Angela Duckworth Gr'06
argues that character—
not intelligence, quality of
instruction, family situation,
or income level—is the
crucial determinant of
achievement in school.
Now she just has to figure out
how to measure character—
and influence it
BY K E V I N H A RT N ET T
Every year large percentages of American elementary-
school students fail to learn basic math skills like how to add fractions with unlike denominators. The
situation is even worse among students from the poorest American neighborhoods, despite the fact that from fourth grade on their teachers drill them in these simple steps: find a common denominator; add the numerators; reduce.
There are many explanations for why such a simple proce-
dure proves to be so hard to convey. Reformers and policy-makers point to subpar teachers and inadequate principals; to single-parenthood and other demographic drags; to health, nutrition, and the intangible handicaps of poverty.
Assistant Professor of Psychology Angela Duckworth Gr'06
has another explanation. Before she entered graduate school at Penn in 2002 she spent five years teaching math and sci-ence in poor urban neighborhoods across the United States. In that time she concluded that the failure of students to acquire basic skills was not attributable to the difficulty of the material, or to a lack of intelligence, or indeed to any of the factors mentioned above. Her intuition told her that the real problem was character.
"Underachievement among American
youth is often blamed on inadequate teachers, boring textbooks, and large class sizes," she wrote in a paper titled "Self-Discipline Outdoes IQ in Predicting Academic Performance in Adolescents," which served as her first-year graduate thesis and was published in Psychological Science
in 2005. "We suggest another reason for students falling short of their intellectual potential: their failure to exercise self-discipline … We believe that many of America's children have trouble making choices that require them to sac-rifice short-term pleasure for long-term gain, and that programs that build self-discipline may be the royal road to build-ing academic achievement."
Effortful practice; persistence though
boredom and frustration; gritty deter-mination in pursuit of a long-term goal. In Duckworth's view these are the qual-ities that separate more and less suc-cessful students, and in recent years she's emerged as one of the most influ-ential voices in American education reform, where she argues that cultivating "achievement Charter-school networks like the Knowledge is Power character" in kids may be the last, best way to narrow educa-
Program (KIPP) have embraced Duckworth's work.
tional inequality in America.
"Schoolwork is not hard in the way that electromagnetism
long-term goals." Today grit is a buzzword in the hallways of
is hard. It is hard because it's aversive and not fun to do,"
charter schools around the country, where teachers, princi-
Duckworth, who joined the faculty at Penn in 2007, explains.
pals, and deep-pocketed board members have all come to
"So the straightforwardness of the material combined with
believe that inculcating grittiness in students is every bit as
the abject failure of students to learn it made me think there
important as building academic skills.
must be something besides IQ holding them back. That's maybe
Duckworth's view, if correct, would have dramatic implica-
more obvious for teachers than it is for policymakers."
tions for the way policymakers and educators think about
The intuitive appeal and expansive application of Duckworth's
student achievement. It also raises provocative questions
research has earned her increasing popular recognition (a
about the limits of research in the social sciences and the
profile is in the works) as well as a privileged posi-
malleability of human character: Is it possible to design
tion at the crossroads of basic research and public policy. This
measurements to quantify character with the same preci-
past fall U.S. Secretary of Education Arne Duncan invited
sion that researchers quantify intelligence? And if so, are
Duckworth down to Washington to share her policy recom-
self-control and persistence amenable to cultivation, let
mendations. There she cautioned Duncan about the useful-
alone on the scale of public policy?
ness of standardized tests as an accountability tool, arguing that performance on those tests tends to be more a function of native intelligence (IQ) than of how well students are actu-ally learning in their classrooms. She also urged Duncan to
Angela Lee Duckworth grew up in Cherry Hill, New Jersey,
the daughter of well-educated parents who'd immigrated from China. She's quick to say her mom and dad were
throw the full weight of the Department of Education behind
not Tiger Parents, though academic success was always assumed.
initiatives to use "the hard-fought insights of psychological
What was less expected of her, she says, was that she'd throw
science" to improve the way schools teach students.
herself into community service. "When I was in high school I was
Duckworth's experience as a classroom teacher has also
sort of spontaneously and not very reflectively drawn to public
helped her build strong ties in the education reform com-
service activities," she says. "I don't know where that impulse
munity, where leaders like Dave Levin, the co-founder of the
came from. You could do some retrospective reconstruction, but
KIPP (Knowledge is Power Program) charter-school network,
that is always a dangerous game to play."
