Details Department: Clinical Professional Development - PeriOperativeSchedule: Full Time, Days (M-F, no weekends, no evenings!)Hospital: Columbia St. Mary's Milwaukee, Columbia St. Mary's OzaukeeLocation: Milwaukee, OzaukeePerioperative/ORSurgical servicesMust have OR experienceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community*Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: Travel, PRN, Short-Term Option, etc.). Actual compensation offer will vary based upon role, education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics.Responsibilities Assess, plan, implement, and evaluate educational activities related to nursing clinical areas across the continuum of care. Serve as a strategic consultant for nursing clinical performance initiatives to create, implement, and evaluate multi-faceted competency-based programs, delivery mechanisms, and clinical performance.Collaborate with leaders and staff to assess nursing educational needs and competencies.Develop, implement, and evaluate nursing and clinical educational plans/programs. Utilize methods,measurements and tools to evaluate achievement of learning goals.Consult on the analysis, design, development, implementation, and evaluation of Nursing Professional Development (NPD) programs and performance processes that support core nursing and clinical competency across the organization.Manage performance and competency standards for inter-professional programs to support practice at the highest extent of licensure.Requirements Licensure / Certification / Registration:BLS Provider obtained within 1 Month (30 days) of hire date or job transfer date requred. American Heart Association or American Red Cross accepted.Registered Nurse obtained prior to hire date or job transfer date required.Education:Diploma from an accredited school/college of nursingAdditional Preferences Required professional licensure at time of hire.Why Join Our Team Ascension Wisconsin has been providing rewarding careers to healthcare professionals since 1848. Operating 17 hospital campuses and over 100 related healthcare facilities from Racine to Appleton, you will find opportunities that allow you to create a career path you love, all while delivering compassionate, personalized care to the communities we serve.Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.Equal Employment Opportunity Employer Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish)poster.As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.Pay Non-Discrimination NoticePlease note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.This Ministry does not participate in E-Verify and therefore cannot employ STEM OPT candidates.

Be fit. Change lives. Have fun. If you’re reading this, you’re probably a committed fitness professional who wants to inspire others to work hard to be the best they can be. You know how to motivate to get that one more Burpee, and know when to hold back to be sure workouts are safe and effective. If that sounds like you, then keep reading because OTF is looking for Fitness Coaches to lead our coach inspired, science backed and technology tracked workouts. We are looking for coaches who can make our members feel welcome, and that they’re an integral part of the hour you spend together. Coaches whose positive energy stays with a member long after they’ve left the studio, and they find themselves counting the hours till their next workout. Well, now’s your chance to join Orangetheory and start leading the best 1-hour full-body group workout. We’re hiring and here’s what you need to know about working in a company that exudes positivity, passion, expertise and growth. As a Fitness Coach you can expect to perform the following duties: Leading and motivating members through pre-defined workoutsHelping members set and achieve goalsMaking sure members are using correct form and offering corrections if they aren’tUnderstanding the science behind our workouts specifically, heart-rate focused training programs in general, and being aware of what the competition is doingKnowing how to use and demonstrate usage for every piece of equipment utilized in every workoutBeing a team playerAll other duties as assigned Additionally, you’ll need to meet these requirements: Being AED/CPR certifiedHold and maintain a current fitness certification from an education company approved by Orangetheory Fitness Specific job duties and selection requirements vary between Orangetheory studio locations and more details can be provided by the studio’s hiring manager if you are selected to move forward in the interview process.Disclaimers: This employment opportunity is with one of the largest independently owned and operated Orangetheory Fitness Franchise, OT Growth Partners. OT Growth Partners participates in the federal government's E-Verify Program. E-Verify ParticipationRight to Work OT Growth Partners provides equal employment opportunities to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Discrimination of any type will not be tolerated. EEO is the Law supplement OT Growth Partners is an Employment-at-Will Employer OTGPCJobs That Make a Real Difference About Us Orangetheory is a science-based, full-body workout that uses technology to measure performance so members can prove they are improving. In a 60-minute class, led by a highly trained and certified coach, members target at least twelve minutes in the Orange Zone to raise their heart rate and charge up metabolism. The result is an increase in