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Write debate essay

Writing debate essay

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C2-fractures: part II. A morphometrical analysis of computerized atlantoaxial motion, anatomical alignment and related clinical outcomes. Knowledge on the outcome of C2-fractures is founded on writing debate heterogenous samples with cross-sectional outcome assessment focusing on union rates, complications and technical concerns related to surgical treatment. Reproducible clinical and functional outcome assessments are scant. Milton Friedman Essay 1972? Validated generic and disease specific outcome measures were rarely applied.

Therefore, the aim of the current study is to writing, investigate the radiographic, functional and athens essay, clinical outcome of a patient sample with C2-fractures. Essay? Out of a consecutive series of 121 patients with C2 fractures, 44 met strict inclusion criteria and 35 patients with C2-fractures treated either nonsurgically or surgically with motion-preserving techniques were surveyed. Outcome analysis included validated measures (SF-36, NPDI, CSOQ), and a functional CT-scanning protocol for the evaluation of C1#x02013;2 rotation and alignment. Mean follow-up was 64#x000a0;months and admission college, mean age of patients was 52#x000a0;years. Classification of writing debate C2-fractures at essay, injury was performed using a detailed morphological description: 24 patients had odontoid fractures type II or III, 18 patients had fracture patterns involving the writing, vertebral body and friedman 1972, 11 included a dislocated or a burst lateral mass fracture.

Thirty-one percent of patients were treated with a halo, 34% with a Philadelphia collar and 34% had anterior odontoid screw fixation. At follow-up mean atlantoaxial rotation in left and writing essay, right head position was 20.2#x000b0; and 20.6#x000b0;, respectively. According to essays college, the classification system of essay posttreatment C2-alignment established by our group in sources of uk constitution essay, part I of the C2-fracture study project, mean malunion score was 2.8 points. In 49% of patients the fractures healed in anatomical shape or with mild malalignment. In 51% fractures healed with moderate or severe malalignment. Self-rated outcome was excellent or good in 65% of patients and moderate or poor in 35%. The raw data of varying nuances allow for comparison in writing debate, future benchmark studies and metaanalysis. Detailed investigation of C2-fracture morphology, posttreatment C2-alignment and college, atlantoaxial rotation allowed a unique outcome analysis that focused on the identification of risk factors for poor outcome and the interdependencies of writing outcome variables that should be addressed in studies on athens C2-fractures. We recognized that reduced rotation of C1#x02013;2 per se was not a concern for the patients. However, patients with worse clinical outcomes had reduced total neck rotation and rotation C1#x02013;2.

In turn, C2-fractures, especially fractures affecting the lateral mass that healed with atlantoaxial deformity and malunion, had higher incidence of atlantoaxial degeneration and osteoarthritis. Writing Debate Essay? Patients with increased severity of C2-malunion and thinking, new onset atlantoaxial arthritis had worse clinical outcomes and significantly reduced rotation C1#x02013;2. The current study offers detailed insight into the radiographical, functional and clinical outcome of debate essay C2-fractures. Resume Cook? It significantly adds to the understanding of essay C2-fractures. The online version of essays this article (doi:10.1007/s00586-009-0901-4) contains supplementary material, which is available to authorized users. Writing Debate Essay? The ideal treatment of odontoid and other C2-fractures remains controversial. The lack of a comprehensive treatment-oriented classification of C2-fractures, that guides when to operate and when to select conservative treatment, reflects the fact that there exists no ideal solution for essay the clinical problem, yet [56]. In contrast, there is a large body of literature concerning techniques, indications and union rates in C2-fractures [72], but data regarding the most important outcome measure, the functional and clinical outcome, are scant [24, 68]. Writing Debate Essay? Currently, in addition to nonsurgical treatment including semirigid collars or the Halo-thoracic-vest (HTV), contemporary surgical techniques for the treatment of C2-fractures include anterior odontoid screw fixation (AOSF) [2, 62], posterior and anterior transarticular screw fixation C1#x02013;2 [51], C1-lateral mass and C2-Isthmus/lamina fixation [32] and institute for applied, plated anterior discectomy and fusion for the unstable Hangman#x02019;s fracture (Hmfx) [46, 83]. These techniques are standardized and, if used for the appropriate fracture subtype, can show favourable results. For the treatment of isolated odontoid type II fractures in the young patient AOSF is increasingly favoured while accepted standards for the remaining multitude of distinct C2-fracture patterns are lacking.

The question remains which treatment method is appropriate for which fracture pattern to yield superior functional outcome? In addition to the interest in outcomes concerning pain and debate essay, well-being, the treatment of C2-fractures is also to be discussed with regard to athens, the impact on writing debate the resulting posttreatment function and atlantoaxial motion. Any C2-fracture affects at least theoretically the ability of the C1#x02013;2 complex to take the examples, major part in total neck rotation. Using functional CT-scans in 14 patients, Jeanneret [39] showed that the range of motion (ROM) for writing the rotation C1#x02013;2 (Rot C1#x02013;2 ) was significantly reduced even after anatomical reduction of odontoid fractures with AOSF. Hence, discussions concerning the friedman essay 1972, motion-preserving merits of writing any technique should be done carefully. Being? Therefore, the authors intended to add objective outcome data in the C2-fracture research evaluating clinical and debate, functional long-term results after non-surgical or surgical treatment of milton C2-fractures on a homogenous sample of debate essay neurologically intact patients. For a detailed insight into functional outcome, validated generic and disease specific outcome measures and the use of functional CT-scanning for milton essay the assessment of the ROT C1#x02013;2 were indicated. In this context, the malunion rates were also assessed.

Additionally, the authors applied the previously established classification of posttreatment C2-alignment [44]. The scoring system enables correlative analysis of posttreatment C2-alignment, ROT C1#x02013;2 and clinical outcome measures. This study was undertaken to: (1) assess the interdependencies between posttreatment C2-alignment and the range of ROT C1#x02013;2 , (2) assess the impact of fracture pattern, C2-alignment and writing essay, ROT C1#x02013;2 on the clinical outcome in resume cook examples, terms of validated measures, (3) identify risk factors for poor outcome. With the use of objective outcome measures applied on a homogenous group of patients with C2-fractures, the debate essay, current study is unique in the cervical spine trauma literature. We reviewed all charts of patients treated for cervical spine injuries at the authors#x02019; institution between 1997 and 2007. Patients#x02019; demographics including injury type description were recorded. A detailed case review indicated 121 patients treated for acute injuries of the C2-vertebra. Stop? For the purpose of reconstructing a strongly homogenous sample patients had to fullfill the following criteria: (a) C2-fracture with or without stable atlas fracture treated surgically or nonsurgically, (b) age between 18 and 80#x000a0;years at injury, (c) full set of injury cervical spine antero-posterior (ap) or transoral and lateral radiographs, (d) interval between injury and debate, treatment #x02264;10#x000a0;days, (d) understanding of admission essays author#x02019;s language, (e) minimum 6-months follow-up, (f) absence of spinal cord injury (ASIA A-D).

Cases were excluded if they met the following criteria: (a) significant shoulder-girdle injury neccessitating surgery, (b) peripheral nerve injuries, (c) prohibitive medical comorbidity and endstage diseases, (d) drug or alcohol withdrawl, (e) a subaxial cervical spine injury, (f) polytrauma, (g) congenital cervical deformity, (h) injuries from neoplastic disease, infections or lesions associated with AS or DISH, (i) psychiatric illness necessitating medical treatment, (j) documented osteoporosis, (k) postoperative tracheostoma, (l) grade II or III skull#x02013;brain trauma, (m) prior medical treatment for degenerative cervical disease or trauma, (n) worker#x02019;s compensation claims, (o) fusion of C1#x02013;2. Patients were assessed by written interview prior to follow-up and results were blinded to the authors during clinical survey. Writing? Outcome measure included the 36-item short-form health survey (SF-36) version 2, the long-term cervical spine outcome questionnaire (CSOQ) [4] and the neck pain disability index (NPDI) [77]. Milton Friedman Essay? The questionnaires have been validated for writing debate essay issues related to cervical disorders [4, 23, 75] and the methods for scoring as well as the interpretation of results were illustrated in detail in previous articles [23, 38, 44, 50, 75, 77]. The subjective perception of global outcome was rated by resume, the patients as excellent, good, moderate or poor. The participants#x02019; satisfaction was also expressed according to distinct answers ticked within the CSOQ (No. 40#x02013;42). The incidence of dysphagia was evaluated with the grading system of writing essay Bazaz [3].

None, mild, moderate or severe was graded by distinct combinations of institute for applied critical difficulties with liquid and solid nutrition. Any medical or surgical complication documented between the index treatment and follow-up related to the procedure was recorded. Writing? Plain injury ap and lateral radiographs were available in all cases. Injury CT-scans were available in sparta athens, 32 patients (86%). At follow-up, all patients were subjected to functional CT-scanning including a CT-scan in neutral position with 0-degree gantry angle. The cervical spine CT-scans were performed on a 4-row helical CT scanner (Somatom Volume Zoom, Siemens) using a 14#x02013;18#x000a0;cm field of interest (FOI) with 4#x000a0;#x000d7;#x000a0;1#x000a0;mm collimation and overlapping axial slice thickness of writing debate essay 1#x000a0;mm. Sagittal and coronal reconstructions were performed using standard spine algorithms and essay, files were stored digitally (PACS Magic View VC 42, Siemens). Digital CT measurements (0.1#x000a0;mm increments) were performed on the reconstructed CT-scans in a commercially available software program (Escape Medical Viewer V3). Radiographs and CT-scans were reviewed for fracture classification. Global radiographical assessment of fracture types was performed with differentiation into main categories, such as odontoid or Hmfx, using a descriptive taxonomy (see Table#x000a0;1 in Electronic supplementary material).

For the purpose of future data pooling as well as due to the lack of a single comprehensive classification including all kinds of C2-fracture patterns [47] detailed stratification of writing debate essay C2- and concommittant C1-injuries was done using a numerical system as templated in Electronic supplementary material Table#x000a0;2. Through combinations, the admission college, numerical classification addresses all kinds of writing essay C2 and C1#x02013;2 fracture patterns. It allows for nominal statistical analysis and correlative assessment of both radiological and clinical outcome. It differentiates straight forward anatomical structures that are affected in C2-fractures (it is purely anatomical). It does not rely on fracture mechanism or morphometric measurements of displacement, but embodies the hierarchy of damage within the C2-vertebra and in particular articulating surfaces. Interpretation of the cook, inherent stability of the various fractures is debate essay not different to athens essay, accepted definitions [56] e.g., qualifiers of writing instability like discoligamentous injury C2#x02013;3, axial osseo-ligamentous distraction of C2, rupture of transverse ligament of C1, burst fracture of C2 or displaced odontoid fracture. Assessment of lateral atlantoaxial joint degeneration. On injury-ap radiographs or CT-scans degenerative changes at the lateral C1#x02013;2 joints were assessed.

Grading of degeneration of the lateral atlantoaxial joints (AAJ) was performed in two types of atlantoaxial osteoarthritis (AAOA) as previously elaborated [44]. Type A, none or mild degeneration; Type B, advanced degeneration/arthritic joint. At follow-up, lateral atlantoaxial joint degeneration was assessed using above mentioned grading on coronal CT-scans. In addition, the left and right atlantoaxial joint hights (lAAJH and rAAJH) were measured on injury CT-scans, if available, and on all follow-up CT-scans at the center of the lateral C1#x02013;2 joints as described [44]. For the purpose of comparative studies, AAJ degeneration was assessed using the classification of Lakshmanan [54] too. Stop Depressed? Assessment of fusion and writing essay, posttreatment C2-alignment. At final follow-up, reconstructed sagittal and coronal CT-scans in neutral head position were assessed for osseus union by three of the authors. Sources Of Uk? Fusion was present if bridging trabeculae were confirmed at least on one of the cortices in both the sagittal and lateral plane by all observers. Debate? With the same CT-reconstructions, assessment of C2-alignment was performed using the classification for posttraumatic C2-alignment (CPA-C2) [44].

With the CPA-C2 the morphometrical measurements showed substantial interobserver agreement. Distinct cut-off values of the athens essay, 95% upper and writing, lower limits of a physiological standard were assigned end-point anchors of 1 or 2 pts delineating non-physiological dimensions. Of Uk? The final grading of the writing essay, C2-aligment into normal, mild, moderate and severe malalignment based on the summed points [44]. Functional computerized tomography. Apart clinical examination by the author all patients were subjected to functional computerized tomography. The assessment of ROT C1#x02013;2 was performed using functional CT-scans in supine position. A reduced radiation exposure with low energy beam was selected with settings of sparta athens essay 120#x000a0;kv and 80#x000a0;mA sufficient to delineate bony landmarks, joint configurations and fusion. Because subaxial flexion or extension influences the rotational capacity at the C1#x02013;2 joints and total neck rotation, meticulous care was given to level the patients#x02019; cervical spine in essay, neutral sagittal alignment.

The subject#x02019;s body was kept in the same supine position for all head rotation sequences. First, a CT-scan scout-view was obtained with neutral vertical head orientation. The field of interest (FOI) was centered between the clivus and the C3 vertebra distally. After the neutral CT-scan the patients were asked to milton 1972, rotate their neck to the right, as far as possible. CT-scans were completed following adjustments of the writing debate, FOI for axial slice reconstructions in friedman essay 1972, the plane of the approximately 20#x000b0; inclined atlas vertebra. Writing Debate? Finally, the procedure was repeated for the assessment of milton friedman essay 1972 left-sided rotation. With the functional CT-scans, axial, sagittal and coronal slices were reconstructed and stored digitally.

To investigate the ROT C1#x02013;2 , adjacent motion at the C0#x02013;C1 joints (ROT C0#x02013;1 ), total neck rotation (ROT C0 ) and subaxial rotation (ROT C2 ) computer measurements on the axial slices were as follows (Fig.#x000a0; 1 ): in each head position the writing debate essay, occipital midline indicated maximum head rotation (ROT C0 ) delineating the ability of the total cervical spine to rotate to either side. The landmarks for the occipital midline included the beak of the hard palate, the midline of the clivus and occpital protuberance. Admission Essays? Next, the mid-sagittal line of C1, that is a line connecting the anterior atlas tubercle with the middle of the posterior atlas arch, was drawn. Essay? Its perpendicularity to a line connecting the center of the two transverse foramina was essential. The mid-sagittal line of C1 was calculated to the vertical axis delineating maximum atlas rotation to either side (ROT C1 ). Similarly, rotation of stop C2 was assessed drawing a mid-sagittal line of C2, that is a line perpendicular to writing debate essay, the posterior cortical wall of the C2-vertebral body at milton friedman 1972, its most caudad level. If the C2-vertebral body was affected by writing debate, fracture trace up to the mid-sagittal plane, then the admission essays, mid-sagittal axis of C2 was the line joining the slight midline anterior prominence on the C2-body and writing, the cleft of the resume cook examples, bifid spine or the perpendicular of the debate essay, intertransversarium line.

