therefore made to balance the ‘signal’ of a publication (i.e. our judgement of its potential value to illuminating access to health care for people with learning disabilities) against its ‘noise’ or poor methodological quality. 15. Quality evaluation tool development. Critical appraisal of the literature in this review draws on a number of orange business, established criteria 16,17 and approaches. 18–20 There is some agreement on the most important elements of narrative, research that embody methodological and epistemological quality that should be appraised to establish the credentials of evidence. In diffuse topics, many titles and/or abstracts retrieved are inadequate, there can be an extensive grey literature and, almost certainly, use of a wide range of methodologies. It is, therefore, preferable to use a parsimonious tool that provides opportunities to decide further analysis is unproductive. The quality evaluation tool described here was designed to scholarship, incorporate the multifarious nature of research evidence on ‘access to health care’ and provide two opportunities for features in a, data rejection before appraisal of findings and research paper automated system, final quality rating. Quality evaluation tool summary. Use of the tool is dependent on an adequate appreciation of the issues denoting rigour in qualitative and quantitative research. Features In A Narrative Essay? These are alluded to in the description of orange plans, this tool, however, the reader is recommended to see the work of in a, Popay, Rogers and Williams 18 and Mays and Pope 19 regarding evaluation of spike lee do thing, qualitative research, and Gomm 21 for a discussion of the issues affecting quality in quantitative research. Phase 1—paper identifiers and assessment of features in a, relevance. Fields—author(s), title, source, year, study type.  Paper identifiers (noted above) were recorded for every paper. Those not relevant to our model on examining the full text were discarded and the reason noted. Material System? Full details of selection criteria are given in the first paper. 6. Phase 2—evaluation of methodological rigour. Part 1. Method—fields: design, aims, participants, instruments.  Methodological details were recorded for remaining papers. The design and other details informed assessment of methodological quality, and enabled the reviewer to interpret the findings in context during synthesis. Adequate description of methodological detail in research papers is crucial to evaluation of features, quality. Business? 22. Part 2. Methodological quality indicators—fields: clarity of aims, appropriateness of design, clarity of context/setting description, sampling adequacy, data collection technique adequacy, data analysis techniques adequacy.  These indicators were applied to both quantitative and qualitative papers as they have been identified as central to features narrative, methodological rigour in both types of research. 18,19,21. It is a prerequisite of business plans, any piece of rigorous research that the aim of the features essay, study, hypothesis or research question is clearly stated as this is the yardstick against ransome essay, which findings are considered. The design of the study should then be capable of providing evidence to answer the question, support or refute the hypothesis. The reader is features in a narrative essay, unable to adequately assess the extent to which findings provide answers to research automated, research questions without knowledge of the context within which the research was conducted. Settings may exert significant influence on features in a narrative essay outcomes. For example, interviews conducted in ransome scholarship, participants’ own homes may allow more reflective and open comment than those either conducted in features in a essay, the high street or in the presence of an authority figure such as their manager, doctor or teacher. Issues of sampling also have a bearing on research outcome. Orange Business? In quantitative research, considerations of statistical power 23 often mean that large numbers of participants must be included in order to detect statistically significant effects. In qualitative research, the essay, absolute number of participants is less significant than the range 18 whose experiences reflect different perspectives on the research subject and therefore allow a more considered analysis of the topic. Methods used to collect data also influence outcome. Face-to-face interview, telephone interview, postal survey, using structured, semi-structured or grounded questioning/interviewing will all produce data, but with varying levels of detail. Data collection must be appropriate to the aims of the study and its participants. Data analysis, therefore, whether conducted on conclusion of data collection, as in much quantitative research, or concurrently, as is common in qualitative research, needs to be appropriate to the sample, type of data collected and the question it is spike thing essays, trying to answer. Part 3. Review organisers—fields: area of model, age group, severity of narrative essay, disability.  Details were recorded of which aspects of the model were covered in the paper, participants’ age group and disability range. The review aimed to reflect differences in access to health care across the lifespan and any effect severity of disability had on access. These details were recorded at this point to aid decisions on the usefulness of including the paper where the indicators showed the study to be lacking rigour. The remaining analysis was differentiated by method, however, the overall structure for writing middle, each section was consistent. Part 1. Key findings.  Findings from the research paper, relevant to the review topic, were recorded. Part 2. Evaluation of findings by method.  Whether the in a essay, findings connected with existing bodies of knowledge, or generated new research evidence, was considered and formed the ‘knowledge indicator’. Teaching Narrative Essay? Such connections were considered to signify rigour by positioning the in a essay, findings within the orange business plans, wider evidence base. This involved reflection on the findings and their relation to evidence cited in the introduction to the paper, as well as other ‘bodies of knowledge’ that the reviewer became aware of through the process of review. Quantitative studies were assessed with respect to features essay, the aim of the research and particularly whether confounding may offer an alternative explanation to the findings and whether there had been attempts to control for, recognize and address, confounding. 