calorie burn post-workout, backed by the science of excess post-exercise oxygen consumption (EPOC). After twelve minutes of hard work in the Orange Zone, your body burns additional calories as you recover over the next 24 hours. Our Philosophy For us, physical fitness transcends weight loss and bikini season. Fitness is a way of life -- in fact, our brand purpose is tohelp people live longer, more vibrant lives. When we help our members to put in the work at our studios, they will experience benefits in their day-to-day. They will be physically stronger, but beyond that, they will notice improvements to their mood, cognition, sleep, and overall happiness and quality of life. This workout actually changes your body at the cellular level and has been known to help members through disease, chronic illness, depression, and even heartbreak and the loss of loved ones. They’ll simply have the energy to play with their grandchildren, run a 5K, or go hiking. When we can help our members to take care of their body and mind, amazing things can happen.More Orangetheory, More LIFE. Diversity, Equity and Inclusion Orangetheory is committed to encouraging, facilitating and upholding an environment centered on diversity, equity and inclusion across every facet of the Orangetheory brand. We will work to create a sustainable culture that supports a healthy space for learning and growing, valuing and empowering every employee, inspiring a diverse franchise network, and uplifting the members and communities we serve. Click here to see more about Diversity, Equity and Inclusion at Orangetheory.

Ready to guide a healthcare vertical sales program while managing a team of high-performing sales representatives You can do that. Do you want to develop extensive contacts within the healthcare business community As a Manager of Sales Strategic Accounts, Healthcare at Spectrum Enterprise, you can do that.Spectrum Enterprise provides modern enterprise technology solutions that meet the unique needs of some of the country’s biggest brands. If you’re looking to build your most successful career, support client growth and work alongside intelligent, driven professionals, you can do that. We're ready to go all in on your future and create an engaging environment. BE PART OF THE CONNECTIONYou focus your team on highlighting how our products simplify the business needs of healthcare clients. You develop your team through mentorship, innovative sales training and constructive feedback.WHAT OUR MANAGERS OF SALES STRATEGIC ACCOUNTS ENJOY MOSTMotivate the sales team to achieve or exceed monthly revenue goals using supportive techniques.Attend sales call and facilitate sales team meetings to discuss progress and provide coaching. Assign high-priority clients or business development to qualified team members to close deals. Conduct sales and team activities within compliance of the Spectrum Enterprise policies and procedures to mitigate risks. Provide weekly sales forecasts and summaries for executive teams to leverage.WHAT YOU’LL BRING TO SPECTRUM ENTERPRISERequired QualificationsExperience: Three or more years of leadership experience in a competitive telecommunications sales environment; Five or more years of Enterprise level sales experience. Education: Bachelor’s degree in a related field or equivalent experience.Technical Skills: Familiar with Ethernet, cloud services, high-speed data, fiber services and fiber connected networks; Proficient with Microsoft Office.Skills: Team building, leadership, organizational and English communication skills. Abilities: Deadline-driven with the ability to manage a team in a high-volume and fast-paced environment while developing and implementing a strategic plan. Travel: Availability to travel to and from assigned territories and company facilities. Valid driver’s license. Preferred QualificationsPrevious experience in the healthcare industry.SPECTRUM ENTERPRISE CONNECTS YOU TO MOREEmbracing Diversity: Culture of excellence that celebrates diversity, innovative thinking and dedication to exceeding client expectations.Learning Culture: Company support in obtaining technical certifications.Dynamic Growth: Paid training and clearly defined paths to advance within the company.Total Rewards: Comprehensive benefits that encourage a work-life balance. Apply now, connect a friend to this opportunity or sign up for job alerts!#LI-AB5 SCM518 2024-43224 2024 Here, employees don’t just have jobs, they build careers. That’s why we believe in offering a comprehensive pay and benefits package that rewards employees for their contributions to our success, supports all aspects of their well-being, and delivers real value at every stage of life.A qualified applicant’s criminal history, if any, will be considered in a manner consistent with applicable laws, including local ordinances.Get to Know Us Charter Communications is known in the United States by our Spectrum brands, including: Spectrum Internet®, TV, Mobile and Voice, Spectrum Networks, Spectrum Enterprise and Spectrum Reach. When you join us, you’re joining a strong community of more than 100,000 individuals working together to serve nearly 32 million customers in 41 states and keep them connected to what matters most. Watch this video to learn more.Who You Are Matters Here We’re committed to growing a workforce that reflects our communities, and providing equal opportunities for employment and advancement. EOE, including disability/vets. Learn about our inclusive culture.

