INTEGRATING FAMILY SERVICES - Vermont

INTEGRATING FAMILY SERVICES - Vermont

Vermont Agency of Human Services: INTEGRATING FAMILY SERVICES Collaborative Leadership and Decision-Making Framework A Guide for State and Regional Service Integration December 2016 TABLE OF CONTENTS Part I: Introduction to IFS Context and Key Assumptions Intended Use IFS Guiding Principles IFS Core Values Underlying Beliefs Part II: Collaborative Leadership and Decision-Making in the IFS Context Collaboration and Service Delivery Collaboration Continuum Defining Collaborative Leadership Decision-Making

IFS Partners Overview of Decision-Making Authority Balancing Statewide Consistency and Local Flexibility Part III: IFS Partners Key Roles and Responsibilities Key Roles and Responsibilities Shared by all IFS Partners Key Roles and Responsibilities of Each IFS Partner Vermont Agency of Human Services IFS Grantees IFS Regional Core Teams IFS Regional Advisory Councils Part IV: Guidance Regarding Operating Agreements for IFS Regional Core Teams and IFS Regional Advisory Councils Guidance on Operating Agreements Part V: For More Information 2 PART I

INTRODUCTION TO INTEGRATING FAMILY SERVICES (IFS) 3 CONTEXT AND KEY ASSUMPTIONS This framework: Was initially conceived and developed by the IFS Leadership and Governance Work Group, with substantial input from community partners, the IFS State Leadership Team, and the IFS Management Team. Assumes continued funding of IFS services through grants (rather than contracts), thus the reference to grantees and grants. Foresees the likelihood of more than one grantee in new IFS regions. Is an effort to translate the leadership and governance element of the IFS model into practice.

Is intended to provide clarity regarding decision-making authority and guidance to regional teams (see following slide for details). Strives to strike a balance between statewide consistency and local flexibility when it comes to such components of the work as: practice innovation, decision making, and accountability. 4 INTENDED USE While developed primarily with Integrating Family Services (IFS) in mind, this framework may be used by AHS community partners to provide general guidance to regional groups that have a decision making (deliberative) OR advisory (consultative) role in their communitys health and human services delivery systems. Communities are urged to build on, adapt, merge with, or otherwise use existing groups, committees, boards, or coalitions to take on the work described in this document. It is the hope of AHS that regions create efficiencies to achieve the IFS outcomes wherever possible. AHS leadership is committed to removing barriers toward this end. AHS regions are asked to use this information to help create, develop, and move forward with your regions teams. Much of this framework is meant to support rather than prescribe how each region will develop decision making processes and commitments among the provider network, and with youth and families.

5 INTENDED USE (cont.) The establishment of Regional Core Teams and Regional Advisory Councils will create opportunities for holistic and systems-level conversations to occur; these groups also offer opportunities for regions to create and support specialized working groups regarding children, youth, and families. Regional teams may serve as vehicles for: Decision-making and relationship-building, Promoting reciprocity, Sharing accountability, Maximizing resources, Implementing and expanding best practice, and Creating safe spaces for difficult conversations regarding issues of shared concern. 6 IFS GUIDING PRINCIPLES These guiding principles give life and form to the Integrating Family Services vision and mission 1. Promote the well-being of Vermonts children, youth and families. Policies, services and service providers are sensitive and responsive to the unique aspects of each family. 2. Build communities capacity to provide a full range of resources in a flexible and timely way that is responsive to the needs of children and youth (prenatal through age 22) and families.

3. Focus on the individual and the family. Understand the child's needs in the context of his/her family. 4. Ensure that families voices inform processes, plans and policies. 5. Adopt the Strengthening Families approach. Strengthening Families five protective factors guide our work. 6. Invest in a skilled, competent and valued workforce. People working with children, youth and families need training, support and adequate compensation. 7. Balance innovation with families experiences, research and data to inform decisions about how to best use available resources and achieve positive outcomes. 8. Assure continuous quality improvement. Data informs decisions and drives change at the state and local level. 9. Promote a common language, shared decision-making and cross-disciplinary team work. 7 IFS Core Values Integrating Family Services is an approach to human service delivery that is based on the following core values: Child-Centered, Family-Focused Collaborative Between and Among Families, Agencies, and Community Individualized Family-Driven Strength-Based Culturally Competent Community-Based 8

