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lumiere resume Nouveau: CD audio. La Brulante Lumière de l’amour. Il est disponible dans toutes les librairies ou sur le net. Texte pour Jean Morzadec. Ecrire un livre sur l'amour, c'était m'offrir un cadeau. Template Template Resume. Chaque jour, j'avais rendez vous avec la partie essentielle de moi-même, celle qui était dépossédée par l'obsession de l'autre, de l'aimé, et celle qui se sentait terriblement vivante de sentir le désir dans ses veines comme une coulée d'ambroisie, et la chaleur du coeur comme un éveil à la palpitation de l'âme. Letters Of Recommendation Guys. L'amour n'est pas dehors mais dedans. Resume. Tout se passait comme si je prenais toujours plus conscience de cette merveilleuse réalité. Letter For How Cover - My. Je pensais à cette phrase de Breton à sa fille je vous souhaite d'être follement aimée et je me disais que je souhaitais à la mienne de follement aimer. Autorise toi à développer ta capacité d'amour, ose t'ouvrir toujours d'avantage au goût des cerises, à la beauté du monde, à la tendresse de la vie et d'un autre en particulier.

Viens vers toi, viens toujours plus près de moi et continue d'avancer vers toi, enracine toi toujours plus profondément, plus solidement dans cette accceptation-découverte de ce que tu es. Photographer Resume Template | Resume. Je ne peux te promettre l'amour qu'en fonction de l'amour que je m'accorde à chaque instant. La queste d'amour. 1. Essential For Social Plan. Tu m'aimes donc j'existe : je reçois. Dépendance et identification. J'ai besoin d'amour.

Handicapé du recevoir. je suis une victime. De la victime au créateur. Recevoir sans demander. La sexualité du recevoir. 2. Photographer Template | Resume. je t'aime donc j'existe : je donne. Geôlier et prisonnier.

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Le culte du désespoir. Du raisonnement à la résonance. L'ouverture du coeur. Le centre de la croix. La sortie du conflit intérieur. La voie tantrique.

L'amour comme totalité Le désir, totale réalité et surprenante illusion. Chance et brûlure du désir. Amour du désir et désir de l'amour. La coupure de l'ego et l'amour du pouvoir. Le paradoxe du désir. La folie du désir. Les exaltations du désir. Les sublimations du désir.

La culture du désir. Les liens du désir et de la liberté 6. | The. Le miel de la passion. Le culte de la caresse et de la sensualité Le corps comme un temple.

L'exercice du sourire intérieur. La recherche de l'extase. La respiration consciente. Le muscle papillon. Un rituel de rencontre. Combat ou éclosion. Une sexualité consciente. Ouvrir ses sens à l'extase de vivre. Les sens conduisent au sens et à l'essence.

La voie du Bien-Aimé La solitude et la rencontre. Viens, va vers toi! L'amour sans posssession. Éros et la blessure de l'âme. Agrandir l'âme, faire la perle de l'âme. L'histoire de Jacques. Comment connaître son complémentaire intérieur. Couple intérieur et extérieur. Une mutation progressive.

Le corps d'amour. Une voie pour l'avenir. L'amour romantique et l'amour conscient. Un nouvel art d'aimer. Une civilisation extatique. Une spiritualité androgyne. DE LA VICTIME AU CREATEUR. Heureusement, la victimisation n'est pas à l'oeuvre dans tous les aspects d'une personne.

Chacun porte des émotions négatives mais aussi une partie joyeuse et légère à laquelle il peut s'adresser. Photographer Template. Il y a aujourd'hui beaucoup de séminaires et de thérapeutes qui permettent de développer cette possibilité positive. | Algebra. La victime cherche au départ un sauveur et n'a pas l'intention de se remettre en cause mais, rapidement, elle se trouve en face d'une part de ses impuissances et d'autre part de sa possibilité de recontacter son pouvoir. Photographer Resume | Resume. Il arrive qu' elle prenne en otage son thérapeute et qu'elle fasse de lui un bourreau de plus à juger et à condamner. Top 25+ Dividing Ideas | Algebra. Mais, dès qu'elle commence à regarder comment fonctionne son piège, elle découvre aussi le moyen d'en sortir, d'accepter sa responsabilité.

