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Ann Romney playing video games
In a new video, Ann Romney, wife of former Massachusetts governor and past Republican presidential candidate Mitt Romney, shows people how to be "a freaking awesome grandma" – or at least shows that she is one.
In a new video, Ann Romney, wife of former Massachusetts governor and past Republican presidential candidate Mitt Romney, shows people how to be "a freaking awesome grandma" – or at least shows that she is one.
The final battle in Slate's Political Kombat '12 is about to go down, but this time the community gets to decide who goes on the be the president of the arena and who gets dragged off to the local mortuary. Previous battles in Slate's video series inspired by the gory combat of the Mortal Kombat series included Mitt Romney versus Rick Santorum and Herman Cain, Romney versus Newt Gingrich and Ron Paul, President Obama versus Donald Trump, and Paul Ryan versus Joe Biden.
While Microsoft's presidential debate live stream had a lot of problems, apparently they were able to glean some data from the event. An Xbox Spokesperson tells IGN that Mitt Romney was declared the winner of the debate by the Xbox Live audience.
Nexon America has released data from its first Maple Story player poll – part of its "Great Maple Election Quest 2012" in-game event. According to poll data President Barack Obama was the hands-down favorite, garnering 80 percent of the vote, while Republican presidential candidate Mitt Romney received 20 percent of the vote.
The Republican party is in tatters following last week's presidential win by Barack Obama. Party officials are now trying to assess the damage and figure out how they might reconnect with the American electorate.
It's ridiculously early to make predictions about the next run for the White House, of course, but CNN speculates that 2012 might be Mitt Romney's year.
A Romney candidacy will be of concern to gamers. Among major Republican candidates in this year's race, Romney by far had the most negative view of video games, portraying them as part of an "ocean" of filth in which modern children swim. He also promised to legislate the sale of games.
From CNN:
Since the economy began its historic downturn six weeks ago, Romney's stock in his party appears to have skyrocketed. The former business consultant and founder of Bain Capital handled economic issues during his campaign with an ease and confidence that seemed to elude Sen. John McCain. As the stock market tanked throughout the fall, a growing chorus of conservative pundits speculated Romney would have boosted the GOP ticket considerably more than Alaska Gov. Sarah Palin did.
Now the onetime front-runner for the Republican nomination is schmoozing influential party insiders on the National Review's annual cruise — a gathering of 700 conservative activists and the same forum where Palin wowed the movement's media elite last year…
But even as Romney publicly declares he has no intentions to run again, several former aides said they believe he will, and this week's get-together with leading conservatives is only the latest sign the man who spent more than $50 million of his own money to vie for the party's nomination last year is itching to do it again…
Although they were bitter enemies during the primaries, recent reports – like this one from Reuters – have Republican presidential candidate John McCain and former Massachusetts Governor Mitt Romney getting rather chummy.
And that could be bad news for gamers.
Among possible Republican VP choices, Romney has been far and away the most outspoken on video game content issues. GamePolitics readers may recall Romney making comments like this on the campaign trail:
It's time to clean up the water in which our kids are swimming. I've proposed that we enforce our obscenity laws again and that we get serious against those retailers that sell adult video games that are filled with violence, that we go after those retailers.
Romney also released a campaign video which played to this theme.
Among 2008 presidential candidates, Republican Mitt Romney was one of the more strident critics of video games.
GamePolitics readers will likely recall a 2007 Romney campaign ad which lumped video games into a cesspool of "violence and sex and drugs and indolence and perversions" in which today's young people were supposedly swimming.
Beyond the infamous ad, Romney repeated the theme again and again as he campaigned around the nation, courting conservatives and the religious right.
It seems, however, that the so-called cesspool will now flow on without interference from the former Massachusetts governor. Fresh off a Super Tuesday primary drubbing at the hands of Arizona Sen. John McCain, Romney has "suspended" (read: abandoned) his bid for the Republican presidential nomination.
Mitt Romney's plan to regulate violent video game sales is confusing some conservatives.
On Race 4 2008, a Republican-oriented political site, readers are actively debating whether Romney is on to something with his "ocean of filth" (see video below) concept or is simply advocating a nanny state.
The lively discussion on Race 4 2008 was sparked by a post on Hot Air, which quotes Romney's video game position as stated to Common Sense Media earlier this month:
I want to restore values so children are protected from a societal cesspool of filth, pornography, violence, sex, and perversion. I've proposed that we enforce our obscenity laws again and that we get serious against those retailers that sell adult video games that are filled with violence and that we go after those retailers.
(see GamePolitics coverage of the Common Sense Media report here).
Like many GamePolitics readers, I was disappointed that none of the videos submitted by gamers made the final cut for last night's CNN/YouTube Republican debate.
To be fair, however, there are many other crucial issues such as Iraq, abortion, gun control, the economy and the influence of religion on politics. Host Anderson Cooper focused on these.
One telling moment for me, however, came when Mitt Romney could not bring himself to condemn the practice of waterboarding. Here's a guy who decries violent video games as part the "cultural cesspool" in which today's children are supposedly swimming but can't even find it within himself to condemn this acknowledged form of torture?
Sen. John McCain – who was a torture victim during his years of captivity by the North Vietnamese – absolutely ripped Romney on the issue and he was right to do so.
For Romney, the take-away is that virtual violence is a horror, but real-life torture is okay.
Governor, your hypocrisy is showing…
Here's the video of McCain-Romney exchange. Full text version after the jump.
UPDATE: Entertainment Consumers Association president Hal Halpin has weighed in on the debate:
I was disappointed not to see a gamer question in much the same way that I was disheartened not to hear many other secondary, but important, questions posed.
The ECA member I ran into at PAX… put it into context well in that anyone watching a two hour debate on CNN very likely already knows where the candidates stand on the major issues, and it's certainly easy enough to find out otherwise.
What we don't know is where – or even "if" – they stand on the secondary matters. We won't let up however. Consumer rights are topically important and our demographic can and will be motivated to vote, but only if those politicians are willing to make the effort to speak to issues that are important to us.
GamePolitics readers may recall the Mitt Romney campaign ad that lumped violent video games into a "cesspool of violence, sex, drugs, indolence and perversions."
Apparently, candidate Romney is willing to dip his toe into that cesspool a bit in search of a few extra votes. As reported by Joystiq's Alexander Sliwinski, a Romney banner ad (left) has popped up on the GameTrailers site:
It is interesting that this ad pops up on a site that proudly displays clips of those violent video games and has a viewership that likes them too.
We have no idea how the advertising process works at GameTrailers, for all we know we could have that ad pop up soon on our own pages, but how times have changed to see political ads on video game sites.
GP: Romney's flip-flops on a variety of issues are pretty well documented as the former governor of a liberal state (Massachusetts) tries to re-invent himself to appeal to the Republican base.