20 Confounding occurs where statistical significance, or association, is apparent between an business plans independent and dependent (or outcome) variable, but may in fact be attributable to a third factor, or variable, that is related to both. For example, research may demonstrate a statistical relationship between socio-economic status (SES) and computer literacy amongst 8-year-old children. Features? Further investigation may suggest that an intermediate factor—access to a computer—may mediate the lee do the right essays, relationship between SES and computer literacy. The research is therefore confounded, as it is unclear whether SES relates to features in a essay, aptitude or opportunity differences between the children. Qualitative research was assessed using established standards 18,19 with particular consideration given to essay, the validity and adequacy of studies. This was judged through theoretical and conceptual adequacy—clarity of description, logic of analysis, imagination in interpretation, coherence, fairness, honesty—and transferability of findings. For both types of study, consideration was given to its policy relevance—the extent that the study addresses issues of concern to features, practitioners and policy makers and empowers service users. Part 3. Notes—idiomatic translation.  The quality evaluation tool uses a heuristic approach to teaching writing middle, the exploration of the features narrative essay, literature, rather than rigid criteria. The Right? It was designed to include idiomatic translation of findings, to place the study within the wider literature. Notes were therefore made on the focus of the research and its fit within the model of access guiding the review, along with other relevant concerns. The literature reflected a wide range of themes, disciplines and paradigms, which represented forms of narrative and in a essay, therefore issues of audience, language and knowledge. This is in keeping with literature synthesis as a form of ethnography where the synthesiser identifies key metaphors and concepts in order to understand competing ‘world views’ of a topic. 24 This section guided final synthesis. Mixed method studies underwent both types of evaluation for their component parts. Final consideration was given to whether these met quality criteria and were adequately integrated. Part 4. Final quality rating.  Taking all the above factors into account, studies were allocated a quality rating as described below. 1 Highly rigorous—all or most quality indicators met including knowledge indicator. 2 Rigorous—main quality indicators met including knowledge indicator. 3 Less rigorous—some lack of methodological detail but knowledge indicator met. 4 Poor—lack of essay, methodological detail and/or knowledge indicator not met. Two researchers were involved in reviewing literature but, given that over 800 papers were identified as potentially relevant and there was a timescale of 1 year, it was not possible for in a, both researchers to review every paper. Research Automated System? It was therefore important to ensure that the tool provided a firm structure through which a thorough review would be conducted consistently. The tool was piloted on a sample of six qualitative, quantitative, and features in a narrative, mixed-method papers, to allow reviewer familiarization and evaluate its capacity to proper essay, capture the features in a narrative essay, dimensions of the publications to be assessed. Scholarship Essay? Comparisons were made between three sets of features in a, completed assessments and essay title, discrepancies discussed. A further three sets of papers were then completed in light of these discussions to ensure compatibility between the reviewers in application of the tool. The pilot phase was brief, but considered adequate, as the reviewers were not expected to conduct their reviews in isolation. They were able to meet to discuss and features narrative, learn from discrepancies and generate a consistent method for dealing with future cases. The co-location of the reviewers was an important factor in being able to conduct data extraction and evaluation in this way. As a result of the pilot exercise, some amendments were made to the tool to extend the number of options for classifying the literature by type, design, age group and disability range. The number of coding boxes for identifying the areas of the model explored by the publication were also increased from three to five. The tool was then converted into a database format using Microsoft ‘Access’ software. The evaluation of all remaining papers was carried out by entering data directly onto the database. Application of the evaluation tool. The tool facilitated ‘funnelling’ of literature, 22 that is stages of manual scanning and filtering search results to compensate for the lower level of specificity occurring in essay title, diffuse topic searches. The process is illustrated in features narrative, Fig. 2 below. Funnelling of references. *Discarded studies were methodologically poor and narrative essay writing school, covered areas of model where more rigorous studies were identified, or they applied to health care in the USA. Stage 1—initial inclusion/exclusion. Stage 1 funnelling was completed during the search phase where inclusion/exclusion criteria were applied to records retrieved from databases (titles and abstracts). Of the features narrative, 2221 records screened, 839 appeared to meet our criteria. This stage was deliberately over inclusive because we did not wish to lee do, exclude relevant papers/publications because of obscure titling or inadequate abstracts (see first paper 6 ). Implementation of ‘quality evaluation’ therefore began in earnest with the consideration of these 839 records. Twelve of the 839 ‘relevant’ publications identified were unobtainable. The reviewers considered the full text of remaining publications. After recording paper identifiers, confirmation was sought that the in a, paper addressed one or more of the areas of the lee do the right essays, model adopted for the research. Narrative? Any publication where the assessor was unsure or doubtful was discussed jointly to agree a status. Six hundred and forty-four publications did not address ‘access’ as defined by our criteria and were abandoned. Stage 3—methodological quality evaluation. Twenty-four of the 183 publications confirmed relevant were reviews. These were read to proper pages, ensure that papers we had failed to identify were included. Methodological rigour was poor on many of the remaining papers. The audiences for in a narrative, these publications were often practitioners, and evidence cited based on very small samples or anecdotes of proper title, experience. A few studies surviving to this stage addressed access to the insurance-based health care system in the USA and were therefore not included. Papers were read fully and assessed against a ‘generic’ set of methodological quality indicators as described above. In A? This involved considering the background to the investigation, its aims in relation to these issues, and the appropriateness of the methodological and analytical techniques employed. Proper Essay Pages? The areas of the model of ‘access’ covered in the study, age groups and features narrative, disability range were recorded and used to organize the review in synthesis. These items were valuable for highlighting ‘gaps’ in research. Papers which scored well on these ‘generic’ quality indicators, and/or those that applied to areas of the model for which no more rigorous literature was identified, proceeded to a detailed evaluation of their findings based on study design. Poor quality papers had their limitations made explicit. Stage 4—method specific quality evaluation. Eighty-two studies were considered of adequate quality and relevance to the ‘access’ model including 15 qualitative, 62 quantitative and five mixed-method studies. These proceeded to the final stage of evaluation of findings according to specific quality criteria. The data extraction and quality evaluation process included evaluation of the literature using both literal and idiomatic techniques. 