Le passage de la victime au créateur, du passager arrière au passager avant d'une voiture se fait par un véritable retournement de l'être. | Resume And Professional Resume. J'accepte de considérer que tout ce qui m'arrive est directement ou indirectement relié à ma responsabilité créatrice. Cane Line Stock Photos, Royalty-Free Images & Vectors. Prendre conscience de cette possibilité et de ses conséquences est l'affaire de toute une vie. Resume | Resume And Professional Resume. Car un être véritablement créateur est un être libre. Essential Tips Marketing Plan. La guérison de soi commence avec la prise de conscience de ce pouvoir créateur : plus on Template Template And Professional, l'exerce, plus on Letters Of Recommendation Process | The Law School Guys, a confiance en lui et plus il augmente.

La vie tourne dans un sens positif. Photographer Resume Template | Resume Template And Professional. L'attachement au thérapeute a besoin d'être sur-veillé, car ce tu m'aimes intermédiaire, ce regard, cette écoute, pour bénéfiques qu'ils soient, peuvent encore tourner à la dépendance et aggraver la frustration. D'une forme d'amour à une autre forme d'amour. Chapter Ppt Download. Comment vais-je pouvoir aimer si je suis le créateur de ma vie ? La victime attend que l'amour de l'autre la remplisse. Photographer Resume Template | Resume And Professional. Le créateur apprend à se remplir lui-même ou à attirer l'amour de l'autre vers lui. Chapter. La victime est pétrie de mésestime de soi, de culpabilité, de passivité, de dépendance, elle a transformé ce creux en piège pour pouvoir capter malgré tout une énergie qui ne vient pas à elle de droit comme elle l'avait cru. Photographer Template Resume. De l'expérience du nourrisson, la victime a gardé le droit au biberon.

En s'apercevant que cette toute puissance ne marche pas, elle l'assortit du droit de blâmer, d'accuser et de se plaindre, elle se révolte mais elle est encore prisonnière du creux. Letter A General - My. Elle a même de plus en plus peur. Photographer And Professional Resume. Ce n'est qu'en acceptant de sortir la tête à l'air frais qu'elle découvre le plaisir de s'étirer et de jouer avec les autres sans les faire tomber dans son piège. Essential Marketing. Désormais elle expérimente une autre facette de l'existence. Photographer Resume Template | Resume And Professional Resume. Tu m'aimes devient une aventure créative. Best Dividing Monomials Ideas | Algebra. Mystérieusement cette liberté qui joue avec la mienne m'apprivoise et s'apprivoise. Photographer Resume | Resume And Professional. L'intimité que nous partageons est comme un fruit rond, d'abord vert, qui mûrit, qui délivre ses senteurs, se déguste et se renouvelle.

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LA SORTIE DU CONFLIT INTERIEUR. La prise de conscience de ces quatre piliers de l'amour que sont le besoin d'être aimé, le besoin d'aimer, le besoin de s'aimer, et le besoin d'aimer la vie permet d'accéder à une sortie de l'emprise des conflits intérieurs et extérieurs. Template Template. Pour l'exprimer autrement, une autre vie commence avec la sortie du champ psychologique et de ses limites délétères. Process Guys. Pour aborder le voyage de l'amour conscient nous avons besoin de commencer à nous guérir au moins à 50 % de nos manques et de nos névroses individuelles et collectives. Photographer Resume | Resume Template And Professional Resume. La maison de l'amour conscient repose sur quatre piliers, et il faut d'abord réparer, consolider ces piliers avant de vivre sereinement à l'intérieur et s'y déployer. Letters Of Recommendation Law School Guys. Une autre manière de parler serait de constater que ce que nous appelons l'ego ne se construit sur des bases saines que dans la mesure où ces quatre polarités de la personnalité fonctionnent dans une affirmation positive. Photographer Resume | Resume Resume. Tant que l'ego est malade, trop faible, insuffisant, l'être fonctionne en dessous de lui-même, dans la victimisation, dans la revendication, la plainte et le malheur.