The mid-sagittal line of C2 was calculated to the vertical axis delineating maximum rotation of C2 to either side and maximum rotation of the subaxial cervical spine (ROT C2 ). Finally, left and right ROT C1#x02013;2 were calculated and expressed as the separation angle between C1 and C2, i.e., subtracting the C2 angle by the C1 angle. Similarly, the atlantooccipital rotation (ROT C0#x02013;1 ) was calculated subtracting the C1 by the C0 angulation. In addition, angulation C1#x02013;2 was calculated as percentage rotation C1#x02013;2 of the total neck rotation, expressed as %ROT C1#x02013;2 . ROT C0 resembles total neck rotation to friedman essay, either side and the results were controlled for age and gender and also expressed as percentage restricted total neck rotation (%restricted neck rotation) compared to data of normals published by writing debate essay, Castro [9]. With functional CT-scanning, the left and right ROT C1#x02013;2 were classified into cook, four types: Type 1 (no restriction), #x02265;30#x000b0;; Type 2 (mild), 20 to #x0003c;30#x000b0;; Type 3 (substantial), 10 to writing, #x0003c;20#x000b0;; Type 4 (severe), 0 to #x0003c;10#x000b0;. The worst type of restriction of ROT C1#x02013;2 (left or right) was used for statistical analysis. We determined a cut-off rendering physiological and of uk constitution essay, pathological ROT C1#x02013;2 as any measure #x0003c;30#x000b0;, that is a deviation of approximately #x000b1;2SD from normalcy. Essay? For the friedman essay, purpose of writing essay assessing changes of the resume cook, instantenous center of debate essay rotation (ICR) of the C1#x02013;2 joints the authors applied a technique similar to White and Panjabi [81] on each subject (For technique and results see Electronic supplementary material).

Statistical analysis included parametric methods (independent and dependent two-sided Student t tests, Pearson#x02019;s correlation coefficient) and nonparametric tests (Kruskal#x02013;Wallis ANOVA, Mann#x02013;Whitney U test, Spearman#x02019;s correlations coefficient). Analyses of cross-tabulation tables were done using Pearson Chi-square test and Fisher#x02019;s Exact test. Stop Depressed? A P value less than 5% indicated statistical significance. All analyses were done using Statistica 6.1 (StatSoft, Tulsa, OK). Statistical analysis was performed by writing debate essay, one of the authors (WH). The author (HK) performed the classification of the posttreatment C2-alignment as described [44] on all CT-scans. As there are currently no data on the reliability of measurements using CT-scans, the cook, author performed the assessment of the C2-alignment with all indicated measurements on writing essay plain radiographs and on sparta athens essay CT-scans in writing, six patients having a healed C2-fracture. Reliability was expressed using the essay, intraclass correlation coefficient (ICC). Interpretation of writing essay ICC was done as described [44]. Friedman Essay? Fourty-four (36.4%) of 121 patients identified met all eligibility criteria.

Five patients (including 3 unstable Hmfx treated with plated ACDF) were lost to follow-up. Of another 4 patients that were successfully tracked, 1 denied taking part in the study because of no sequelae after nondisplaced odontoid type III fracture treated nonsurgically. One 61-years-old patient had a displaced odontoid type III fracture with burst left lateral mass that went to severe malunion. She joined the follow-up but could not be included into the study because of mental retardation. Essay? She displayed restricted axial rotation in flexed position (10#x000b0;#x02013;0#x000b0;#x02013;5#x000b0;), complained of pain during head rotation, had a cock-robin head posture and suffered from left-sided suboccipital neuralgia. Another patient with 8-years follow-up answered to the questionnaires having moderate self-rated outcome after AOSF for dislocated odontoid type III fracture (SF-36 PCS: 31.6, MCS 31.1, NDPI: 32%) but could not take part in further survey because of advanced cardiac disease. One 19-years-old with 2-years follow-up after combined odontoid type II and C1 posterior arch fracture treated with double AOSF was working abroad, doing well as assessed by telephone questioning, but could not be surveyed. Finally, 35 patients could participate resembling a follow-up rate of 80%. Mean age at injury was 46.9#x000a0;#x000b1;#x000a0;21.7#x000a0;years (range 17#x02013;78#x000a0;years) and thinking, 52#x000a0;#x000b1;#x000a0;20.7#x000a0;years (range 18#x02013;80#x000a0;years) at essay, follow-up. There were 12 female and 23 male patients.

Follow-up was 65.4#x000a0;#x000b1;#x000a0;7#x000a0;months on average (range 7#x02013;142#x000a0;months) and mean hospital stay was 12.2#x000a0;#x000b1;#x000a0;9.8#x000a0;days (range 1#x02013;40#x000a0;days). Athens Essay? Eleven patients (31.4%) were smokers. Except for mild skull traumas, 12 patients (34.3%) had co-morbidities and concommittant peripheral skeletal injuries (Table#x000a0;3 in Electronic supplementary material). Debate? At follow-up, no patient complained about disability derived from shoulder-girdle injuries or peripheral injuries. Main injury mechanism was a motor-vehicle or bicycle accident in sources of uk constitution essay, 15 patients (42.9%), a skiing casual in writing essay, 4 (11.4%) and a fall from being, height in writing essay, 15 (42.9%). One suffered a direct blow (2.9%). Eighteen patients (51.4%) had initial treatment in a referral hospital and were transferred for definitive treatment. Except for three patients that had plain radiographs, we had injury radiographs and CT-scans available.

Twenty-three patients (65.7%) were subjected to nonsurgical treatment: 11 patients (31.4%) had HTV treatment and 12 (34.3%) had a Philadelphia collar. Stop Depressed? Twelve patients (34.3%) had anterior surgical treatment using AOSF and 1 patient had secondary anterior buttress-plating at C2 for writing debate redislocation of her odontoid type III fracture. Mean time to index surgery was 2.5#x000a0;days (range 0#x02013;10#x000a0;days). Patients#x02019; characteristics are summarized in examples, Table#x000a0;1 in debate, Electronic supplementary material. Stop Being Depressed? Twenty-three patients (65.7%) had 2-part-fractures, 11 (31.4%) had 3-part-fractures and 1 (2.9%) had a 4-part-fracture. Debate Essay? There were 24 fractures (68.6%) involving the odontoid that could be classified into 12 (50%) type II fractures (including IIa) and 12 (50%) type III fractures according to the Anderson classification. Eighteen patients (51.4%) had a fracture pattern involving the vertebral body. Resume? Seven patients (20%), out of essay a total of 8 with an admission essays college, atypical Hmfx, had a vertebral body fracture separating the debate essay, posterior axis wall [45, 46]. In 11 patients (31.4%) the fracture pattern included a dislocated or a burst lateral mass fracture of C2. Essay 1972? At all, 19 patients (54.3%) had an intraarticular fracture pattern resembling an writing essay, involvement of the lateral mass and critical thinking, its articular surface inside or outside the weight-bearing zone, displaced or non-displaced. Out of 35 patients, 7 (20%) had a concomittant C1 fracture.

C1 fractures included 1 lateral mass fracture with articular surface involvement and two stable extraarticular Jefferson burst fractures. Writing Debate? Follow-up CT-scans showed that 31 fractures (88.6%) of C2 (and all fractures of C1) went on to union, in 4 cases (11.4%) a nonunion developed. Athens? Nonunion was mobile in 2 (50%) patients, showing a tight fibrous-stable nonunion in the remaining 2 (50%). Writing? Stability was established on flexion-extension films at follow-up. Statistical investigation showed that union was not related to follow-up length, age, gender, type of fracture or any other variable.

At injury 7 patients had a left-sided AAJ configuration of Type B and 5 of these had also a right-sided Type B. At time of injury only two patients showed preexisting advanced atlantodental and lateral atlantoaxial degenerative process. Sparta Athens? At follow-up nine patients had left-sided and ten had right-sided Type B AAJ changes. Seven patients (20%) had a new onset AAOA of Type B. Writing Debate Essay? According to the classification of Lakshamanan [54] AAOA was a mean of athens 1.1#x000a0;#x000b1;#x000a0;1.0#x000a0;points (range 0#x02013;3) left and 1.0#x000a0;#x000b1;#x000a0;1.0#x000a0;points (range 0#x02013;3) right at follow-up. Injury AAJH was assessable in debate essay, 16 patients (45.7%). LAAJH was a mean of 2.9#x000a0;#x000b1;#x000a0;0.7#x000a0;mm (range 1.6#x02013;4#x000a0;mm) and rAAJH was 3.1#x000a0;#x000b1;#x000a0;0.8#x000a0;mm (range 1.6#x02013;4.5#x000a0;mm). Essays? At follow-up lAAJH was a mean of 2.9#x000a0;#x000b1;#x000a0;0.8#x000a0;mm (range 1#x02013;4.4#x000a0;mm) and writing debate essay, rAAJH was 3.1#x000a0;#x000b1;#x000a0;0.7#x000a0;mm (range 1.5#x02013;4.3#x000a0;mm).

Unlike in normals [44] left- and right-sided AAJH at follow-up did not correlate with patients#x02019; age ( P #x000a0;=#x000a0;0.05, P #x000a0;=#x000a0;1.0). There was a significant difference regarding the incidence of left- and right-sided AAOA of Type A and of Type B between time of injury and follow-up ( P #x000a0;=#x000a0;0.0001 and P #x000a0;=#x000a0;0.0008, two-tailed test). LAAJH and rAAJH were significantly reduced ( P #x000a0;=#x000a0;0.0007, P #x000a0;#x0003c;#x000a0;0.0001) in patients that had AAOA of Type B (left #x000d8;2.0#x000a0;mm, right #x000d8;2.2#x000a0;mm) compared to patients that had AAOA of Type A (left #x000d8;3.1#x000a0;mm, right #x000d8;3.4#x000a0;mm). The results of the functional CT-scans are illustrated in Table#x000a0; 1 and sources of uk essay, compared to data derived from normals. An illustrative case is given in Fig.#x000a0; 2 . The interdependencies of the cervical rotation angles are ranked in Table#x000a0; 2 . Patients displayed an increased total neck rotation (ROT C0 ) in the presence of increased subaxial rotational capacity (ROT C2 ). As expected, total neck rotation was further increased if the C1#x02013;2 joints (ROT C1#x02013;2 ) could substantially contribute to writing debate essay, overall neck rotation. Likewise, with increasing ROT C1#x02013;2, the %ROT C1#x02013;2 of total neck rotation increased significantly too.

On the contrary, ROT C1#x02013;2 did not correlate with subaxial rotation (%ROT C1#x02013;2 had strong inverse correlation with the subaxial rotation (ROT C2 ) because of the definition of %ROT C1#x02013;2 ). In case of decreased atlantoaxial rotation the subaxial spine tended towards compensational rotation not reaching significance: In patients with no subaxial degenerative changes we observed a trend of the subaxial spine to compensate for a lack of stop being depressed ROT C1#x02013;2 but a reduced ROT C1#x02013;2 could not be fully compensated by subaxial or atlantooccipital rotational efforts. Writing Debate? Our analysis showed a significant difference between left and being, right ROT C0 ( P #x000a0;=#x000a0;0.01), ROT C1 ( P #x000a0;=#x000a0;0.002) and ROT C2 ( P #x000a0;=#x000a0;0.007) with the higher rotational ability to the right for all measurements. But the differences were small (3#x000b0;#x02013;4#x000b0;) and there was no significant difference between left and right %ROT C1#x02013;2 or between left- and right-sided ROT C1#x02013;2 . A unilaterally restricted ROT C1#x02013;2 was not compensated for by a substantially increased contralateral rotation. Debate Essay? In contrast, reduced ROM for atlantoaxial rotation to admission essays college, the left or right was accompanied by debate essay, a significantly reduced ROM for the ipsilateral subaxial rotation. Stop Depressed? Out of 35 patients 4 (11.4%) were identified having ROT C1#x02013;2 according to Type 1, 6 patients (17.1%) Type 2, 20 patients (57.1%) Type 3 and 5 patients (14.3%) Type 4. Thus, more than 70% had substantial (#x0003c;20#x000b0;) or severe (#x0003c;10#x000b0;) restriction of ROT C1#x02013;2 at least to one side. The different types of debate rotational restriction and the definition of total neck rotation with a cut-off of 30#x000b0; had no impact on the clinical outcome measures. We calculated the rotation against age and sources of uk constitution essay, encountered a significant inverse correlation (Table#x000a0; 3 ). It was strong for total neck rotation (ROT C0 ) and subaxial rotation (ROT C2 ) but weak for ROT C1#x02013;2 . Calculated separately for isolated odontoid fractures we observed a total ROT C1#x02013;2 of 36#x000b0; on average and debate, a mean total neck rotation of 96#x000b0;. The first author performed all measurements. The analysis of intraobserver reliability demonstrated good to excellent agreement between radiographic and CT-based measurements with intraclass coefficients of #x0003e;0.6 for sparta essay all measurements applied.

There were no measurements performed that were classified as #x02018;pathological#x02019; but otherwise were within normalcy on CT-scans, et vice versa. According to the author#x02019;s classification and grading of morphometrical alignment [44] after treatment of debate essay C2-fractures, mean malunion score was 2.8#x000a0;#x000b1;#x000a0;2.5#x000a0;points (range 0#x02013;11points). According to the classification [44], in sparta, 5 patients (14.3%) the C2-fracture healed in writing essay, anatomical shape without any malalignment and in 12 (34.3%) with mild malalignment. Twelve fractures (34.3%) healed with moderate and 6 (17.1%) with severe malalignment. At all, the C1#x02013;2 complex showed moderate or severe malalignment in 18 fractures (51.4%). Statistical analysis revealed a significantly reduced ROT C1#x02013;2 in critical, patients with the higher malunion score ( P #x000a0;=#x000a0;0.01) and in those classified with a #x02018;moderate#x02019; or #x02018;severe malalignment#x02019; ( P #x000a0;=#x000a0;0.01). Accordingly, patients with higher malunion score had a higher grade of rotational restriction (Types 1#x02013;4, P #x000a0;=#x000a0;0.02). In addition, it striked that patients with higher malunion scores (ANOVA) and moderate/severe malalignment showed a significantly reduced clinical outcome in terms of SF-36 MCS ( P #x000a0;=#x000a0;0.02 and P #x000a0;=#x000a0;0.001), NPDI ( P #x000a0;#x0003c;#x000a0;0.0001 and debate, P #x000a0;#x0003c;#x000a0;0.00001), CSOQ-neck pain severity composite score ( P #x000a0;#x0003c;#x000a0;0.005 and P #x000a0;#x0003c;#x000a0;0.0001), CSOQ-functional disability score (p#x000a0;#x0003c;#x000a0;.0002 and P #x000a0;#x0003c;#x000a0;0.00001), CSOQ-psychological distress score ( P #x000a0;=#x000a0;0.04 and P #x000a0;=#x000a0;0.03), physical symptoms score ( P #x000a0;=#x000a0;0.004 and P #x000a0;=#x000a0;0.0002) and CSOQ-health care utilization score ( P #x000a0;=#x000a0;0.036 and P #x000a0;=#x000a0;0.036). For Applied Critical? Means, SD, and ranges of outcome measures are illustrated in Tables#x000a0; 4 and #x200B; and5. 5 . Writing Debate? Data are presented in comparison to results of 1972 other studies. The outcome measures and questionnaires utilized showed good consistency when assessing differences in clinical outcome.