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|Home > RNJ > 2010 > July/August > Psychological Resilience and Depressive Symptoms in Older Adults Diagnosed with Post-Polio Syndrome
Psychological Resilience and Depressive Symptoms in Older Adults Diagnosed with Post-Polio Syndrome
Depression is a serious comorbidity in people with disabilities; however, few studies have focused on depressive symptoms in older adults with post-polio syndrome (PPS). This study used a resilience conceptual framework that focused on patient psychosocial strengths to investigate the relationship between psychological resilience factors (e.g., acceptance, self-efficacy, personal resources, interpersonal relationships, self-rated health, spiritual growth, stress management) and depressive symptoms in a large sample (N = 630) of people older than 65 years who were diagnosed with PPS. Forty percent of the sample scored ≥ 10 on the Center for Epidemiologic Studies Short Depression Scale (CES-D 10), which is a higher percentage than what has been previously cited in other studies; however, 53% of the sample had good or excellent self-rated health, suggesting psychological resilience. Depression scores were regressed on seven selected resilience factors after controlling for functional limitations. Four of the seven variables accounted for 30% of the variance in depressive symptoms, with spiritual growth representing the main predictor (β = -.26). The implications for rehabilitation nurses in developing a patient-strengths perspective in the assessment and counseling of older adults with PPS are discussed.
A conservative estimate of the number of noninstitutionalized polio survivors in the United States is approximately 426,000 (this estimate is adjusted downward for mortality, but it does not account for new cases due to immigration or underreporting of cases, a known phenomenon in this illness; Becker, 2006). More than half of this group is older than 65 years, and because of advances in technology, they are expected to experience longevity that is similar to that of the population with disability. Post-polio syndrome (PPS) has been defined as a failure of oversized motor units that were created during the recovery process of paralytic poliomyelitis, which leads to an exacerbation of existing weakness or development of new weakness or paralysis (National Institute of Neurological Disorders and Stroke, n.d.). Previous estimates place the incidence of PPS from 25% to 50% in polio survivors (Mayo Clinic, n.d.); however, Kling, Persson, and Gardulf (2000) predicted that this number would increase to 60%–80% because of the risk factor of aging. One important healthcare problem for this group is that younger providers may not be familiar with effective management strategies for older adults with PPS because acute polio infection is considered a disease of the past in developed countries (Halstead, 1994, as cited in Westbrook and McIlwain, 1996; March of Dimes, 2000). A renewed interest in research aimed at developing clinical psychotherapeutic counseling techniques that emphasize a "personal strengths" perspective (Greene, 2002) may help ameliorate this situation.
Although research on aging issues continues to expand, few studies have focused on the mental health of older adults with PPS. It is generally accepted that depression-related morbidity and mortality rates are associated with significant personal suffering and substantially higher medical utilization in the general population (Unutzer et al., 1997; Kemp, 2006; Simon & VonKorff, 1995). However, the higher levels of depression in people diagnosed with PPS (Kemp, Adams, & Campbell, 1997; Maynard, 1991; Stuifbergen, 2005; Westbrook & McIlwain, 1996) should compel healthcare providers to be knowledgeable and competent about the provision of mental health care for this subgroup.
Studies have shown that losses unique to the polio experience can combine with normal age-related losses to threaten the emotional well-being of people with PPS (Bruno, 1999; Halstead, 1998; Harrison & Stuifbergen, 2006; Westbrook & McIlwain, 1996). Clearly, not all people facing the challenges of PPS experience depression. It is possible, however, that individual psychological strengths linked to resilience, including the way people view disability and their ability to manage stressors, as well as personal resources such as social support, may have a significant role in checking the development of depressive symptoms (Fredrickson, Tugade, Waugh, & Larkin, 2003; Lazarus & Folkman, 1984; McCubbin, 2001; Rutter, 2007). The purpose of this study was to determine whether the resilience factors of acceptance, personal resources (social support), self-rated abilities for health practices (self-efficacy), interpersonal relationships, self-rated health, spiritual growth, and stress management were predictive of fewer depressive symptoms for a sample of persons diagnosed with PPS. Our research questions were (1) What is the relationship between selected psychological resilience factors and depressive symptoms in older adults diagnosed with PPS? and (2) Which factors best predict depressive symptoms for older adults with PPS, after controlling for age and functional limitations?
Post-Polio Syndrome
PPS develops when new disease-related symptoms occur, or when there is an unusual increase in severity of residual symptoms from the initial illness (Mayo Clinic, n.d.). Risk factors for acquiring PPS include aging, being female, and having severe initial infection with permanent residual impairment (Ramaraj, 2007; Ramlow, Alexander, LaPorte, Kaufman, & Kuller, 1992). PPS may strike 10–50 years after the initial polio infection (Halstead, 1998; Ramaraj) and presents the polio survivor with the disappointment of an unexpected surge in physical deterioration. Symptoms may include extreme mental and physical fatigue, muscle and joint pains, new or increased muscle weakness or atrophy, difficulty swallowing, intolerance to cold, and, occasionally, respiratory dysfunction (Westbrook, 1991). Depending on severity, these new symptoms are viewed by some as an unwanted hassle, and for others, an overwhelming stressor leading to fear, frustration, anger, and depression (Hallam, 2000; Halstead, 1998; Westbrook). For many, the onset of PPS demands a regrouping of coping skills for individuals who thought they had overcome their biggest polio-related hurdles.
Conceptual Framework
Psychological resilience (PR) is a broad construct that represents a combination of positive traits and coping responses or behaviors that facilitate the successful management of unexpected changes or formidable stressors in one's life (Kobasa, Maddi, & Kahn, 1982; Rutter, 2007; Tugade & Frederickson, 2004; Wagnild & Young, 1990). Inherent in the broader framework of PR are multiple factors that include (1) personal values and belief systems (i.e., religion, spirituality); (2) personality traits (i.e., optimistic outlook, sense of humor); (3) behaviors (i.e., problem solving versus internalization of stress); and (4) interpersonal resources such as social support. Mental health outcomes are also affected by functional decline and environmental factors such as social climate. The combination of this complex interplay of factors makes it possible for certain individuals to survive and even thrive in the face of adversity (Connor & Davidson, 2003; Greene, 2002; Luthar, Cicchetti, & Becker, 2000; McCubbin, 2001). Rutter (2007) viewed resilience as a changing life process, the success of which depends on the situation and individual perception. McCubbin looked at resilience as an outcome variable, positing that coping skills, attitudes toward obstacles, cultural world view, and environmental factors influence individual resilience. In this study, PR is viewed as a multifactorial patient strength that helps people cope with adversity, and thus, may predict lower levels of depressive symptoms. Because so many variables have been identified with PR, it is important to isolate those factors that are most salient to each population of study—in this case, people with diagnosed PPS.
The development of Stress and Coping Theory preceded the study of PR and was important to the broader construct of resilience (Lazarus & Folkman, 1984). Researchers have suggested that the success with which a person copes with age-related changes can affect depression and life satisfaction (Jang, Poon, & Martin, 2004; Kemp & Krause, 1999). Lazarus and Folkman proposed that coping with stressful changes is less about the number or nature of changes and more about the complex interplay of psychological factors, such as personal perceptions of change, personality traits, level of social support, and coping methods used. Tugade and Frederickson (2004) emphasized the role of positive emotions in coping and resilience. Sanchez (1997) found that people with PPS who used a problem-focused coping style in dealing with life stressors had fewer depressive symptoms. Thus, methods of coping are woven into the fabric of PR. A well-accepted theory of resilience for older populations has not been formulated at this time; therefore, we used the construct of resilience as a conceptual guide for the study.