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Faire une liste de ce que vous pouvez changer. Comprendre que vous êtes une personne unique qui ne peut se comparer à personne. Comprendre qu'être aimé ne signifie pas être parfait, premier, riche, beau. Faire une liste de ce que vous appréciez chez vous. Faire une liste de ce que vous ne feriez pas aux autres et que vous faites à vous-même. Faire une liste de tous les gens que vous rejetez. Faire une liste de tous les gens que vous considérez comme plus importants que vous.

Méditer régulièrement les phrases suivantes Plus je m'aime et plus les autres m'aiment. Resume Template | Resume And Professional. Plus j'ai du respect pour moi et plus les autres me respectent. Plus je suis honnête avec moi-même et plus les autres sont honnêtes avec moi. Plus j'ai confiance en moi et plus les autres me font confiance. Letters | The Guys. Plus je pense à moi et plus les autres pensent à moi. Plus je pense à moi et plus je peux penser aux autres. Pour être en amitié avec moi-même, pour être un bon compagnon pour moi, que dois-je faire ? C'est une question à se poser chaque jour au niveau de son bien-être corporel, de sa nourriture, de ses temps de repos, de ses achats, de ses temps de plaisir, d'apprentissage. Photographer Resume And Professional. Quand j'ai un désir, je n'attends pas que mon bonheur vienne des autres, je crée ce bonheur. Letters Process. je suis responsable de mon bonheur. je n'ai pas besoin de plaire à tout le monde. Resume | Resume Template. je n'ai pas besoin de l'approbation de qui que ce soit quand je prends une décision. UNE PRATIQUE : LA RESPIRATION CONSCIENTE. Il n'est pas possible de vouloir vivre quelque chose d'intense dans l'amour sans apprendre à respirer.

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An Analysis of Outcomes of Reconstruction or Amputation after Leg-Threatening Injuries. Michael J. Bosse, M.D., Ellen J. MacKenzie, Ph.D., James F. Kellam, M.D., Andrew R. Burgess, M.D., Lawrence X. Webb, M.D., Marc F. Swiontkowski, M.D., Roy W. Sanders, M.D., Alan L. Photographer Resume Template Template Resume? Jones, M.D., Mark P. McAndrew, M.D., Brendan M. Patterson, M.D., Melissa L. McCarthy, Sc.D., Thomas G. Travison, Ph.D., and Renan C. Castillo, M.S. N Engl J Med 2002; 347:1924-1931 December 12, 2002 DOI: 10.1056/NEJMoa012604. Limb salvage for Of Recommendation Process Law School Guys, severe trauma has replaced amputation as the primary treatment in Photographer Template | Resume many trauma centers. However, long-term outcomes after limb reconstruction or amputation have not been fully evaluated. We performed a multicenter, prospective, observational study to determine the functional outcomes of 569 patients with severe leg injuries resulting in reconstruction or amputation. Top 25+ | Algebra? The principal outcome measure was the Sickness Impact Profile, a multidimensional measure of self-reported health status (scores range from 0 to 100; scores for the general population average 2 to 3, and scores greater than 10 represent severe disability). Secondary outcomes included limb status and the presence or absence of major complications resulting in rehospitalization. At two years, there was no significant difference in scores for the Sickness Impact Profile between the amputation and reconstruction groups (12.6 vs. Photographer And Professional Resume? 11.8, P=0.53).

After adjustment for the characteristics of the patients and their injuries, patients who underwent amputation had functional outcomes that were similar to those of patients who underwent reconstruction. Predictors of a poorer score for the Sickness Impact Profile included rehospitalization for Letter Sample Fax Fax Cover Sheet Template, a major complication, a low educational level, nonwhite race, poverty, lack of private health insurance, poor social-support network, low self-efficacy (the patient's confidence in being able to resume life activities), smoking, and involvement in disability-compensation litigation. Patients who underwent reconstruction were more likely to be rehospitalized than those who underwent amputation (47.6 percent vs. 33.9 percent, P=0.002). | Resume Template Resume? Similar proportions of patients who underwent amputation and patients who underwent reconstruction had returned to work by Top 25+ Best Monomials Ideas | Algebra two years (53.0 percent and 49.4 percent, respectively). Patients with limbs at high risk for amputation can be advised that reconstruction typically results in two-year outcomes equivalent to those of amputation. Template | Resume? Medical and surgical advances of the past two decades have improved the ability to reconstruct severely injured legs. 1-3 Limbs that once would have been amputated are now routinely managed with complex reconstruction protocols. For Social Marketing? 4,5 Because most studies evaluating reconstruction have been small and retrospective, the results are not definitive. 2,3,6,7 Although the results are contradictory, some investigators have suggested that functional outcome is often poorer after successful limb reconstruction than after treatment with early amputation and a good prosthesis.

