At What Age Do Child Maintenance Payments Stop?
Find local food near null! Use our map to locate farmers markets, family farms, CSAs, farm stands, and u-pick produce in your neighborhood. Find Your Farmer. The American Civil War (also known by other names) was a civil war in the United States from to , fought between northern states loyal to the Union and southern states that had seceded to form the Confederate States of America. The principal cause of the war was the status of slavery in the United States, especially in the territories.. After Abraham Lincoln won the November
TORONTO Ч A report from the Canadian Securities Tsop says that women now sit in two out of 10 corporate board seats Ч but just six per cent are chairwomen of public Canadian companies surveyed. The securities regulators also said that 79 per cent of the companies in how to stop csa taking money report had at least one woman on the board, up from 49 per cent in But moneh report also noted that 21 per cent of companies had no women on their ro, and only five per cent of the companies surveyed had a woman as chief executive.
After a three percentage point decline in the how to stop csa taking money of vacant board seats filled by women last year, the CSA says it will not only continue to monitor the companies' progress, but will also consider its role in the broader diversity conversation. The CSA says manufacturing, real estate, and retail industries companies were most likely to have women on their boards, while biotechnology, mining and oil how to lower liver enzyme count gas industries had the fewest companies with at least one woman on the board.
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TORONTO Ч A report from the Canadian Securities Administrators says that women now sit in two out of 10 corporate board seats Ч but just six per cent are chairwomen of public Canadian. Mar 01, †Ј The entire tournament was played within a bio-secure environment (BSE) in the coastal city from February A total of 17 matches were played with the Dolphins topping the table with five wins from five matches, automatically qualifying for the final while the Lions ended second and beat the third-placed Dafabet Warriors in the play-off on Saturday. Apr 09, †Ј My son turns 18 in July and heТs working 2days a week and go to college when do I stop paying csa IТm looking high and low but canТt find out anything the csa are not helping they just want to take my last penny IТm currently on furlough have children to buy food for and IТm not getting help anyway any advice would be great.
The GP medical training website for everyone, not just Bradford. Our goal here is to make complex educational theory as practical and as accessible as possible for busy medical teachers Ч to stimulate you, reduce duplication of work and help you add creativity to your educational programme.
If you have files you would like me to host on here and share with others, OR if you would like to help develop these pages further, then please email me. A framework is a basic structure that helps guide your approach to something.
What should I do? I could get in the car and just drive around. Okay Ч there is a possibility I will end up getting lost. But if I get onto the main roads and read all the road signs carefully I should be able to find the motorway which will then direct me further. And yes, it might take 2 hours longer than expected Ч but I could be successful and end up in Sunderland!
BUT this method is messy and unstructured and that makes it lengthy, unpredictable and therefore unreliable. There is a better way Ч and that is by using a map. With a map Ч we can get an overview of how to get there and keep that in our minds. That map will help us do the journey in half the time! In this example, the map serves as a framework for our journey. In fact, we might even be able to enjoy the ride and admire the scenery. In a similar way, a consultation framework is like a consultation map Ч it helps with our consultation approach by making the consultation journey smooth and structured.
And hopefully even enjoy that journey. The other advantage of a framework is that it provides a reference structure that you can fall back on. For instance, if you get all nervous and flustered: take a deep breath, revisit that CSA framework in your mind. Identify where you got flustered and where you need to start back from. Then you can determine what steps needs to happen to get to the end.
Just like the you would do if you accidentally took the wrong turn during your Sheffield to Sunderland trip. You would pull up somewhere safe, take a breather, get your map out the framework , identify where you are and determine how to get back on track. This video explains why models or frameworks Ч the same thing , and why they are important. Basically, they have developed over the years. I think the first formal model came out in the 70s and different generation of doctors have build upon what has gone before.
There is a large overlap between the different models in terms of the tasks to be achieved by the consultation. And some place more emphasis on certain tasks than others. And the newer models does not mean that they are better than the old. Reading a consultation book or two will definately help you get some of the cores communication skills to consult effectively with patients.