consider her a kindred spirit and are using her work to
When Duckworth was 18 she went to Harvard, where she
develop strategies for teaching achievement character to
majored in neurobiology but continued to perplex her father
low-income kids. Duckworth is best known for the study of
(who is a color chemist at DuPont) by devoting much of her
"grit," which she defines as "perseverance and passion for
time to leadership roles in several community service orga-
nizations. "I don't think in Chinese culture there is as much
For most of her time as a teacher she assumed she'd apply her
of a tradition of helping anonymous strangers of a different
insights about student achievement by opening her own char-
race," she says. "My dad was like, ‘ You have a science degree
ter school, which would have allowed her to stay in public edu-
from Harvard but instead you want to spend your time help-
cation while also giving her significant discretion over exactly
ing poor black kids?'"
how and what students were taught. But after five years in the
Following graduation Duckworth spent two years found-
classroom, ending in a stint teaching high school science at
ing a summer program for disadvantaged kids and then
Mastery Charter in West Philadelphia, she concluded that char-
went to Oxford on a Marshall Scholarship. After returning
ter schools were not the answer to the achievement gap.
from Oxford she consulted with McKinsey for a year and
"I looked around at these charter schools and it seemed to
spent another year as the chief operating officer of a web
me intuitively they weren't the way to reform education," she
startup called Great Schools that allows parents to compare
says. "I saw these charter schools writing their own curricula,
public schools. But the bulk of her time over the next seven
creating their own HR departments, and it seemed to me
years was spent teaching math and science at public schools
intuitively that the diseconomies of scale were working
in New York, San Francisco, and Philadelphia.
against them." (Today she says her critique was wrong, owing
"It seemed to me that if I was going to work on issues of
to "a lack of imagination" when it came to foreseeing the
equity I should start earlier in the life course rather than
development of national charter organizations like KIPP and
later," she says, explaining why she was drawn to the class-
Mastery, which provide their network schools with the effi-
room. "The earlier you start the bigger bang for your buck
ciencies of scale that early charters lacked.)
you get in terms of closing the gap between the privileged
Duckworth wasn't going to open her own school, but she still
and the non-privileged. I also just enjoyed working with
wanted to make a bigger impact on public education than she
young people, so that kind of led naturally to teaching."
could as a teacher—at first, she just didn't know how. "I thought
Duckworth jokes that the job-hopping she did in her twen-
about the biggest problem that needs to be solved in K-12 educa-
ties was a case study in "how not to be gritty," but it seems
tion and then I listed out all the things I'm good at: I like to write,
more a function of the intensity and dynamism of her person-
I like analysis, I like math, I like to think hard about problems,"
ality. In the course of reporting this article I heard colleagues
she says. "So I sort of put the Venn diagrams together and in a
call Duckworth the most extroverted person, the quickest
very top-down deductive way I concluded I should go into psy-
learner, and the fastest thinker (and talker) they'd ever met.
chology and become a researcher in order to understand these
On the day I visited she had a half-dozen bubble gum con-
character competencies, and then go back into these schools and
tainers on her desk, suggesting an atmosphere of restless
help them solve their achievement problems."
activity and a need to replenish the saliva that's lost through
One night in July 2002 Duckworth was up late with her infant
such rapid-fire speech. She also uses expletives in a way that
daughter (she and her husband, the president of a Philadelphia-
might impress even high-powered cursers like Rahm Emanuel.
area real-estate investment fund, now have two girls), and
In the course of a 90-minute conversation she called a princi-
researching psychology programs online when she came across
pal she knew "an asshole," described the opinion of a leading
the website of Martin Seligman Gr'67, the Zellerbach Family
education foundation as "fucking idiotic," and did a spot-on
Professor of Psychology and director of Penn's Positive
impression of a teenager with attitude when explaining the
Psychology Center (not to mention the founder of the discipline).
challenge of conducting experiments with adolescents: "When
Duckworth, who'd never taken a psychology class before, was
you pay adults they always work harder but sometimes in
such a neophyte in the field that she didn't recognize Seligman's
schools when I've done experiments with monetary incen-
name. "I didn't know he was famous. I was like, he writes very
tives there's this like adolescent ‘fuck you' response. They'll
well, I like his website, so I emailed him," she says.
be like ‘Oh, you really want me to do well on this test? Fuck
As it happened, Seligman was up late too, playing bridge
you, I'm going to do exactly the opposite.'"