4,6-9 We performed a prospective observational study comparing functional outcomes of a large cohort of patients from And Professional, eight level I trauma centers who underwent reconstruction or amputation. Our hypothesis was that after adjustment for the severity of the limb injury, the presence and severity of other injuries, and other characteristics of patients, those undergoing amputation would have better outcomes than those undergoing reconstruction. Patients 16 to 69 years old who were admitted to Top 25+ Dividing Monomials | Algebra eight level I trauma centers for the treatment of high-energy trauma below the Resume | Resume Template And Professional distal femur were eligible. 10 High-energy trauma was defined as complicated fractures (Gustilo grade IIIB and IIIC fractures 11 and selected grade IIIA fractures), dysvascular limbs (knee dislocations, closed fractures of the tibia, or penetrating wounds with vascular injury), major soft-tissue injuries (degloving or severe crush or avulsion injury), and severe foot and ankle injuries (Gustilo grade IIIB ankle fractures, all grade III intraarticular fractures of the distal tibia [pilon], 11 and severe hind or midfoot injuries). (The specific types of fractures are defined in Supplementary Appendix 1, available with the full text of this article at http://www.nejm.org.) Excluded were patients with a score on the Glasgow Coma Scale of less than 15, indicating some impairment in consciousness, 21 days after hospitalization or discharge 12 ; patients with a spinal cord deficit, prior amputation, or third-degree burns; patients who were transferred more than 24 hours after the injury; patients who did not speak English or Spanish; patients with a documented psychiatric disorder; and patients who were on active military duty. Chapter? We enrolled 601 patients between March 1994 and June 1997. For the present analysis, 32 patients who had bilateral injuries that met the study criteria were excluded. | Resume And Professional Resume? An additional 24 patients were excluded owing to Letters a lack of Resume Template And Professional Resume, follow-up (i.e., they were enrolled at the time of hospital discharge but could not subsequently be located). Of the remaining 545 patients, 149 underwent amputation during the initial hospitalization (including 37 traumatic amputations). After the Cover Letter To Write A General Cover Letter - My initial hospital discharge, 25 additional patients underwent amputation: 12 by three months, 6 by six months, and 7 after six months.

Most injuries resulted from motor vehicle collisions (29 percent), motorcycle collisions (22 percent), or collisions involving pedestrians and motor vehicles (13 percent). The study was approved by Resume Template Template And Professional Resume the institutional review board at Monomials On Pinterest the coordinating center and each study site. Template | Resume Template And Professional Resume? Written informed consent was obtained from all study participants. Letter Pdf Social Template? The patients were evaluated at base line (before hospital discharge) and 3, 6, 12, and 24 months after the injury. At each point, patients were evaluated by an orthopedic surgeon to Template | Resume Template ascertain limb status and the presence or absence of complications, by a physical therapist to Letters Process | The Law School Guys evaluate the extent of Resume Template | Resume Template Resume, impairment, and by a research nurse to assess the patients' perception of functional outcome. Line Photos,? Of the 545 patients, 502 (92.1 percent) were evaluated at 3 months, 503 (92.3 percent) at 6 months, 493 (90.5 percent) at 12 months, and 460 (84.4 percent) at 24 months. All available data on these 545 patients were used in the outcome analysis. Although patients with incomplete follow-up data were more likely to be male, nonwhite, and without a high-school education than those with complete follow-up data (P0.05 for all comparisons), the rates of follow-up did not differ significantly between the amputation group and the reconstruction group. Functional outcome was measured with use of the Sickness Impact Profile. 13 The Sickness Impact Profile is a multidimensional measure of self-reported health status, consisting of 136 statements about limitations in 12 categories of function: ambulation, mobility, body care and movement, social interaction, alertness, emotional behavior, communication, sleep and rest, eating, work, home management, and | Resume Template recreation.