IFS UNDERLYING BELIEFS Positive, respectful and collaborative relationships are central to our success. The public/private partnership integral to IFS is effected by the balance of power between local autonomy and centralized decision-making. This partnership requires a commitment to: Developing a deep and shared understanding of the opportunities and constraints under which the state and local partners are operating; and Co-creating solutions within the environment of opportunities and constraints. Aspects of systems change are inherently incremental and developmental. Trust and frequent open communication are essential. IFS requires partners to support these aspirational concepts: Trust is built over time as groups and individuals work together. Everyone around the table(s) wants: To do their best work possible; To work collaboratively; and To know their work is contributing toward good outcomes for all children, youth and families. IFS at all levels asks partners, state and non-state, to be curious and seek to understand any behavior that seems to contradict these beliefs.

9 PART II COLLABORATIVE LEADERSHIP AND DECISION-MAKING IN THE IFS CONTEXT 10 COLLABORATION AND SERVICE DELIVERY The IFS approach seeks to ensure positive outcomes for Vermonts children, youth and families, as measured by the IFS population indicators and performance measures. Success depends on many factors, notably a flexible, integrated, and responsive service delivery system. Such a system, in turn, relies heavily on the ability of service providers to collaborate effectively. Effective collaboration includes: shared decision-making and accountability; democratic and egalitarian processes; and participants with well-developed socialemotional skills. High levels of collaboration require trust and strong relationships, both of which are

built over time. 11 COLLABORATION CONTINUUM 1 2 NETWORKING COORDINATIN G Exchanging information for mutual benefit. This is easy to do it requires low initial level of trust, limited time availability and no sharing of turf.

Exchanging information and altering program activities for mutual benefit and to achieve a common purpose. Requires more organizational involvement than networking, higher level of trust and some access to ones turf. 3 COOPERATIN Handing G Objective Exchanging information, altering activities and sharing resources for mutual benefit and to achieve a common purpose.

Increased organizational commitment, may involve written agreements, shared resources can involve human, financial and technical contributions. Requires a substantial amount of time, high level of trust and significant sharing of turf. 4 COLLABORATIN G Exchanging information, altering activities, sharing resources and enhancing each others capacity for mutual benefit and to achieve a common goal. Organizations and

individuals are willing to learn from each other to become better at what they do. Collaborating means that organizations share risks, responsibilities and rewards. It requires a substantial time commitment, very high level of trust, and sharing turf. 5 INTEGRATING Completely merging organizations [programs] in regards to client operations as well as administrative structure. 12

DEFINING COLLABORATIVE LEADERSHIP [Leaders] operate on the basis of shared power and management among peers[T]he point of the process is to take advantage of the creativity of interaction among diverse perspectives. It is not to emphasize differences, setting one participant apart from another or empowering some over others. That may be the reality outside the collaborative space, but, within it, results depend on mutual respect and reciprocity in the exchange of ideas.1 Collaborative leadership styles distribute power, authority and responsibility across the group. Leadership fosters shared commitments, helps resolve conflicts, facilitates lasting relationships, and stimulates effective action. 2 Collaborative leadership structures involve team approaches rather than single person approachesEssentially collaborative leadershipmobilizes collective "know-how," clarifying problems, resolving conflicts, and building consensus to act. 3 www.crosscollaborate.com/2010/06/collaborative-leadership-eshift-the-burden-thinking/ 1 Ohio Community Collaboration Model for School Improvement, Implementation Guide, version 2, Collaboration and Collaborative Leadership, pp. 3.4-3.5.

2 Ohio Community Collaboration Model for School Improvement, Implementation Guide, version 2, Collaboration and Collaborative Leadership, pp. 3.4-3.5. 3 13 DECISIONMAKING Successful collaboration and a restorative practice approach to leadership require partners to have protocols to guide decision-making that fall within their lines of authority and scope. Such protocols must allow for expression of diverse points of view and ensure successful resolution of differing opinions. Successful implementation of the IFS approach hinges on IFS partners ability to include youth and family voices in decision-making.

