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Pediatric Palliative Care and Pediatric Medical Ethics: Opportunities and Challenges. The fields of Communication pediatric palliative care (PPC) and pediatric medical ethics (PME) overlap substantially, owing to a variety of historical, cultural, and social factors. This entwined relationship provides opportunities for leveraging the strong communication skills of both sets of providers, as well as the potential for resource sharing and symbolism, research collaboration. At the same time, the personal and professional relationships between PPC and PME present challenges, including potential conflict with colleagues, perceived or actual bias toward a palliative care perspective in resolving ethical problems, potential delay or underuse of PME services, and a potential undervaluing of the medical expertise required for PPC consultation. International Communication. We recommend that these challenges be managed by: (1) clearly defining and communicating clinical roles of The Nordic Model Essay PPC and Essay on International Communication, PME staff, (2) developing questions that may prompt PPC and PME teams to request consultation from the other service, (3) developing explicit recusal criteria for PPC providers who also provide PME consultation, (4) ensuring that PPC and PME services remain organizationally distinct, and (5) developing well-defined and broad scopes of citing website apa practice. Overall, the rich relationship between PPC and PME offers substantial opportunities to better serve patients and families facing difficult decisions. pediatrics palliative care medical ethics hospital care Abbreviations: PME — pediatric medical ethics PPC — pediatric palliative care. Prologue A 14-year-old boy, who we will call John, lies in bed. His head and back are propped up by pillows, his breathing appears labored, and his brow glistens with sweat. Next to Essay on Communication, his bed stands an single issues IV pole with a patient controlled analgesia pump, a long thin clear plastic tube connected to the central venous catheter that protrudes from underneath his shirt.

The room is dark, the shades being drawn and all but the bathroom lights turned off. Outside, in the hallway, with the door to his room closed, his parents are conversing in an animated manner with the International Communication attending physician. They do not want their son to be told that the cancer has returned and is now widely spread. At the same time, they recognize how uncomfortable their son is and want all efforts to be made to lessen his pain and ease his breathing. After a fairly lengthy discussion, the parents and the attending physician agree to requesting both a palliative care consultation, to help with pain and symbolism, symptom management as well as further clarification of Essay on International Communication goals and limits of creek care, and an ethics consultation, to help think through the pros and cons of telling John the full truth or something less than the full truth. For the past several decades, in the realm of pediatric hospital practice, the on International fields of palliative care and medical ethics have to a large degree overlapped and entwined. Indeed, this special supplement to Pediatrics , 1 of a series of supplements devoted to pediatric ethics, testifies to The Nordic Model, the particular relevance of pediatric palliative care (PPC) to pediatric medical ethics (PME), and vice versa. In this issue, the reader will find illuminating discussions of the ethical “hot topics” of autonomy, truth telling, futility, the role of values in decision-making, the extent of professional duties, and on International, the line between the easement of creek massacre definition suffering and on Communication, euthanasia (all fitted out with compelling apt examples from The African Congress South African PPC). Even if the relationship between PPC and ethics is evident, we should not consider the Essay International depths of the relationship to parenthood issues, be self-evident, nor should we be blase about how to best manage aspects of this relationship. 1 , 2 In this essay, we will explore the reasons for the association (at times verging on an alliance) between PPC and pediatric ethics, consider the advantages and disadvantages of this tight relationship, and Communication, offer up some recommendations about social examples how to manage and make the most of this set of connections (Fig 1). Reasons, opportunities, challenges, and recommendations for managing the relationship between pediatric palliative care and pediatric medical ethics.

In writing this essay, one of Essay on International us is sand creek, fully aware that he (albeit as a flawed example) personifies this enmeshed relationship, being both a practicing PPC physician as well as a practicing pediatric ethics consultant at a large children’s hospital. The reader should also be aware of these facts, as the journey along this dual-path career may have provided not only on International, certain insights but also some personal baggage that may have influenced what we write. The origins and causes of the association between PPC and good health examples, ethics can be traced to historical and cultural factors, as well as a combination of self and social selection. In 1965, the concept of using “intermittent positive pressure ventilation” to treat immature infants was born into the world. 3 Although physicians had long provided care to infants who were born well before their due date, the introduction of intubation and mechanical ventilation led to the creation not only of neonatal intensive care units during the ensuing decade, but also to a host of pressing ethical dilemmas. Doctors had to on International, decide which premature infants should be treated with this level of high-intensity care. The alternative to intubation, mechanical ventilation, and symbolism, other invasive neonatal intensive care unit interventions was to provide “comfort care measures,” or what we would today call palliative care.

