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She seems confused and I was wondering if there is anything we or I can do to remedy the problem. I know the logical thing would probably be to call it quits but we are both willing to work on it. Its been pretty hard on me because I was planning on proposing to her in March.

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pandora rings Finally, as an organising framework, it also provides a reproducible and flexible tool to engage clinical teams and local communities with the principles of the chronic care model14 in a way that both feels achievable and enables them to see their role within the change process.House of care. When used in the training programme, a blank outline of the house is provided and participants are asked to consider what needs to be in place to deliver and support the care planning process and then reflect on current local services. The clinician training curriculum, which explores attitudes, behaviours, and clinic infrastructure changes simultaneously with skills, has shown that complex transformational change can occur in UK general practice enabling care and support planning to become the norm for large numbers people with long term conditions (box 3).Box 3: Examples of house of care approach to care and support planningWhole health community Tower Hamlets, London, UKAs part of a wider reorganisation, care and support planning was implemented for diabetes in 31 of 32 practices in Tower Hamlets, which has a disadvantaged, multiethnic population. pandora rings

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