24 That is, the main details of each paper were transcribed literally (word for word) from the original text onto the quality evaluation pro-forma to accurately represent original findings. These were then evaluated in light of the criteria for the study type, as described above and, using idiomatic translation, comments were added on the quality, paradigms and approaches used, comparisons with previously reviewed literature and ransome, relationship to features narrative, the model. Idiomatic translation identifies the proper, underlying ‘meaning’ of the text, from its literal meaning, and has been highlighted as a precursor for synthesizing and interpreting qualitative literature into features, a new construction or dialectic. 24 Diffuse literature review needs to proper essay, recognize competing ‘world views’ and evaluate their relevance to the model employed. This translation means that reviewer perspectives, along with the features narrative, substance of the literature, are reflected in proper title, synthesis of findings. This is a feature of literature review in features narrative essay, more diffuse, ‘soft’ topics. Final ratings are shown in Fig. 2. Proper Essay? Many papers evaluated failed to attain higher ratings as a result of lack of detail on the methodology, which made judgements on confounding, representativeness and transferability difficult. Narrative? The nature of the topic meant that statistical analysis in the vast majority of quantitative papers was merely descriptive. Statistical considerations were therefore not critical to evaluation and many of the papers rated ‘less rigorous’ were considered adequate in terms of the soundness of the data on which conclusions were based. Use of a Microsoft ‘Access’ database to manage information generated by data extraction and evaluation proved invaluable. It allowed the reviewer to extract data easily according to areas of the model underpinning the literature review. Berlin Wall Essay? Equally important, in the light of evidence from the features in a essay, consultation exercise, it enabled us to describe the distribution of the berlin wall essay, evidence across the model and hence identify ‘gaps’. Time and effort in converting the hard copy pro-forma to a database format were more than repaid at this stage. The type of literature evaluation described here is increasingly being commissioned to in a essay, inform decision making on future priorities for research, and to assess the narrative, impact of policy 9,25 from a stakeholder perspective. This has implications for the research infrastructure, of which librarians are part, in terms of capacity and skills to respond. Librarians are familiar with literature across a range of methods and disciplines and are therefore well placed to contribute to the evaluation of literature, particularly in identifying and categorizing the features in a narrative essay, different narratives that converge in orange plans, a diffuse topic. Identifying the essay, underlying assumptions, or ontology, on which research is research paper material handling system, based draws on traditional librarian skills of classifying the features in a essay, literature. Spike The Right Essays? The evaluation phase of the literature review required the authors to focus on the content of the features essay, evidence gathered during which the librarian identified and categorized the variety of orange business plans, ‘world views’ 24 reflected. This facilitated the mapping of the literature. Quantitative papers using parametric statistics, although a small proportion of the studies using this methodology, were evaluated by the first author who has the necessary skills in this area. Critical appraisal of quantitative research and features narrative, statistical methods has been identified as a skills gap among health librarians. To contribute effectively to all stages of the systematic review process, and proper pages, provide an evidence-based service, it is important that skills are developed in this area. 26. The quality appraisal tool was devised by the first author, drawing on her research experience. Essay? However, ensuring the tool was ‘fit for purpose’ required further development work during the spike the right thing, pilot phase as the narrative, tool was applied to a variety of literature. Librarians have done a good deal of work in assisting research users to identify and apply the plethora of quality evaluation tools and ransome scholarship essay, checklists available, through the features in a, Critical Appraisal Skills Programme 27 (CASP). They can extend this role by contributing to the development and piloting of research material handling, quality appraisal tools, by in a essay using their extensive knowledge of the literature, and by further testing and applying these tools in subsequent literature reviews. To this end, participating in all stages of a literature review, from the funding proposal to the dissemination of findings, can provide a vehicle for developing the role of the librarian in the health services context. At the same time, their developing research skills will enable them to orange, conduct research both on the services they provide and, as a member of narrative, a team, on research projects. Implications for wall essay, systematic review methods. Literature reviews of diffuse concepts require additional stages of features in a narrative essay, manual sieving, or ‘funnelling’ data, as final criteria for inclusion only emerge after examining the full range of automated material, available literature. 22 A high level of wastage would then seem to be an unavoidable feature of this type of review as many references initially obtained as of potential, or undeterminable, relevance are later discarded on examining the full text. The evaluation of the literature was an in a intense, iterative process, reflecting the developing literature around quality assessment in qualitative research, which suggests that further criteria refinement may be necessary during evaluation as qualitative research incorporates a wide range of proper title pages, techniques and approaches. 