4. During the 1970s and early 1980s, the practice of issuing “do not attempt resuscitation” orders both came into existence and became a focal point for ethical debates about the Essay on involvement of parents in the process of making decisions about the medical care that their children receive. 5 Here again, the dilemmas about the appropriate ways to The African and the Fight, care for dying children and children who have serious illnesses were the focus of both medical ethicists and Essay on International, of specialists in palliative care. In 1979, the paradigm-altering ethnographic study of the “private worlds of dying children” revealed that children who had advanced cancer often fully understood the grim nature of their prognosis. 6 Even so, the children seldom talked about their thoughts, beliefs, or dreams about dying, death, or an citing apa afterlife, maintaining this lonely isolation by a sad dance of “mutual pretense.” Both the children and their parents continued to behave with each other as though everything would be okay to provide support to the person they loved. The ethical concern of truth telling was henceforth apiece with PPC. In 1982, Baby Doe was born with Down syndrome and International, an esophageal atresia with a tracheal esophageal fistula. After a decision to not operate to correct the atresia was made by his parents and physicians, the infant was treated with sedating and pain relieving medications until he died 6 days later. 7 The subsequent outcry and passage of federal regulations underscored again the contentious dilemma of who to treat and how. Citing Apa. More pointedly, the Baby Doe controversy brought to International, the fore concerns about biases against disabled individuals, as well as concerns when family interests seem to outweigh the best interests of the citing website child, with both sets of concerns potentially leading to fundamental injustices. 8 , 9.

These examples can be multiplied, illustrating how historically some of the most trenchant issues in pediatric medical ethics have arisen in Essay International Communication the context of patients who have grave illness potentially confronting the end of life, with difficult decisions to single, make about how to Essay on International, best care for these individuals. The observed historical association of PPC and PME is no coincidence, reflecting instead several aspects of our cultural milieu that make this association likely. Health Examples. 10 Death is an oddly marginalized topic in American culture, being on the one hand the centerpiece of violent or frightening mainstream entertainment, yet on Essay on Communication, the other hand being an parenthood issue so painful and difficult to contemplate privately or discuss publicly that doing so in a sustained, thoughtful, considered manner is on Communication, felt by many to be taboo. As a result, even though the National Fight Against South Apartheid death rate is ultimately 100%, we struggle as a society to envision the ideal care of dying individuals, to engage each other in formulating plans to assure such care, and to enact these care plans. These struggles are difficult when the patient is a competent adult, and exponentially more difficult when concerning children.

PPC engages in this struggle, patient by Essay on Communication patient. Such efforts require not only grappling with death, but also with other difficult and marginalized issues that are central to PME, such as views regarding the value of life, the degree to which impairments do or do not diminish this value, the practical and spiritual implications of symbolism of apples pediatric suffering, and the pursuit of a path of on Communication care that is in social the child’s best interest while respecting the Essay International child’s emerging capacity to make reasonable decisions that may be contrary to the decisions of the parents. People who engage in PPC and PME also tend to exhibit similar personality characteristics: good collaborative communication skills, a manner of interpersonal interactions perceived by others as especially respectful and kind, an often broadly ecumenical personal world view, and an openness to both joy and sadness. This is not to say that PPC and PME practitioners have a corner on the market of any of single parenthood these characteristics, or exhibit all of them to an exemplary degree, but these characteristics do seem to cluster in both of these sets of practitioners. This clustering may be driven by individual self-selection, based on one’s sense of personal interests and strengths, or by Essay Communication the encouragement of others. The overlap of PPC and PME, in terms of both core content concerns and personnel with interest and aptitude, presents several advantageous opportunities. Shared Collaborative Communication Skills. A core set of collaborative communication skills enables PPC and PME personnel to single parenthood, have productive and Essay on International, sometimes transformative encounters with patients, parents, and other health professionals. Collaborative communication can help to clarify everyone’s (often differing) sense of the clinical situation, explore and support feelings of The Nordic Essay hope, fear, and frustration, examine the rationale and goals of care, and formulate consensus treatment plans. Communication. Such collaborative communication, when empowered by citing emotional intelligence, can promote a common sense of purpose and International Communication, respect, and can create shared agendas out of apparent conflict.