Are you a people person who loves solving problems Do you love music Do you believe in the power of music to bring people together If you do, and you want to be a key player in an organization whose purpose is to fill the world with more music and to develop generations of new musicians then we have a position where you can find your sound. The Lesson Studio at Music & Arts is the #1 provider of music lessons nationwide. We believe that private lessons are the building blocks to a lifelong relationship with music. Our strong commitment to music education is fundamental to our business, and we work hard to find instructors who are experts in their instrument. We take care of all the administrative work so you can do what you do best: inspire learning and creating the next generation of musicians!Essential Functions (not all-inclusive):Teach music lessons to a diverse population of studentsCommunicate with parents of students (where applicable) on the progress of each studentWork with students in our clean and safe studios or through online lessonsCollaborate with store team to maximize lesson experienceWhy Music & Arts Here's just some of the rewards:For our employees who are musicians we offer the unique opportunity of gig leave--take time off to share your music with the world and return to your job after your tour! Music & Arts offers robust benefits and perks for full time employees including Medical, Dental, Vision, 401K plus company match, mental health support, paid sick/holiday/vacation time, employee discount program, and tuition reimbursement options.Additional Information:Music & Arts is an Equal Opportunity Employer and provides fair and equal employment opportunity to all employees and applicants regardless of race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, veteran status or any other protected status prohibited under Federal, State, or local laws. All employment decisions are based on valid job related requirements.If you are a qualified individual with a disability or a disabled veteran and are unable or limited in your ability to use or access our website, you may request a reasonable accommodation to express interest in a specific opening. You can request reasonable accommodation by calling 1 ext. 2862 or by sending an email to . Skills, Experience and Education: Minimum Requirements:Bachelor's Degree or equivalent substitutable experience2 years of music teaching experience

Description: Milton Hershey School (MHS) is one of the world's best private schools, where students in pre-K through 12th grade from disadvantaged backgrounds receive an exceptional career-focused education with housing, meals, and moreand all costs are covered. Thanks to the generosity of Milton and Catherine Hershey, who founded the school in 1909, the school is fully endowed and has the resources to ensure both students and staff are provided everything they need to thrive. MHS is hiring married couples to become flex houseparents. Flex houseparents are couples who reside in on-campus student homes, guiding and nurturing a group of approximately 8-12 students. Flex houseparents provide a consistent family-like structure for students and handle responsibilities such as driving, administering medication, budgeting, reporting, etc. When initially hired, flex houseparents cover different student homes before being assigned to one specific home. Benefits ·Salary of $43,825 per person (a total compensation package of approx. $150,000 per couple which includes free housing, meals while on duty, utilities, and more) ·Comprehensive benefits: medical, dental, and vision insurance; health savings and flexible spending accounts; life insurance; disability options; retirement savings ·Relocation assistance and paid training provided ·Schedule of nine days on followed by three days off. Workdays include a period of personal time while students are at school ·Three-week paid summer vacationQualifications: ·Experience working or volunteering with youth, preferably from under-served settings ·This is a two-person job for couples who have been legally married for at least two years ·Both spouses should be age 27 or older ·No more than three dependent children may reside in the student home ·Abide by a smoke-free and weapon-free campus. No alcohol is permitted while on duty ·Limitations on pets. Only fish and one dog of approved breeds is permitted ·Valid driver’s license; ability to become certified to drive student home vans ·Couples must be comfortable leading students in daily devotions and take students to Judeo-Christian Sunday chapel services (Note: Proselytizing is prohibited) ·High school diploma or GED required ·Must be able to lift up to 50 lbs. ·Candidates must demonstrate a high degree of integrity as all staff are role models for students. ·Both spouses must complete an individual employment application This is a unique career path that takes consideration and commitment from both spouses. If you have any specific questions before or after applying, please reach out to our recruitment team at .