28. The development and in a, piloting of the quality appraisal tool was of necessity a rapid process. Time limitations also meant the literature had to be divided between the two authors. However, ongoing consultation was conducted as necessary. Given more time, each paper could have been evaluated by both assessors. This would have enhanced the scientific validity of the review findings by enabling calculation of research automated material handling system, inter-rater reliability, and further assessment of the evaluation tool. A common practice in in a essay, literature review, particularly within short timescales, is for teaching essay writing, reviewers to take the lead on specific pieces of the overall work, which are later assembled and honed into a complete review. The advantage of features narrative essay, researchers reviewing the orange business, full range, as opposed to carving out discreet areas of the essay, literature, is the depth of knowledge acquired around the topic. Narrative? As quality appraisal progressed, the reviewers’ understanding of the literature and its relationship to the model of ‘access to health care’ deepened and they were therefore able to feed this more rounded or ‘holistic’ view into the synthesis. The authors plan to further test and develop the tool and would encourage other researchers and practitioners involved in reviewing different types of evidence to provide feedback on its use. In this regard, the section of the evaluation tool entitled ‘Area(s) of the model’ was specific to the research project described here. Essay? However, this section is interchangeable and could be replaced with criteria from models or frameworks underpinning any review through which the evidence is to business plans, be organized. Finally, this literature review adopted a relativist approach congruent with the multi-faceted nature of health care service delivery, recognizing that human activity reveals a wide range of subjective perspectives and narratives. Unlike traditional systematic reviewing, therefore, all methodological perspectives and types of features in a essay, publication were considered valid. Consequently, the findings of this review challenge conventional ways of delivering health services by identifying both the proper, ‘thick’ and ‘thin’ descriptions 29 of contextual factors that may result in failure to gain access to services by people with learning disabilities. The authors believe that the value of this approach to literature review is demonstrated by the range and depth of publications identified and gaps in knowledge highlighted. They suggest that it is possible to conduct such reviews systematically, although they do not constitute a ‘systematic review’ in narrative, the traditional sense. We thank our colleagues Angela Swallow and Caroline Glendinning, all those who participated in the consultation exercise and the NCC SDO for funding this project. A full report of the business, project is features in a narrative, available from the NCC SDO website at: http://www.sdo.lshtm.ac.uk/access.htm. The full quality evaluation tool is available on teaching essay writing middle school the NPCRDC, University of in a, Manchester website at: http://www.npcrdc.ac.uk/publications/Quality%20Evaluation%20Tool.doc. •  Participating in the evaluation phase of a literature review is a valuable role that provides skill development opportunities for health librarians. Wall? •  Traditional librarian skills of organizing and classifying information can assist in identifying and mapping underlying themes and components in features narrative essay, literature reviews of title pages, diffuse topics. •  Librarians need training in features in a narrative, both qualitative and narrative writing middle, quantitative methods, and evaluation of research quality to participate in in a essay, research and become evidence-based practitioners. Issue online: 9 December 2004 Version of record online: 9 December 2004. 1 Moher, D. , Pham, B. , Lawson, M. L. & Klassen, T. Spike Thing? P. The inclusion of reports of randomised trials published in languages other than English in systematic reviews . Health Technology Assessment 2003 , 7 , 1 – 90 . CrossRef | PubMed | CAS 2 Sutton, A. , Abrams, K. Features In A? , Jones, D. , Sheldon, T. & Song, F. Systematic reviews of trials and other studies . Essay School? Health Technology Assessment 1998 , 2 , 1 – 276 . PubMed | CAS | Web of Science® Times Cited: 2 3 Song, F. , Eastwoood, A. , Gilbody, S. , Duley, L. & Sutton, A. Publication and related biases . Health Technology Assessment 2000 , 4 , 1 – 115 . PubMed 4 Egger, M. , Juni, P. , Bartlett, C. , Holenstein, F. & Sterne, J. Features Narrative? How important are comprehensive literature searches and teaching narrative writing school, the assessment of trial quality in systematic reviews? Empirical study . 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Narrative Essay Middle School? & Deans, J. ‘Fit for purpose’ health impact assessment: a realistic way forward . Public Health 2003 , 117 , 295 – 300 . CrossRef | PubMed | CAS | Web of Science® Times Cited: 4 26 Booth, A. & Brice, A. Clear-cut? Facilitating health librarians to features narrative essay, use information research in practice . Health Information and Libraries Journal 2004 , 20 ( Suppl. 1 ), 45 – 52 . 27 NHS Public Health Resource Unit. Critical Appraisal Skills Programme , 2003 . Available from: http://www.phru.nhs.uk/casp/casp.htm (accessed 23 September 2003). 28 Dixon-Wood, M. , Shaw, R. Ransome Scholarship? L. , Agarwal, S. & Smith, J. A. In A Narrative Essay? The problem of ransome essay, appraising qualitative research . Quality and Safety in features in a essay, Health Care 2004 , 13 , 223 – 5 . CrossRef | PubMed | Web of Science® Times Cited: 36 29 Geertz, C. The Interpretation of Cultures: Selected Essays . Scholarship Essay? New York: Basic Books, 1973 . Web of Science® Times Cited: 7. Articles related to the one you are viewing. 1 Pär Mårtensson , Uno Fors , Sven-Bertil Wallin , Udo Zander , Gunnar H Nilsson , Evaluating research: A multidisciplinary approach to assessing research practice and quality, Research Policy , 2016 , 45 , 3, 593 CrossRef 2 Nicola Wright , Maria Moldavsky , Justine Schneider , Ipsita Chakrabarti , Janine Coates , David Daley , Puja Kochhar , Jon Mills , Walid Sorour , Kapil Sayal , Practitioner Review: Pathways to care for features in a narrative, ADHD - a systematic review of barriers and facilitators, Journal of Child Psychology and Psychiatry , 2015 , 56 , 6, 598 Wiley Online Library 3 Blaine Reeder , Ellen Meyer , Amanda Lazar , Shomir Chaudhuri , Hilaire J. Thompson , George Demiris , Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: A systematic review, International Journal of Medical Informatics , 2013 , 82 , 7, 565 CrossRef 4 Andrew Booth , Using Evidence in Practice: Retrospective, Health Information & Libraries Journal , 2008 , 25 , 49 Wiley Online Library. Copyright © 1999 - 2017 John Wiley & Sons, Inc. All Rights Reserved.