Having personnel who are particularly adept at collaborative communication use this skill in both the single practice of PPC and Essay International, PME is good social health, a sensible use of a valuable and sometimes limited resource. The fields of PPC and PME can provide cross-fertilization regarding skills and International Communication, intellectual agendas. The specific collaborative communication challenges confronted by The Nordic Model practitioners in either PPC clinical consultation or PME ethics consultation can promote the further growth and Essay, development of Congress and the Fight Against African Apartheid these practice skills in ways that can benefit either realm of International practice. The 2 disciplines also have, as noted, many common areas of interest, presenting opportunities for scholarly or research collaboration. Some organizations combine palliative care and medical ethics programs, housing them underneath 1 administrative umbrella. This arrangement, which seems sensible given the overlap of The Nordic PPC and Essay Communication, PME outlined here, permits the colocation of like-minded colleagues and efficient use of The Nordic Model support staff and joint program resources. The overlap of PPC and PME also presents certain challenges that need to be recognized and managed.

Potential Conflict With Colleagues. PPC sometimes involves conflict among health care colleagues, and PME consultation sometimes is sought to address and resolve these conflicts. To the degree that members of the PPC team are also members of the PME consultation service, the handling of the on Communication case by good examples the PME consultation service may appear to be influenced by a conflict of collegial interests. The potential for Essay, such conflicts exists regardless of which configuration of colleagues is involved. Citing Apa. For example, overlap of the PME consultation service with members of the neonatal, pediatric, cardiac, or surgical ICU staffs would all raise similar concerns. Although these concerns motivate some to Essay Communication, call for PME consultation services to be staffed by social examples individuals outside of the hospital or organization, such staffing models raise other practical concerns, while still not necessarily dissolving all potentially influential interpersonal relationships. Potential Conflict of Commitments. At a deeper level, PPC represents a certain stance regarding the goals of medical care. 11 , 12 This stance can be best summed up as follows: “to cure when possible, to comfort always.” This philosophy of International care is often accompanied by The Nordic Essay a deep sense of purpose and personal mission, which can be good or bad.

A powerful sense of International Communication mission motivates practitioners of both PPC and PME to plunge into difficult emotional situations. If one’s commitment to this sense of personal mission is citing, very strong, however, then the ability to take on the perspectives of Essay International others (which can be critical for exploring and understanding the citing website ethical dimensions of difficult clinical situations) may be compromised. Again, this challenge is not unique to those who practice PPC. International. Neonatologists and oncologists, intensivists and cardiologists, surgeons and general pediatricians all may have deep personal and philosophical commitments that need to be managed when engaging in ethics consultation. Similarly, health care personnel who perform PME consultation are often committed to a deliberative process that may be at odds with the pace of decision-making required by a particular case, or to the attainment of parenthood consensus, which may not be possible in all cases. Potential Delay or Underuse of PME. Although PME clinical consultations sometimes identify unmet PPC needs, and thereby result in a PPC consultation, the opposite does not occur as frequently: PPC consultation rarely results in Essay International Communication a subsequent PME consult. While such a chain of events does occur from definition time to time, PPC staff, given their collaborative communication skills (and for some, their formal training in Essay on Communication PME or involvement in PME consultations), may be able to manage most of the single parenthood ethically challenging cases (but not all of them) and thus run a risk of not drawing on the resources and potential benefits of PME consultation in a timely manner. This may be especially true for cases in which PPC staff have forged a strong therapeutic relationship with the patient or family, yet other clinicians are nonetheless struggling with a sense of moral distress.

PME consultation in these situations can provide a forum for on, dialogue, enhanced team-wide understanding of the goals of care, and ultimately better therapeutic relationships across the entire health care team. Potential Undervaluation of PPC Medical Expertise. To meet the needs of children living with life-threatening conditions and their families, PPC demands a thoroughgoing knowledge of advanced pain and symptom management, as well as a firm understanding of the disease processes that cause serious pediatric illness. Social Health Examples. PPC practitioners also need to Communication, have high-functioning relationships with community-based hospice and home nursing agencies. Equating PPC only website apa, with communication and decision-support (which is to say, with the components of PPC that most overlap with PME) is to misunderstand the Essay on International scope of website medical expertise that PPC requires. Potential Limitation of the Scope of Medical Ethics.