online ["Passion Play," Mar Apr 2011]. He replied to Duckworth's
Duckworth also has a degree of entrepreneurial energy that,
email within minutes, inviting her to attend a research meet-
at first blush, makes her an odd fit for the academy. I asked
ing at his house the next day—and ended up being so bowled
her whether she sees herself more as a reformer, like Dave
over by Duckworth's super-charged demeanor that he would
Levin, the KIPP founder—driven by the desire to achieve spe-
ultimately convince his colleagues to throw the admissions
cific outcomes—or as a scientist—dedicated to asking ques-
timeline out the window and allow Duckworth to join the pro-
tions and following prescribed methods for answering them.
gram that September. All things considered, it wasn't a hard
"I think that Dave and I have always had this passionate
sell. "Angela was fast, about as fast mentally as it is possible
commitment to children combined with an incredible for a human being to be," Seligman writes in his latest book, amount of energy and optimism about doing," Duckworth
Flourish: A Visionary Understanding of Happiness and Well-
says. "My dad used to say to me, ‘There are thinkers and
. "She blew us away in the interview. In violation of prec-
there are doers.' Very few people are both. And I think to the
edent, the admissions committee gave in and accepted her."
extent that I'm a professor I'm a thinker and it's my duty to
For her part, Duckworth was drawn to the Positive Psychology
analyze things and see if I can figure out how the world
Center because of the way it encourages students to think
works. But Dave and I are both very much doers. We share a
about the real-world implications of their research. "Marty is
kind of boldness, an attitude of just try it, just do it, and
only interested in questions with significant relevance to
don't just sit on your hands and think all day."
people's well being," Duckworth says. "Marty is a basic scien-
tist, of course, but he's always been someone with one foot in
After failing to measure persistence Duckworth shifted to
the world beyond the lab. He's always cared about how psy-
self-control, which researchers had been studying since 1972
chology actually changes people's lives within his lifetime for
when the eminent psychologist Walter Mischel conducted his
the better. I came in to graduate school very much in that
famous "marshmallow test." Mischel presented pre-kindergar-
view, and it only got reinforced while I was there."
teners with a marshmallow but told them they could have two if
Achievement—the main focus of Duckworth's research—is
they waited 15 minutes to eat the first. In a conclusion that hov-
the last of the five key elements in positive psychology's tax-
ers over middle-class parenting across America, Mischel found
onomy of well-being, which goes by the acronym PERMA. (The
that kids who were able to hold out for the second marshmallow
others are Positive Emotion, Engagement, Relationships, and
tended to have higher SAT scores years later.
Meaning.) For decades psychologists studying achievement
Duckworth conducted her own version of Mischel's experi-
focused almost exclusively on intelligence. As Duckworth saw
ment with students at the Julia R. Masterman Laboratory and
it the problem with this single-minded emphasis was two-fold.
Demonstration School, Philadelphia's top magnet school, and
For one, IQ scores didn't explain everything about why some
drew on additional measurement techniques to make her
individuals achieve more than others. In fact, they were not
results more robust. In the fall of 2002 she offered 140 eighth
even particularly good at predicting something as basic as the
graders a choice between receiving $1 immediately or $2 a
amount of education adolescent-aged kids would go on to
week later, and also administered self-control questionnaires
attain later in life.
to the students, their parents, and their teachers. She com-
The second problem was more practical: IQ may be easy to
bined her survey and experimental data to create a "self-con-
measure, but it's hard to change. IQ tests given as early as
trol index," which she used to anticipate how well students
kindergarten are highly predictive of adult intelligence, mean-
would fare on their final report cards. When grades came out
ing that if boosting intelligence was the only way to boost
that spring she found that self-control and GPA were not only
academic achievement, reformers were not going to get far.
strongly correlated—her self-control index was twice as good
The story was very different with personality. While IQ sta-
at predicting academic performance as IQ scores.
bilizes before kids even learn to read, many psychologists
Following the Masterman study, Duckworth turned to what
including Duckworth point to longitudinal survey data to con-
has become her signature topic—grit. Grit
is a nebulous con-
clude that personality doesn't become similarly fixed until at
cept compared to self-control, and the way people pursue
least age 50. Along the way average levels of personality traits
long-term goals is hard to measure experimentally. So
change (most people become more conscientious as they grow
instead of a lab task Duckworth developed the "Grit Scale," a
older), as do rank-order levels, meaning that the most consci-
12-item questionnaire that asks respondents to rate them-
entious 10-year-olds are not necessarily the most conscien-
selves on statements like "Setbacks don't discourage me"
tious adults four decades later. To Duckworth, this fluidity
and "I have difficulty maintaining my focus on projects that
suggested a tantalizing possibility: If personality evolves so
take more than a few months to complete."
much as people get older, why shouldn't schools be able to
Duckworth wanted to test the Grit Scale in high-achieving
influence the direction in which it changes?
populations, to see if it could reveal distinctions even within
Before Duckworth can hope to modify personality she
groups where everyone was talented. In 2004 she adminis-
needs to know how to measure it, which is no small task. In
tered the Grit Scale to 1,200 incoming cadets at West Point,
fact, according to Seligman, measurement challenges are
just before they began "Beast Barracks," the academy's
the primary reason that researchers have long shied away
intensive summer training program that every year leads 5
from studying personality.
percent of admitted freshmen to drop out.