Description: Milton Hershey School (MHS) is one of the world's best private schools, where students in pre-K through 12th grade from disadvantaged backgrounds receive an exceptional career-focused education with housing, meals, and moreand all costs are covered. Thanks to the generosity of Milton and Catherine Hershey, who founded the school in 1909, the school is fully endowed and has the resources to ensure both students and staff are provided everything they need to thrive. MHS is hiring married couples to become flex houseparents. Flex houseparents are couples who reside in on-campus student homes, guiding and nurturing a group of approximately 8-12 students. Flex houseparents provide a consistent family-like structure for students and handle responsibilities such as driving, administering medication, budgeting, reporting, etc. When initially hired, flex houseparents cover different student homes before being assigned to one specific home. Benefits ·Salary of $43,825 per person (a total compensation package of approx. $150,000 per couple which includes free housing, meals while on duty, utilities, and more) ·Comprehensive benefits: medical, dental, and vision insurance; health savings and flexible spending accounts; life insurance; disability options; retirement savings ·Relocation assistance and paid training provided ·Schedule of nine days on followed by three days off. Workdays include a period of personal time while students are at school ·Three-week paid summer vacationQualifications: ·Experience working or volunteering with youth, preferably from under-served settings ·This is a two-person job for couples who have been legally married for at least two years ·Both spouses should be age 27 or older ·No more than three dependent children may reside in the student home ·Abide by a smoke-free and weapon-free campus. No alcohol is permitted while on duty ·Limitations on pets. Only fish and one dog of approved breeds is permitted ·Valid driver’s license; ability to become certified to drive student home vans ·Couples must be comfortable leading students in daily devotions and take students to Judeo-Christian Sunday chapel services (Note: Proselytizing is prohibited) ·High school diploma or GED required ·Must be able to lift up to 50 lbs. ·Candidates must demonstrate a high degree of integrity as all staff are role models for students. ·Both spouses must complete an individual employment application This is a unique career path that takes consideration and commitment from both spouses. If you have any specific questions before or after applying, please reach out to our recruitment team at .

Description: Milton Hershey School (MHS) is one of the world's best private schools, where students in pre-K through 12th grade from disadvantaged backgrounds receive an exceptional career-focused education with housing, meals, and moreand all costs are covered. Thanks to the generosity of Milton and Catherine Hershey, who founded the school in 1909, the school is fully endowed and has the resources to ensure both students and staff are provided everything they need to thrive. MHS is hiring married couples to become flex houseparents. Flex houseparents are couples who reside in on-campus student homes, guiding and nurturing a group of approximately 8-12 students. Flex houseparents provide a consistent family-like structure for students and handle responsibilities such as driving, administering medication, budgeting, reporting, etc. When initially hired, flex houseparents cover different student homes before being assigned to one specific home. Benefits ·Salary of $43,825 per person (a total compensation package of approx. $150,000 per couple which includes free housing, meals while on duty, utilities, and more) ·Comprehensive benefits: medical, dental, and vision insurance; health savings and flexible spending accounts; life insurance; disability options; retirement savings ·Relocation assistance and paid training provided ·Schedule of nine days on followed by three days off. Workdays include a period of personal time while students are at school ·Three-week paid summer vacationQualifications: ·Experience working or volunteering with youth, preferably from under-served settings ·This is a two-person job for couples who have been legally married for at least two years ·Both spouses should be age 27 or older ·No more than three dependent children may reside in the student home ·Abide by a smoke-free and weapon-free campus. No alcohol is permitted while on duty ·Limitations on pets. Only fish and one dog of approved breeds is permitted ·Valid driver’s license; ability to become certified to drive student home vans ·Couples must be comfortable leading students in daily devotions and take students to Judeo-Christian Sunday chapel services (Note: Proselytizing is prohibited) ·High school diploma or GED required ·Must be able to lift up to 50 lbs. ·Candidates must demonstrate a high degree of integrity as all staff are role models for students. ·Both spouses must complete an individual employment application This is a unique career path that takes consideration and commitment from both spouses. If you have any specific questions before or after applying, please reach out to our recruitment team at .