Conversely, too much emphasis on the ethical issues that arise in the care of children who have serious life-threatening illness limits the scope of on International all the single parenthood issues topics that PME should address. Many medical ethics issues are far afield from end-of-life dilemmas, ranging from the ethics of expanding newborn screening programs and other innovations emerging from Essay on Communication genomic-based medical practice, to the quotidian challenges of access to high-quality care or the detrimental effects on The Nordic Model Essay, long-term wellbeing of exposure of Essay on Communication children to poverty or violence. Ethicists worry about the regulation of sand creek massacre definition research, about enhancement therapies, and about the policy issues and Essay Communication, looming challenges of intergenerational distributive justice. Furthermore, PME has not only an important role in performing clinical consultations, but also a vital role in issues the formulation or review of a wide variety of Communication hospital policies that extend beyond the domain of symbolism PPC, as well as the provision of ethics education to members of the health care staff across the range of PME topics. With these thoughts regarding opportunities and challenges in Communication mind, we offer the following set of recommendations about managing the relationship between PPC and PME. Define Clear Roles and Promote Role Identification. Health care personnel involved in both PPC or PME, like all other health care personnel, need to Essay, be clear in their own minds regarding the clinical role that they are entrusted to fulfill in Communication the care of patients and families, and be explicit when communicating the nature and expectations of this role to patients and parents. If, in the passage of time and turn of events, a health care professional moves from one role to another in the care of a patient, this role transition also has to be recognized inwardly, and symbolism, communicated clearly to patients, family members, and others.

Identify Clear Consultation Trigger Questions. Both PME and PPC clinical staff should, when going about their consultative duties, pose to themselves (and potentially other health care staff as well as patients and families) a few questions to prompt recognition or awareness that the other consultative service might be beneficial. For PME staff, some useful questions are: Does this patient have unmet pain or symptom management needs? If the patient has serious illness, are the goals of care clear? Is the patient in a failing state of health with no single clinical service providing guidance, in partnership with the patient and family, about how to proceed with care? For PPC staff, questions might include: Is there any debate about what is the “right thing” to do to help this patient? Is this debate at the level of dissension or discord?

Are the patient or family feeling that they are not being heard? Are members of the clinical staff reporting feeling uncomfortable with the Essay on International Communication care that is being provided, or even a strong sense of moral distress? If now is not the “right time” to request a PME consultation, what events or discussions would indicate that the right time has indeed arrived? Weekly team meetings of PME staff, monthly ethics committee meetings, and weekly interdisciplinary PPC team meetings are good occasions to symbolism, pose or to revisit these questions. Essay On International Communication. These meetings can essentially provide a level of clinical supervision to these realms of overlapping practice. Similarly, health care personnel involved in PME need to develop criteria that can provide prompts or guidance about creek when to recuse oneself from a PME ethics consultation. International. Individual PME providers may find themselves involved in an ethics consultation on a case in good examples which they are intimately involved as a medical provider. Ideally, ethics consultants should bring an impartial perspective to each consult, which can be more challenging if that individual is also providing clinical care to Essay on International, the patient. PME consultants who also provide direct patient care need to be able to recognize the limitations to sand creek definition, their objectivity in these circumstances and appreciate the on International value of calling in an outside consultant in such cases. Maintain Organizational Distinction.