Depression has recently been cited as the leading cause of medical disability in the United States, costing $53 billion annually (Insel, 2007). The prevalence of depression for older adults without disability is 8%–20% (U.S. Department of Health and Human Services, 1999), whereas Kemp (2006) reported that for people with disability the rate is 25%–50%. Although disability is associated with higher risk for depression, few studies focus on depression or depressive symptoms in older adults with PPS. For example, in a search of Medline, PsychINFO, and CINAHL-Plus databases from 2000 to 2008 using the keywords "post-polio syndrome" and "depression," only two studies were retrieved that focused on depression in people with PPS. Weber, Schonknecht, Pilz, and Storch-Hagenlaocher (2004) assessed 15 PPS patients for depression using the ICD-10 criteria and found that depressive episodes were recognized in 8 of the 15 patients (53%). Wenneberg and Ahlström (2000) completed qualitative interviews with 15 individuals who reported that current complications of living with PPS revived past painful memories of prejudice and mistreatment. Sample sizes were notably small in these studies. However, more recently, Stuifbergen (2005) identified secondary conditions in a large sample of polio survivors (n = 2,153) and found a sizeable difference between reports of physician diagnosed depression (32%) and the experience of depressive symptoms (50%). These findings suggest that depressive symptoms are more prevalent in people with PPS than previously reported.
An important caveat is that overall rates of depression in polio survivors may be skewed by a significantly higher incidence in the subsample of people diagnosed with PPS. For example, Hazendonk and Crowe (2000) originally set out to examine the cognitive differences between a sample of polio survivors (including those with PPS) and a control group without disabilities. The researchers used single-factor, repeated measures ANOVA with planned comparisons analysis. The combined polio and PPS group reported a significantly higher frequency of 11 symptoms (e.g., depression, fatigue, muscle pain) that disrupted their usual daily activities (p < .001) compared to the control group. This finding was an artifact because it was skewed by the scores of the PPS subgroup. Depression scores (BDI-II; Beck, Steer, & Brown, 1996) in the PPS and polio survivor groups were significantly different. The PPS group (M = 16.22, SD =10.35) scored more than 10 points higher than the control group (M = 5.86, SD = 4.63) and the polio survivor's group (M = 6.05, SD = 4.96). Repeated studies of similar design using distinct subgroups are needed to clarify the reliability of this finding; however, it appears that people with PPS suffer from higher levels of depression than polio survivors do.
Regarding the specific correlates of depression in people with PPS, Maynard (1991) found that higher levels of depression were associated with higher pessimism and holding in or venting anger in the absence of constructive problem solving. Westbrook and McIlwain (1996) surveyed 176 people with PPS at 1- and 5-year intervals about their emotional reactions to having PPS. Accommodating or accepting the diagnosis was related to the use of more positive strategies (r = .25, F3.162, p < .01). These studies highlight the importance of individual attitudes about aging with a disability.
Researchers have investigated the relationship between the following resilience factors and mental health in the general population: acceptance (Langer, 2004; Tate et al., 1994; Westbrook & McIlwain, 1996), self-efficacy (Becker & Schaller, 1995; Caplan, 1990; Wagnild & Young, 1990), personal resources/social support (Fredrickson et al., 2003; Rabkin, Remien, Katoff, & Williams, 1993; Stuifbergen, Seraphine, & Roberts, 2000; Werner & Smith, 1982), interpersonal relationships (Heisel, 2006; Kinsel, 2005; Rutter, 1985, 1987), self-rated health (Acierno, Ruggiero, Kilpatrick, Resnick, & Galea, 2006; Kling et al., 2000; Tate et al., 1994), spiritual growth (Harrison & Stuifbergen, 2006; Higgins, 1994; Kinsel, 2005; Langer, 2004; Silberman, 2005), and stress management (Caplan, 1990). Taken together, studies with polio survivors and the general population suggest that interpersonal resilience factors such as optimism, problem-solving attitude, and acceptance may be integral sources of successful coping with the sometimes overwhelming stressors of PPS. We suggest that for people with PPS, who have spent a lifetime managing the challenges of living with functional limitations, resilience characteristics and responses may be important keys to coping with change. The factors measured in this study represent a portion of the total construct of PR and were selected from a larger data set of health indicators in a sample of older adult polio survivors (older than 65 years) as described below.
This cross-sectional secondary analysis involved a convenience sample of 630 adults who were 65 years or older and had indicated they had been diagnosed by a physician as having PPS. The sample was derived from a larger group who had participated in a study of factors influencing quality of life in polio survivors (Stuifbergen, Seraphine, Harrison, & Adachi, 2005). The original sample was recruited from the mailing list of the International Polio Network, which represents approximately 6,000 polio survivors in all 50 states. After the local institutional review board approved the study, the executive director of the organization provided an initial description of the study, which was mailed to a random sample of 2,962 participants. A second letter from the primary investigator gave further details about participation in the study. People who were interested and returned an enclosed participation form were mailed a consent letter, instructions, the survey booklet containing a battery of health instruments, and a stamped preaddressed envelope. A total of 2,153 usable surveys formed the basis of the initial study. The mean age of participants in the older subgroup (n = 630) selected for this study was 72.43 years (SD = 5.65), and the majority were female (65.4%), married (61.4%), and white (98.7%). More than 70% of the sample had 12 or more years of education, 17.1% were working full or part time, 7.7% were unemployed because of age or disability, and 74% were retired.
The original Incapacity Status Scale (Kurtzke, 1981) is a 16-item self-report questionnaire used to measure functional limitations in activities of daily living in people with multiple sclerosis. The scale was adapted for use with people with polio (Stuifbergen et al., 2005). Responses range from 0 for no functional deficit to 5 for inability to perform the activity by one's self. Areas assessed include vision, feeding, bowel and bladder functioning, and stair climbing. An internal consistency reliability of .88 was reported in a sample of people with multiple sclerosis using the original scale. The Chronbach's alpha was .80 for this sample using the 15-item adapted version for people with PPS.
The Acceptance of Illness Scale (Stuifbergen et al., 2000) is a 14-item, 5-point Likert-style scale used to measure the belief that disability is integrated into one's way of life—one accommodates, but does not "give up" on life (Harrison, Stuifbergen, Adachi, & Becker, 2004; Stuifbergen et al., 2000; Tate et al., 1994). Items range from 1 (strongly agree) to 5 (strongly disagree). Good internal reliability coefficients of .83 and .84 were obtained for people with chronic disabling conditions and polio survivors, respectively (Stuifbergen et al., 2000, 2005), and .82 was obtained for this sample.
Self-efficacy or the quality of being self-confident in mastering difficult situations (Bandura, 1982) was measured using the 28-item, 5-point Self-Rated Abilities for Health Practices Scale (SRAHP; Becker, Stuifbergen, Oh, & Hall, 1993; Becker & Schaller, 1995). The SRAHP is used to gauge beliefs about a person's ability to perform specific health-promoting practices within the context of lifestyle and disabilities. Ratings from 0 (not at all) to 4 (completely) are possible with a total range of 0–112 (higher values indicating higher self-efficacy). A Chronbach's alpha of .93 was previously reported in a sample of people with chronic and disabling conditions (Stuifbergen et al., 2000); it was .89 for this sample.