Although some people are naturally good at patient-centred consultting and others less so, the good news is that these skills can be learnt. Even if you are not good at consulting in a person-centred way, with practise you can learn to be as good as those who are naturally good. Of course, the key word here is practise!
So, out of all the models how do you choose? Well, just have a look at some of them and find one that you feel would work with your personality and style. You can then practise that model and add your own tweaks and style to it. Of course, you may want to play with several, like I did. Some good consultation books areЕ. An examiner cannot give you marks for Clinical Management if you ran out of time to do it.
They cannot second guess what you would have done Ч not matter how well you did the Data Gathering bit or how nice you were as a doctor. Both of these sections the first and second 5 minutes offer an opportunity for you to provide evidence for all three marking areas Ч Data Gathering, Clinical Management and Interpersonal Skills. For example, in the first 5 minutes:. In the second 5 minutesЕ. Some CSA cases will undoubtedly require more time on the Data Gathering whilst others will need less.
But one thing is for sure: by the 6 minute stage, you definitely need to start thinking about wrapping things up and closing. There are several frameworks out there to help you with the CSA Ч not just mine. You could modify one or combine bits from each to develop a framework that suits your personality and style.
Remember, this is not about making all GP trainees into replicas of one model. You are individual and unique. The frameworks define the content Ч i.
BUT how you go about achieving those outcomes is entirely up to you. You can peel an orange a variety of ways. Some will use their hands. Others will use a knife. Yet others might use a fancy gadget. What really matters is whether the orange is successfully peeled at the end of the day without bruising it. Can you bruise an orange? Now, if you look at all the frameworks you will notice that what they have in common is the content Ч they all spell out the same sorts of things that need to be covered.
The way they differ is in their order or style. And you can do the same too. Please do play around with the different frameworks and develop your own if none of them suit. Actually, if you look at qualified GPs, you will see that they all follow a framework. Yes, all of us follow a consultation framework of some sort and each GP will have developed their own version to fit in with their own personality and style.
Some GPs may not even realise they are following a model Ч but they are Ч because if you watch them repeatedly, you will be able to map out a common structure that they tend to follow. We all forget to follow our usual consultation now and then e. For instance, I saw a patient who I actually thought we had a good consultation. It was about whether she should give anti-anxiolytics a go and i subsequently prescribed some.
And when I thought back, I do remember not particularly exploring her Ideas, Concerns and Expectations. If I had done, then perhaps we could have come up with a better joint management plan like engaging with an anxiety management programme or mindfulness.
So Ч all GPs use some sort of consultation framework. Newer qualified GPs tend to use some variant of the CSA framework that they practised with as a trainee. Therefore do invest time in developing the right CSA framework for you Ч because it will continue to serve you after qualification and often for life!. It becomes a part of you and the process becomes natural as it is internalised.
But even after qualification, I continue to loosely follow this model because a it has become an effortless part of my work-life being i. I no longer have to think about it and b it works i. In other words, it gives me peace of mind. In summary, invest in your CSA framework Ч because it will serve the basis of your approach in the rest of your working GP life.
The only difference between pre and post CSA is that you can take longer than 10 minutes in the real GP world Ч what a luxury! Neither position is particularly good in terms of helping you. And do you think it is a nice position to put the shop assistant in? What is a good position is a nice positive joyful interactive encounter between both of you which results in a seamless return of the item. The shop assistant and I had a little giggle as I told her about how slim I thought I was until the T shirts told me otherwise!
And the exchange was lovely. Do you thing they will be on guard and defensive? And will the rest of out coffee morning be nice and relaxed or edgy and uncomfortable?
What has this got to do with the doctor-patient encounter? It means getting the first minute right is really crucial because it has a big impact on the rest of the consultation.
And the way you behave will affect how the patient behaves and how long they talk and open up. Their monologue will last less than 30 seconds and you will get very little information of useful value.
It provides a starting point that provides a bit of guidance for the rest of the consultation. So, how do you it? Start of by being quiet but also start off by being yourself. Be nice. Be kind. Be compassionate. Be forgiving. Show that you want to help them. And do all of this with true genuine feeling. Show that you care.