Clarity of roles extends beyond the context of direct patient care: PPC teams and PME consultative services should have different names for these distinct organizational roles, along with separate budget lines and reporting structures. As noted, locating PPC and PME services under one administrative umbrella can increase efficiency through resource sharing. At the same time, clear separation needs to of apples, be maintained between the two, as they serve different roles within the organization, and if the distinctions are blurred organizationally they are more likely to be blurred at the bedside. Additionally, for some of the most ethically challenging cases, distinct PPC and PME services may need to be an organization double-check (or potentially a check-and-balance) for each other. International Communication. Indeed, for such cases, PPC and PME staff can potentially role model how to address differences of opinion among health care staff regarding the best course of action, engaging in discussion that is respectful and Essay, vigorous, listening and challenging, sensitive and Essay on, searching. Build and Maintain a Broad Scope of Work. At the national level, the issues fields of both PPC and PME are promulgating practice guidance and standards, such as have been articulated by the American Academy of Pediatrics regarding PPC and PME consultation and hospital ethics committee work, 13 , 14 and as are set forth in an increasing number of textbooks and on International Communication, professional society guidelines. 15 – 19 At the local level, within hospitals and health care systems, PPC and PME programs should identify their own practice standards, including their scope of practice, and monitor whether their performance drifts over time to unduly focus on one area of their intended scope of practice while neglecting others. The relationship between PPC and PME, arising from historical, cultural, and social underpinnings, is too important to leave to chance.

On balance, we believe that the relationship offers substantial opportunities for symbolism, the better care of the patients we serve and their families. To achieve that lofty goal, professionals in both fields must be mindful of the Essay on International Communication challenges that need to good examples, be managed in terms of on Communication organizational structure, role expectations, and reflective practice. Accepted November 12, 2013. Address correspondence to Chris Feudtner, MD, PhD, MPH, The Children's Hospital of Philadelphia, 3535 Market St, Rm 1523, Philadelphia, PA 19104. E-mail: feudtner email.chop.edu. Dr Feudtner conceptualized and drafted the initial manuscript; Ms Nathanson critically reviewed and added content to massacre, the draft manuscript and edited the manuscript; and both authors approved the Essay on final manuscript as submitted.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. FUNDING: No external funding. POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. Morrison W , Derrington SF . Stories and the longitudinal patient relationship: what can clinical ethics consultants learn from palliative care? J Clin Ethics . 2012 ; 23 ( 3 ): 224 – 230 pmid: 23256402.

Carter BS , Wocial LD . Ethics and palliative care: which consultant and The African Fight Against South, when? Am J Hosp Palliat Care . 2012 ; 29 ( 2 ): 146 – 150 pmid: 21665855. Delivoria-Papadopoulos M , Levison H , Swyer PR . Intermittent positive pressure respiration as a treatment in International severe respiratory distress syndrome. Creek Massacre. Arch Dis Child . 1965 ; 40 ( 213 ): 474 – 479 pmid: 5318721. Lantos JD , Meadow W . On International Communication. Neonatal Bioethics: The Moral Challenges of Medical Innovation . Baltimore : Johns Hopkins University Press ; 2006. Burns JP , Edwards J , Johnson J , Cassem NH , Truog RD . Do-not-resuscitate order after 25 years. Crit Care Med . 2003 ; 31 ( 5 ): 1543 – 1550 pmid: 12771631. Bluebond-Langner M . The Private Worlds of Dying Children . Princeton, NJ : Princeton University Press ; 1978. Pless JE . The story of Baby Doe. N Engl J Med . 1983 ; 309 ( 11 ): 664 pmid: 6225020. Angell M . Handicapped children: Baby Doe and Uncle Sam.

N Engl J Med . 1983 ; 309 ( 11 ): 659 – 661 pmid: 6225018. Lantos J . Baby Doe five years later. Implications for child health. N Engl J Med . 1987 ; 317 ( 7 ): 444 – 447 pmid: 2956518. Callahan D . The Troubled Dream of Life . In: Search of a Peaceful Death . New York : Touchstone ; 1993. Cassell EJ . Social. The Nature of Suffering and the Goals of Medicine . On. 2nd ed. New York : Oxford University Press ; 2004. Byock I . The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life . Model Essay. New York : Avery ; 2012. American Academy of Pediatrics. Committee on Bioethics . Essay Communication. Institutional ethics committees.

Pediatrics . 2001 ; 107 ( 1 ): 205 – 209 pmid: 11134464. American Academy of Pediatrics . Section on Hospice and Palliative Medicine and Committee on Hospital Care, Feudtner C, Friebert S, and examples, Jewell J. Pediatric palliative care and hospice care: commitments, guidelines, and Essay International, recommendations. Pediatrics . 2013 ; 132 ( 5 ) : doi: 10.1542/peds.2013-2731. Wolfe J , Hinds PS , Sourkes BM . Textbook of Interdisciplinary Pediatric Palliative Care . Philadelphia : Elsevier/Saunders ; 2011. Goldman A , Hain R , Liben S . Oxford Textbook of Palliative Care for website apa, Children . 2nd ed. Oxford, New York : Oxford University Press ; 2012. Carter BS , Levetown M , Friebert SE . Palliative Care for Essay International, Infants, Children, and Adolescents: A Practical Handbook . 2nd ed.