The Personal Resource Questionnaire (PRQ-85; Weiner & Brandt, 1985) is a 7-point (from strongly disagree to strongly agree), 25-item tool used to assess individual resources based on five dimensions: worth, social integration, intimacy, nurturance, and assistance. Social integration is inversely related to depression scores in people with disability (Fuhrer, Rintala, Hart, Clearman, & Young, 1993). In this study, we used the PRQ-85 as a measure of overall social support. The PRQ-85 is widely accepted as having sound convergent and discriminate validity and high internal reliability. A Chronbach's alpha of .93 was reported for a sample of people with multiple sclerosis; it was .92 for this sample.
Lawton's Self-Rated Health Scale (SRH; Lawton, Moss, Fulcomer, & Kleban, 1982) was used to evaluate self-appraised health. SRH is a well-documented predictor of longevity (Idler & Beniamini, 1997). Low self-rated health predicts higher morbidity, including depression (Beal & Stuifbergen, 2007) and mortality (Idler & Beniamini). Lawton's SRH scale contains four questions with a total range from 0 to 13, with higher total scores indicating better overall self-rated health. Lawton and colleagues reported an adequate Chronbach's alpha of .76. Chronbach's alpha for this sample was slightly higher at .78.
Interpersonal relationships, spiritual growth, and stress management are three subscales of the Health Promoting Lifestyle Profile II (Walker & Hill-Polrecky, 1996). Participants are asked to rate 52 current health-seeking habits using one of four choices: N (never), S (sometimes), O (often), or R (routinely). Nine items measure interpersonal relationships (Chronbach's alpha = .76); nine items assess spiritual growth (Chronbach's alpha = .85); and eight items gauge stress management (Chronbach's alpha = .71). All internal consistency reliabilities were for this sample. The interpersonal relationship subscale includes statements related to meeting one's needs for intimacy, spending time with close friends, and showing concern and love for others. The spiritual growth subscale includes questions that rate one's feelings about purpose in life, working toward long-term goals, and feeling connected to a force greater than oneself. In the stress management subscale, respondents are asked to rate how often they engage in pacing to preserve energy and balancing work, sleep, and play. In testing the assumptions of all seven independent variables, the distributions approximated normal curves, and bivariate correlations were <.67, indicating that multicollinearity was not problematic in the analysis.
The dependent variable—depressive symptoms—was measured by the short version of the Center for Epidemiologic Studies Depression Scale (CES-D 10; Radloff, 1977). The CES-D 10 was developed in older adult samples and has good reliability and predictive accuracy when compared with the longer 20-item version (κ = .97, p < .001; Andresen, Malmgren, Carter, & Patrick, 1994). On the CES-D 10, participants are asked to rate how often they have experienced feelings such as "depressed" or "lonely." Items range from 0 (rarely or none of the time; less than one time per day) to 3 (most of the time; 5–7 days). Chronbach's alpha for this sample was .89. Importantly, the CES-D 10 may not fully control for the influence of fatigue and pain, known mediators of depression in disabled populations; therefore, this issue must be considered in the final analysis. A cutoff score of ≥10 was used to indicate the presence of moderate to severe depressive symptoms (Andresen et al.).
Although the entire sample was older than 65 years, survivors of polio, and currently diagnosed with PPS, the majority (53%) rated their health as good or excellent (Figure 1). The overall mean CES-D 10 score for the sample was 8.69 (SD = 5.2), as compared with only 4.7 (SD = 0.1) for a large sample (n = 1,206) of older adults (Andresen et al., 1994). The typical cutoff score on the CES-D 10, indicating the presence of moderate to severe depressive symptoms, is ≥10. Forty percent of the sample scored in this range, a percentage well above the average cited for both older people without disability (1.8%–24%; Cole & Dendukuri, 2003 ) and older people with disability (10%–30%; Fuhrer et al., 1993; Kemp et al., 1997; McColl & Rosenthal, 1994; Zauszniewski, Morris, Preechawong, & Chang, 2004). Thus, depressive symptoms were pervasive, even while the majority of participants reported good or excellent health.
The bivariate correlations between the PR factors and the dependent variable are shown in Table 1. As expected, the seven resilience variables had moderately high negative and significant (p < .01) correlations with depression, ranging from -.33 (stress management subscale) to -.51 (spiritual growth subscale). Thus, people who tended to have higher scores on measures of spiritual growth (r = -.51), acceptance (r = -.44), social support (r = -.44), and self-rated health (r = -.41) reported fewer depressive symptoms.
A stepwise multiple regression analysis was completed to determine the extent to which resilience factors predicted depressive symptoms. Functional
limitations and age were entered into the first block of the analysis to control for their known effects on depression (Conrady, Wish, Agre, Rodriguez, & Sperling, 1989; Kemp et al., 1997; Kling et al., 2000). The four factors with the strongest correlations were entered into the second step of the regression model, and the last three factors entered into the third step. The model summary is shown in Table 2. Age was not a significant predictor, probably because of the low variance of age across the sample. After controlling for functional limitations, which accounted for 7% of the variance in depressive symptoms, the first four factors (spiritual growth, social support, acceptance, and self-rated health) explained 30% of the variance in depressive symptoms. Spiritual growth was the main predictor (β = -.25), followed by social support (β = -.18). The final three variables—self-efficacy, stress management, and interpersonal relationships—contributed only 1% to the overall model.
Returning to our conceptual framework of PR in the context of older adults with diagnosed PPS, we proposed that resilience is a broad construct consisting of a combination of various resilience factors: character traits (e.g., acceptance, curiosity, flexibility) and coping responses or behaviors (e.g., talking to family or friends about PPS, problem solving) that facilitate the successful management of unexpected changes (i.e., diagnosis of PPS) or formidable stressors (unexpected increase in functional limitations) in one's life. It was hypothesized that as the use of resilience factors increased, the level of depressive symptoms would decrease. PR was suggested by the results; 53% of the sample rated their health as good or excellent (Figure 1) despite the following findings: (a) they were polio survivors currently experiencing PPS; (b) there was a high level of self-reported depressive symptoms (M = 8.69, SD = 5.2); and (c) 40% scored at or above 10 on the CES-D 10, indicating the presence of moderate to severe depressive symptoms.
These findings reveal a paradox. How could depressive symptoms be quite pervasive, yet more than half the sample report good or excellent self-rated health? Studies of people who have survived severe crises or illnesses such as polio have shown that depression may be a lingering and chronic problem throughout the remainder of life (Bruno, 1999; Hollingsworth, Didelot, & Levington, 2002); however, resilience traits and coping responses may counter depressive symptoms by fostering feelings of hope, self-reliance, and optimism. Further study may unravel the relationship between high levels of self-rated health and concomitant high levels of depressive symptoms in the context of aging with a disability such as in PPS.