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In an features in a, IELTS opinion essay for writing task 2, your introduction has a background statement and a thesis statement. Proper Essay Title. You should aim for between 40 to 50 words for the length of your essay introduction. Features In A. While the background statement introduces the topics, the thesis statement is proper title pages, your answer to the task given by IELTS. It should introduce the main points and features in a essay, show the essay title pages, direction your essay will take. In A Essay. Below are two possible introductions with different thesis statements for the following IELTS task. The increase in the amount of traffic is responsible for material system growing problems in many large cities and this has resulted in more traffic congestion, particularly at rush hour. What measures could be taken to deal with this problem? The introductions below have different thesis statements. Which one do you think is the best? 1. Essay. The growth in the quantity of essay middle, traffic in most major cities has led to problems of congestion in the peak travel hours. There are a number of solutions to this issue which I will discuss in this essay. 2. The growth in the quantity of traffic in features in a, most major cities has led to problems of congestion in the peak travel hours. Wall Essay. This can be solved by having a traffic free zone and improving the public transportation system offered to the public. Number 2 is the best introduction. Although the first introduction has academic language in the thesis statement, it is not appropriate for a high score essay in IELTS. IELTS is a test of in a narrative essay, your ability to use your own language not your ability to learn an academic sentence and use it in your essay. Therefore, introduction number 2 shows the main points and uses language directly relating to the task. IELTS Opinion Essay Model Band Score 9 , click here. IELTS Writing Task 2 Video: How to write an introduction, click here. hi MS.liz back ground and thesis statement are only for opinion essay or applicable all types of essay, essay in task 2 ?? please let me know. thanks in advance. Liz could you give me some good introduction sentences to start with in the opinion essay. There are no sentences which you can learn for a high score. Any sentences you learn to put in your essay will lower your score. You should start by paraphrasing the statement given – that’s all. Then add your thesis statement and your introduction is complete. Features Narrative Essay. See this page: http://ieltsliz.com/ielts-writing-task-2/ Can I write all advantages in one body paragraph and all disadvantages in one body paragraph. Sure you can for scholarship essay an advs/disadvs essay. Features Essay. It’s a logical way to organise ideas into spike essays, body paragraphs. April 5, 2017 at 7:53 pm. Hi Liz I wanna ask a question. In this essay question: Some people think that the best way to reduce crimes is to apply longer prison sentences, while other people think that there are better methods of doing so.Discuss both points of view and narrative, give your opinion. Some people believe that the most effective method towards reduction of ransome, crime rate is to lengthen prison sentences while others think that mandatory, unpaid community work would be better. Features In A Essay. In my opinion, capital crimes should attract longer prison sentences while minor offenders should be rehabilitated. Now the ransome, question did not state what other people think, it just stated” while others think that there are better methods of doing so”. Is it OK for me to insert what I think that β€œother people” thought so that I can use and develop it in the body paragraph. Or should I just leave it and add all my points in my thesis Statement. Thanks..looking forward to getting a reply from you. Always paraphrase the background directly from the statement given. The actual views of others should be explained in in a narrative, your body paragraph. In your intro just mention “while others do not agree and believe in other solutions”. Liz I am bit confused about advantages and disadvantages essays.do I need to put advantage and disadvantages separately or just like option essay in a paragarph. I have been attempted IELTS more than 6 times. Each time I get the required overall score which is ransome scholarship essay, 7.5. However I don’t get the required score for the individual modules(which is features narrative, 7). For instance if I get a score 8 in listening, 7.5 in reading and ransome scholarship essay, 7.5 in speaking, i get only 6.5 in writing. At the same time , in narrative essay, the next attempt i get a 7.5 in writing with a reading score of 6.5. this continues to happen in each attempts i make. Any one of the module will be scored 6.5 each time (even I got a 6.5 in ransome scholarship essay, listening when i had all my modules markred 7.5. Features In A Narrative Essay. This make me depressed . Please help me . This means that you have the ability to hit band 7.5 in all sections but fail to do so repeatedly. This is can be due to your understanding of the requirements of the band scores. You may produce a band 7.5 essay in one test without realising why but then fail on your technique when you write the title pages, next test. Also tests have an features in a narrative, element of luck involved. Research Automated Material Handling System. Your performance may vary depending on in a narrative, the topics and wall, questions given. I suggest you review your reading skills: http://ieltsliz.com/ielts-reading-tips-how-can-i-improve-my-score/. Make a list of all errors you make in reading practice – why you made the error, the trap used and the paraphrasing used. Then review your understanding of the writing requirements. Don’t just look at the requirements for the score you want, read all band score requirements to learn why your score goes up or down: http://ieltsliz.com/ielts-writing-task-1-band-scores/ and features narrative essay, also: http://ieltsliz.com/ielts-writing-task-2-band-scores-5-to-8/. Also consider getting one or more of proper essay, my advanced writing task 2 lessons so see where you are going right and where you are going wrong: http://subscriptions.viddler.com/IELTSLizStore. Some people think that the government spend money on public service rather that wasting money on the arts .to what extend do you agree ? Allocating state funds for arts considered to features in a, be unfair for ransome scholarship many , so according to them state funds should used used for the betterment of the public services. In my opinion , major share of public funds should necessarily be used for the basic requirement for the people such as health care system and public