"There's a hegemony of silence in science, things you don't work
Admission to West Point is determined in large part by a
on because they are too fuzzy," Seligman says. "So, while the impor-
"Whole Candidate Score," a weighted index comprised of
tance of self-control, self-discipline, grit may be obvious once we've
variables like SAT score, class rank, and performance on the
said it, that doesn't mean that they become eligible as scientific
Army's Physical Aptitude Exam. Duckworth found, however,
endeavors until a creative person like Angela comes along and
that cadets with the highest scores on the Grit Scale were 60
says, ‘Oh come on, we can measure these things!'"
percent more likely to make it through Beast Barracks than
Duckworth is naturally optimistic about the potential for
cadets of merely average grittiness. What's more, her Grit
human ingenuity to solve social problems. She likes to say,
Scale was nearly four times as good at predicting which
"Rather than curse the darkness, light a candle," but in her very
cadets would drop out as any of the Whole Candidate Score
first research project as a graduate student at the PPC the dark-
indicators that the Army had spent years refining.
ness won. Her years in the classroom had convinced her that
Despite this and other successes administering the Grit
persistence was essential for academic achievement, so she
Scale (she's used it to study Scripps National Spelling Bee
designed a study in which students were asked to find a pattern
Contestants and Ivy League college students, among oth-
in what was (unknown to them) a series of non-repeating digits.
ers), Duckworth acknowledges that questionnaires have
The problem, though, was that no one gave up within the allot-
significant pitfalls as a research tool: answers can be faked
ted time. "I found, as has been found by many psychologists,
and respondents are often biased when evaluating people
that any good lab experiment has to end within 60 minutes,"
they know. Even more significant, people don't have a good
Duckworth says. "But I couldn't find a task that was so frustrat-
intuitive sense of the appropriate scale to use when assess-
ing that people would give up within that time."
ing their own personalities.
"Let's say I ask you to evaluate yourself on the question, ‘I
In the Gates project, Duckworth and a group of high-profile
am a hard worker.' What standard would you use?" Duckworth
collaborators will conduct several studies that attempt to quan-
says. She ran into this problem recently while studying delay
tify the personality factors that distinguish college graduates
of gratification in students in the US and Taiwan. On objective
from college dropouts with similar demographic and academic
measures US students showed much less self-control, but on
backgrounds. Their goal will be to "provide new insight into
surveys they gave themselves higher marks than Taiwanese
student factors that predict college persistence and develop
students gave themselves.
strategies to cultivate them via school-based interventions."
The success of Duckworth's research will hinge ultimately on
Duckworth's part of the study is based on the work of Anders
whether she and her colleagues can devise measurement tools
Ericsson, the Florida State University psychologist whose
that produce more replicable and precise results than the ones
work on the personality characteristics and training habits of
they are using today. Or, as she puts it, "If we cannot figure out
truly exceptional performers was popularized in Malcolm
how to measure these characteristics in
Gladwell's recent best-seller Outliers
some kind of reasonable timeframe, with
Duckworth and her research team will
"If you wanted to help
some kind of objectivity, the research will
conduct an in-depth analysis of a small
grind to a halt because we can't measure
kids, it's not immediately
number of high school students from
what it is that we want to actually study."
minority backgrounds who demonstrat-
obvious how you'd go
Measurement innovations are at the
ed superior academic growth from ninth
heart of two large-scale projects that
about changing poverty.
to 12th grade. These superstar students
Duckworth is launching this year: The
will be compared against peers who
So the direction I'm
first is a three-year-long study of self-
entered high school at similar levels of
control funded by a grant from the John
achievement but made significantly less
more excited about is
Templeton Foundation. Students rang-
academic progress en route to gradua-
ing from pre-kindergarteners to college
the effects that schools
tion. One technique she'll be using to
seniors will be asked to complete boring
make the comparisons is an innovative
can have on kids.