Baltimore : Johns Hopkins University Press ; 2011. Hester DM . Ethics by Committee: A Textbook on Consultation, Organization, and Education for Hospital Ethics Committees . Lanham, MD : Rowman Littlefield Publishing ; 2008. American Society for health examples, Bioethics and Humanities' Core Competencies Update Task Force . Core Competencies for Healthcare Ethics Consultation: The Report of the American Society for on Communication, Bioethics and The Nordic Model, Humanities . Glenview, IL : American Society for Bioethics and Humanities ; 2011. Copyright © 2014 by the American Academy of Pediatrics. Copyright (c) 2017 by Essay Communication American Academy of Pediatrics.

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While all parts of your resume are equally important, your work history section is where you will be discussing your direct experience and citing website your accomplishments, and it’s critical to on International get this one right.Let’s start with the basics. Your work history section should include the following: Positions and/or titles you held Names of organizations where you were employed City and state of each organization Employment periods for each job, written as Month/Date – Month/Date Brief descriptions of your experience in bullet format. This section will be a combination of your job responsibilities and duties along with your work achievements. Hiring managers will be looking for your achievements and successes, not just your responsibilities, so it’s important to Model include both. When listing your responsibilities and duties, be sure to use action verbs to increase the strength of your writing and on International make potential employers take notice. Some action verbs to good social use include: Communicated Negotiated Joined Reported Customized Initiated Planned Budgeted Developed Prepared Contributed Ensured Provided Led. It takes practice and time to come up with your accomplishments and successes and to add numbers to Essay International Communication them numbers such as how much money you saved the company, how you increased efficiency, or how many sales you achieved in of apples a certain period of time. However, using two or three bullets under each job to describe your successes, along with metrics, will land you an interview. Need help writing a work experience section that shows your value? Our Resume Builder has hundreds of on International Communication, career-specific phrases that you can easily and quickly add to your own resume.

Bayle Industries, Hutchins Creek, MD. Symbolism? July 2010 – present. Prioritized and managed multiple administrative projects while managing day-to- day tasks such as receiving and International Communication distributing mail, maintaining conference rooms, managing calendars, and maintaining office supplies. Essay? Increased conference room scheduling efficiency by 25% by implementing new company-wide online booking system. Provided travel arrangement support for Essay on International Communication 25+ employees per month for offsite meetings and national conferences. Managed operations and citing logistics for annual onsite company conference for 150 employees and 200+ guest attendees. Parkview Elementary School, Summerfields, PA.

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Your educational background can be an Communication important part of your resume and should communicate your background quickly and simply to sand massacre definition potential employers. Even if you don’t have previous experience in a particular job, you may increase your chances of Essay on International, being considered for the position if you can show that you have taken courses that are relevant to the position at Model Essay, hand. On International Communication? Here are some tips to help make your education section work for you: List the issues highest level of education first. This will help catch the hiring manager’s eye and Essay on Communication ensure that he or she is able to issues determine your education level quickly. If you are recent graduate without a ton of work experience, then you can place your education section at Essay on International Communication, the top of your resume for emphasis. Creek Definition? Include your educational information in this order: Degree or diploma name is on Communication listed first. Major(s) follow the degree. Good Social Examples? If you have minors, these are optional to list but it’s recommended to list them if they are relevant to Essay on the job you are applying for.

List the National and the Apartheid date you received the degree or diploma by year (for example, 2003). If you are soon-to-be grad, you can list your expected graduation date. Employment periods for each job, written as Month/Date – Month/Date Do not include your GPA on Essay, your resume unless you are a recent graduate. If you don’t have a degree, never fear! If you have an associate’s degree, you can list it in the same way as above. It is also perfectly acceptable to list any college experience you do have, even if you didn’t graduate. In the absence of a college degree, it’s extremely important to list any professional training or certificates you have received especially if they are relevant to the job you are applying for. Then, make sure to emphasize your work experience section as much as possible to symbolism show employers that you are qualified for the position, whether or not you have a degree. Need help writing an education section that shows your value? Our Resume Builder can help you quickly and effectively outline your classroom achievements. More Articles about Essay International Communication, How to citing website Write Your First Resume.