It was not surprising to find that functional status explained 7% of the variance in depressive symptoms. Nevertheless, our theoretical framework focuses on psychological factors that may moderate self-reported functional impairment (Jang et al., 2004). Table 3 contains a synthesis of related resilience themes: Column I contains strategies from the literature that people with PPS found helpful in managing PPS; Column II contains related resilience factors; and Column III contains items from the spiritual subscale of the HPLP II, the primary predictor of lower depressive symptoms in the study. Reflecting on the conceptual connections between items presented in Table 3 may be useful in helping nurses and other healthcare providers promote resilience in older adults diagnosed with PPS. For example, three items in the spiritual subscale, "looking forward to the future," "expose myself to new experiences and challenges," and "feel content and at peace with myself" represent psychological inner-strength concepts that can be encouraged during the vital two-way interaction that occurs during the clinical visit. At the same time, these themes are general enough to respect the diversity of religious differences in patient populations. Spiritual growth is conceptualized as a search for purpose or meaning in life or belief in the goodness of the world and one's ability to change it and improve the self (Silberman, 2005). Pargament (1997) and Silberman have proposed that religious meaning systems can influence emotions, well-being, and the decision-making processes that help people cope with adversity. The results of this study support this notion.
Rehabilitation nurses can use these findings by first recognizing and encouraging resilient attributes in their patients such as realistic acceptance of PPS, a future orientation, optimistic self-rated health, and willingness to maintain social ties with at least one confidant or friend. Establishing a trusting collaborative relationship is the vehicle through which these patients' strengths are discovered. Most importantly, it is essential to assess older adults with PPS for depressive symptoms as a routine practice at each point of care.
Gordon and Feldman (2002) recommended other useful counseling techniques to help individuals with PPS deal with the stresses associated with the illness, beginning by examining how clients view new problems associated with PPS. Helping the client to look at new symptoms as part of a "larger chronic health condition" (p. 31) is a healthier alternative than seeing symptoms as an acute problem. Inviting the client to become part of the management team can benefit passive patients. Providing information about techniques to deal with anxiety and anger management may be useful. Finally, supporting patients' personal values and beliefs is an ethically sound component of caring for all patients regardless of diagnosis. Further research may determine whether this type of counseling can produce lasting benefits.
Limitations of the study include the self-report nature of data and the cross-sectional design of the study. The original sample was recruited through a polio-related organization whose members may not represent the general population of peopls with PPS. In addition, other variables were not explored that may significantly affect depression, including pain, fatigue, and other comorbidities.
Preventing depressive symptoms from developing into depression is a worthwhile goal for health promotion in older adults diagnosed with PPS. Although no causal relationships are posited as a result of the study, future studies should explore the potential for psychological resilience factors to ameliorate depressive symptoms. Rehabilitation nurses are in an ideal position to encourage resiliency while providing emotional support. Although the vicissitudes of life cannot be altered, patients diagnosed with PPS can be helped in positive ways by offering encouragement and hope.
Grant number R01NR003195 from the National Institute of Nursing Research supported this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.
About the Authors
Diana Pierini, BSN RN, is a doctoral student at the University of Texas at Austin, School of Nursing, Austin, TX. Address correspondence to her at email@example.com.
Alexa K. Stuifbergen, PhD RN FAAN, is professor and associate dean of Research at the University of Texas at Austin, School of Nursing, Austin, TX.
Acierno, R., Ruggiero, K. J., Kilpatrick, D. G., Resnick, H. S., & Galea S. (2006). Risk and protective factors for psychopathology among older versus younger adults after the 2004 Florida hurricanes. The American Journal of Geriatric Psychiatry, 14(12), 1051–1059.
Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). American Journal of Preventive Medicine, 10(2), 77–84.
Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist, 37(2), 122–147.
Beal, C. C., & Stuifbergen, A. (2007). Loneliness in women with multiple sclerosis. Rehabilitation Nursing, 32(4), 165–171.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.
Becker, L. C. (2006). Polio survivors in the U.S. 1925–2000 age distribution data. Retrieved on July 8, 2008, from www.post-polio.org/PolioSurvivorsInTheUS1915–2000.pdf.
Becker, H., & Schaller, J. (1995). Perceived health and self-efficacy among adults with cerebral palsy. Journal of Rehabilitation, April/May/June, 36–42.
Becker, H., Stuifbergen, A., Oh, H. S., & Hall, A. (1993). The Self-Rated Abilities for Health Practices Scale: A health-efficacy measure. Health Values, 17, 42–50. Retrieved December 16, 2008, from www.crowdbcm.net/measures/Measures-III-HPbehav.htm.
Bruno, R. L. (1999). Emotional stress in polio survivors and post-polio sequelae. In Handbook of the Late Effects of Poliomyelitis. St. Louis Gazette International Network 1999. Retrieved on January 6, 2009, from www.poliooutreach.com/EmotionalStressinPolioSurvivorsandPPS1.htm.
Caplan, G. (1990). Loss, stress, and mental health. Community Mental Health Journal, 26, 27–48.
Cole, M. G., & Dendukuri, N. (2003). Risk factors for depression among elderly community subjects: A systematic review and meta-analysis. American Journal of Psychiatry, 160(6), 1147–56.
Connor, K. M., & Davidson, J. R. T. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, 76–82.
Conrady, L., Wish, J., Agre, J., Rodriguez, A. A., & Sperling, K. B. (1989). Psychologic characteristics of polio survivors: A preliminary report. Archives of Physical Medicine and Rehabilitation, 70, 458–463.
Fredrickson, B. L., Tugade, M. M. Waugh, C. E., & Larkin, G. R. (2003). What good are positive emotions in crises? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. Journal of Personality and Social Psychology, 84, 365–376.
Fuhrer, M., Rintala, D., Hart, K., Clearman, R., & Young, M. (1993). Depressive symptomatology in persons with spinal cord injury who reside in the community. Archives of Physical Medicine and Rehabilitation, 74, 255–260.
Gordon, P. A., & Feldman, D. (2002). Post-polio syndrome: Issues and strategies for rehabilitation counselors. Journal of Rehabilitation, 68, 28–32.
Greene, R. R. (Ed.). (2002). Resiliency: An integrated approach to practice, policy, and research. Washington, DC: National Association of Social Workers, NASW Press.
Hallam, H. (2000). Post-polio syndrome: From learning it exists through to better managing your life. Retrieved March 11, 2008, from www.ott.zynet.co.uk/polio/lincolnshire/linkpin/lincpinvol02issue09.html#5.
Halstead, L. (1994). Living with the late effects of disability: A five year follow-up survey of coping among post-polio survivors. Australian Occupational Therapy Journal, 43, 60–71.
Halstead, L. (1998). Post polio syndrome. The Scientific American, April, 36–41. Retrieved June 26, 2008, from www.ott.zynet.co.uk/polio/lincolnshire/library/halstead/sciampps.html.
Harrison, T., & Stuifbergen, A. (2006). Life purpose: Effect on functional decline and quality of life in polio survivors. Rehabilitation Nursing, 31(4), 149–154.
Harrison, T., Stuifbergen, A., Adachi, E., & Becker H. (2004). Marriage, impairment, and acceptance in persons with multiple sclerosis. Western Journal of Nursing Research, 26(3), 291–292.
Hazendonk, K., & Crowe, S. F. (2000). A neuropsychological study of the postpolio syndrome: Support for depression without neuropsychological impairment. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 13(2), 112–118.