transport , but minimal support from state would help for the conservation of arts and culture for in a narrative the future . Firstly, spending huge amount of state revenue on proper essay, arts adversely affect on service sectors , mainly based on health . Recently , there is a tremendous growth in number of features narrative essay, people who rely on berlin wall essay, hospital for both acute and in a essay, chronic illness .lf the government fail to cope up with the public needs ,that lead to proper essay, the deterioration of health of a society as a whole . Features Narrative. Consequently , this would worsen the paper system, standard of features, health delivering services of the country. Another point to consider before investing public funds on arts is , it can weaken transportation system of the country . Whether the berlin wall essay, country developed or developing ,popularity of the public transport always remains the same , most citizen rely on public transport for their daily commuting . In such cases scarcity of enough funding would cause ineffective services . Moreover many solitary agencies will take over from government , which can result service users to pay exorbitant ticket prices . This would certainly become unaffordable and that weaken the infrastructure of the in a essay, specific country . Finally , role of art and business, museums on prosperity of country’s culture is undeniable,so that sufficient contribution on conservation of those arts are worthwhile . More precisely , museums and art galleries are valuables that handed over by our ancestors , so it’s our turn to in a narrative, give adequate protection and narrative essay middle school, also hand that over to our future generation . For that, little aid from state would be better off for the protection of those valuables. In conclusion , investing state funds on art is not feasible because government has got various other sectors to consider . However , offering financial aid for art is applicable for its protection and features narrative, promotion . Can you please tell me band score as well ,thank you. Sorry I don’t comment on writing. HELLO LIZ I HAVE A QUESTION. CAN WE WRITE “THE RELATIVE IMPORTANCE OF TRAFFIC AND ITS PROBLEM IS A FREQUENT TOPIC OF DISCUSSION ” IN THE START OF THE INTRODUCTION….. Sorry I don’t comment on writing. kindly tell me about different discourse markers one can use in speaking? They are listed on the speaking page under “linking devices for speaking”. hello mam, is this thesis is orange, right ? in the following text , I will ponder upon features, the entire articulates verdiction on proper essay title pages, it. Thank you for all the stuff you’ve been doing so far because I find them really helpful in order to achieve a great band score on the IELTS test. I have a question here. I know that the introduction 2 is way better. Features Essay. But I’m afraid that if I write my introduction in pages, that way which gives the two main solutions then I probably won’t be able to in a, paraphrase these two in the beginnings of each of my body paragraphs and berlin essay, also my conclusion. As a matter of fact, this might lower my score in terms of lexical resource because I run out of vocabulary. Am I right ? You can repeat words in IELTS and still get a high score. Paraphrasing skills should be demonstrated but that doesn’t mean you change the words all the time. English has a limited number of words in the language so it is normal that some words are repeated. Aim for accuracy at all times. Is it necessary to include all my solutions in the introduction part? I’m afraid that I can not expand the features narrative, two ideas of automated material, having a traffic free zone and improving the narrative essay, public transportation system enough, so in order to ransome scholarship, reach 250 words, I may include more small solutions which take one or two sentences each. But if I include them in the introduction, it seems tedious. Features In A Narrative. How can I do in this case? Thank you very much! I don’t really understand what you mean. Orange Business Plans. Each body paragraph should contain one solution and each body paragraph should be equally developed. You can’t put one solution in in a, one body paragraph and then two solutions in the next body paragraph. Your paragraphs must be planned properly and your solutions must be explained clearly. I was just afraid that I have no enough descriptions for one solution a while back so I hoped to proper essay title, achieve 250 words by adding more solutions which seems not working now. I will try to focus one solution with more actual examples. Your task is to answer the question and the question is narrative essay, about language not tourism. Don’t get distracted because there is extra information given by IELTS. Business Plans. You must identify what the issues are that you are responding to. Features In A Essay. This essay is easy because there’s a direct question for you to answer. OK! I know what to do. I find problem in essay, writing please help me to get better score. I have tried an narrative essay, essay please correct it so that I can improve. The growth in the quantity of traffic tends to increase problem in major cities therefore, it has lead issue of wall essay, congestion in the peak travel hours. they can be solved by having various traffic zones and improving the public transportation system offered to the public. Firstly, places should be divided into different zone, such as traffic free zone, school zone, heavy vehicle zone. Such areas must be traveled in a strict rule so that no misuse can cause traffic problem. Mostly in the main cities where most important work are to be finalized within a short period of time, one has to features narrative, struggle half of the time in traffic to research automated material, get to features narrative essay, the destination. If provided free traffic zone t these areas, it will positively solve the problem of congestion and help smooth flow of work more easy and conveniently. Moreover, people’s improve their health unknowingly doing walking exercise. Another measure to scholarship, control traffic problem is features essay, through making public transportation more available to the public. Spike Essays. Government transportation should be accessible in different parts of features in a, country, mostly in cities in a large number. Frequent travel time and cheaper fare will increase in use of public transport in which people feel more comfortable and convenient in teaching narrative essay middle, using these transportation rather than their own, undoubtedly, decrease congestion through fewer vehicles. People are motivated in narrative, saving money if provided minimal fare in wall, government vehicle. More flow of public transport helps people prefer to use such transport most. thus, the less use of private vehicle will obviously play a vital role in minimizing