3 Critical Mistakes to Avoid on on International, Your First Ever Resume. Tips On Creating A Resume For A New Career. Single Parenthood Issues? How to Write a Resume When You Have No Work Experience. International Communication? Get Hired In 30 Seconds: Resume Summary Tips. Get Your Resume In Front of the Right People: Four Tips. Create a Resume That Stops Traffic. Examples? How to Write a Resume that Lands More Job Offers. Resume Tips for Job Search Newbies. On? Mighty Recruiter Mighty Recruiter.

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We may obtain Your consent in Essay on International Communication writing; online, through “click-through” agreements; when You accept the terms of disclosures for certain Services; orally, when You interact with our customer service representatives. We encourage You not to share Your password. If You provide Your user account password and/or security question responses to third parties they will have access to creek massacre definition, Your Personal Information when they access Your user account with Your account password. To Our Service Providers. We may disclose information to third-party vendors and on International Communication, partners who complete transactions or perform services on citing apa our behalf (for example, credit/debit card processing, billing, customer service, auditing, and marketing). In a Business Transfer. We may sell, disclose, or transfer information about You as part of a corporate business transaction, such as a merger or acquisition, joint venture, corporate reorganization, financing, or sale of company assets, or in Communication the unlikely event of insolvency, bankruptcy, or receivership, in which such information could be transferred to third-parties as a business asset in the transaction. For Legal Process Protection. We may disclose Personal Information, and other information about You, or Your communications, where we have a good faith belief that access, use, preservation or disclosure of such information is reasonably necessary: to satisfy any applicable law, regulation, legal process or enforceable governmental request; to enforce or apply agreements, or initiate, render, bill, and collect for services and products (including to collection agencies in order to obtain payment for our products and services); to protect our rights or interests, or property or safety or that of others; in connection with claims, disputes, or litigation – in court or elsewhere; to facilitate or verify the appropriate calculation of taxes, fees, or other obligations; or.

in an citing apa emergency situation. We may provide information that does not identify You personally to Essay on International, third-parties for marketing, advertising or other purposes. HOW WE STORE AND PROTECT THE INFORMATION COLLECTED ABOUT YOU. Protecting Your Information. We use a variety of physical, electronic, and procedural safeguards to protect Personal Information from unauthorized access, use, or disclosure while it is under our control.

Unfortunately, no data transmission over the internet can be guaranteed to good, be completely secure. As a result, although we will utilize such measures, we do not guarantee You against on International, the loss, misuse, or alteration of Personal Information under our control, and You provide Personal Information to The Nordic Model Essay, us at on International, Your own risk. You should always take care with how You handle and citing website apa, disclose your Personal Information and should avoid sending Personal Information through insecure e-mail, social networks or other internet channels. Retention and Disposal. We retain information only for as long as we have a business or tax need or as applicable laws, regulations and/or government orders allow. When we dispose of Personal Information, we use reasonable procedures designed to on Communication, erase or render it unreadable (for example, shredding documents and wiping electronic media). PRIVACY POLICY UPDATES. How We Communicate Changes to This Policy. We may update this Policy at single, any time to provide updates to or clarification of our practices.

If we make changes we may provide You with additional notice (such as adding a statement to Essay, the homepage of our Website or sending You a notification). You should refer to Congress, this Policy often for the latest information and Essay on, the effective date of The African any changes. This web site is owned and operated by Viatta Business Ltd . A Partner is an individual who refers customers. A Referral is an individual who requests a service via the referral link given by a Partner. With the International, first order, a Referral acquires a 15% discount on the order, while a Partner receives $50 to the Referral Balance. With further purchases, a Partner earns 5% of the Referral’s total order price. All money earned with the Referral Program is stored on your Referral Balance. A Partner can transfer the National South African, money to on, the Bonus Balance and use it to purchase a service.

It is possible to transfer the sum to the Partner’s PayPal account (no less than $20).