Assessment of clinical outcomes with the validated measures (SF-36, NPDI, CSFQ) and their correlation with the patient#x02019;s self-rated clinical outcome (#x02018;excellent#x02019; to #x02018;poor#x02019;) showed strong consistency (Kruskal#x02013;Wallis testing: P #x000a0;=#x000a0;0.03 to P #x000a0;=#x000a0;0.003). There were significant differences within the validated measures if calculated for the 4 groups of global outcome: #x02018;excellent#x02019;, #x02018;good#x02019;, #x02018;moderate#x02019; and #x02018;poor#x02019; (Table#x000a0;4 in Electronic supplementary material). There was also a significant correlation between the validated outcome measures and writing essay, inbetween the various scoring items of the queries (Table#x000a0;5 in Electronic supplementary material). Self-rated outcome was judged excellent by sources constitution essay, 15 patients (44.1%), good by 7 (20.6%), moderate by 10 (28.6%) and poor by 2 patients (5.9%). So, 65% of patients judged their outcome as good or excellent and 35% as moderate or poor. With the worse self-rated outcome patients displayed a significantly reduced total ROT C1#x02013;2 rotation ( P #x000a0;=#x000a0;0.02) and total neck rotation ( P #x000a0;=#x000a0;0.05). Likewise, reduced total ROT C1#x02013;2 showed slight correlation with decreased outcome measures yielding significance for the SF-36 PCS ( R #x000a0;=#x000a0;0.36, P #x000a0;=#x000a0;0.04), the NPDI ( R #x000a0;=#x000a0;#x02212;0.34, P #x000a0;=#x000a0;0.05) and the CSOQ-shoulder pain severity composite score ( R #x000a0;=#x000a0;#x02212;0.44, P #x000a0;=#x000a0;0.01). Essay? Patients with reduced total neck rotation had decreased outcomes yielding stronger significance for stop being depressed the SF-36 PCS ( R #x000a0;=#x000a0;0.53, P #x000a0;=#x000a0;0.002), the writing, NPDI ( R #x000a0;=#x000a0;#x02212;0.37, P #x000a0;=#x000a0;0.04) and the CSOQ-shoulder pain severity composite score ( R #x000a0;=#x000a0;#x02212;0.45, P #x000a0;=#x000a0;0.01). When calculating the age and sources essay, gender matched percentage restriction of total neck rotation [9] against writing the clinical outcome measures, correlations existed for the SF-36 PCS ( R #x000a0;=#x000a0;0.54, P #x000a0;=#x000a0;0.001), the NPDI ( R #x000a0;=#x000a0;#x02212;0.38, P #x000a0;=#x000a0;0.03), the college, CSOQ-shoulder pain severity composite score ( R #x000a0;=#x000a0;#x02212;0.45, P #x000a0;=#x000a0;0.007), the CSOQ-neck pain severity composite score ( R #x000a0;=#x000a0;#x02212;0.39, P #x000a0;=#x000a0;0.02) and the CSOQ-functional disability score ( R #x000a0;=#x000a0;#x02212;0.35, P #x000a0;=#x000a0;0.04). Summarizing, reduced clinical outcome was more reflected by a decreased total neck rotation rather than a reduced C1#x02013;2 rotation. As it was with the ability to debate, rotate the neck, statistical analysis revealed a decreased clinical outcome for elderly patients in terms of the friedman essay, NPDI ( R #x000a0;=#x000a0;0.41, P #x000a0;=#x000a0;0.02) and the SF-36 PCS ( R #x000a0;=#x000a0;#x02212;0.56, P #x000a0;=#x000a0;0.001).

Older patients had higher health care utilization demands in terms of the CSOQ ( R #x000a0;=#x000a0;0.36, P #x000a0;=#x000a0;0.04). Elderly patients had a significantly shorter follow-up period ( R #x000a0;=#x000a0;#x02212;0.45, P #x000a0;=#x000a0;0.006) that might put age and outcome related interdependencies into writing debate, perspective. It is of note that patients with worse outcomes had reduced total neck rotation, however, the %ROT C1#x02013;2 did not correlate with the clinical outcome reflecting that a reduced absolute rotational ability affecting the depressed, whole cervical spine was a factor of aging, motion induced pain and a low functional outcome. Significant gender-related differences existed in terms of the NPDI ( P #x000a0;=#x000a0;0.03), the CSOQ-psychiological distress score ( P #x000a0;=#x000a0;0.005) and debate essay, the physical symptoms score ( P #x000a0;=#x000a0;0.01). Milton Friedman? These results have to be interpreted with the awareness of writing essay gender distribution with varying fracture patterns and essays college, ages.

So, 8 of 11 patients (73%) with a burst or dislocated lateral mass fracture were female. Similarly, when assessing intraarticular fracture pattern as a variable, 8 of writing debate essay 12 females depicted reduced motion pattern and sparta athens, increased pain-levels. Writing Essay? Neither the presence of a nonunion nor combined C1#x02013;2 fractures, nor any complication or whether surgery was performed or not had impact on clinical outcome or cervical rotation (Table#x000a0; 3 ). Notably, the resume examples, number of main fragments identified (2-part, 3-part, 4-part-fractures of C2) had significant impact on the %ROT C1#x02013;2 ( P #x000a0;=#x000a0;0.03) but not on the clinical outcome measures. If the smallest denominator was assumed to writing debate, be an intraarticular fracture pattern involving the C2-superior articulating facets then patients had significantly reduced total ROT C1#x02013;2 ( P #x000a0;=#x000a0;0.03) and in particular reduced %ROT C1#x02013;2 ( P #x000a0;=#x000a0;0.006). Rotational abilities were strongly affected by the presence of an intraarticular fracture pattern.

Calculating any intraarticular fracture pattern against the outcome measures did reveal trends, but did not yield significance. In this context it is of note that only 11 patients were identified to milton friedman essay 1972, have had a dislocated fracture or burst pattern involving the articular pillar and lateral mass. If calculating rotation and debate essay, clinical outcome against the presence of a burst or dislocated lateral mass fracture in eight patients at resume, all, the statistical analysis still revealed a trend for writing debate essay reduced %ROT C1#x02013;2 , but it striked that this group of institute for applied patients had significantly reduced outcomes in terms of the essay, SF-36 MCS ( P #x000a0;=#x000a0;0.006), the NDPI ( P #x000a0;=#x000a0;0.04), the CSOQ-functional disability score ( P #x000a0;=#x000a0;0.01) and the CSOQ-physical symptoms score ( P #x000a0;=#x000a0;0.01). SF-36 PCS scores did not reach statistical significance but a strong trend existed (SF-36 PCS #x000d8;35.7#x000a0;#x000b1;#x000a0;9.0 vs. #x000d8;43.0#x000a0;#x000b1;#x000a0;10.2). College? Differences of debate essay 2.5 points are thought to be a clinically meaningful difference for the SF-36 [18, 80].

Patients that had the vertebral body affected (51%) had reduced total ROT C1#x02013;2 ( P #x000a0;=#x000a0;0.02), but %ROT C1#x02013;2 and total neck rotation were not significantly reduced. However, these patients had worst scores with the CSOQ-functional disability score ( P #x000a0;=#x000a0;0.007) and essay 1972, the SF-36 MCS ( P #x000a0;=#x000a0;0.05). This group of debate essay patients included most of the dislocated burst lateral mass fractures, patients with intraarticular fractures and the group with highest malunion scores. Eleven patients (31.4%) had at least one lateral AAJ of Type B and 6 of admission college these 11 (54.5%) had signs of C2-nerve root mediated pain with radiculopathia suboccipitally. Debate? At all, 20 patients (57.1%) reported on pain when approaching the mid-range or extremes of axial head rotation in neutral or sagittally flexed head position or reported on tenderness and institute thinking, localized pain at the C2-spinous process during daily activities. Debate Essay? According to distinct questions within the CSOQ 20% of patients reported that they would need additional treatment for for applied critical their neck condition in the future.

Sixty-one percent of patients judged they would be extremly or moderately satisfied if their neck condition would be the same as at follow-up, while 20% judged they would be moderate or extremely dissatisfied if the neck condition would remain the same (20% ticked #x02018;neither satisfied nor dissatisfied#x02019;). Twenty-three percent reported that the essay, actual result was somewhat or much worse as expected, 49% reported it was somewhat or much better than expected, and 28% as expected. Concerning AAOA, the presence of Type B changes at of uk, follow-up had significant impact on the rotational ability and outcome measures. Type B patients displayed significantly decreased total ROT C1#x02013;2 ( P #x000a0;=#x000a0;0.006) and %ROT C1#x02013;2 ( P #x000a0;=#x000a0;0.04) but not significantly reduced total neck rotation. Clinical outcomes were worse than in debate essay, patients with Type A changes in terms of the SF-36 PCS ( P #x000a0;=#x000a0;0.01), the SF-36 MCS ( P #x000a0;=#x000a0;0.01), the resume cook, NPDI ( P #x000a0;=#x000a0;0.002), the CSOQ-psychological distress score ( P #x000a0;=#x000a0;0.0005), the CSOQ-physical symptoms score ( P #x000a0;=#x000a0;0.01) and writing, health care utilization score ( P #x000a0;=#x000a0;0.02). The same interdependencies existed even more in patients that had newly developed Type B changes with a significantly decreased total ROT C1#x02013;2 ( P #x000a0;=#x000a0;0.01) and %ROT C1#x02013;2 ( P #x000a0;=#x000a0;0.02) as well as reduced outcome measures in milton 1972, terms of SF-36 MCS ( P #x000a0;=#x000a0;0.0009), NPDI ( P #x000a0;=#x000a0;0.003), the CSOQ-neck pain severity composite score ( P #x000a0;=#x000a0;0.04), CSOQ-functional disability score ( P #x000a0;=#x000a0;0.02), CSOQ-psychologic distress score ( P #x000a0;=#x000a0;0.0009), CSOQ-physical symptoms score ( P #x000a0;=#x000a0;0.04) and essay, CSOQ-health care utilization score ( P #x000a0;=#x000a0;0.006). Patients that had preexisting AAOA of Type B, that had just progressed, had significantly reduced left and right AAJH ( P #x000a0;=#x000a0;0.04 and critical thinking, P #x000a0;=#x000a0;0.03) as compared to Type A patients, but clinical outcome measures were not different (Table#x000a0; 4 ). Fracture of the essay, C2 articular pillar. In 8 of 11 patients (72.7%) with displaced or burst lateral mass fractures the essay, left side was affected. At follow-up, these patients had significantly reduced left-sided AAJH ( P #x000a0;=#x000a0;0.02).

With increasing malunion score, ROT C1#x02013;2 was significantly reduced, the writing, most on sources constitution essay the left side ( P #x000a0;=#x000a0;0.0005). When calculating for the intraarticular fracture pattern that affected the left side in writing debate essay, 11 of 19 patients (58%) it also striked that left-sided %ROT C1#x02013;2 ( P #x000a0;=#x000a0;0.005) and left-sided ROT C1#x02013;2 ( P #x000a0;=#x000a0;0.02) were significantly affected in milton essay 1972, comparison to the contralateral side. The findings of left-sided preponderance were incidental, but substantiated that the intraarticular and debate essay, particularly burst fracture patterns show their main adverse effects on admission the development of ipsilateral AAOA, reduced total ROT C1#x02013;2 and %ROT C1#x02013;2 and C2-malunion scores. The latter had the largest impact on clinical outcome measures. Fourteen patients (40%) were already retired at time of injury unrelated to writing essay, disorders of the neck. Of 21 patients occupied at time of resume examples injury 15 achieved a level of W1 (42.9%) according to Denis#x02019; Work Scale, 1 had W2 (2.9%), 2 had W3 (5.8%) and 3 patients (85.7%) were not able to debate, resume previous full-time employment or were unable to work because of stop being depressed neck related impairment. Eighteen patients (85.7%) went back to a full-time employment with a mean time out of work of 17.0#x000a0;#x000b1;#x000a0;6.8#x000a0;weeks (range 3#x02013;24#x000a0;weeks) after injury. Writing? With the dysphagia grading system of Bazaz [3] the mean score was 1.4#x000a0;#x000b1;#x000a0;0.7 (range 0#x02013;3) for liquids and for applied critical thinking, 1.7#x000a0;#x000b1;#x000a0;1.0 (range 1#x02013;4) for essay solid nutrition.

Buzz-scores were not significantly affected by anterior surgery. In summary, 7 out of essay 1972 35 patients (20%) sustained a complication: 1 (2.9%) with odontoid type II fracture had delayed-union in the HTV but eventually fused after 6#x000a0;months. Another patient suffered from neuralgia at a former pin-site with subsequent phobia wearing huts. Writing Debate? One patient had screw-related dysphagia following double AOSF but denied screw removal. Another had hard-to-treat C2-referred pain lasting for admission essays 8#x000a0;months after nonsurgical treatment of an writing debate essay, odontoid type III fracture with split-impression fracture of the lateral mass. Another had early fracture redislocation after double AOSF for odontoid type III fracture with oblique split-impression fracture of the lateral mass. The fracture healed uneventful. One female patient with 10#x000a0;years follow-up had HTV treatment for a displaced odontoid type III fracture with en bloc fracture-separation of the for applied critical, comminuted lateral mass. Symptomatic nonunion with severe malalignment developed and the patient was subjected to anterior retropharyngeal release with reduction and C2-buttress-plating 6#x000a0;months after the index treatment. Writing? Implant removal was performed 1.5#x000a0;years after index therapy. After 3#x000a0;years the patient showed up reporting a progression of myelopathic signs during a 4-weeks period which was found to be related to anterior subluxation of C1 on stop C2.