Description: Milton Hershey School (MHS) is one of the world's best private schools, where students in pre-K through 12th grade from disadvantaged backgrounds receive an exceptional career-focused education with housing, meals, and moreand all costs are covered. Thanks to the generosity of Milton and Catherine Hershey, who founded the school in 1909, the school is fully endowed and has the resources to ensure both students and staff are provided everything they need to thrive. MHS is hiring married couples to become flex houseparents. Flex houseparents are couples who reside in on-campus student homes, guiding and nurturing a group of approximately 8-12 students. Flex houseparents provide a consistent family-like structure for students and handle responsibilities such as driving, administering medication, budgeting, reporting, etc. When initially hired, flex houseparents cover different student homes before being assigned to one specific home. Benefits ·Salary of $43,825 per person (a total compensation package of approx. $150,000 per couple which includes free housing, meals while on duty, utilities, and more) ·Comprehensive benefits: medical, dental, and vision insurance; health savings and flexible spending accounts; life insurance; disability options; retirement savings ·Relocation assistance and paid training provided ·Schedule of nine days on followed by three days off. Workdays include a period of personal time while students are at school ·Three-week paid summer vacationQualifications: ·Experience working or volunteering with youth, preferably from under-served settings ·This is a two-person job for couples who have been legally married for at least two years ·Both spouses should be age 27 or older ·No more than three dependent children may reside in the student home ·Abide by a smoke-free and weapon-free campus. No alcohol is permitted while on duty ·Limitations on pets. Only fish and one dog of approved breeds is permitted ·Valid driver’s license; ability to become certified to drive student home vans ·Couples must be comfortable leading students in daily devotions and take students to Judeo-Christian Sunday chapel services (Note: Proselytizing is prohibited) ·High school diploma or GED required ·Must be able to lift up to 50 lbs. ·Candidates must demonstrate a high degree of integrity as all staff are role models for students. ·Both spouses must complete an individual employment application This is a unique career path that takes consideration and commitment from both spouses. If you have any specific questions before or after applying, please reach out to our recruitment team at .

Description: Milton Hershey School (MHS) is one of the world's best private schools, where students in pre-K through 12th grade from disadvantaged backgrounds receive an exceptional career-focused education with housing, meals, and moreand all costs are covered. Thanks to the generosity of Milton and Catherine Hershey, who founded the school in 1909, the school is fully endowed and has the resources to ensure both students and staff are provided everything they need to thrive. MHS is hiring married couples to become flex houseparents. Flex houseparents are couples who reside in on-campus student homes, guiding and nurturing a group of approximately 8-12 students. Flex houseparents provide a consistent family-like structure for students and handle responsibilities such as driving, administering medication, budgeting, reporting, etc. When initially hired, flex houseparents cover different student homes before being assigned to one specific home. Benefits ·Salary of $43,825 per person (a total compensation package of approx. $150,000 per couple which includes free housing, meals while on duty, utilities, and more) ·Comprehensive benefits: medical, dental, and vision insurance; health savings and flexible spending accounts; life insurance; disability options; retirement savings ·Relocation assistance and paid training provided ·Schedule of nine days on followed by three days off. Workdays include a period of personal time while students are at school ·Three-week paid summer vacationQualifications: ·Experience working or volunteering with youth, preferably from under-served settings ·This is a two-person job for couples who have been legally married for at least two years ·Both spouses should be age 27 or older ·No more than three dependent children may reside in the student home ·Abide by a smoke-free and weapon-free campus. No alcohol is permitted while on duty ·Limitations on pets. Only fish and one dog of approved breeds is permitted ·Valid driver’s license; ability to become certified to drive student home vans ·Couples must be comfortable leading students in daily devotions and take students to Judeo-Christian Sunday chapel services (Note: Proselytizing is prohibited) ·High school diploma or GED required ·Must be able to lift up to 50 lbs. ·Candidates must demonstrate a high degree of integrity as all staff are role models for students. ·Both spouses must complete an individual employment application This is a unique career path that takes consideration and commitment from both spouses. If you have any specific questions before or after applying, please reach out to our recruitment team at .