14 IFS PARTNERS VERMONT AGENCY OF HUMAN SERVICES Regional Advisory Council Regional Core Team Grantees 15 OVERVIEW OF DECISION-MAKING AUTHORITY AHS Grantees Regional Core Team

Regional Council Determine which organizations are grantees of the State with communities playing a consultative role Establish grantees performance measures and deliverables, as well as expectations of regional state offices Determine how their resources will be used to meet grant obligations related to the performance measures and other deliverables Develop (annually) a regional strategic/work plan that includes specific strategies the partners commit to toward achieving the plans goals Serve an advisory role vis--vis each grantees and AHS district offices progress toward meeting performance measures and its impact on IFS population indicators Advise core team on strategic plan and other issues related to the system of care 16 BALANCING STATEWIDE CONSISTENCY AND LOCAL FLEXIBILITY

This framework strives to strike a balance between ensuring statewide consistency in how the IFS approach is implemented in each of AHS twelve regions while ensuring enough local flexibility to encourage innovation and support communities to tailor services to meet their communitys particular needs and build on each communitys unique assets. The remainder of this document describes each partners roles and responsibilities in more detail and outlines the essential elements and guidance related to collaborative leadership. Discretionary areas will be determined collaboratively between the IFS Director or the appropriate IFS team and the regional IFS Core Team on a case-by-case basis. 17 PART III IFS PARTNERS KEY ROLES RESPONSIBILITIES AND 18

KEY ROLES AND RESPONSIBILITIES SHARED BY ALL IFS PARTNERS The following key roles and responsibilities are shared among all entities responsible for implementation of the IFS approach: AHS, IFS grantees, IFS Regional Core Teams, and IFS Regional Advisory Councils: Share responsibility as stewards of public resources Ensure regular and effective communication among community partners and with AHS Play a constructive role in resolving conflict within the community, between the community and AHS, and within AHS Adopt and implement decision-making protocols that ensure transparent and participatory decision-making processes Ensure that youth and families voices inform processes, plans, and policies Apply a Results-Based Accountability lens to accountability and oversight The following slides provide details regarding each of these areas. 19 KEY ROLES AND RESPONSIBILITIES OF EACH IFS PARTNER AHS Grantees

Allocate funding and resources Manage funding restrictions Set statewide policy Ensure accountability of grantees and regional AHS state offices Support regional collaborative decisionmaking Build and support an AHS culture of trust, mutual accountability, and collaboration Administer day to day organizational operations and service delivery Ensure grant performance measures and deliverables are met Provide leadership in Regional Core Teams

functioning Regional Core Team (Regional Key Partners) Develop and implement regional strategic/work plan Share (annually) performance data Contribute to effective working relationships between and among community partners Share responsibility for IFS population indicators Build and support a community culture of trust, mutual accountability, collaboration, and teamwork Regional Council Conduct systems-level

gap and resource/asset assessments Track IFS population indicator trends Review data 20 VERMONT AGENCY OF HUMAN SERVICES FOCUS: Create a collaborative, respectful, and inclusive partnership with community providers toward a shared goal of service integration. VERMONT AGENCY OF HUMAN SERVICES 21

AHS OBLIGATIONS Leadership and DecisionMaking Work with leadership in the Agency to remove barriers to integration as expressed by grantees, regional teams, and IFS councils including those related to finances, policy, practices, and culture Promote a culture and an environment that foster respectful and regular communication, a commitment to continuous quality improvement, clear decision-making pathways, and conflict-resilient relationships Ensure AHS and regional decision-making bodies reflect the full array of AHS services, promote integration, include the voices of youth and families, and model collaborative and inclusive processes 22 AHS OBLIGATIONS (cont.)

Accountability and Oversight Ensure the components of IFS accountability and oversight framework are robust (population indicators; performance measures; data collection; and reporting) Funding Develop and fund IFS grants and provide clear guidance documents that support IFS grants General Implementation and Management Ensure consistent application of the IFS model (e.g., decision-making, service delivery, funding) and activities within and across regions Enable and support planning efforts at the state and local level 23 GRANTEES FOCUS: Provide high quality services, and work collaboratively with community and state partners to improve outcomes