The patient denied a second trauma. Intraoperatively, there was no significant sagittal motion C1#x02013;C2. After posterior decompression of C1 the patient recovered completely. Finally, during survey of our patients a 76-year old was subjected to C1#x02013;2 Magerl fixation for painful C1#x02013;2 joint destruction (Fig.#x000a0; 3 ). Debate? The patient achieved immediate pain resolution after immobilization of the C1#x02013;2 joints. Admission? The current study is a unique approach to the outcome investigation of C2-fractures, and it is the writing debate essay, largest reporting of stop being functional CT-scanning in patients with cervical trauma. The author identified several articles [47, 49, 68] reporting on miscellaneous C2-fractures included into cross-sectional outcome analysis or using nonvalidated instruments; most studies are reluctant to further delineate distinct fracture morphology and debate, outcome variables in heterogenous samples [5, 25#x02013;27, 29, 62, 68]. Therefore, we intended to seek objective outcome data through assessment of validated outcome measures, functional outcome using dynamic CT-scanning, a detailed classification of fracture pattern and an analysis of institute critical posttreatment C2-alignment using a classification system based on valid measurements [44]. Writing? The efforts are indicated as there is no consensus on the ideal treatment for all subtypes of C2-fractures [2, 29, 43, 46, 62].

Our study yielded for a homogenous sample. We assessed different fractures (odontoid, vertebral body, Hmfx,#x02026;), but unlike prior studies with difficulties addressing all fracture patterns, the authors#x02019; characterization of C2-fractures at injury and at follow-up implicates the focus on identical morphological characteristics within the C2-fracture subtypes. Consequently, beside general outcome analysis of C2-fractures, we sought to analyse the influence of distinct morphological subtypes (intraarticular fracture pattern, number of stop being main fragments, burst component,#x02026;) on the remaining rotation C1#x02013;2 and writing debate essay, the clinical outcome. We wanted to identify risk factors for poor outcome and thereby identified the severity of malunion. Milton Friedman Essay? We aimed out being able to identify at an early stage of treatment those fractures prone to symptomatic malunion and poor outcome, thus resulting in essay, an adaption of treatment protocols (nonsurgical vs. surgical, nonfusion vs. fusion procedure).

Rarely, the sparta athens, type of anatomical alignment and associated outcome after various motion-preserving treatments is writing essay reported [1, 10#x02013;12, 21, 26, 34, 41, 42, 46, 47, 57, 63, 71, 74, 78]. A meaningful number of admission subtypes of writing debate essay C2-fractures exists where complete reduction, normal C1#x02013;2 rotation and a physiological anatomy is difficult to restore [1, 10, 11, 34, 42, 43, 71, 82]. Likewise, a non-anatomical posttreatment C2-alignment, resembling a malunion, can cause significant symptoms even indicating fusion C1#x02013;2 [13, 26, 30, 42, 47, 51, 52, 67, 70, 71, 78, 79] as it had to be done in one of our cases (Fig.#x000a0; 3 ), two others being scheduled (Fig.#x000a0; 4 ). Malunion in C2-fractures can produce significant sequelae and we sought to for applied critical thinking, stratify those C2-fracture subtypes prone to malunion after motion-preserving therapy: In the writing, literature, the approximate rate of malunion in odontoid fractures was reported to be 12#x02013;22% [57, 63]. Using the resume cook examples, classification we established in part I of the project [44] we identified 49% of patients having either no or only mild malalignment but 51% having moderate or severe malalignment of C2 or the C1#x02013;2 complex. Writing? Patients with advanced malalignment had significantly reduced ROT C1#x02013;2 and, even more important, the presence of advanced malunions had a strongly significant adverse impact on all clinical outcome measures. This study offers evidence for the correlation between a distorted posttreatment C2-alignment, including distortion of the physiologic C1#x02013;2 relationships, and worse clinical outcomes, both involving restricted ROT C1#x02013;2 . Our findings substantiate previous studies that noted reduced outcomes in patients with distorted C1#x02013;2 joint configurations [19, 26]. Stop Being? Dvorak [18] reported on 34 Jefferson fractures and writing essay, demonstrated that patients with residual lateral displacement of the lateral mass of C1#x000a0;#x02265;#x000a0;7#x000a0;mm were more likely to report worse functional status in terms of the SF-36.

In another study [17] on 90 isolated subaxial facet injuries, the group of essay 1972 18 patients treated nonoperatively contained the most benign fracture patterns but had significantly worse clinical outcomes (NASS, SF-36 subscales). Dvorak hypothesized that the worse outcome even after non-displaced, non-surgically treated facet fractures is due to the development of writing debate secondary degenerative changes with malalignment at sparta, the injury level. Similarly, we observed that malunion as a result of distorted C2-lateral mass, altered C2-articular surfaces, widening of the vertebral body or increased odontoid tilt caused a remarkable drop in outcome measures and ROT C1#x02013;2 . Debate? We demonstrated that maintaining anatomic C2-alignment has a decisive role for clinical outcomes (Table#x000a0; 5 ). Milton Friedman Essay? Functional outcome and atlantoaxial rotation. Essay? After motion-preserving C1-ring osteosynthesis in five Jefferson fractures, Ruf [65] reported a mean left and right ROT C1#x02013;2 of 20.6#x000b0; and 18.6#x000b0; using dynamic MRI-scans. The patient with worst C1#x02013;2 incongruency had the essays college, worst functional and clinical outcome which was attributed to the distorted C1-2 articular surface pattern. Writing Debate? Jeanneret [39] measured left and right ROT C1#x02013;2 25#x000b0; and 24#x000b0; after AOSF using functional CT-scans.

Likely due to stop being depressed, sample size and fracture analysis, the study did not find any correlation between residual ROT C1#x02013;2 and fracture pattern, quality of writing reduction or osteosynthesis. We investigated the ROT C1#x02013;2 after treatment of C2-fractures. In our sample with 35 patients, only resume cook examples 30% had normal ROT C1#x02013;2 or mild restriction, but 70% had substantial (#x0003c;20#x000b0;) or severe (#x0003c;10#x000b0;) restriction of writing debate ROT C1#x02013;2 at least unilateral. Likewise, in 1972, Jeanneret#x02019;s sample only 38% had normal motion C1#x02013;2 and Verheggen [10] noted that only 61% of patients revealed standard rotation after AOSF. We explored the rotational interdependencies (Table#x000a0; 2 ) and observed that in case of decreased C1#x02013;2 rotation, the writing essay, subaxial spine yielded for compensation, but did not reach significance and is suggested to athens, be an effect of pain-mediated (due to malunions) overall restriction of rotation and coincident a factor of writing aging. Concerning age, some elderly patients showed advanced subaxial spondylosis and normally the C1#x02013;2 rotation increases compensatorically with aging [9]. Calculating the ability for neck rotation against age we observed a significant inverse correlation, pronounced for sources of uk essay total neck rotation (ROT C0 ) and subaxial rotation (ROT C2 ). Essay? Although we expected an admission, increased %ROT C1#x02013;2 in the elderly, the correlations were weakest for the %ROT C1#x02013;2 and ROT C1#x02013;2 rendering other factors decisive for reduced ROT C1#x02013;2 also in the elderly patients. Writing? Concerning compensational mechanisms we observed that unilaterally restricted ROT C1#x02013;2 was not compensated for by a substantially increased contralateral rotation. In addition, reduced ROT C1#x02013;2 to one side was accompanied by a significantly reduced ipsilateral subaxial rotation. We did not observe a significantly increased C0#x02013;1 rotation in admission college, case of reduced ROT C1#x02013;2 as it was in writing, children with pathological stickiness C1#x02013;2 [58, 60].

We had a mean ROT C0#x02013;C1 of 2.6#x000b0; and 2.7#x000b0; to admission college, the right and left suggesting a normal coupling between C0 and C1 [58]. Only a few patients exhibited increased motion above 2SD but never achieved ranges of 30#x000b0; as in the forementioned study. Debate? Overall, we demonstrated a significant reduction of ROT C1#x02013;2 in stop being, the C2-fractures with decreasing order in writing debate, odontoid, vertebral body and atypical Hmfx, and fractures affecting the articular pillar of C2. Like Jeanneret, we investigated the reasons for reduced ROT C1#x02013;2 . For Applied? While reduction of total neck rotation after the C2-fractures is assumed to writing, be a function of pain-related restriction of overall motion [42], aging and degenerative processes, we showed the reduction of ROT C1#x02013;2 and milton friedman essay, %ROT C1#x02013;2 to be significantly associated with the degree of anatomical distortion and the severity of malunion, outperforming the statistically analysed influence of essay pain in terms of the outcome vehicles. Institute Thinking? Our patients had no other cervical injuries and writing essay, the source of pain could be focused at C1#x02013;2. Statistically a pain-related reduction of sparta ROT C1#x02013;2 and an associated reduction of total neck rotation existed, but the severity of malunion had the highest effect on essay the rotational ability of C1#x02013;2.

There was a slight correlation between total ROT C1#x02013;2 and clinical outcome measures, but no correlation existed for the %ROT C1#x02013;2 and the clinical outcome. It seemed that the restriction of cook examples rotation was perceived by the patients to essay, be an stop, acceptable #x02018;price#x02019; to pay causing less disability if they did not perceive motion induced pain. Likewise, Grob [31] reported the residual neck rotation in 35 fusions of C1#x02013;2 for writing essay AAOA with a mean of 58#x000b0;. Athens Essay? Notably, rotation was not different between the writing debate, patients reporting a #x02018;good#x02019; or a #x02018;poor#x02019; outcome. Our current findings substantiate that loss of ROT C1#x02013;2 and total neck rotation do not cause worse outcomes. In normals the C1#x02013;2 joints are responsible for stop up to 60% of total neck rotation equaling 30#x000b0;#x02013;45#x000b0; [16, 25, 58, 64, 73]. Even though the osseus contour of the lateral C1#x02013;2 joints looks concave on radiographs, the padding of joint cartilage converts the articulating surfaces to debate, biconvex discs [58] with the cartilage cover averaging 1.5#x02013;2#x000a0;mm [48, 51]. The spaces anterior and posterior where the articular surfaces diverge are filled by intra-articular meniscoids [48]. In neutral head position the constitution essay, summit of the writing essay, atlantal convexity rests on the convexity of the axial facet.

As C1 rotates, one atlantal facet slides down the admission essays, posterior slope of its axial facet, and the contralateral atlantal facet slides down the anterior slope of its facet (Fig.#x000a0; 4 ) [8]. Because of the essay, convex shape of the articular surfaces each facet of C1 and C2 moves downwards and forwards/backwards at the same time during rotation [15, 69]. The articular surfaces of C1 and C2 touch each other at the mid- point during the rotational process. The understanding of this process is friedman crucial for recognizing the essay, C1#x02013;2 joints as a source of 1972 pain. Pang [58] established the blue print of normal rotation C1#x02013;2 by analysing CT-based motion curves containing three distinct phases [58, 59]: a single motion phase (C1#x000b0;#x000a0;=#x000a0;0#x000b0;#x02013;23#x000b0;) when only C1 turns; a double motion phase (C1#x000b0;#x000a0;=#x000a0;24#x000b0;#x02013;65#x000b0;) when both C1 and C2 are turning in debate essay, the same direction because of ligamentous yoking; and a unison motion phase (C1#x000b0;#x000a0;=#x000a0;65#x000b0;#x02013;90#x000b0;) when both C1 and C2 turn as a fixed couple. The authors showed that neck rotation was initiated at the C1#x02013;2 joints and rotation of C1 occured before C2 rotated [64]. Therefore, any rotation of the head is conferred to the C1#x02013;2 facets and in the current sample with an overall reduced total ROT C1#x02013;2 of 40#x000b0; the articulating surfaces of C1 and C2 must, at some point, have encountered a restraint.

As Jeanneret [39], Pang [58], Ruf [65], Kim [42] and others pointed out, soft or bony interlock can have its source in malunited vertebral bodies, odontoid or lateral mass fractures, intraarticular scarring and pieces of cartilage wedged into the joint spaces, or can be a sequelae of capsular and periarticular ligamentous scarring like arthrofibrosis. Admission Essays? We demonstrated that an writing essay, altered joint anatomy of C1#x02013;2 caused reduced ROT C1#x02013;2 and %ROT C1#x02013;2 , sometimes deformation being striking and the restraint of axial rotation obvious (Fig.#x000a0; 3 j). Concerning the critical thinking, loss of rotation, our findings echo previous observations describing significantly reduced rotation C1#x02013;2 after prolonged immobilization, e.g., with temporary Magerl fixation [7, 71], after ligamentous and capsular injuries to debate essay, the C1#x02013;2 joints [60] and after intraarticular or malunited fractures of C2 [52, 57]. In addition to articular surface deformities, distortion of the rotational axis of C1 and C2 in terms of deviated instantaneous center of rotation (ICR C1#x02013;2 ), e.g. as a sequelae of sources of uk constitution a widened C2-vertebral body, deformed lateral mass or tilted odontoid is thought to contribute to reduced ROT C1#x02013;2 [37]. We investigated the ICR C1#x02013;2 and observed a trend towards an anterior shift of the writing, ICR C1#x02013;2 (Electronic supplementary material). Currently there is no definition of normal ICR C1#x02013;2 or grading of any deviation of the ICR C1#x02013;2 , so observations warrant further research. Jeanneret noted three patients with restricted ROT C1#x02013;2 and admission essays college, explained the decreased motion with intraarticular comminution of the C1#x02013;2 joints that was supposed to produce painful posttraumatic AAOA [39]. AAOA can disrupt the smooth, gliding joint motions [60] and debate essay, a clinical hallmark of AAOA is known to be the significantly reduced ROT C1#x02013;2 [20, 31, 35, 66]. Accordingly, our patients with AAOA (preexisting and new onset Type B joints) had significantly decreased total ROT C1#x02013;2 and friedman essay 1972, %ROT C1#x02013;2 . The same interdependencies were stressed if calculated separately for patients with new onset degeneration of debate essay Type B as a result of intraarticular fracture pattern or lateral mass comminution.

The patient#x02019;s subjective perception of the milton friedman, treatment-related outcome has increasingly become the focus in spinal care. The current study is one of the first to assess clinical outcomes of fractures at C1#x02013;2 using validated outcome measures [18] applied on a sample, homogenous for the neurologically intact, with exclusion of writing debate many confounding patient based variables through hard selection process. Constitution Essay? Notably, we identified significant impairment in generic (SF-36) and debate, disease specific (CSOQ, NPDI) outcome vehicles. The use of validated measures allowed an objective comparison of stop depressed C2-fractures morphologically classified with other spinal injuries: Tables#x000a0; 4 and #x200B; and5 5 illustrate that our outcome was better than reported with, e.g., Jefferson burst fractures, except for essay the SF-36 MCS. On the other hand in comparison to, e.g., subaxial discoligamentous injuries in the neurologically intact treated with plated ACDF our results were inferior. Essay? For our purpose of identifying prognostic factors we investigated whether pain and debate essay, disability in patients with reduced outcomes depended on (1) a restricted ability for axial rotation, (2) distortion of C1#x02013;2 anatomy and severity of malunion, or (3) intraarticular damage with subsequent degeneration and development of AAOA. The statistical analysis revealed that clinical outcome was in examples, the majority influenced by the severity of malunion.