traffic congestion. In a conclusion, traffic problems can be solved easily if different zones are adopted strictly as well as the government implement more flexible travel rate and increase number of transportation to public. It’s a good essay but your paragraphs are difficult to see. This will be a problem in the test. Leave an empty line between paragraphs. thank you for your reply,I’m really worried with my writing part. I’m aiming band 7 in gt test so could you please help me. is it possible to guess a line to above essay. My vocabulary and grammar are terribly bad. You must have very good English to get band score 7. Features Narrative. If your vocabulary and grammar are not strong, you will need to improve them. Just a silly question, what is a traffic free zone? It’s a good question. It means an area where traffic can’t enter. Many cities have a traffic free zone in the center which is open to only people not vehicles. I am a bit confuse about handling which task for this writing because you wrote in the first sentence; for features narrative essay Writing task 1 – but I think this is for task 2, not 1. What do you think? Thanks for scholarship letting me know. Liz your teaching system is very good. Current IELTS exam topics and questions: Share your IELTS test results. IELTS Model Essays for September 2017. IELTS Writing Questions September 2017. Answer to yesterday’s paraphrasing exercise 3. IELTS Writing Task 2 Paraphrasing Practice No. In A. 3. IELTS Listening Using (Brackets) for Answers. Hi, my name is Elizabeth (Liz). I'm an experienced IELTS teacher from the UK and a graduate of the University of London. I have been teaching for over 16 years and for the last 9 years I have specialised, exclusively, in IELTS. I have taught in plans, a number of countries: England, Spain, New Zealand, South Korea, China and Vietnam, where I taught at the British Council.

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This article originally appeared in the July 2011 issue of AccessWorld. As this issue focuses on students heading back to school, I wanted to showcase this still very relevant information as an additional resource for students to keep in their virtual backpack. For high school and college students, research papers are either viewed as a walk in features, the park or the bane of one's existence. Proper Title! Some may be able to reel off several pages on in a a given topic in a matter of berlin wall a couple of hours, while for essay, others the very thought of a 10- or 20-page research paper on the rise and fall of the Roman Empire is cause for cringing. If you are a cringer, this article provides tips and the right thing tools to help make that next research paper a bit easier. Narrative! Even those who enjoy writing research papers might learn a thing or two. Before tackling any research paper, it's a good idea to get your house in order, so to speak. The tools you use to gather and sort your research don't need to paper automated handling system be fancy, but they do need to be functional and efficient. Using a laptop computer or notetaker, consider creating a new, project-specific directory in which to store any relevant data or information you run across in your research. In A Narrative Essay! When you find an article or piece of information, simply drop a text file into this directory. Be sure to include the title, author, publisher, copyright date, page numbers, and website URL in a consistent spot in your file. This will make it exponentially simpler to cite your sources later. You may also wish to write some notes near the top of the file describing the specific information or facts you plan on using from the source. Teaching Narrative Essay Writing Middle School! These additional steps may seem a bit tedious, but they'll likely help you out in the end, especially if you're the type to finish your paper at the very last minute. If your research includes printed materials, attempt to in a obtain these materials in an accessible format. As we'll discuss below, many common sources are available online. Orange Business! Others can be digitized using scanning software such as Omnipage or Kurzweil 1000 or a portable system such as the KNFB Reader Mobile or Intel Reader. Alternatively, a human reader may be able to help you write down important information from your printed research. Having these documents in a digital format will allow for easier searching later on, especially when you may not be able to find someone with enough vision to read the printed material. Defining your Topic and Beginning your Research. Sometimes your instructor will assign a topic or area as your paper's subject, while at other times you may be given the freedom to choose a topic within given parameters. In either case, you may have some leeway in narrative, the exact topic you write about. A common mistake is to pick a topic that is either too broad or too narrow for the type and size of the paper. For example, suppose you are assigned the topic "My home state of Michigan" for a 12-page paper. Michigan became a state in 1836. It would be impossible to cover all 170 years of pages Michigan's history in a dozen pages. Instead, you will need to decide on in a narrative an area to focus on. Through your initial research, you might learn about paper automated handling system Michigan's role in shaping the automobile industry, Michigan's tourist attractions, or the effects of the recent economic downturn on the state. These are much more manageable topics for features in a narrative, a paper. Now that you have a narrower focus, you can do some more preliminary research. If it seems that the topic you've chosen does not have much written about it, you may need to teaching narrative essay writing middle broaden your scope. Essay! Conversely, if it seems like there is too much to cover in a single paper, you will want to narrow your topic even further. Begin your online research with the basics: Google and Wikipedia. While neither of these references functions well as a primary source, each can be a great jumping off point for further research. Successful and efficient searching with Google requires some skill. Searching for the term "Michigan" will return all sorts of plans likely irrelevant results including the Michigan Lottery and features in a narrative the University of business plans Michigan. Google is not smart enough to read your mind; instead of a single general search term, include additional keywords to in a essay limit and target your search. Searching for "automobile history Michigan" returns an entire page of relevant results. The first result, in fact, is an article entitled, "Motor City: The Story of proper essay Detroit" by Thomas J. Sugrue from the Gilder Lehrman Institute of American History--a great starting point for this topic. In A Essay! Google includes dozens of powerful and often hidden features that can be used to spike thing perform more powerful searches. This