software tasks while resisting the temp-
new measure called an "emote-aloud
tation to divert their attention to more
protocol" in which participants are
We might not be able
instructed to narrate their feelings as
On the day I visited Duckworth she was
to make a family richer,
they perform a demanding task.
holding a conference call where the proj-
"We're going to be applying the same
but maybe we can make
ect team was debating whether to have
methodology that Ericsson used to
kids use iPads or computers in the exper-
their kids grittier or
understand Olympic athletes to under-
iment. (The concern was that very young
stand kids in school," Duckworth says.
kids wouldn't be dexterous enough with
"We're going to put the kids under the
a mouse; in the end the team decided on
microscope to understand what high-
iPads and within a couple weeks Duckworth had rounded up an
achieving kids do differently. We'll follow them through col-
additional $10,000 of funding to pay for them).
lege and see whether the habits we identify actually have a
"So kids are going to be doing these boring tasks on iPads
payoff when they're in a new environment. We want to know
while trying to resist the temptation of switching over to play
what achievement personality looks like in kids and how we
Angry Birds," Duckworth says, referring to the notoriously
get more of it—what do you do, what do the parents do, what
addictive online game. "We'll measure how well kids exert
do the schools do."
self-control in the face of temptation to take immediate grati-fication. Once we have these measurements established the question will be identifying strategies kids can adopt that will
THE most concerted effort to date to implement
Duckworth's research is taking place at KIPP
make it easier for them to do well in these tasks."
Infinity Middle School in Harlem, New York. The KIPP net-
The second study is on college persistence and will be car-
work of charter schools was co-founded by Dave Levin and
ried out over the next two years with a $1.8 million grant
Mike Feinberg C'91 ["Alumni Profiles," Nov Dec 2000] in
from the Gates Foundation. College persistence has become
Houston in 1994, when they were both working as fifth-
a hot topic recently, as evidence has emerged showing that
grade teachers through Teach for America. Since then KIPP
even when low-income students catch up academically with
has expanded to 109 schools in 30 low-income regions
their middle-class peers, they still end up dropping out of
around the country, and has become one of the most promi-
college at disproportionately high rates. Most recently, the
nent education-reform organizations in the country.
KIPP Foundation reported that while its intensive approach
The KIPP model is based on the premise that a high-per-
to academic instruction succeeded in getting 80 percent of
forming school by itself can overcome the disadvantage that
its students into college over the last decade, only 33 percent
poor, typically minority students face in many other areas of
of those students ended up with a college diploma. That
their lives. The basic tools of a KIPP school are an extended
number is above the 8 percent of low-income students
school day (often running from 7:30 a.m. to 5 p.m. or later), a
nationwide who complete college, but it still falls well short
longer school year, intensive math and literacy instruction,
of college graduation rates for middle-class students.
and a pervasive focus on the goal of graduating from college.
From the beginning, character development has been an
prepared," "Allows others to speak without interruption," and
essential part of a KIPP education, as captured by the orga-
"Remembers and follows directions."
nization's ubiquitous slogan: "Work Hard. Be Nice." Over the
Duckworth is aware that measuring character to two deci-
last five years Levin, who serves on the KIPP board of direc-
mal places on a report card could be perceived as unduly
tors and is superintendent of KIPP's eight schools in the
harsh, particularly if it's seen to overlook the role that pov-
New York area, has teamed up with Duckworth to formalize
erty plays in depressing achievement among low-income
the way KIPP NYC teaches character—to measure and moni-
students. But in her view character isn't purely innate—
tor it, and institute strategies for enhancing it.
instead, she argues, it's just as influenced by environmental
The cornerstone of the initiative is the "KIPP Character Report
forces as things like reading scores and high school gradu-
Card," which teachers use to assess students on character traits
ation rates, which most people feel entirely comfortable
that KIPP considers intrinsic to high achievement. The idea for
quantifying and evaluating.
the character report cards originated in a 2005 meeting at Penn
"One of the problems with the word character
is that it
that included Seligman, Levin, Duckworth, and Christopher
carries a lot of baggage," Duckworth says. "People some-
Peterson, a psychologist at the University of Michigan.
times think that emphasizing character means not empha-
At the time of the meeting Peterson and Seligman had just
sizing environmental conditions like growing up in poverty
finished collaboration on an 800-page tome called Character
or not having good role models. But I think it's a false dis-
Strengths and Virtues: A Handbook and Classification
tinction, because your character is influenced by how you
write the book they had scoured essential texts from cul-
grew up—it's not like there's character on one side and envi-
tures throughout history, looking for character strengths
ronmental forces on the other. Given that, if you wanted to
that have been considered building blocks of the good life no
help kids, it's not immediately obvious how you'd go about
matter where or who you are. In the end they came up with
changing poverty. So the direction I'm more excited about is
24, ranging from bravery to prudence to self-control.