Malunion was a frequent sequelae of intraarticular and essay, particularly burst lateral mass fractures with subsequent evolvement of AAOA over time. At all, 65% of patients judged their outcome as good or excellent. But 35% judged their outcome as moderate or poor and 20% assumed that they would need additional treatment for their neck condition in sources, the future. In contrast, in writing debate, literature the results of various treatment modalities for C2-fractures, particularly for odontoid fractures, were frequently recognized as #x02018;good#x02019; if not #x02018;excellent#x02019; [25, 62, 72]. In the resume cook examples, past, detailed data have been sparse commonly not exceeding cross-sectional assessments and despite the prevailing opinion that overall outcome was favourable, long-term analysis identified persisting symptoms of debate pain and stiffness in a meaningful number of patients [1, 11, 57, 76]. Platzer [62] reported on 110 patients subjected to essay, AOSF. Outcome was 1.4#x000a0;points on a #x02018;Smiley-Webster#x02019; scale, judged #x02018;good to excellent outcome#x02019;. Astonishingly, only 14% were reported complaining about limitations in daily living, occasional or chronic pain symptoms and debate, decrease of cervical motion. Unfortunately, the sample was heterogenous including neurologically injured, one-third was reported to have significant co-morbidities or injuries and morphological characteristics of C2-fractures were lacking.

In contrast, after AOSF subjective-rated pain can be found in 10#x02013;40% [1, 11, 57, 76]. M#x000fc;ller [57] reported on critical thinking 27 odontoid fractures subjected to AOSF. Fourty-one percent of writing essay patients demanded pain medication and 29% noted motion related pain, only 18% were completely satisfied with their outcome and 22% of fractures went on stop being depressed to malunion. Several patients were noted to have combinations of reduced ROM, persistant pain, a malunion or AAOA. M#x000fc;ller [49] stressed the debate essay, importance of anatomical alignment in C2-fractures and the findings of the current study give evidence that with an increasing number of C2-fragments, deformation of the C2 vertebral body and particularly fractures of the C2 lateral mass clinical outcome drops: Fractures involving the C2 articular pillar can be isolated articular or lateral mass fractures or extensions of sparta athens vertebral body fractures [5, 26] and were found to debate, be prone to a high rate of constitution non-anatomical union [21] frequently indicating secondary fusion of debate essay C1#x02013;2 [30, 67, 70]. Up to 50% of Hmfx involve the articular facets of C2 and in the largest sample regarding anterior fusion C2#x02013;3 for sources essay the treatment of unstable Hmfx, Koller [46] observed a decreased functional and clinical outcome with a subset of patients having reduced rotation C1#x02013;2 and writing debate essay, motion induced C2-referred pain. Resume? Similar to our study, several of these patients showed incongruency and deformity of the C1#x02013;2 joints and a positive correlative relationship between the severity of malunion C1#x02013;2 and reduced clincial outcomes. Likewise, Fujimura et al. [26] reported on 31 C2-vertebral body fractures subjected to nonsurgical treatment including 3 burst and 17 sagittal fractures of the lateral mass. In 15 of 17 sagittal fractures malunion C1#x02013;2 was recognized at follow-up, 8 of the debate, 17 fractures (47%) went to AAOA reporting moderate or severe nuchal pain.

At all, patients that had suffered from critical, lateral mass fractures had moderate to severe pain in 82%. Since Jeanneret#x02019;s series, several reports substantiate that C2-fractures affecting the upper facets of C2 can show symptomatic C1#x02013;2 incongruency at follow-up [26, 40, 42, 52] and our study adds objective data delineating a significantly decreased outcome in terms of writing essay validated measures with increasing C2-malunion. Sparta Essay? Accordingly, from the current results the writing debate, authors support primary fusion C1#x02013;2 in C2-fractures with comminuted or displaced C1#x02013;2 joints showing a high risk of malunion and poor outcomes. Literature [20, 26, 31, 35, 39, 40, 52, 66] and our current results demonstrate that the C1-2 facet joints can be a meaningful source of pain. Thirty-one percent of essay our patients had at writing essay, least one lateral C1#x02013;2 joint displaying advanced AAOA, more than half had signs of C2-nerve root conferred radiculopathy and motion induced suboccipital pain. The pain was not caused by college, nerve root or C2-ganglion compression, as there was no abnormal interlaminar space at writing debate essay, C1#x02013;2 [6] in any patient. Facet joint pain is likely to be transmitted by unencapsulated receptors and free nerve endings in the joint capsule and synovial lining [35]. With aging or posttraumatic changes, degeneration with capsular laxity and synovitis can occur and finally AAOA can arise with a mechanical nature of pain [35, 36].

As in our sample, pain derived from the C1#x02013;2 facet joints is frequently described in nonneuropathic terms such as #x02018;pressurelike#x02019;, #x02018;deep boring#x02019;, #x02018;dull#x02019;, and #x02018;heavy#x02019; [20, 35] and located almost exclusively at the ipsilateral retromastoid and occipital region [14, 20, 22, 28, 31, 35, 66]. Stop Being? As in the current study the debate, main manifestations of C1#x02013;2 degeneration and AAOA are pain with significantly restricted ROM [22, 31], elicited or exacerbated by ipsilateral neck rotation [20, 22, 28, 35, 66]. Our current findings are in line with previous authors#x02019; symptoms predominating on the side of the more significant lateral mass arthropathy, some patients even reporting crepitation [22, 45]. Friedman? The pain in AAOA is secondary to an irritative phenomenon in writing debate essay, the joint itself. When motion is eliminated in the joint, the irritation within ceases and institute critical thinking, pain generation is halted [22].

Therefore, immobilization and essay, definite posterior fusion C1#x02013;2 relieves pain in patients with sequelae of AAOA [22, 28, 31, 35, 55] like in one of our cases with intractable pain resulting from a C2-vertebral body fracture with a burst pattern at of uk constitution essay, the lateral mass (Fig.#x000a0; 3 , #x200B; ,4). 4 ). Several authors noticed AAOA to be a distracting source of pain [20, 31, 35, 36] and debate essay, one of the sequelae following C1#x02013;2 fractures [26, 33, 39]. In part I of our project we elaborated the incidence of AAOA with 5% in normals with a mean age of stop being depressed 50#x000a0;years [84]. Nevertheless, degenerative AAOA [28, 31] and posttraumatic AAOA seem to be a neglected and underdiagnosed clinical entity [20, 22, 35, 36, 39]. Thus, we sought to contribute to the understanding and awareness of C2-joint referred pain. With a detailed assessment of writing debate essay clinical and for applied, radiographic outcome, we identified posttraumatic AAOA in 20% of debate essay cases. We observed a strong correlation between the milton essay, presence of posttraumatic AAOA and worse clinical outcome.

Hence, beside its influence on ROT C1#x02013;2 , the debate, restoration of C1#x02013;2 anatomy is another important factor to be considered in milton essay, C2-fracture treatment to avoid C2-malunion and writing essay, accelerated atlantoaxial degeneration. With growing awareness and the more liberal use of CT-scans using 3D-reconstructions, distinct fracture subtypes that frequently come along with odontoid, Hmfx or vertebral body fractures (e.g. articular surface involvement of C2 or vertebral body widening) will be diagnosed more often. Essay? The current study entailed a new approach to the outcome investigation of C2-fractures emphasizing the morphological stratification of distinct fracture subtypes. Using a functional CT-scanning protocol to assess rotation C1#x02013;2, validated outcome vehicles and applying a validated classification for the posttreatment alignment of C2 and debate, the C1#x02013;2 complex, we demonstrated that malunion in C2-fractures had strong association with development of AAOA and a significant impact on clinical outcomes, atlantoaxial and total neck rotation. Further studies will have to analyse the impact of different treatment strategies not only on fusion rates, but also on the anatomical alignment achieved and its effect on outcome.

Electronic supplementary material. Below is the link to the electronic supplementary material.

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Within his transaction experience, we asked him specifically about results for stop being depressed each entry and emphasized that aspect (e.g. the debate $3 million price reduction) more. We changed the milton 1972 focus of his older consulting experience and highlighted the leveraged buyout transaction he was working on – he was focused on PE-related roles, so it was important to writing debate, emphasize his exposure to LBOs. Ordinarily, the part-time experience at “PowerSoft Analytics” (some type of milton friedman, consulting role in a side business) would have been fine to list – but we were space-constrained and this was less relevant, so we deleted it. Overview of Problems in writing essay, Initial Version – and How We Fixed Them: Summary sections in the beginning are generally useless for recent graduates and current university students, so we removed that. The formatting suffered from being, issues with spacing, bold text, and so on, so we made the resume more in-line with our own templates. She listed too many different work experience entries and did not go into much detail on debate, any of them; we changed this by only listing 4 entries and cook focusing on the top 3 most useful ones. Writing Debate! For each work experience entry, we changed the focus to the skill set that was most useful in the finance industry – valuation, financial analysis, and so on. We shifted the focus to results and recommendations , including added emphasis on deal and investment recommendations and the potential $2 million expense reduction in one of the entries.

It’s very, very unlikely you’ll have a question we haven’t heard and successfully answered before, or that you have a work experience or educational background that we haven’t seen on a resume in resume cook, the past. You’re tapping into a vast reservoir of writing debate essay, finance resume knowledge when you use our service. Hear What Some of Our Previous and essays college Current Clients Have To Say About Their Experiences… Note that our clients typically sign up for package deals , so these comments refer to writing debate essay, both our coaching and athens essay resume / cover letter editing services. “By the Third Week, I Was Spoiled by debate, Choice; I Had About Half a Dozen Callbacks and Even Received an Interview Request from a Firm I Hadn’t Even Applied to!” “For the Latter Part, I Can Confidently Say That Had I Not Undergone Your Coaching, I Would Have Made Some Serious Networking No No’s and of uk essay Awkward Conversations.” “I Recently Just Landed Two Offers, One at a Boutique, One at a Canadian Bank-Owned Dealer. A Big Shout Out to Nicole for Her Help Over Resume, Cover Letter, and Interview Tips!!” “I Would Definitely Recommend This Service, Particularly to writing essay, People Looking to Break Into the Industry from Non-Finance Backgrounds.” “This Was the Best Career Investment I’ve Ever Made. Sources Essay! I Had No Idea What Investment Banking Was in October, Submitted My Resume Online (!) in debate essay, December, and depressed Got an Interview with a Major Bank in February.” “MI Helped Me Think About the Specific Impact I Had On All My Deals and debate Projects, Which Resonated with Employers. Now I Have a Dream Job at sparta athens essay a Leading Cleantech Private Equity Firm.” “The Improved CV Indeed Landed Me More Interviews and I Have Recently Landed a Job at writing debate a Private Equity House Which Specializes in milton essay, Real Estate Investment.” “I Would Like to Express My Special Thanks to Ms. Nicole Lee. With Her Profession, Efficiency and Intelligence, She Really Changed My Messy Resume and Cover Letter Into Interview-Winning Ones.” “The Overall Effect is writing debate, That My Resume Now Looks Far More ‘Banker Appropriate’ Than Before, Despite the institute critical Fact That I Have No Previous Experience in Investment Banking.” “The Coaching Service Was Fantastic!

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If I’m a Sophomore or Junior in University, Can I Still Use This? If you’re a Sophomore or Junior in university, this service is writing essay, NOT right for you. Our focus is on clients who have at constitution essay least several internships and/or several years of debate, full-time work experience. If you do have significant internship experience anyway, then yes, we may be able to stop depressed, help – but please contact us first. What About for writing essay Senior-Level Positions? This service is admission essays, appropriate for professionals up to the VP level. Writing Debate Essay! It’s not appropriate if you’re a Managing Director or C-level executive, as those types of resumes have very different requirements and accepted styles. Yes. In fact, we normally review your cover letter at the same time as we review your resume. Cook! We also offer more comprehensive coaching packages (please see options below).

My Resume is Already “Pretty Good” – How Much Can You Really Help? Many clients we work with DO start out with a “good” resume – but they’re looking to make it “great.” Whenever you work on your own resume, it’s all to easy to over-analyze until you “can’t see the forest for the trees”. We add a professional, third party perspective that can often add substantial value. Almost every resume we’ve seen could use some improvement – whether in writing, content, formatting, structure, or all of for applied critical thinking, those. Formatting , in writing, particular, tends to kill otherwise good resumes – we’ve seen plenty of essay 1972, qualified candidates get rejected simply because their resumes were difficult to read. You wouldn’t want to debate, spend days working on milton, your resume and debate then get rejected because you misspelled a word , or because your hyphens were different lengths… right?

That’s the level of detail you need to essays, ensure your resume is favorably received. Do You Edit Both Content and Formatting? Yes, both formatting and debate essay content are covered. After all, it’s hard to get interviews if your resume looks like a 5-year old scribbled it together with crayons. With all that said, this coaching service is NOT a fit for sparta essay everyone. We’re not going to sugar-coat this and spin some BS about how “everyone from high school students to seasoned industry professionals can benefit from our services!” The truth is only a relatively small and exclusive group of candidates is a fit for writing debate essay our services . Client fit is sources constitution essay, very important to us, and writing we only of uk constitution essay want to work with people we know we can help. Eight Important Things You Need To Know Before You Apply.

While we promise to give you our full expertise and attention, we cannot guarantee your success , because there are so many factors beyond our control. However, we CAN help you to writing essay, put your very best foot forward and achieve your goals much faster than you otherwise would.If you have a 2.0 GPA from an unknown school with 0 internships and expect us to stop being, magically get you an offer at Goldman Sachs Investment Banking in writing, New York or London, then keep dreaming . In this situation, we would actually recommend NOT signing up at all because our services would not be terribly helpful for you. Do NOT apply if you’re a university student with no previous work experience. Admission! We focus on helping 3 main categories of essay, candidates only: University or Master’s students with previous internships who are now seeking full-time employment ( sometimes we can help with internships, if you’ve had solid previous work experience) Current investment bankers who are now looking to critical, move to writing debate essay, the buy-side at a private equity firm, hedge fund, or venture capital firm Career changers who want to break into finance at the MBA level or post-MBA levelIf you are NOT in one of those categories above, please do NOT sign up for these services.Yes, there is a chance that our strategies might still help you… so if you fit slightly outside the categories above, you could contact us first to get our thoughts before you commit to anything.But in most cases, these services will be FAR more helpful if you’re in critical thinking, one of those 3 categories above.And please, whatever you do, do NOT sign up if you’re currently a 1st or 2nd year university student with no previous internships or work experience, because these services will not help you at all. Essay! You have to sources of uk, do the work. We will deliver value in a number of ways, including editing your resume, helping you to perfect your pitch, explaining exactly how to essay, network, practicing interview questions with you, and so on. But you still have to admission essays college, do the debate essay work. Constitution Essay! You have to be 100% committed to landing your dream job and be 100% responsible for debate your results. This isn’t a “pay the money, automatically get a job in investment banking” deal. Essays College! This may seem like a ridiculous statement to make, but we’ve gotten some odd requests over the years… There are NO REFUNDS and NO DISCOUNTS for this service. Here’s where we’re coming from: we are investing a significant amount of our own personal time into working with you – often days or weeks.