for children, youth, and families. Grantees 24 GRANTEE OBLIGATIONS Leadership Participate in state-level IFS strategic planning and professional development activities. Bring performance-related data to the Regional Core Team for input and feedback, including but not limited to prioritization of resources. This will be done at least annually by IFS grantees and state partners. Work with AHS State Leadership Team to ensure the robust functioning of the Regional Core Team and Regional Advisory Council, including but not limited to active participation of local AHS staff, effective channels of communication, a clear process for resolving conflict, and clear decision-making protocols. Ensure the Regional Advisory Council identifies strategic priorities

based on data, and the Regional Core Team develops an accompanying strategic/work plan (must link to AHS strategic priorities and include population-level indicators). Work in partnership with the IFS Management Team and the IFS State Leadership Team. 25 GRANTEE OBLIGATIONS Decision-Making Create opportunities for youth and family voice to inform IFS service delivery and policy development. While IFS grantees are expected to consult with the Regional Core Team, the grantees are ultimately responsible for making decisions in all areas detailed in their grants. IFS grantees determine how their resources will be used to meet obligations related to the performance measures and other deliverables detailed in their grants. However, grantees must ensure that regional/local decisions related to IFS align with: Eight elements of the IFS model and their related components IFS Building Blocks for Change (IFS Theory of Change) IFS guiding principles Regions IFS grants

The regions strategic plan IFS Manual IFS population indicators and performance measures 26 GRANTEE OBLIGATIONS Accountability and Oversight Meet IFS performance measures and other grant deliverables Provide required data and submit reports as stipulated in the grant agreement Funding The Agency of Human Services awards and oversees IFS grants. In this context, the regional IFS grantees (the organization/agency to which the IFS grant(s) have been awarded) is/are responsible for ensuring the grant requirements are met. Service Delivery Apply research and scientific evidence to design and implement services promote use of best practices and support innovation informed by evidence Communication

Facilitate communication between AHS and the Regional Core Team 27 REGIONAL CORE TEAM FOCUS: Create a community environment that fosters collaboration and service integration with an eye on population level outcomes and indicators. Regional Core Team 28 REGIONAL CORE TEAM MEMBERSHIP* Essential Membership Other Partners to Consider

Family members and youth Additional family members and youth IFS grantees Executive Director or designee for all IFS core Blueprint Coordinator (unless another member of the core team is supports and services including, but not limited to: Depts. for Mental Health and Disabilities, Aging and Independent Livings Designated Agencies Specialized Service Agencies (if they serve children) Child Development Divisions Childrens Integrated Services fiscal agent Executive Director (or designee) Agency of Human Services Field Services Director Department of Health District Director Department for Children and Families Family Services Division District Director (or Supervisor) Economic Services Division District Manager (or Reach Up Team Leader)

represented on the local Community Collaborative) Parent Child Center Executive Director or designee (if not the CIS fiscal agent or IFS grantee) Family Supported Housing grantee Executive Director or designee (or other Housing related service provider) Home Health Agency Executive Director Youth Services Agency Executive Director Building Bright Futures Regional Coordinator Supervisory Union or school representative(s) Family advocacy or peer organization representative Anyone else the Regional Core Team wants to invite * Decision-making authority and knowledge of childrens services is key to this teams membership. 29 REGIONAL CORE TEAM OBLIGATIONS Leadership

Use Regional Advisory Councils guidance to develop a strategic/work plan that fleshes out regional strategic priorities and addresses needs Ensure the IFS regional strategic/work plan and activities related to its implementation align with existing regional and state plans (e.g., AHS strategic plan, System of Care/Act 264, BBF Regional Plan, and Blueprint strategic priorities) and the work of other local/regional groups that also serve children, youth, and families. Oversee implementation of the strategic/work plan. Leverage the skills, talents, and resources of community partners to bend the curve on IFS population indicators (through sub-committees and other means). 30 REGIONAL CORE TEAM OBLIGATIONS Decision-Making Adopt an operating agreement While the IFS Regional Core Teams are not the appropriate place to make individual case decisions, the operating agreement