the effects that schools can have on kids. We might not be
Peterson and Seligman's book provided Levin with a
able to make a family richer, but maybe we can make their
framework for thinking about character in a more system-
kids grittier or more self-controlled."
atic way, and in Duckworth he found the perfect person to
There is scattered evidence showing that programmatic
help him translate that framework into an assessment tool
school-based character interventions work. Some of the
he could use at KIPP. "Angela is one of the elite people in the
most frequently cited interventions include Tools of the
country to combine a deep understanding of K-12 education
Mind, a preschool program that helps students develop self-
with the highest credentials of a researcher," Levin says. "It
regulation tools, and the Chicago School Readiness Project,
was a natural fit for us to work together."
which trains preschool teachers on how to instruct kids in
Levin and Duckworth's first step was to boil the 24 traits
self-control. Overall, though, the research in this area has
down to those with particular relevance for school. They
been limited. It's still unknown whether personality is like a
removed traits like modesty, spirituality, and fairness, and
person's height—which is measurable, but not modifiable—or
settled on a list of seven that seemed particularly essential for
whether it's more like blood pressure or cholesterol levels,
high academic achievement: zest, grit, self-control, curiosity,
which can be measured and modified, and which can be
social intelligence, gratitude, and optimism. (Love actually
influenced at a population level by public health initiatives.
made the initial cut, but, Duckworth says, "Dave didn't want to
At the end of my conversation with Seligman I asked him
have to tell a parent, ‘Your kid is low on love,'" so they swapped
whether he thinks we'll see the day when schools are teaching
it out for curiosity.)
kids grit and self-control alongside phonics and fractions. I
Once the seven traits had been determined, the next step was
expected the father of positive psychology to be bullish, but
to figure out how to measure them—to define, for example, what
he was surprisingly skeptical. "I think Angela has made some
optimism or zest looks like in practice. The criteria for measur-
progress in this area," he said. "But it is interesting to me that
ing each trait didn't have to produce results that concurred with
for 3,000 years at least teachers have been trying to get more
some absolute value, because there is no truly objective defini-
self-discipline out of kids without figuring out how. So for me
tion or measure of something like zest. Instead, Levin and
the modification of grit and self-discipline are still hopes and
Duckworth's goal was to agree on criteria that matched their
promissory notes as opposed to fact."
general understanding of the character traits, that were easy
For Duckworth, however, the challenge of her research ques-
for teachers to observe, and that produced results which corre-
tion is part of its appeal. She spent the first decade of her
sponded roughly with anecdotal evaluations of which students
professional life unsure of how to apply her abundant talent.
had more or less of a given trait.
Now she no longer has any doubts. "I have complete convic-
In the final KIPP Character Report Card each trait is broken
tion that this is an incredibly important scientific question,"
down into two to four indicators on which students are given
she says. "If we can figure out the science of behavior and
scores from 1-5. The indicators for optimism are "Gets over
behavior change, if we can figure out what is motivation and
frustrations and setbacks quickly" and "Believes that effort
how to motivate people, what is frustration and how do we
will improve his or her future." One of the indicators for zest is
manage it, what is temptation and why do people succumb to
the relatively easy to quantify "Actively participates," while
it—that to me would be akin to the semiconductor."◆
another is the less tangible "Invigorates others." Indicators for
Kevin Hartnett, a former teacher, is a freelance writer living in Ann Arbor,
self-control are more concrete and include: "Comes to class
Michigan. A collection of his work can be found at GrowingSideways.net.
IN THE SUPERIOR COURT OF PENNSYLVANIA MARY SMITH, Executrix of the Estate of Anne Doe, Deceased, JANUARY PHARMACEUTICA, INC., FEBRUARY CORPORATION, MARCH & MARCH, and APRIL E.P.S. PHARMACY, MAY HEALTH, INC., BRIEF OF APPELLANT Appeal from the Order of January XX, 20XX entered in the Court of Common Pleas of Washington County at docket number XXXX-XXXX
Prescribing ACEI and ARBs (Sartans) For Cardiac Patients - Key Messages This guidance represents the consensus view of the South East London Cardiac Network Cardiac Prescribing Forum. The guidance does not, however, override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.