Our time can never be replaced. We’ll play full on, and we expect you to as well, working “without a net”, just like in the real world. But please be assured that if we don’t feel there is writing, a fit, we will immediately refund what you’ve paid. Constitution! However, once we do accept your payment and we both decide to proceed, there will be no refunds granted. Only apply for this program if investing in it would NOT be a financial burden for you and your family . We do not want you taking on essay, credit card debt or any other type of debt to sources of uk essay, pay for this – and if we find out that you’ve done that, you will be refunded immediately and we’ll cancel the services.

This program is ONLY applicable if you’re interested in debate, investment banking, private equity, hedge funds, sales trading, private banking, or asset management . Please do NOT sign up if you’re interested in working at a normal company, going into milton law, applying to debate essay, medical school, becoming a circus performer, and so on. Admission Essays College! Yes, this may seem silly to state here but you’d be surprised at essay the questions we’ve gotten over the years… We edit resumes and cover letters based on our official templates (ExampleResumeTemplates and Cover Letter Template) and the advice given on the site, and we only institute for applied provide one-page resumes and cover letters. Please review the templates before you sign up to see if these templates suit your needs or not. Essay! If they do not suit your needs, do NOT sign up for these services. Yes, of course we’ll work extensively with you to customize these documents to reflect your own experiences – but these templates represent the sources of uk constitution essay starting point for debate essay everything else we do. We ask that you be respectful and give us 10 hours of notice when cancelling any coaching session with us. Please note that the coaching session will still be counted if there is a no show or less than 10 hours of notice was given before the session commences. Again, we invest a lot of time into working with you, and the relationship has to work both ways for it to be mutually beneficial.

So you’ve read through everything here now… Including this list of 8 important points to keep in essay, mind before signing up. If you thoroughly understand everything and debate essay you’re convinced that these services are right for you, then here are the sign-up options we offer: Investment Banking Resume / CV Editing Service. A line-by-line edit of your resume / CV to attract the attention and interest of institute thinking, investment bankers and private equity / hedge fund / other investment professionals, and present your academic and professional history in the best light possible. NOTE: We will ONLY edit ONE version of your resume / CV. If you have multiple different versions and you require editing for essay all of them, you’ll have to pay an additional fee for each version. NOTE: We use our own resume / CV template as the starting point for this process.

Please click here to see several examples of this template. If you do NOT want to use this template or you are looking for a resume / CV that is longer than this, please do not sign up for these services. You’ll speak directly with our Investment Banking Resume and Coaching Specialist, so we can better understand your unique background and provide you with a strong direction for your resume and cover letter. NOTE: This is stop depressed, NOT a coaching call or mock interview. Instead, this is a brief call that lets us understand your background and debate how we can best position your experience. Cook Examples! So it does NOT include extended feedback on debate, your pitch, your story, your networking efforts, and athens so on – all of that is writing essay, offered ONLY in the coaching calls. Once you sign up, you MUST submit your resume, cover letter (if applicable), and stop being other documents within 60 days, and debate essay you must respond to our edits and email requests and arrange your diagnostic call and coaching calls (if applicable) within that time frame.

Please do NOT sign up for 1972 these services if you’re planning to wait several months to use them. Writing Debate Essay! We will not be able to accommodate you, and essay will instead immediately refund your money if you do not submit everything that is writing debate, required within 60 days. # of Rounds of Editing (Each round is 5 business days apart) Getting your resume and cover letter “just right” is the goal. We’ll provide several rounds of editing (5 business days apart) to ensure you get a result you’re thrilled with. NOTE: We will ONLY edit ONE version of your resume / CV. If you have multiple different versions and cook you require editing for all of debate, them, you’ll have to pay an additional fee for each version. 2 Business Day RUSH Service (Optional)

If you’re in constitution, a hurry, we can guarantee 2 business day turnaround of your resume and/or cover letter. You must pay the rush service fee for each document you submit. For example, if you need rush service for both your resume / CV and cover letter, you will have to pay the fees listed on the right twice . Investment Banking Cover Letter Editing Service. If your cover letter is no good, your resume will never even get noticed. Our industry experts will edit your cover letter to pique the interest of writing debate essay, bankers and being depressed make them eager to read your resume. NOTE: We use our own cover letter template as the starting points for this process.

Please click here to writing debate, see the template. If you do NOT want to use this template or you are looking for a cover letter that is longer than this, please do not sign up for any package that includes cover letter editing. Our experts will be on call to being, answer any questions you have about putting your best foot forward in networking and writing essay interviews and achieving maximum success. NOTE: This email QA expires in sparta athens essay, 30 days after your initial sign-up. You MUST ask your questions within that time frame, because personalized QA expires at the end of this period. If you want to writing, commence your QA later than your sign-up date, please let us know your reasons and your time frame in advance, and we may make exceptions depending on your case. Sparta Athens! Please note that we will not be able to answer individual QAs after the 30-day period.

NOTE: To see exactly what is writing debate essay, included in this email QA and the questions we can and resume cook examples can’t answer, please read this document that describes the support services. We CANNOT answer questions that are listed under the “What is NOT Included in the Support Services” category. We will also revise and writing essay edit emails of institute for applied critical thinking, your choosing, including follow-up / thank you emails, interview request emails, introductory emails, and so on. NOTE: This only includes revisions of EXISTING emails that you have written, NOT drafting emails from scratch. 1-on-1 “Personal Pitch” Coaching Calls. During these 30-minute calls with our Senior Coach Nicole, you’ll get feedback and writing debate guidance on how to construct and deliver a winning Personal Pitch – and you’ll get answers to any recruiting-related questions you have. Access to BIWS IB Networking Toolkit. You’ll get secure online access to our popular training program, the BIWS Investment Banking Networking Toolkit , including unlimited QA and admission college support via our expert help desk. Your email questions will go to the “front of the line” for writing debate essay the fastest response. Following your personalized coaching call, you can submit your revised 2-3 minute pitch (a 2-3 minute audio file or a 1-page written document).

We’ll provide you with feedback and suggestions to revise your pitch and make it “pitch-perfect” within 5 business days. Personalized Customized Action Plan. This is a 1-page document that sums up our recommended recruiting strategy for sources of uk you, and gives you a concrete set of Action Steps to follow when networking. One “LinkedIn For Investment Banking” Done-For-You Profile Creation. LinkedIn is a powerful networking tool for budding investment bankers when it’s used to writing debate essay, its full potential. Essay 1972! We’ll create a professional profile specifically for Investment Banking job-finding success, so you can put your best foot forward online.

When considering which option is best, please remember: How much is it costing you to delay starting your career by another week, another month, or another year? Even if you consider an entry-level analyst role that pays $100,000 per year… it’s costing you $2,000 per debate essay, week not to be in the role you want. Winning a lucrative investment banking job could mean that you pay off your entire investment in the first week or first month (and still have more than enough to celebrate your new career move with family and friends!). Sparta! Professional job placement agencies will charge you thousands of dollars upfront and debate essay provide you with nothing more than tired, old regurgitated training materials that are completely useless. And finance-focused headhunters won’t even speak with you unless you have the exact experience they’re looking for. For personalized, industry-specific coaching and support, you will not find better value anywhere else.

Yes, there are some standalone services for sparta JUST resume editing or JUST coaching that may save you a few bucks. But you get what you pay for. If you want help from professionals with a track record – who are now doing this as their full-time jobs as opposed to “side projects whenever there’s some downtime in their 80 hour per week job” – then this is the best service around. What we offer is writing debate, certainly not for everyone… But if what you’ve tried so far has not gotten you the results you want at the speed you want them, then we can help you gain traction and get a better outcome for yourself right away. Choose your preferred option above , and we’ll be in touch to find out more about stop being depressed your situation and writing essay advise you on the next steps. And if you decide that it’s not for you before we begin, or we decide that we can’t coach you effectively, we’ll refund every cent you paid. We look forward to potentially working with you! To YOUR success, Nicole Lee Senior. Investment Banking Coach.

P.S. To recap: we believe this is the admission essays most comprehensive, IB and finance-specific coaching service available anywhere, online or offline. Writing Debate Essay! We have hundreds of testimonials on file from finance professionals whom we’ve helped. And while this isn’t right for everyone, we DO pledge to only take you on as a client if we firmly believe we can add value. Admission Essays! We look forward to hearing from writing essay, you. P.P.S. Still have questions? Feel free to contact me and I will be happy to milton 1972, respond to any specific concerns, questions, or comments you have. Enter Your Email to Get These Two Sets of Financial Modeling Tutorials for Free! We guarantee 100% privacy.

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Advertising’s 15 Basic Appeals Essay. Fowles has written other books on the effects of media on society such as “Advertising and Popular Culture” published in essay 1996. He is also a researcher, publisher, and professor in media. “Advertising’s” has also appeared in “Mass Advertising as Social Forecast” by Jib Fowles. From the title, you can expect that this essay will explore the reasoning behind advertisements and resume cook examples why people like them. It is an appropriate title because Fowles breaks down each “appeal” he lists and explains why it is used to draw in audiences.

This essay’s focus is about the techniques that advertisers use to appeal to audiences. Fowles got his ideas about the appeals from studying advertisements and using interviews by Henry A. Writing Essay? Murray, a Harvard professor. Fowles separates the appeals into 15 parts and gives details on how each is constitution essay used and how often. His purpose it to inform advertising, marketing and media students, and also other educators on how to writing us ads to appeal to the public. Also, he wanted to inform the general public on how they are being influenced. The target audience is mainly students who are studying media. Fowles does a good and effective job of getting his point across.

His goal is to admission educate students and he does that well. Debate? His information is organized well, which makes the essay easy to essay 1972 understand. He uses a lot of details and examples to back up his points. Finally, Fowles ends his analysis by explaining to the reader how to look at ads for debate essay, the things he wrote about. “Advertising’s Fifteen Basic Appeals” is a good resource for any student interested in learning more about the media. When looking at “Advertising’s” by Jib Fowles, the reader can easily see what each of his appeals is.

He gives each appeal in a number list and describes each appeal in that list. Resume Cook Examples? This way of writing essay, presenting information makes it very easy for the reader. Someone can simply pick and choose what parts of advertising appeals he or she would like to explore and find it right away. The good organization is a positive aspect of the writing as well as how thorough Fowles is. “Advertising’s” can be seen as a good resource because it is very detailed. With each appeal there is a description with examples or background provided. Constitution Essay? One appeal is the need for debate, autonomy. Being? If the reader does not know what this appeal is just by looking at the title, he or she will soon know by reading Fowle’s description.

Fowles gives examples of companies that use this need for autonomy. One slogan he quotes is from Visa, “you can have it the way you want it,” they say. Fowles explains why Visa would use this as an effective marketing tool. “The focus here is upon the independence and integrity of the individual; this need is the debate essay, antithesis for guidance…” (Fowles 562). Now the reader, who may not even know what autonomy is, has an understanding of the appeal and an example to clarify. After the explanation of the appeal comes the lesson on how to analyze advertisements. This part is important because if people know all of these things about ads but don’t know how to stop depressed apply them to what they see everyday, then “Advertising’s” has missed the debate essay, point. Friedman? “When analyzing ads yourself for their emotional appeals, it takes a bit of practice to learn to ignore the product information#8230; sort out from all the non-product aspects of an ad the chief element which is the most striking,” (Fowles 566). The viewer must not only writing debate, learn to sort the information, but also he says to look at the angle the ad is viewed in and the audience it is stop being depressed targeted to. Again, good examples are provided to explain this.

He writes about the Green Giant who is looking down on you and appealing to your need for guidance, and about the difference between the message of the same ad if it’s in “Penthouse (need for sex)…and Cosmopolitan (need for attention),”(Fowles 566). There are some who may think that despite Fowles organization, detailed explanation, and analysis, that the essay is too old to be useful to a modern audience. When describing the need for writing debate essay, sex, appeal number one, Fowles uses some example that could be seen as dated. First he says that sex is athens essay only used in two percent of ads because it can be too much for the viewer. Essay? Sex is definitely something seen a lot more in today’s ads. Depressed? He then provides examples using companies and products that aren’t around anymore. The description of the writing debate, “lithe blouse-less female astride a similarly clad male” (Fowles 555), in the Jordache jeans commercial could paint a picture for some in their forties.

Today’s students might not get anything from that visual. Even though the examples are dated, the essays, information remains true. You may find more sex in different ads these days but advertisers are still marketing to that need and doing it in the same ways. Jib Fowles was an educator with a strong background and understanding of the media. For this reason his goal with this essay was mainly to appeal to students.

He does that well by staying organized and giving a lot of details. He puts his theory into use by informing the reader on who to analyze ads. Writing Essay? Though some of Fowles examples are old and people may think they are outdated, his ideas are still good for today’s audience. All of this makes “Advertising’s Fifteen Basic Appeals” a good place for students to turn to when wanting to learn more about advertisements. Stop Depressed? Fowles, Jib. Debate Essay? “Advertising’s Fifteen Basic Appeals”. Writing and Reading Across the Curriculum Ed. Lavrence Behrens and admission essays college Lenard J. Rosen. Boston: Pearson, 2013 551-68. Print. Debate? University/College: University of Arkansas System. Type of paper: Thesis/Dissertation Chapter.

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Eavan Boland Boland, Eavan (Poetry Criticism) - Essay. (Full name Eavan Aisling Boland) Irish poet and critic. Boland is viewed as one of the most important poets in contemporary Irish literature. Critics commend her exploration of feminist issues in her work, particularly the role of women in Irish literature and society. In her poetry she has also subverted traditional Irish mythology and concepts of female identity in debate essay, order to express a more accurate perspective on the contributions and achievements of women in Irish history, politics, and culture. Boland was born on September 24, 1944, in of uk essay, Dublin. Her father, the Irish diplomat Frederick H. Boland, was posted in 1950 as the Irish Ambassador to the Court of debate essay, St. Sparta Athens! James in London, and then in 1956 as the President of the United Nations General Assembly. Growing up in London and New York City, Boland felt alienated from writing debate essay, her Irish heritage, particularly in London, where she encountered prejudice against the Irish. As a teenager she returned to Ireland and attended the sources of uk constitution essay Holy Child Convent in writing, Killiny, County Dublin.

She immersed herself in Irish culture and began to write poetry. Milton! In 1962 she attended Trinity College in essay, Dublin and published her first collection of verse, 23 Poems. In 1966 she received degrees in English and Latin from Trinity and milton essay, was hired by the English department as a lecturer. In a short time, however, she left Trinity and became a full-time literary critic and poet. Much of her early poetry focused on domestic concerns, such as marriage, children, and writing, her home in a suburb of Dublin. Yet with the publication of In Her Own Image (1980), critics began to being, take notice of writing essay, her exploration of feminist issues, particularly the role of female poets within the patriarchal literary establishment in Ireland. Her work generated much controversy and brought her international recognition as a feminist literary figure.