Speech Language Pathologist Key information: Title: Speech Language PathologistLocation/work environment: In facilityReporting structure: Reporting to Director of Rehab Powerback is proud to offer a comprehensive and unique benefits package for those candidates that are qualified, including health insurance benefits, 401k, paid time off, clinical support network, online CEUs, on-demand pay, Visa or Green Card sponsorship, and more! Select benefits are available to part time and PRN employees as well! * These rates are negotiable and, in some cases, can be augmented with things like a sign on bonus, relocation assistance. About the job As a Speech Language Pathologist, you help patients get their power back. You are the person who can help people communicate, swallow, and work to diminish or remediate disorders or deficits. In doing this, you take responsibility for the effective and efficient delivery of rehab services, you design the plan, and work with patients to execute those plans. You're a healer and a helper, which is why you got into this line of work. You're equally adept at addressing the whole patient and seeing them as an individual, and you know your goal is the design of a program that will restore, reinforce, and enhance their speech and communication abilities. You're adaptable to the needs of the patient and can find joy in the variety of the work and the settings. From cleaning equipment to reporting to meetings, you thrive in a setting that keeps you moving through your day. You're a teammate and are looking for collaboration with your peers, but you're also happy to make referrals to help your patient get the care they need to thrive. You know that being a Speech Language Pathologist means you're a teacher who can train patients and caregivers on the skills they need to promote independence and productivity. If this sounds like you, we'd love to meet you! Who is Powerback Powerback Rehabilitation (Powerback) is a new way of delivering recovery, rehabilitation, respiratory, and wellness services to patients across the nation. We deliver an empowered approach to achieving your full potential by providing integrated and individualized solutions. Our reimagined approach to rehabilitation connects directly to the patient experience, which is centered on transforming the road to recovery for everyone and helping patients get their power back. It's patient-centered care that provides a sustainable way of feeling better, moving better, breathing better, and living better. Why Now Working in a company that values growth and understands what it means to be a caregiver is refreshing. Our CEO is a former staff therapist. We offer growth, paths forward, and we are committed to patient-centered care. We are growing, stable, and need people like you, who have a calling to help people thrive. Isn't it time for you to work with a team where 86% of them know and feel their work makes a difference So much so, we're certified as a 2023 Great Place to Work. Now is the time for you to join Powerback. What's next Powerback has streamlined our hiring process: Applying takes 3 minutes, give or take.You'll hear back from us within 1 business day.If you meet the qualifications, a recruiter will call you for a 10-minute conversation within 2-3 business days, depending on your availability.You will then be presented to the hiring managerThe hiring manager will reach out within a business day to schedule the interview. ^^ This all happens within 1-5 business days from the phone screen. ^^ After your interview, the hiring manager makes a quick decision. We aim to accomplish this within the week.If the hiring manager wants to move forward, you will hear from us within a business day, because we are excited to get you started! ShareSTH1 Qualifications1. A Master's degree in Speech-Language Pathology, Communication Disorders, Communicative Disorders or similarly-titled area that is consistent and acceptable to the American Speech-Language-Hearing Association. 2. A Certificate of Clinical Competence from the American Speech-Language-Hearing Association (ASHA) or be eligible to participate as an ASHA Clinical Fellow. We will also accept candidates who are eligible to obtain the Certificate of Clinical Competence.3. Licensed, certified or credentialed, as required in the state of practice.