Respondents are asked to endorse statements that describe their health status on a given day. Scores are computed for the overall instrument, for each of the 12 categories and for 2 major dimensions of health (physical health, which reflects limitations noted in Dividing Monomials Ideas the first 3 categories, and psychosocial health, which reflects limitations noted in the second 3 categories). The reliability and validity of the Sickness Impact Profile have been well tested, 14 especially with respect to the outcome after injury. 15 The overall scores can range from 0 to 100; scores greater than 10 represent severe disability, and differences in scores of 2 to 3 points reflect meaningful differences in function. 16 Scores average between 2 and 3 points for the general population.

17. | Resume Resume? Patients were evaluated by the orthopedic surgeon, and the subsequent limb treatment was based on the best clinical judgment of the surgeon and, in some cases, the desires of the patient. 18 Because treatment assignments were not randomized, comparisons of Letters Process Law School Guys, outcomes based on the Sickness Impact Profile were adjusted for potential confounders, including the characteristics of the patients and their injuries. The injuries were prospectively characterized according to the type and extent of bony damage, the extent of soft-tissue injury, and the initial pulse assessment and plantar sensation (Supplementary Appendix 1). Two orthopedic trauma surgeons who were unaware of the patients' injury classification and eventual treatment reevaluated the case histories by reviewing radiographs, photographs of the wounds, and operative findings. Forty-one (7.5 percent) injuries were reclassified on the basis of this second evaluation. Amputations were further classified according to the level and type of closure (typical elective skin-flap design or atypical, best-possible skin coverage, including split-thickness skin grafts and free-tissue transfers). Associated injuries were classified with the use of the Abbreviated Injury Scale, 19 the Injury Severity Score, 20 and two scores on the Abbreviated Injury Scale denoting the maximal severity of nonstudy injuries to the contralateral and ipsilateral leg and pelvis. Shock was defined by a systolic blood pressure lower than 90 mm Hg before the initiation of resuscitation. 21 To account for the effect of complications on recovery, a variable was constructed to indicate rehospitalization for one or more of the following conditions: late amputation or stump revision, fracture nonunion, hardware failure, flap failure, wound infection, or osteomyelitis. Data collected on Resume Template Template And Professional Resume, the characteristics of the patients that were hypothesized to Letter Work Fax Fax Cover Template influence the treatment assignment or outcome have previously been described in detail.

10 They included age; sex; race or ethnic group; education; income level 22 and insurance status before the Photographer Template | Resume Template Resume injury; work status, occupation, 23 and physical demands of the job before the Essential Media Plan injury 24 ; personality characteristics, as measured by the Neuroticism, Extroversion, and Photographer Resume Resume Openness (NEO) Personality Inventory 25 ; social support, measured with use of a modified version of the The Presidency Inventory of Socially Supportive Behaviors, which assesses a patient's level of support in terms of tangible assistance, directive guidance and emotional support 26,27 and self-efficacy 28 (how confident patients were at Resume Template And Professional the time of hospital discharge in their ability to resume their chief life activities). Additional measures were self-rated health and the presence or absence of chronic conditions before the injury; exercise, smoking, and drinking habits before the injury 29,30 ; and whether compensation was received for the injury and legal services were retained. 31. Longitudinal multivariate regression techniques were used to assess associations between treatment and Of Recommendation Guys outcomes over a two-year period, after adjustment for characteristics of the patients and their injuries. 32 Both additive and multiplicative regression models were considered, but the multiplicative model was chosen because we observed that although scores for Template And Professional, the Sickness Impact Profile continually improved, the rate of Top 25+ Best Dividing Monomials Ideas On Pinterest, this improvement declined over time.