She has taught at several universities, including University College, Dublin; Bowdoin College; the University of Utah; and Stanford University. In addition, she has received several awards for her work, such as the being Lannan Award for Poetry in 1994, the Bucknell Medal of Merit in 2000, and essay, the Frederick Nims Memorial Prize in 2002. Boland's early poems were conventional in style, centered on a celebration of resume cook, domestic issues such as marriage and children, and were heavily influenced by the work of William Butler Yeats. Yet even at debate essay, this early stage she demonstrated a recurring interest in the role of women in Irish literature and sources of uk essay, society, which later became a central thematic concern of her poetry and essays. In In Her Own Image, Boland explores such topics as domestic abuse, anorexia, breast cancer, and infanticide. She also addresses the lack of real women in Irish myths and national history and announces her suspicion of the male literary tradition and writing debate, its portrayal of sparta essay, women. Night Feed (1982) considers the concept of female identity through an examination of ordinary women as well as female figures who have been marginalized in Irish mythology.

Through these depictions of regular women, she celebrates the complexity of women's lives. Debate Essay! In Outside History (1990) she continues her exploration of female identity, and essay, strives to debate essay, uncover the silence of essay 1972, generations of women whose lives and contributions to history and writing essay, culture have been largely ignored. For example, “The Achill Woman” portrays Boland's encounter, during a stay in Achill, with an old woman, who discusses of the Irish Famine and the people's struggle to survive such difficult times. The poet relates this woman's story to her own life and sparta, realizes her own failure in recognizing the importance of debate, this woman's voice and her own connection to women throughout Irish history. In these collections, Boland also rejects the notion that women who live in resume cook, suburbia and raise families are unworthy of attention. Writing Debate! Her poetry celebrates the beauty in these lives and the importance of milton friedman essay, family, marriage, and domestic responsibilities. The Lost Land (1998) returns to the dynamics of family, as Boland reflects on her children growing up and leaving home and the ways in which this process affects her sense of identity.

In Against Love Poetry (2001), Boland once again finds value and beauty in everyday existence and explores the writing debate essay tension between marriage and independence. Boland has emerged as one of the most important female voices in Irish poetry. Feminist critics have applauded her attempts to locate herself within the Irish poetic tradition by rejecting and reexamining the limited, traditional role of women in Irish mythology and history. By subverting these myths and admission essays, history, they contend, she succeeds in repossessing her identity as an Irish woman and poet. In a broader sense, critics maintain, Boland's poetic development reflects the dramatic political and cultural shifts in Ireland in the past several decades. Commentators have noted the exploration of such controversial themes as child abuse, violence against women, self-esteem, and eating disorders in her verse. She also touches on issues of alienation, assimilation, identification, and exile. Writing! Critics praise her painterly consciousness, poignant lyrics, keen sense of poetic ethics, and use of the concrete to reveal hidden stories in Irish histories.

A few critics caution against a strict feminist reading of her poems, contending that this minimizes her work and her contribution to modern poetry. Others have derided her verse as strident and stop depressed, accuse her of mythologizing the domestic sphere and the suburban life. Yeats and Adrienne Rich are regarded as profound influences on essay Boland's poetry, and commentators have found affinities between the poetry of essays college, Boland and Seamus Heaney. Access our Eavan Boland Study Guide for writing debate essay Free. New Territory 1967. In Her Own Image 1980.

The War Horse 1980. Introducing Eavan Boland 1981. The Journey 1983. Selected Poems 1990. Outside History: Selected Poems, 1980-90 1990. In a Time of Violence 1994. Collected Poems 1995. An Origin Like Water: Collected Poems, 1967-1987 1996. Anna Liffey 1997. The Lost Land 1998. Against Love Poetry 2001.

Journey with Two Maps: An Anthology 2002. Three Irish Poets, An Anthology: Eavan Boland, Paula Meehan, Mary O'Malley [edited by Boland] 2003. W. B. Yeats and His World [with Michael MacLiammoir] (nonfiction) 1970. A Kind of Scar: The Woman Poet in National Tradition (nonfiction) 1989. Object Lessons: The Life of the Woman and sources constitution essay, the Poet in Our Time (nonfiction) 1995. Patricia L. Hagen and Thomas W. Zelman (essay date winter 1991) SOURCE: Hagen, Patricia L., and Thomas W. Zelman. Essay! “‘We Were Never on the Scene of the resume Crime’: Eavan Boland's Repossession of History.” Twentieth Century Literature 37, no. 4 (winter 1991): 442-53. [ In the following essay, Hagen and Zelman assert that Boland aims to “repossess” her place within the Irish literary tradition. ] From Yeats and the Celtic Revival onward, Irish poets have recorded, shaped, and criticized their nation's emerging independent identity.

In the process, of course, they also attempted to reforge links to writing, the past by creating for Ireland a literary tradition incorporating the myths, folklore, and symbols of a long-suppressed Gaelic heritage. Now, at the end of the essays college twentieth century, the writing debate literary tradition wished into existence by athens essay Yeats has been expanded, modified, complicated, and virtually completed: it has become, so the argument goes, a “given” in Irish literature, a dead issue. Thus in writing debate essay, Modern Irish Poetry, Robert Garratt “assumes a change among a younger generation of writers in their attitude toward tradition” (5). For today's poets, Garratt argues, the “need to create and establish a tradition in literature no longer appears foremost in their thoughts” (5); contemporary poets no longer feel compelled to write the “definitions” and “apologetics” that so obsessed their poetic forefathers. Although Garratt does not use the word, forefathers is by implication a key concept in his formulation; the tradition Garratt traces (“from Yeats to Heaney”) is critical thinking, exclusively male. For women, who until recently have appeared only as subjects and objects of poems, not as their authors, the matter of tradition carries considerably more urgency than it does for writing debate essay their male counterparts.

Indeed, just as the early Revivalists sought reconnection with a Gaelic heritage suppressed by centuries of admission college, English domination, so Irish women poets seek reconnection with a female heritage suppressed by centuries of debate essay, male domination. Sparta! Eavan Boland, a major figure in the current generation of Irish poets, is vitally concerned with the “ethics” underlying the Irish poetic tradition, most notably the ethical choices involved in a writer's selection of debate essay, themes worth exploring in poetry, for these themes will naturally reveal the writer's—and, collectively, the tradition's—ability to bear witness to the truth of experience. As a poet and a critic, Eavan Boland displays a painterly consciousness, a keen, painful awareness of the shaping power of language, and a fundamental sense of poetic ethics, three strands that merge into essays, a vital concern with the artistic image and its relationship to truth. Art—poetry, painting, history—outlasts human lives; its images offer us a sense of the past which allows us to view and situate ourselves, individually and debate essay, collectively, as heirs to tradition. As Boland notes, “we ourselves are constructed by cook examples our constructs” ( Kind of essay, Scar 20).

Given the relation between image and selfhood, the poet—especially the of uk woman poet—has an ethical obligation to writing debate essay, de- and re-construct those constructs that shape literary tradition, bearing witness to the truths of of uk constitution essay, experience suppressed, simplified, falsified by the “official” record. In their broad strokes these issues are not, of course, uniquely Irish; as Boland acknowledges, “poetic ethics are evident and urgent in any culture where tensions between a poet and her or his birthplace are inherited and established” ( Kind of Scar 7)—a view suggesting the difficulty women poets encounter as they approach a sanctioned national myth. Nevertheless, it is within the Irish poetic tradition that, by both birth and choice, Eavan Boland locates herself. Writing Debate! Indeed, because of her upbringing, as she describes in “Irish Childhood in England,” issues of assimilation and estrangement, identification and exile—issues themselves central to an Irish tradition in literature—became significant for for applied her at an early age. She arrived in England, a “freckled six year old” For this child in exile, “filled with some malaise / of love for what [she'd] never known [she] had” (50), educated in English schools, the songs and poems of her birth-country—the Irish poetic tradition—in many ways created Ireland for her. “Fond Memory” ( Journey 52) juxtaposes her early sense of identification with the Ireland of debate, song and poem against her adult sense of estrangement from that construction. Evoking her disturbingly peaceful childhood in postwar England, one in which she “wore darned worsted” and. Boland moves from her primary-school experience in the first half of the poem to her home in the second, where her father plays the “slow / lilts of athens, Tom Moore” at the piano. Debate! She is affected strongly by the music and.

As an adult, she rejects the “safe inventory of pain,” with its manifold falsifications and simplifications, but nonetheless retains a fundamental sense of identity as an Irish poet. For Applied! “I didn't know what to hold, to keep” ( Journey 50), the speaker claims in “An Irish Childhood in England: 1951.” “On the one hand,” Boland writes, “I knew that as a poet, I could not easily do without the idea of a nation. … On the other, I could not as a woman accept the nation formulated for me by essay Irish poetry and its traditions” ( Kind of Scar 8). Resume Cook! The only reconciliation possible for her was to “repossess” that tradition. Debate Essay! By affirming herself as an Irish poet, and thus rejecting the common notion that women's poetry should be quarantined from mainstream literature, Boland is in essence claiming her birthright, her say in that tradition, her right to constitution, “establish a discourse with the idea of a nation” ( Kind of Scar 20). As Boland cautions, such “repossession” is neither a single nor a static act, but a fluid process of de- and debate, re-construction. It is as if she has been presented with a seemingly completed jigsaw puzzle, but herself holds a series of additional pieces.

In defiance of those who suggest she create a nice border around the original, Boland would break apart the completed picture and reconstruct a new image. In this model, the athens essay first part of the tradition to be shattered must be its alienating “fusion of the national and the feminine which seemed to simplify both” ( Kind of debate, Scar 7). Instead of real lives, the tradition offers Dark Rosaleen, the Old Woman of the Roads, and being depressed, Cathleen Ni Houlihan, images that by their mythic and ornamental nature necessarily reduce the complex feelings, aspirations, and lives of real women—but not only of women. Boland views these emblematic women, “passive projection[s] of a national idea” ( Kind of Scar 13), as “an underlying fault in essay, Irish poetry; almost a geological weakness” because “all good poetry depends on resume examples an ethical relation between imagination and image. Images are not ornaments; they are truths” ( Kind of Scar 23). By recasting a defeated nation into a triumphant woman, the debate essay Irish literary tradition may have gained aesthetically, but it lost ethically: gone were the “human truths of milton friedman essay, survival and humiliation” and in their place were the “hollow victories … the rhyming queens” ( Kind of Scar 13). Boland's poems, then, attempt to unseat the rhyming queens and reinscribe the human truths they have suppressed, to “repossess” those portions of writing essay, history ignored by the Irish canon and to reassess the truth of the national identity. In this task, her starting point is frequently the driving of a wedge into milton essay 1972, the “almost geological weakness” of the Irish poetic tradition. In its simplest terms, the resulting division is the distance between male and female—the split, in Boland's terms, between “hearth and history,” her hearth and his story.

Her world, if seen at all, is confined to the margins of writing, his story, the celebration of the grand sweep of Irish heroism. As Boland notes, while the nation's “flags and battle-cries, even its poetry” at times use feminine imagery, “the true voice and vision of admission essays college, women are routinely excluded” ( Kind of Scar 19). “It's our alibi / for all time,” she writes in “It's a Woman's World,” “that as far as history goes / we were never / on the scene of the crime” (357). In the official records—the history books, battle-cries, songs, and debate essay, poems—women exist largely as lamenting voices, mouthpieces, ornaments: the Young Queen, the Old Mother, the Poor Old Woman. “So when the king's head / gored its basket,” the speaker notes, “we were gristing bread” “Like most historic peoples,” women are “defined / by what we forget, by what we never will be: / star-gazers, / fire-eaters” (357). Stop Being! The unsensational and writing essay, therefore unwritten sufferings of ordinary women, ordinary people, are doomed to resume cook examples, become unhistory: “And still no page / scores the low music / of writing debate essay, our outrage” (358). Within his story, gristing bread is of no consequence, despite its overwhelming importance in sustaining life; her hearth (a precondition of the “heroics” celebrated by his story ), trivialized into recipes and for applied, gossip, is. (The entire section is 4041 words.) Get Free Access to this Eavan Boland Study Guide. Start your 48-hour free trial to unlock this resource and thousands more.

Get Better Grades. Our 30,000+ summaries will help you comprehend your required reading to ace every test, quiz, and essay, essay. We've broken down the chapters, themes, and characters so you can understand them on your first read-through. Access Everything From Anywhere. We have everything you need in one place, even if you're on the go. Download our handy iOS app for free. Anne Stevenson (essay date January-February 1992)

SOURCE: Stevenson, Anne. “Inside and Outside History.” P.N. Review 18, no. 3 (January-February 1992): 34-5. [ In the following essay, Stevenson regards Boland's encounter with the Achill woman, chronicled in milton, her verse and her essay “Outside History,” as an important moment in her life and work. ] As will be evident to writing essay, anyone who has followed Eavan Boland's purgatorial journey into friedman 1972, self-placement, the story of her meeting with the debate essay Achill woman occurs at stop, least twice in her published work: once in the verse sequence of Outside History (Carcanet, 1990), and again as a prologue to her essay of the same title ( P.N.R. 75). Boland, then a student at Trinity. (The entire section is 1552 words.) Get Free Access to this Eavan Boland Study Guide. Start your 48-hour free trial to unlock this resource and thousands more. SOURCE: Weekes, Ann Owens. “‘An Origin like Water’: The Poetry of Eavan Boland and Modernist Critiques of debate, Irish Literature.” Bucknell Review 38, no.

1 (1994): 159-76. [ In the following essay, Weekes applies Richard Kearney's theory about the connection between Irish Revivalism and modernism to Boland's poetry. ] In his excellent study, Transitions (1988), Richard Kearney explores the sparta athens essay tensions between Revivalism and modernism in twentieth-century Irish narratives. Revivalism is associated with Yeats's attempt to present a unity of culture by privileging “primordial images of ancient Celtic mythology which predated all subsequent historical divisions into. (The entire section is 6463 words.) Debrah Raschke (essay date June 1996) SOURCE: Raschke, Debrah. Essay! “Eavan Boland's Outside History and In a Time of friedman, Violence : Rescuing Women, the Concrete, and debate essay, Other Things Physical from the Dung Heap.” Colby Quarterly 32, no. Admission! 2 (June 1996): 135-42. [ In the writing debate following essay, Raschke asserts that “Boland's Outside History and In a Time of resume cook, Violence use the essay concrete, physical world to revise notions of what sustains, to query historiography, and to expose the dangers of mythology.” ] Eavan Boland's poetry has been described as “impeccably scornful,” as “denunciatory,” as too “strident” and too “vehement” (Henigan 110), and as justification for “her dangerous.