Heisel, M. J. (2006). Suicide and its prevention among older adults. Canadian Journal of Psychiatry, 51(3), 143–154.
Higgins, G. O. (1994). Resilient adults: Overcoming a cruel past. San Francisco: Jossey-Bass.
Hollingsworth, L., Didelot, M. J., & Levington, C. (2002). Post-polio syndrome: Psychological adjustment to disability. Issues in Mental Health Nursing, 23, 135–156.
Idler, E. L., & Beniamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38(1), 27–37.
Insel, T. (2007, April 2). Depression: Top cause of medical disability. AMNews. Retrieved June 26, 2008, from www.ama-assn.org/amednews/2007/04/02/hlsb0402.htm.
Jang, Y., Poon, L. W., & Martin, P. (2004). Individual differences in the effects of disease and disability on depressive symptoms: The role of age and subjective health. International Journal of Aging and Human Development, 59(2), 125–137.
Kemp, B. (2006). Depression as a secondary condition in people with disabilities: A new look—Summary and background papers. Board on Health Sciences Policy, Appendix N. NAP, 234–250. Retrieved March 17, 2008, from www.nap.edu/openbook.php?recore_id=11579&page=234(–250).
Kemp, B., Adams, B., & Campbell, M. (1997). Depression and life satisfaction in aging polio survivors versus age-matched controls: Relation to postpolio syndrome, family functioning, and attitude toward disability. Archives of Physical and Medical Rehabilitation, 78, 187–192.
Kemp, B. J., & Krause, S. (1999). Depression and life satisfaction among people ageing with post-polio and spinal cord injury. Disability and Rehabilitation, 21(5/6), 241–249.
Kinsel, B. (2005). Resilience as adaptation in older women. Journal of Women & Aging, 17(3), 23–39.
Kling, C., Persson, & Gardulf, A. (2000). The health-related quality of life of patients suffering from the late effects of polio (post polio). Journal of Advanced Nursing, 32(1), 164–173.
Kobasa, S. C., Maddi, S. R., & Kahn, S. (1982). Hardiness and health: A prospective study. Journal of Personality and Social Psychology, 42, 168–178.
Kurtzke, J. F. (1981). A proposal for a uniform minimal record of disability in multiple sclerosis. Acta Neurological Scandinavica, 64(Suppl. 87), 110–129.
Langer, N. (2004). Resiliency and spirituality: Foundations of strengths perspective counseling with the elderly. Educational Gerontology, 30, 611–617.
Lawton, M., Moss, M., Fulcomer, M., & Kleban, M. (1982). A research and service oriented multilevel assessment instrument. Severe Handicaps, 11(4), 240–245.
Lazarus, R. S., & Folkman, S. (1984). Stress appraisal and coping. New York: Springer.
Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71, 543–562.
March of Dimes. (2000). Identifying best practices in diagnosis and care. March of Dimes International Conference. Retrieved March 4, 2008, from www.marchofdimes.com.
Maynard, F. M. (1991). The late effects of polio: A model for the identification and assessment of preventable secondary disabilities. Post-Polio Health, 7(3), Retrieved December 16, 2008, from www.post-polio.org/edu/pphnews/pph7-3.html.
Mayo Clinic. (n.d.). Post-polio syndrome. Retrieved March 31, 2008, from www.mayoclinic.com/health/post-polio-syndrome/DS00494.
McColl, M. A., & Rosenthal, C. (1994). A model of resource needs of aging spinal cord injured men. Paraplegic, 32, 261–270.
McCubbin, L. (2001, August 24). Challenges to the definition of resilience. Paper presented at the meeting of the American Psychological Association, San Francisco, CA.
National Institute of Neurological Disorders and Stroke. (n.d.). Post-polio syndrome fact sheet. Retrieved June 23, 2008, from www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htm.
Pargament, K. I. (1997). The psychology of religion and coping. New York: The Guilford Press.
Polk, L. V. (1997). Toward a middle-range theory of resilience. Advances in Nursing Science, 19(3), 1–13.
Rabkin, J., Remien, R., Katoff, L., & Williams, J. (1993). Resilience in adversity among long-term survivors of AIDS. Hospital Community Psychiatry, 44(2), 162–167.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measures, 1, 385–401.
Ramaraj, R. (2007). Post-poliomyelitis syndrome: Clinical features and management. Symposium on Neurology. British Journal of Hospital Medicine, 68(12), 648–650.
Ramlow, J., Alexander, M., LaPorte, R., Kaufman, N. C., & Kuller, L. (1992). Epidemiology of post polio syndrome. American Journal of Epidemiology, 136, 769–786.
Rutter, M. (1985). Resilience in the face of adversity: Protective factors and resistance to psychiatric disorder. British Journal of Psychiatry, 147, 598–611.
Rutter, M. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry, 57(3), 316–331.
Rutter, M. (2007). Resilience, competence, and coping. Child Abuse & Neglect, 31, 205–209.
Sanchez, D. I. (1997). Stress, coping, and psychological adaptation of individuals with post-polio sequelae. Dissertation Abstracts International, 58(4-B), October, pp. 2136.
Silberman, I. (2005). Religion as a meaning system: Implications for the new millennium. Journal of Social Issues, 61(4), 641–663.
Simon, G. E., & VonKorff, M. (1995). Recognition, management, and outcomes of depression in primary care. Archives of Family Medicine, 4, 99–105.
Stuifbergen, A. K. (2005). Secondary conditions and life satisfaction among polio survivors. Rehabilitation Nursing, 30(5), 173–178.
Stuifbergen, A. K., Seraphine, A., Harrison, T., & Adachi, E. (2005). An explanatory model of health promotion and quality of life for persons with post-polio syndrome. Social Science & Medicine, 60, 383–393.
Stuifbergen, A., Seraphine, A., & Roberts, G. (2000). An explanatory model of health promotion and quality of life in chronic and disabling conditions. Nursing Research, 49, 122–129.
Tate, D., Kirsch, N., Maynard, F., Peterson, C., Forchheimer, M., Roller, A., et al. (1994). Coping with the late effects: Differences between depressed and non-depressed polio survivors. American Journal of Physical Medicine and Rehabilitation, 73(1), 27–35.
Tugade, M. M., & Frederickson, B. L. (2004). Resilient individuals use positive emotions to bounce back from negative emotional experiences. Journal of Personality and Social Psychology, 86(2), 320–333.
U.S. Department of Health and Human Services (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health. National Insitute of Mental Health. Retrieved January 7, 2009, from www.surgeongeneral.gov/library/mentalhealth/toc.html#chapter5.
Unutzer, J., Patrick, D. L., Simon, G., Grembowski, D., Walker, E., & Rutter, E., et al. (1997). Depressive symptoms and the cost of health services in HMO patients aged 65 and over: A 4-year prospective study. Journal of the American Medical Association, 277, 1618–1623. Abstract retrieved August 20, 2008, from www.ncbi.nlm.nih.gov/sites.
Wagnild, G., & Young, H. M. (1990). Resilience among older women. Image Journal of Nursing Scholarship, 22, 252–255.