Treatment was defined with the use of five categories: amputations above the knee, through the Photographer Template Template knee, below the knee, or of the whole or partial foot and reconstruction. The 12 amputations that occurred within the Chapter Ppt Download first three months after injury were classified according to the site of the amputation. The 13 patients who underwent amputation more than three months after injury were considered to have undergone reconstruction. An analysis was performed including and excluding these 13 patients. When included, they were identified as having a major complication. The results of both analyses were similar; therefore, the results presented reflect the inclusion of these patients. Because the number of variables describing the nature and extent of injuries was large, a summary score, indicating the likelihood of undergoing amputation given a patient's injury profile, was derived with the use of logistic regression that modeled the decision to amputate or reconstruct as a function of the characteristics of the Template Resume injury. 18 Traumatic amputations (for which underlying characteristics of the injury itself were not documented) were assigned a summary score of 1. Multivariate models that included all characteristics of the injury as separate covariates yielded results similar to those obtained with the use of models that included the summary scores; therefore, results based on the more parsimonious model, which used the summary score, are presented. Chapter? Stepwise modeling techniques were used to construct the final model, which included the treatment variables, the summary score, the occurrence of a major complication resulting in rehospitalization, and all characteristics of the patients that remained associated with an outcome at a P value of less than 0.10. The extent to which the effect of these variables on | Resume Template, the outcome varied according to the time since injury or to treatment was examined, and interaction terms were incorporated where indicated.

There were no significant differences in Cover For How - My sociodemographic characteristics between patients who underwent reconstruction and Photographer Resume | Resume And Professional those who underwent amputation ( Table 1 Table 1 Base-Line Characteristics of the 545 Patients Who Underwent at Least One Follow-up Evaluation. ). Patients who underwent amputation had more severe injuries, as evidenced by their greater frequencies of bone loss, soft-tissue damage, initial pulse deficit, and The Presidency Ppt Download lack of plantar sensation. Table 2 Table 2 Clinical Status of 460 Patients Evaluated 24 Months after Injury. summarizes the clinical status of patients 24 months after injury. A moderate proportion of patients had not fully recovered, as indicated by the fact that 10.9 percent of Resume Template And Professional Resume, patients who underwent reconstruction had unhealed fractures, 3.9 percent of those who underwent reconstruction and Cover Letter For How A General Letter 9.1 percent of those who underwent amputation had unhealed soft-tissue injuries, and 19.1 percent of those who underwent reconstruction and 5.0 percent of those who underwent amputation had an anticipated need for Photographer Resume Template, additional surgery. The last known status of patients who were followed for Top 25+ Dividing, less than 24 months (15.6 percent of all patients) was similar to that of patients with complete 24-month follow-up. There were no significant differences between the treatment groups in the percentage of Template Resume, patients with an unhealed fracture, the percentage with an unhealed soft-tissue injury, or the Five Tips For Social Media Marketing Plan percentage requiring additional surgery.

More than one third of the patients were rehospitalized at least once for a complication; patients who underwent reconstruction were more likely to have been rehospitalized than those who underwent amputation (47.6 percent vs. Photographer Resume Template Resume? 33.9 percent, P=0.002). Mean scores for the Sickness Impact Profile were 14.5 at 12 months and Pdf Social Resume Sample Cover Template 12.0 at Photographer Resume Template Template 24 months; at 24 months, 42.0 percent of the patients had scores greater than 10. There were no significant differences in scores between the treatment groups ( Table 3 Table 3 Scores for the Sickness Impact Profile for 493 Patients Evaluated 12 Months after Injury and 460 Patients Evaluated 24 Months after Injury. Process Guys? ). Scores for the work subscale were particularly high. Photographer Resume Template | Resume? At 24 months, 53.0 percent of the patients who underwent amputation and 49.4 percent of those who underwent reconstruction had returned to work (P=0.48). Table 4 Table 4 Association between Clinical and Demographic Characteristics and Scores for the Sickness Impact Profile. presents estimates of the magnitude of change in scores associated with several covariates, including amputations of various types (as compared with reconstruction). The regression analysis confirms the absence of an Chapter, overall difference in outcomes between groups after adjustment for Photographer Resume | Resume Template And Professional Resume, potential confounders.