needs to specify where those decisions are made (e.g., CIS Clinical Team, Local Interagency Team) See Part IV of this document for guidance re: the operating agreement. Agree on decision-making protocol Ensure youth and family voices inform regional service delivery and the IFS strategic/work plan Accountability and Oversight Share responsibility with the IFS grantees and state district offices to improve IFS population indicators and apply a Results-Based Accountability framework Annually review performance data of state district offices and community grantees to increase collaborative problem solving and shared decision making; and specifically to promote: a) maximizing the impact of IFS grants and improving outcomes, b) developing collaborative and integrated strategies to support each others performance, and c) celebrating both collective and organization-level achievements Share reflections on performance data from IFS grantees and AHS district offices with IFS State Leadership Team 31 REGIONAL CORE TEAM OBLIGATIONS Service Delivery Promote shared responsibility among Regional Core Team and Regional Advisory Council

members for achieving integrated service delivery Assure IFS core values are embedded in community service delivery Bring commitment to sharing resources in order to advance IFS regional strategic/work plan goals Promote effective teaming and share resources for professional development across providers Communication Communicate to AHS State Leadership Team any concerns as they arise regarding barriers within AHS to IFS implementation and/or community level concerns regarding AHS role in IFS implementation Conflict Resolution In instances where the Regional Core Team bumps up against systemic barriers, state/partner disagreements or experiences other conflict, the IFS Director and Management Team members are available to assist with resolution of the issue(s) 32 REGIONAL ADVISORY COUNCIL FOCUS: Implementation of the IFS approach at

the systems level, including the annual identification of strategic priorities for the region. Regional Advisory Council 33 REGIONAL ADVISORY COUNCIL Suggested Membership In addition to the members of the IFS Regional Core Team, Regional Advisory Councils may want to consider the following additional partners when determining Council membership: AHS Staff Department of Corrections regional representative VocRehab Regional Supervisor Alcohol and Drug Abuse Program (ADAP) regional prevention consultant Community Partners

Regional Childrens Integrated Services staff Designated mental health services agency staff serving children and adults Designated developmental services agency serving children and adults Other Specialized Services Agency staff Community Action Agencies Vermont Coalition of Homeless and Runaway Youth (VCHRYP) provider Preferred provider and other providers of substance abuse treatment services Organizations/programs related to housing and homelessness (such as the Housing Opportunity Program grantee) Blueprint Community Health Project Manager Local Interagency Team Coordinator Local education agencies Additional family and youth representatives

34 REGIONAL ADVISORY COUNCIL OBLIGATIONS Leadership Establish commitment to IFS vision Develop and update regional IFS strategic priorities annually so that the IFS strategic/work plan: Coordinates with other regional plans, including but not limited to Building Bright Futures, Housing Continua of Care Plan, Substance Abuse Coalition, and Blueprint Regional Governance Aligns with AHS strategic priorities Includes a balanced emphasis on promotion and prevention activities as well as early intervention and treatment supports and services Establish and maintain open and regular communication among Regional Advisory Council members 35

REGIONAL ADVISORY COUNCIL OBLIGATIONS Decision-Making Serve in an advisory capacity to the IFS grantees and Regional Core Team Help the Regional Core Team identify gaps in services, unmet community needs, and regional assets that can be used to improve outcomes Participate in IFS meetings and planning activities and contribute resources to shared initiatives Create opportunities for youth and family to inform IFS regional strategic plan Establish the Councils operating agreement, including the Councils decision-making protocol Include a large group of community partners and stakeholders, and commit to making resources available, as needed, to assure parent/family engagement Undertake a periodic review of Regional Advisory Council membership to ensure it is inclusive of all appropriate partners. (See step #3 in the IFS Regional Steps To Readiness document at: http://ifs.vermont.gov/docs/implementation 36

REGIONAL ADVISORY COUNCIL OBLIGATIONS Accountability and Oversight Apply Results-Based Accountability to discussions and decision-making Service Delivery Identify gaps in service and unmet community needs Respond to requests from the Regional Core Team for assistance with strategic planning and thinking through solutions to challenges that arise Communication Ensure diverse community stakeholders receive adequate and timely notice of meetings and information regarding discussions items and decisions made in the meetings Provide feedback to the Regional Core Team on its annual strategic/work plan Share with the Regional Core Team positive trends, untapped opportunities for integration, systems barriers, gaps in services, and/or troublesome trends 37 PART IV GUIDANCE REGARDING OPERATING AGREEMENTS FOR IFS REGIONAL CORE TEAMS AND IFS REGIONAL ADVISORY COUNCILS