Walker, S., & Hill-Polrecky, D. (1996). Psychometric evaluation of the Health Promoting Lifestyle Profile: Development and psychometric characteristics. Nursing Research, 36(2), 76–81.
Weber, M. A., Schonknecht, P., Pilz, J., & Storch-Hagenlaocher, B. (2004, April). Abstract [Postpolio syndrome. Neurologic and psychiatric aspects]. Nervenarzt, 75(4), 347–354.
Weiner, C., & Brandt, P. (1985). The Personal Resource Questionnaire (PRQ-85). Retrieved August 6, 2008, from www.montana.edu/cweinert/prq85.html.
Wenneberg, S., & Ahlström, G. (2000). Illness narratives of persons with post-polio syndrome. Journal of Advanced Nursing, 30(2), 354–361.
Werner, E., & Smith, R. (1982). Vulnerable but invincible: A longitudinal study of resilient youth and children. New York: McGraw-Hill.
Westbrook M., & McIlwain, D. (1996). Living with the late effects of disability: A five year follow-up survey of coping among post-polio survivors. Australian Occupational Therapy Journal, 43, 60–71.
Westbrook, M. T. (1991). A survey of post-poliomyelitis sequelae: Manifestations, effects on people's lives and responses to treatment. Australian Journal of Physiotherapy, 37, 89–102.
Zauszniewski, J. A., Morris, D. L., Preechawong, S., & Chang, H. (2004). Reports on depressive symptoms in older adults with chronic conditions. Research and Theory for Nursing Practice, 18(2–3), 185–196. Retrieved March 13, 2005, from http://txaustintx.library.ingentaconnect.com.

subset: commoncrawl


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Pepe The Cat
Welcome to my pages! I'm a big, furry black cat who enjoys sleep and mice. I live with my two humans, Ian and Rachel in York, England. There isn't too much on these pages at the moment, but there are my thoughts collected in my blog and some photographs of me so you can see how well groomed I keep myself!
Feel free to drop me an email at firstname.lastname@example.com. Purrr.
Pepe's Pages -:- Pepe's Blog -:- Pepe's family


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"Kromeriz" Kromeriz by Amazonka
Kromeriz Travel Guide: 20 reviews and 95 photos
The birth of Kromeriz's churches dates back to Great Moravia even though their present look has evolved rom the 18th-century reconstruction. The original Gothic parochial Church of the Blessed Virgin Mary was redeveloped in the spirit of baroque in 1724-36. The once modest 12th-century Johanite Maltese hospital church is now the baroque piarist St John the Baptist's Church, richly decorated and part of the complex of the piarist school and campus. Founded by Bishop Bruno, the three-nave Gothic St Maurice's Collegiate Chapter Church was redeveloped in the neoGothic style following the fire in the middle of the 19th century. The Large Square (Velke namesti) shows many valuable samples of baroque architecture - the 16th-century town hall and its 41 m high tower; the 1680 Plague Post; the baroque fountain and burgher houses.
Rieger Square is the former Horse market later renamed to Vegetable Market, the place of the ancient market-place settlement. The square's dominants are the Most Holy Trinity's Plague Post (1724-26), the baroque fountain, and the complex of Emeritus House with St John Sarkander's Chapel and Blessed Virgin Mary's Church's parish (1738). Fuond adjacent to the chateau, the only surviving town gate (Mlynska brana) was part of the 13th-century walls some relics of which are still scattered around the place. The 17th-century Jewish town hallo stands out of the Old Jewish Ghetto in the Moravcova and Tylova Streets and Olbram Zoubek's plastic sculpture at the Community House in Tovacovska Street commemorates the holocaust. The restored episcopal mint now shows a historical survey of coining at Kromeriz (1600-1760) in Na Sladovnach Street. The town centre has been an urban reserve and national treasure since 1955.
The tradition of education, music and culture gave the town an ever valid attribute of local Athens.
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It is very great, beautiful, wonderful and stunning art! Thank you very much! Bravo!
I read books of Zecharia Sitchin. I like aliens, Anunnaki and Ancient Mesopotamia very much.
Look my arts of Sumerian and Akkadian mythology!
Dingir and his entum (Sumerian Jesus):
Nanna and Enheduanna, Inanna and Sargon:
Inanna and Anu - love and sex:
Inanna and Shukalletuda:
Inanna and Gaygamesh:
Gaygamesh and Enkidu - kiss:
Abuni ang Singamil - Sumerian gay-lovers:
Sumerian god Enki:
Inanna and Enki - Stealing Me:
Dumuzi and Geshtinanna - incest hetero-love:
Young Dumuzi and Yong Ishkur:
Dumuzi - the Good Shepard:
Inanna and Dumuzi - wedding:
Young Anu and Alalu:
Nergal and Ninurta:
Nergal and Ereshkigal - love:
Nergal and Jesus Christ - sex:
Jesus and Satan:
Ninurta and shumerologist V.V. Emeljanov - love:
Ninurta, Shara and Enlil:
Enuma Elish - Enlil and Tiamat:
Anunnaki forewer!
I do have one small critique, though. On the buildings and pyramids, you should've added some blue-colored stone tiles to give them a sense of color. Still, it's an incredible creation of what Babylon must've been like. Well done.
All of those little details (the clothe's foldings, pictures in the walls, the architectural elements) must had taken you a considerable amount of time. Lots of pacience.
From my perspective at least they were well invested minutes.
Thanks a lot for your art.
Un saludo.


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On yesterday's episode of "The Bold and the Beautiful," Hope told Wyatt it was more than okay that he had snuck on the Forrester jet to surprise her. Elsewhere, Eric was on a conference call with Thorne and Aly. Eric wondered how Aly was doing and she said everything was great and it would all be better once Hope arrived. She wondered if Liam was coming. Eric reminded her that Hope was with Wyatt now. Aly asked if Wyatt would be coming and Eric said as far as he knew, Wyatt wouldn't be there. Aly thought that was a good thing. Thorne wondered why she would say something like that.
Elsewere, psycho Quinn sauntered into Liam's place once again. Bill told her she had to stop doing this. She advised him not to be such a grump and stated they were like family. An adamant Bill told Quinn that they were not family. He said she was the mother of his son and that was it. Quinn mentioned the wild sex the two of them shared. Bill said it was the evils of alcohol. She said it happened and he couldn't take it back. Bill told her he knew that much, but he also knew he could make sure it never happened again. Quinn simply stood there all confident with a stupid, seductive smile on her face.
Pam had Eric signing some papers and mentioned he had just heard that Wyatt snuck on the Forrester jet to go to Paris. Eric said he was having Stephanie's jewelry appraised in Paris, but he didn't know he was doing it now. Pam was worried, but Eric told her that Wyatt had his complete approval. That was good enough for Pam. Eric said it was more than he could say for Aly. A stunned Pam said Aly had been doing so good lately. She wondered if Eric thought she was having problems again.
Speaking of Aly, she had a chat with Thorne at the office. Thorne seemed concerned about his daughter's take on Wyatt. Aly didn't hesitate to let her father know how she felt about the guy. She said Hope was so smart and knew all the right things to do. She said Hope was so smart except when it came to Wyatt. She said Wyatt was too smooth and too slick. She just didn't like him. She said he was bad for Hope and bad for Forrester. She loved being around Hope, but wyatt just made her different.