Although patients who underwent amputation through the knee had worse scores than patients who underwent other types of procedures, these differences were not statistically significant. To underscore the similarity in scores after amputation or reconstruction, mean adjusted scores (derived from the final regression model) are presented according to the type of treatment in Table 5 Table 5 Mean Scores for the Sickness Impact Profile for the 460 Patients Who Were Evaluated 24 Months after Injury. . In multivariate analyses, factors that were significant predictors of a poor outcome (as indicated by a high Sickness Impact Profile score) included being rehospitalized for a major complication, having less than a high-school education, having a household income below the Five Tips For Social Marketing federal poverty level, being nonwhite, having no insurance or having Medicaid, having a poor social-support network, having a low level of self-efficacy (confidence in one's ability to Resume Template | Resume Template And Professional Resume resume one's chief life activities), smoking, and involving the legal system for injury compensation. Predictors of a poor outcome were the same in Stock Photos, Images & Vectors both groups. The association between having private insurance and a disability, however, changed over time; private insurance was associated with the greatest improvement in scores at | Resume 6 to 12 months. The characteristics of the injury (according to the summary score) were not significantly correlated with the outcomes measured by the Sickness Impact Profile, nor was the presence or severity of other injuries to Top 25+ Dividing | Algebra ipsilateral and Resume Template | Resume Template And Professional contralateral limbs. After adjustment for the severity of the injury and Top 25+ Best Dividing Ideas On Pinterest | Algebra various other characteristics, patients who underwent amputation had functional outcomes that were similar to those of Resume | Resume Template And Professional, patients who underwent reconstruction. However, the Top 25+ Best Dividing levels of disability at two years were high in both groups: more than 40 percent had a score greater than 10 on the Sickness Impact Profile, reflecting severe disability. Except for the scores for the eating and communication subscales, at 24 months scores for all subscales of the Sickness Impact Profile were substantially higher than published norms for the general population. 17 Only about Photographer Resume Template And Professional Resume half of all patients had returned to work by 24 months. Except for the score for the psychosocial-functioning subscale, there were significant improvements in the scores over time in both treatment groups. Poor psychosocial outcomes after serious injuries have been reported by other investigators 36,37 and may be associated with post-traumatic stress disorder.

38,39. Neither the severity of fracture and soft-tissue injury nor the presence of associated injuries of the Five For Social Marketing Plan ipsilateral and Template Template contralateral leg significantly affected functional outcome. This lack of association may be a reflection of the inclusion criteria, in that only Five Tips Media Marketing Plan patients with the most severe limb injuries were included. These injuries affected the patient's ability to walk and most likely masked the effect on functional outcome of other injuries to the leg and Template Resume foot. Tips Media Plan? Factors that were not related to the injury that were associated with a poorer outcome, regardless of the type of injury or treatment, included a low level of education, nonwhite race, poverty, lack of private health insurance, smoking, and involvement with disability-compensation litigation. These results suggest that major improvements in outcome might require greater emphasis on nonclinical interventions, such as early evaluation by Photographer Template psychosocial and Candy Cane Line Photos, Royalty-Free vocational rehabilitation specialists. Template | Resume Template And Professional? Our findings confirm previous research that identified both social support and self-efficacy as important determinants of outcome. 40,41 Interventions aimed at improving patients' perceptions of self-efficacy, in Ppt Download particular, may benefit those who are facing a challenging recovery. Resume | Resume And Professional Resume? The limitations of our study must be acknowledged.

Patients were not randomly assigned to undergo amputation or reconstruction. Patients who underwent amputation were, on average, more severely injured than those who underwent reconstruction. Although an Essential Tips For Social Media Marketing Plan, adjustment was made for Resume Template | Resume Template Resume, these differences in the multivariate analysis, the possibility of residual confounding cannot be ruled out. Top 25+ Dividing Monomials | Algebra? Although the overall rates of follow-up exceeded 80 percent at 2 years, the patients who were lost to follow-up (including 24 patients for whom no follow-up data were available and Resume Template Template And Professional Resume 85 who were followed for Letter For How Cover Letter - My Document, less than 24 months) were of lower socioeconomic status than those with complete follow-up. The results may therefore underestimate the overall extent of disability. However, the rate of loss to follow-up was similar in the two groups, and all available data on the 545 patients who underwent at least one follow-up evaluation were used in the analysis. Also, the extent of healing of Photographer Template And Professional Resume, fractures and soft-tissue wounds at 12 months was similar among those with and those without subsequent follow-up data at Letter Work Resume Fax Fax Sheet Template 24 months. The generalizability of our results beyond level I trauma centers is Resume Template And Professional Resume uncertain. The outcomes may have been influenced by the expertise of physicians and other caregivers.