(The entire section is 3725 words.) Rose Atfield (essay date spring 1997) SOURCE: Atfield, Rose. Sparta Athens Essay! “Postcolonialism in the Poetry and writing essay, Essays of Eavan Boland.” Women: A Cultural Review 8, no. 2 (spring 1997): 168-82. [ In the following essay, Atfield considers the issue of postcolonialism in Boland's verse. ] Postcolonialism in the poetry of Eavan Boland is essays college, a process of the recognition and exposure of colonialism: its denial and repression of identity, and the restoration and reconstruction of that identity in terms of place, history and writing essay, literary tradition. Milton Friedman! Boland established a sense of dual postcolonialism when, in debate, the Ronald Duncan lecture for the Poetry Book Society, she referred to ‘two identities’ which ‘shape and reshape what I. (The entire section is 5299 words.) Nell Sullivan (essay date December 1997) SOURCE: Sullivan, Nell. “Righting Irish Poetry: Eavan Boland's Revisionary Struggle.” Colby Quarterly 23, no. Admission Essays! 4 (December 1997): 334-48. [ In the following essay, Sullivan perceives Boland's “revisionary struggle” with Irish mythology, which depicts women in subordinate and passive roles as an debate essay, attempt to “repossess” Irish poetry for women. ] Traditionally, the friedman essay 1972 envoi sends the poet's work out into the world with modest hopes, anxious disclaimers, and humble apologies.

But in her poem “Envoi” from Outside. (The entire section is 6762 words.) David C. Ward (review date January-February 1999) SOURCE: Ward, David C. “A Certain Slant of Light.” P.N. Review 25, no. 3 (January-February 1999): 66-8.

[ In the following review, Ward considers the place of The Lost Land within Boland's poetic oeuvre and deems the collection to be Boland's return to political concerns. ] ‘My passport is green,’ was Seamus Heaney's defiant assertion of his poetic patrimony. Writing! Heaney's confident nationalism has never been shared by his compatriot Eavan Boland. Sources Of Uk! Boland's poetic career began conventionally enough with her writing nicey-nice lyric poems about Ireland; in one she describes Yeats as the ‘sum’ of all she could learn. But writing poems called ‘Elegy for a. (The entire section is 1599 words.) Kate Daniels (essay date spring 1999) SOURCE: Daniels, Kate. “Ireland's Best.” Southern Review 35, no.

2 (spring 1999): 387-93. [ In the following excerpt, Daniels finds similarities between the poetry of Boland and debate essay, Medbh McGuckian and differentiates the poetry of The Lost Land from Boland's earlier poetic work. ] If one were to sparta essay, compose a scale of oppositions upon which to consider contemporary poetry by Irish women, the Dublin poet Eavan Boland (b. 1944) would appear at one end, and Medbh McGuckian (b. 1951), from Belfast, at the other. Although their work is fundamentally different—Boland the mistress of a highly cadenced, formalistic verse that favors “a lyric speech, a civil tone” (to. (The entire section is 2227 words.) Albert Gelpi (essay date December 1999) SOURCE: Gelpi, Albert. “‘Hazard and Death’: The Poetry of writing essay, Eavan Boland.” Colby Quarterly 35, no. 4 (December 1999): 210-28. [ In the following essay, Gelpi investigates the influence of the American poet Adrienne Rich on sources Boland's poetry. Essay! ] Eavan Boland's growing international reputation is grounded in the recognition that she is the first great woman poet in sources of uk essay, the history of writing debate essay, Irish poetry.

Her success is yet another validation of William Carlos Williams' observation that the local is the universal. Milton Essay 1972! That very American conviction, which runs from Thoreau through Whitman and Dickinson to Frost and Robinson Jeffers on to Robert Lowell and writing debate essay, Elizabeth Bishop and depressed, Denise. (The entire section is 8247 words.) Michael Thurston (essay date December 1999) SOURCE: Thurston, Michael. “‘A Deliberate Collection of Cross Purposes’: Eavan Boland's Poetic Sequences.” Colby Quarterly 35, no. 4 (December 1999): 229-51.

[ In the following essay, Thurston offers a thematic and stylistic examination of Boland's longer poetic works. ] Beginning in the early 1980s, Eavan Boland began to work not only in individual lyrics but in slightly longer poems (“The Journey”) and sequences of essay, lyrics (including the poems gathered in In Her Own Image ). Indeed, since the 1990 American appearance of Outside History: Selected Poems 1980-1990, each of Boland's books has included at least one such sequence ( Outside. (The entire section is 11403 words.) Catriona Clutterbuck (essay date December 1999) SOURCE: Clutterbuck, Catriona. Resume! “Irish Critical Responses to Self-Representation in Eavan Boland.” Colby Quarterly 35, no. 4 (December 1999): 275-87. [ In the following essay, Clutterbuck addresses the critical reaction to debate essay, issues of feminism and nationalism in Boland's verse. ] This article examines Irish critical responses to a central issue in Eavan Boland's work, responses which were published during eight years of vital development, not only in her own aesthetic, but in her reputation as an artist and in stop, the wider position of women in Irish cultural and political life. Essay! In 1987, the college results of abortion and divorce referenda in the Republic had consolidated. (The entire section is 6580 words.)

Jacqueline Belanger (essay date September 2000) SOURCE: Belanger, Jacqueline. Writing Debate! “‘The Laws of Metaphor’: Reading Eavan Boland's ‘Anorexic’ in an Irish Context.” Colby Quarterly 36, no. Sparta Essay! 3 (September 2000): 242-51. [ In the writing debate following essay, Belanger maintains that Boland's poem “Anorexic” “best illustrates her attempts to reinsert excluded realities of female experience into an Irish poetic tradition and to friedman essay, explore the implications of the writing debate essay allegorisation of resume cook examples, nation as woman.” ] In her 1989 pamphlet, A Kind of Scar: The Woman Poet in a National Tradition, Dublin poet Eavan Boland describes her search for writing essay a way to locate herself in an Irish poetic tradition and for ways to render her experiences of. (The entire section is 4623 words.) Paul Keen (essay date September 2000) SOURCE: Keen, Paul. “The Doubled Edge: Identity and Alterity in the Poetry of Eavan Boland and Nuala Ni Dhomhnaill.” Mosaic 33, no. 3 (September 2000): 19-34. [ In the following essay, Keen places the poetry of Boland and milton essay, Nuala Ni Dhomhnaill in relation to their writings on writing essay gender, nationalism, and history. ] In November 1994, the Irish government collapsed. Its disintegration was all the sparta more dramatic because the Taoiseach, Albert Reynolds, was enjoying unprecedented popularity for his role in brokering an IRA cease-fire and securing the prospect of peace negotiations. Within weeks he had resigned in disgrace over his promotion of Harry Whelehan to president of.

(The entire section is 6383 words.) SOURCE: Conboy, Katie. “Revisionist Cartography: The Politics of Place in Boland and Heaney.” In Border Crossings: Irish Women Writers and National Identities, edited by Kathryn Kirkpatrick, pp. 190-203. Tuscaloosa: The University of Alabama Press, 2000. [ In the following essay, Conboy investigates the connection between poet and place in the work of writing debate essay, Boland and depressed, Seamus Heaney. ] (The entire section is writing debate essay, 4902 words.) Anne Shifrer (essay date December 2001) SOURCE: Shifrer, Anne. “The Fabrics and Erotics of Eavan Boland's Poetry.” Colby Quarterly 37, no. 4 (December 2001): 309-42. [ In the athens following essay, Shifrer examines the writing debate role of fabrics in Boland's poetry. ] By focusing on the role of fabrics in Eavan Boland's poetry, I hope to provide readers with a better key to reading Boland's domestic world, one which reveals her demolition of the aesthetic—and its aftermath, in which Boland recuperates the aesthetic for essay feminine pleasure. There's a logic, I believe, in reading Boland's poems, at first, autoerotically, reveling in the fabrics, the flowers, the colors of twilight.

In moving to a deeper understanding, we then. (The entire section is 6794 words.) Richard Rankin Russell (essay date winter 2002) SOURCE: Russell, Richard Rankin. “Boland's ‘Lava Cameo.’” The Explicator 60, no. 2 (winter 2002): 114-17.

[ In the following essay, Russell argues that a close reading of Boland's “Lava Cameo” “illustrates how its subject, tone, sentence structure, and diction enable Boland to imagine this scene, sympathetically write herself into it, and establish a new relationship with her grandparents and her own personal history.” ] Eavan Boland's 1995 volume of poetry, In a Time of Violence, explores her imaginative re-creations of history. The middle section of that volume, “Legends,” contains a remarkable poem entitled “Lava Cameo,” which depicts a. (The entire section is 1367 words.) Burns, Christy. “Beautiful Labors: Lyricism and Feminist Revisions in Eavan Boland's Poetry.” Tulsa Studies in Women's Literature 20, no. 2 (fall 2001): 217-36. Explores “the tension in Boland's work between her political investment in representing women—especially the laboring poor—and her attraction to beautiful images and writing essay, seductive, lyrical language.” Consalvo, Deborah McWilliams. Friedman Essay! “In Common Usage: Eavan Boland's Poetic Voice.” Eire-Ireland 28, no.

2 (summer 1993): 98-115. Examines the range of essay, Boland's craft as a poet and assesses her poetic contribution.

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If there is a specific question that needs to stop being depressed be answered, the thesis statement must address it within the conclusion of the first paragraph. Also, the essay thesis needs to writing debate essay be a plan of attack for what the body paragraphs are going to be about. Click here for more information on writing strong thesis statements. Good writers know that attention to detail is as must. For Applied! Plus, your professor will expect it.

Make sure to clearly read the instructions (all of debate essay, them) and clarify by asking questions. For example, some common things to look out for include: (ii) Required number of sources; (iii) Essay type (argumentative, comparative, narrative…etc); Thoroughly read the original essay instructions and essays, make a plan before even starting to write. Strong Organization = Well-Written Essay.

The structure of an essay can really make it or break it for you. Writing! Make sure that you have strong opening and closing paragraphs and body content that supports your original thesis. The introduction should funnel down to your thesis and narrow down the specific argument you want to make. Body paragraphs must have strong topic sentences and reference credible sources appropriately using the right citation style. Finally, conclusions should not introduce new information and examples, must recap the main essay points that you presented previously. Adherence to Citation Style Guidelines. Finally, make sure to properly style your prepared essay in the appropriate citation style. For example, APA style has strict guidelines for cover pages and running heads while Chicago and Turabian require either footnotes or endnotes.

Knowing how to writing debate essay cite properly and format things accordingly can be worth upwards of sparta, twenty percent of your entire grade. Following the formatting rules is an easy win, but you have to take the time to writing essay do it right. Also, always remember to credit another author’s work and don’t call it your own, especially if you bought an essay online. While writing good essays is time consuming and tedious, it all comes down to athens following best practices and being diligent. Our writers follow a clear methodology that is both practical and efficient for getting the best possible outcome. First, make sure to select a good topic that you can write easily about and make sure you can find scholarly materials about it. Writing Essay! Next, take some time to plan and constitution essay, make an outline based around a clear thesis statement. Proceed to debate essay write the body while adhering to strict rules for paragraphs and inclusion of references.

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Try to athens essay avoid current events as there may be a lack of available research materials. Sample Essay Topics. Death penalty Abortion rights Gun rights Gender inequality. When doing academic research, only trust reputable sources like JSTOR, Google Scholar, your campus library or academic search engines you have access to. Lastly, collect the sources that you need first and go through them thoroughly. Now that you have picked a topic and collected some credible sources, it’s time to make a plan. Essay! Start by identifying common assumptions about the topic and find common themes. For example, if exploring the sparta, causes of poverty, you will inevitably find out debate essay, that governments are the ones that control lots of food production and allocation to the people. Once you have enough evidence to support a general theme, construct a thesis statement and make an outline of the core items that support that assertion.

If you don't think this step is necessary, just remember that our writers are trained to essays college follow this process on all purchased sample essay orders. You are ready to start writing. Start with an essay, introductory paragraph that funnels down from a broad issue to a specific time and admission essays, place. Provide background details as necessary. Writing Essay! Then, conclude the introduction with your thesis statement. Body paragraphs should be 5-7 sentences long and start with a topic sentence. Always introduce your quotes and avoid “dropping them” without context. Finish with a conclusion that recaps each main point and of uk essay, make sure not to introduce any new information. Essay References and Final Review. Finally, construct your works cited page using the right citation style guide.

Depending on the format, you may also need a title page. Review your final essay by reading it out loud and make sure you addressed your original instructions! You should use EasyBib to quickly build citations in almost any format. Have a friend, teacher or trusted essay editing service review your final draft to writing essay make sure it is done properly (if you didn't already buy an essay). References and Considerations Before Buying an Essay.

While the previous section described summarized steps towards writing an essay, consider going through our extended 14-Step Essay Writing Guide for a more thorough look at each section. It also includes template that you can download as well as color-coded visual aids. Constitution Essay! You can also learn about and see examples of essay related terms in writing our extensive glossary section. Whether you choose to use Ultius for buying essays online or not, we hope that our extensive walkthroughs have helped you in depressed your journey to finding essay help. Not what you're looking for writing or not convinced? The links below may help. Search hundreds of services. Click to Verify. Ultius is institute for applied critical, proud to have strong verified reviews from different review vendors. Last updated on writing 16 January 2017 . With every order, you can count on athens the following:

Delivered on time 100% original Free revisions Awesome 24/7 support World-class writers. Every order comes with these free features: 275 Words Per Page Free Title Page Free Bibliography Free Revisions American Writers Plagiarism Scan. Connect with a professional writer by placing your first order. The entire order process takes roughly five minutes and we usually match you with a writer within a few hours. Enter code newcust during checkout and save money on your first order. Have more questions?

Get in touch with us or explore common questions. Ultius provides an online platform where we connect you with a freelance writer for sample writing, editing and business writing services. The company encourages and expects fair use of our services. Here are the guidelines. Order Revisions i. The company offers free revisions, but there are some limitations like the deadline and whether we met the original instructions. Sample Writing ii. Custom sample services are for model and reference use only. Writing! When referencing our work, you must use a proper citation. i Revisions are offered within seven (7) days of a completed order and are free with a three-day deadline.

For earlier deadlines and general changes to sparta essay core instructions, costs may apply. Writing Debate Essay! Explore the full Revision Policy. ii The company does not condone plagiarism, copyright infringement or any form of essays college, academic dishonesty. Writing Debate! All provided sample services must only be used for reference purposes while being cited properly. Please read the Fair Use Policy. Ultius is the trusted provider of content solutions for consumers around the world. Connect with great American writers and get 24/7 support. Ultius is accredited with the Better Business Bureau and has an A+ rating. © 2017 Ultius, Inc.

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