38 GUIDANCE ON OPERATING AGREEMENTS Suggested Elements Whether members may identify a designee to Membership participate on the team in their stead How to address inconsistent participation of a team member, should that situation arise How to handle discussion during meetings Core values Group norms Who has decision-making authority How decisions will be made (e.g., consensus, voting, other process) How the group will resolve conflict How the group will ensure inclusion of the youth and family voice in assessing community needs,

and decision making Responsibilities related to: Meeting facilitation Development of meeting agendas Meeting minutes Meeting frequency Confidentiality (policy regarding handling of confidential information shared among Regional Core Team members) Representation on, or relationship to, other local/regional health and human service related governance or advisory bodies Implementation and monitoring of IFS regional strategic plan The formation of ad-hoc and/or standing committees, work groups, etc., to facilitate group work Other avenues for community input and subcommittee membership for partners who do not sit on the Regional Advisory Council or the Regional Core Team 39

GUIDANCE ON OPERATING AGREEMENTS (cont.) Proposed Team Core Values Sense of shared responsibility for outcomes Focus on family-centered services Responsiveness to community needs, including examining gaps in services (among IFS programs, IFS partners, and beyond) Support of collaboration Respect for all people and partners involved Transparent communication Clarity enough to survive personal and organizational changes Openness to change and to the process of change Attention to data, including family feedback Support of continuous process improvement to achieve better outcomes 4

0 GUIDANCE ON OPERATING AGREEMENTS (cont.) Group Norms: Define and clarify what members expect of themselves and each other. Examples include sharing air time at meetings, expressing feelings as well as ideas, handling disagreement, preparation for and attendance at meetings, and completion of tasks in a timely way. Shared leadership: Consider using the Appreciative Leadership framework to define your teams leadership style and make the most use of the Teams creative potential and individual strengths. Discussion: Consider using the Appreciative Inquiry framework to guide group discussions and create an environment conducive to creative problem-solving and thinking. Decision-Making Clarify how the Team will make decisions. The Team may want to consider using the Gradients of Agreement as a guide to arriving at consensus. Determine how the Team will include youth and family voice in decision-making. Determine whether members may send an informed designee in their place who will have the same decision-making authority as all other team members. 41

GUIDANCE ON OPERATING AGREEMENTS (cont.) Conflict resolution: IFS teams are strongly encouraged to develop a conflict resolution protocol Meeting Frequency: Agree on how frequently the Teams will meet Meeting Facilitation: Identify a strong meeting facilitator(s), with secondary accountability and responsibility for adhering to group norms shared by the entire team Meeting Agendas: Determine how and by whom meeting agendas will be set Meeting Minutes: Clarify who will take meeting minutes and how they will be distributed and made easily accessible (consider using a standardized template) 42 GUIDANCE ON OPERATING AGREEMENTS (cont.) Confidentiality (policy regarding handling of confidential information shared among Regional Core Team members): At minimum, reference the CIS Manual and state and federal privacy rule (e.g., HIPAA, FERPA, and 42 C.F.R.) Self-Assessment: The IFS Management Team strongly encourages all IFS regional teams to conduct an

annual self-assessment of their functioning. Teams may choose to use the IFS team self-assessment tool, which was designed for this purpose and can be found on the IFS website at: http://ifs.vermont.gov/ Coordination with other governing bodies: Regular coordination and communication with other regional/local bodies and teams that also focus on coordinating and integrating services for children, youth and families in the region can help avoid duplication or gaps in services. Teams are strongly encouraged to coordinate (or integrate, if possible) their efforts with the Local Interagency Team (LIT), Childrens Integrated Services (CIS) Administrative Team, Blueprints Community Collaborative, and the Building Bright Futures Regional Council, and other AHS and non-AHS groups. Team Performance: All IFS Regional Core Teams performance goals and related milestones are an important way to assess progress toward those goals. These are different from goals related to IFS implementation. 43 FOR MORE INFORMATION Contact any of the IFS Management Team Members: Carol Maloney, [email protected], (802) 279-6677 Susan Bartlett, [email protected], (802) 917-4852 Cheryle Bilodeau, [email protected], (802) 760-9171 Visit the IFS Website:

http://ifs.Vermont.gov 44

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