page of Google Search Tips includes helpful advice and strategies. Though most professors, for good reason, frown upon the use of Wikipedia as a source, it's still a great idea to read Wikipedia entries related to your chosen topic. Good Wikipedia entries will include a list of sources for the topic, such as this entry on the history of the automobile. As you read through this entry, you will notice a series of numbered links. These refer to the sources cited in this article. By selecting one of these linked numbers, you will be able to view the footnote, which gives the in a narrative title, author, and other location information for the source. Well-researched Wikipedia articles such as this one also include a "Further Reading" heading which provides a list of additional books and articles to consult. While Bookshare is well-known as a source for accessible textbooks and leisure reading materials, recent improvements have increased its usefulness for performing research. Bookshare now includes roughly 100,000 books available in a digital form. Title Pages! It's free for in a narrative, any United States student with a qualifying disability and pages $50 a year for anyone else. Among the more recent improvements to the website is features essay, a full text search of ransome scholarship essay its collection. Typing the search terms "history automobile" into Bookshare reveals a variety of potentially useful book results including Taking Charge: The Electric Automobile In America and Crash Course: The American Automobile Industry's Road to Bankruptcy and Bailout--and Beyond, both of which may provide useful information for the automobile industry's modern history. Bookshare also includes an immense collection of fiction, as well as many opinionated and editorial selections, so be careful to features in a include accurate and pertinent information when performing your research. While on Bookshare, try searching for any books listed in the Wikipedia entries you've read; you may locate some of these sources in ransome scholarship, an electronic form. Most colleges and in a some high schools provide online research tools for students, often linked to the school's library website. Berlin! Sometimes you must be physically present at the library to perform the research, while in other cases a student can log in to access information from home. In A Narrative! If you are required to be at the library for essay, your research, ask if it is possible to log in in a essay, from your own computer or one that provides your required accessibility tools. By law, it is the library's duty to provide you an accessible means to access their research collections. From our experience, most online research collections are quite accessible to use and navigate. Essay! Most include some form of a textual layout for searching. Some of the search forms include a wide array of in a options and berlin features, so it may be necessary to closely examine their structure in order to obtain the most relevant results. Narrative Essay! Some collections, especially those including 19th and earlier 20th century newspapers, offer materials in a scanned PDF format. While these may seem inaccessible on the surface, they can usually be converted using an OCR program such as Omnipage or Kurzweil 1000. If you don't have access to one of orange business these programs, try one of the many OCR conversion websites such as OCR Terminal. Many of features narrative these sites are free or provide a set amount of free pages per month. While at the library, don't overlook the more traditional methods of research. Many older books and periodicals are not easily attainable in a digital format; a reference librarian or student aid may be able to berlin essay help you locate these items. To save time, use your library's website to research available relevant materials. Make a list of the sources you're interested in, print it out, and bring it with you when you visit. You can use a website such as WorldCat to search many libraries at essay once for information. Plans! If you find a book or source at a library other than your branch, find out if it's possible to features in a narrative have it delivered to essay your local library. Creating your bibliography or "Works Cited" page is often seen as very tedious, but putting this important list together should be one of the in a essay simpler parts of your paper. One common mistake made by students is waiting until they are finished with a paper before tackling this list. Proper Title Pages! It's much easier to create your citation list as you write your paper. Microsoft Word and other modern word processors provide for a means to add footnotes to your paper. In A! Each time you add a note, move to the footnotes section of scholarship your document to features in a enter the proper essay title, author, and other source information. This will avoid the in a narrative essay problem of trying to remember where you found a specific piece of information when you need to cite it later. School! There are several acceptable citation forms; find out from your instructor which is required for your paper. Free online tools such as BibMe can be used to properly format your citations. BibMe asks for various information about your sources and then outputs a bibliography in the format you chose. You may at some point find it tempting to copy a few sentences or even an entire paragraph from an in a article directly into your paper, without proper attribution. Doing so is scholarship, plagiarism, a very serious academic offense. Plagiarism usually results in a failing grade for a class, and in some cases leads to expulsion. Always be careful to properly cite your sources. Many students (and teachers) use Turnitin to check papers for plagiarism. Features! Turnitin compares submitted text to practically every page on paper automated the Internet, research indexes and journals, and papers written by other students. With the expansion and proliferation of the features in a essay Internet, online research has transitioned from a luxury to a near necessity. While the Internet does not render your local library obsolete, it's certainly suitable for a wide variety of research tasks. Proper Essay! Online research also helps to level the features essay playing field for performing research as a blind or visually impaired student. Given the proper tools and techniques and a bit of perseverance, that next research paper may be a bit easier to automated tackle. More from this author: Copyright Β© 2016 American Foundation for the Blind. All rights reserved. AccessWorld is a trademark of the American Foundation for the Blind. AccessWorld ® keeps people with vision loss and their families, teachers, rehabilitation counselors, product developers, and features in a essay manufacturers up-to-date about the ransome scholarship technologies that can transform their lives.
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