Finally, the Best Ideas On Pinterest | Algebra results are based on outcomes during the first two years after injury, a period in which many patients have not yet completely recovered. Eventual amputation of dysfunctional or chronically painful limbs and the resolution of fractures may ultimately improve function among patients who undergo reconstruction. Continued modification of the fit of the prosthesis and Resume | Resume Template And Professional increasing experience with the device could improve function among patients who undergo amputation. 42 Although not considered in this study, the Top 25+ Best On Pinterest | Algebra costs of treatment and rehabilitation (including lifetime costs of prostheses) will also be important in guiding treatment decisions. Contrary to Resume Template Template And Professional Resume our hypothesis, at two years, the outcomes among patients who underwent reconstruction were not significantly different from those among patients who underwent amputation. Thus, patients with limb injuries that put them at high risk for amputation can be advised that reconstruction typically results in two-year outcomes equivalent to those of amputation. However, reconstruction is associated with a higher risk of complications, additional surgeries, and rehospitalization.

Funded by a grant (R01-AR42659) from the National Institutes of Health. Dr. Burgess reports having consulted for Howmedica; Dr. Webb reports having consulted for Zimmer, Orthofix, and AO Foundation; and Dr. Jones reports having consulted for Stryker and for Cover For How A General Cover Letter - My, Smith, Nephew and Richards. We are indebted to Photographer | Resume And Professional the coprincipal investigators, study coordinators, and Pdf Social Work Resume Sample Cover Template physical therapists at each of the eight study sites, including Julie Agel, A.T.C., Jennifer Avery, P.T., Denise Bailey, P.T., Wendall Bryan, Debbie Bullard, Carla Carpenter, P.T., Elizabeth Chaparro, R.N., Kate Corbin, M.D., Denise Darnell, R.N., B.S.N., Stephanie Dickason, P.T., Thomas DiPasquale, D.O., Betty Harkin, P.T., Michael Harrington, P.T., Dolfi Herscovici, D.O., Amy Holdren, R.N.C., A.N.P., M.S.N., Linda Howard, P.T., Sarah Hutchings, B.S., Marie Johnson, L.P.N., Melissa Jurewicz, P.T., Donna Lampke, P.T., Karen Lee, R.N., Marianne Mars, P.T., Maxine Mendoza-Welch, P.A., J. Photographer Resume? Wayne Meredith, M.D., Nan Morris, P.T., Karen Murdock, P.T., Andrew Pollak, M.D., Pat Radey, R.N., Sandy Shelton, P.T., Sherry Simpson, P.T., Steven Sims, M.D., Douglas Smith, M.D., Adam Starr, M.D., Celia Wiegman, R.N., John Wilber, M.D., Stephanie Williams, P.A., Philip Wolinsky, M.D., Mary Woodman, B.A., and Dividing Ideas On Pinterest | Algebra Michele Zimmerman, R.N. From the | Resume Template Resume Department of Orthopedic Surgery, Carolinas Medical Center, Charlotte, N.C. (M.J.B., J.F.K.); the Center for Injury Research and Policy, Johns Hopkins University Bloomberg School of Hygiene and Public Health, Baltimore (E.J.M., T.G.T., R.C.C.); the R Adams Cowley Shock Trauma Center, University of Candy Line Photos, Images & Vectors, Maryland at Baltimore, Baltimore (A.R.B.); the Department of Orthopedic Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, N.C. (L.X.W.); the Department of Orthopedic Surgery, Harborview Medical Center, Seattle (M.F.S.); the Orthopedic Trauma Service, Tampa General Hospital, Tampa, Fla. (R.W.S.); the Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, Dallas (A.L.J.); the Department of Orthopedics and Photographer Resume Template And Professional Rehabilitation, Vanderbilt University School of Candy Photos, & Vectors, Medicine, Nashville (M.P.M.); the Department of Photographer Resume | Resume Template Resume, Orthopedic Surgery, Cleveland MetroHealth Medical Center, Cleveland (B.M.P.); and Johns Hopkins School of Medicine, Baltimore (M.L.M.). Address reprint requests to Dr.

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