Hope sprung Wyatt on her mother and Brooke was delighted to see him. He said he just couldn't let Hope go to the city of love without him. Brooke told Hope and Wyatt they were so cute. She said they reminded her of her and Ridge when they were younger. They had seized every moment to spend time together when they were younger. She advised Wyatt and Hope not to lose what they had and said it was a huge help in a world full of distractions.
Bill and Quinn continued their conversation. Quinn said it was interesting that they had become lovers again. Bill said they were not lovers. They simply had sex--adult, consensual sex. Quinn ordered Bill not to accuse her of taking advantage of him because as far as she could tell, he was an active participant. A horried Bill reminded Quinn that he was in love with Brooke and what happened between them didn't change a thing. Quinn advised Bill to lick his wounds and take a look around. She said he might like what he sees. She said they could be the most bizarro couple together. She wanted to know if he wanted to help her release her inner beast.
Pam wondered what had Eric so concerned about Aly. He said Aly had no use for Wyatt. Pam brushed that off and noted a lot of people felt that way about Wyatt. Eric said it was more than that--it was the tone in her voice he heard this morning. Pam wondered if the other kids in the family knew about Aly's history. Eric said they didn't. He said it had been Thorne's choice to handle it that way. He said Aly didn't want anyone to know. Pam said she could relate due to her own struggles. She told Eric it had always been a challenge for her.
A concerned Thorne asked his daughter when she developed these negative feelings for Wyatt. He had been under the impression that Aly liked Wyatt. Aly said she did in the beginning, but once she got to know him, everything changed. Aly said Wyatt was just so arrogant and Hope should be with Liam. Thorne pointed out that Hope had been with Liam for a long time. He said maybe she just needed a break with Wyatt and his free spirit. Aly insisted that Wyatt and Hope were wrong for each other.
Aly talked about when Hope was in love with Wyatt living her dream and sending out her message to the world through the Hope for the Future line. She said she believed in Hope's message back then and that message had helped her get through everything that happened to her. She said now, that Hope was with Wyatt, everything had been ruined. She told her father she just wished that Wyatt would go away.
Bill told Quinn he didn't want to hurt her. He said he couldn't let her think they were at the beginning of something because they were not. Bill reminded Quinn he had been in a bad place when they got together. He said he had indulged in way too much alcohol. Quinn referred to herself as evil and stated she had taken advantage of Bill when he was totally defenseless. Bill said he never would have initiated this, but Quinn had been single minded. He hoped she wasn't going to come to him in a couple of months and tell him she was pregnant.
Quinn laughed at the pregnancy line. Quinn told Bill he really needed to get over himself. She said having a child was nowhere on her list of priorities. She said she would never want another child with Bill given the type of father he was the first time around.
Pam told Eric it was a good thing that Aly was with her father because he knew the signs of her anger and could head them off. Eric said he had seen this all before. One minute Aly could be sweet and confident and, in the next, she would become angry and even violent. Pam was stunned to hear about the violence. Eric explained there had been incidents in the past during her childhood and it only got worse with the bullying.
Hope and Brooke arrived in Paris. Brooke was in Thorne's office chatting with Thorne and Aly. Brooke told Thorne his father loved how he was running the company. Thorne said the staff made it easy and Aly said they all loved her father. She ran downstairs to find Hope. Brooke told Thorne Wyatt was downstairs with Hope and Thorne reacted. Brooke wondered what was wrong. Thorne said nothing was wrong yet, but he was concerned. He told Brooke Aly had a real hatred for Wyatt.
Quinn asked Bill if he ever thought of what it would have been like if they stayed together. Bill insisted he did not. Bill said that ship had sailed and Quinn thought she saw that ship docked in the harbor just a couple of hours ago. Bill said that was a mistake and it would never happen again. Quinn said she had blown her cover by letting Bill know as much as she hated him, she still desired him on some strange level. She assumed Bill didn't want what happened between them to get out. She told him not to worry because she wouldn't say anything. He said she wouldn't talk until he pissed her off. Quinn gave Bill her word their secret was safe with her.
Quinn left Bill and said she would see him, but she didn't mean she would run into him on the street. She knew that he was allegedly all about Brooke, but told him those Logan prom queen bimbos just didn't get him. She knew what he wanted, how he wanted it and when to give it to him. She told the guy he was ruthless and so was she. She said he liked it rough and she could throw the rough stuff back at him twice as hard. She claimed to be the only woman in the world that was perfect for him. Quinn told Bill she was sure he would come looking for her eventually.
Thorne vented about Aly to Brooke and told her Aly had been light and happy. He was concerned about the darkness he saw in her eyes today when she spoke about Wyatt. He said he had been worrying about her being all alone in L.A. Brooke mentioned that Aly had been through a lot after losing her mother at such an early age. Thorne was more than concerned about his daughter's anger issues.
Hope and Wyatt were in the board room and she begged to know what he had locked up in that suitcase. Wyatt revealed that he had Stephanie's collection of jewelry. He assured Hope that Eric had given him permission to bring the jewels to Paris to have them appraised. Wyatt said the Stephanie Forrester collection would be a perfect tie in for the Hope for the Future line. Hope admired how Wyatt was always thinking. Wyatt said he intended to pitch the idea to Thorne.
Hope and Wyatt began to kiss and Wyatt told her he was thinking again. Hope said she liked that and Aly suddenly burst into the board room and ordered Wyatt to take his hands off Hope,
On the next episode, Aly tells Wyatt she intended to put a stop to all of this. Thorne tells Brooke that his daughter is hurting and it's ripping her apart. Taylor tells Eric that if Aly is spiraling downward, Hope and Wyatt will have their hands full. Aly tells Wyatt he is officially fired from Forrester Creations and orders him not to go near Hope again.
Don't miss today's episode of "The Bold and the Beautiful," and do drop a thought or two in the comments section below.


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Nov 22, 2011 8:25 AM
Normally we'd call our landlord if we had a growth sprouting from our wall, but this Wally One Wooly Pocket Garden ($40) is the kind of addition we'd welcome in our apartment. We like the idea of hanging a vertical garden over our entry table so there's still room for mail, keys, and a cute little lamp. Or hung by our kitchen window and filled with fresh herbs. However, we have our doubts that our garden would look as lush as the one in the picture...
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On the men's side sophomore Jeremy Gathright (Vista, Calif.) took home second-place overall in the men's triple jump with a mark of 14.52 meters. With the performance, he was named Heart of America Athletic Conference (HAAC) Field Athlete of the Week.
Kate Thurbon (Topeka, Kan.) led the Baker women with a seventh-place finish in the pole vault, with a national qualifying mark of 3.45 meters. Thurbon was named HAAC Field Athlete of the Week on the women's side.
"We're working as hard as we can even with the weather the way it is and still managing to put up solid marks and times," said assistant coach Zach Atzeni.
The indoor season will continue this weekend when both teams travel to NWU Invitational in Lincoln, Neb.


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A vicious serial killer is on the loose, killing in volume but taking one victim in the process. After escaping the serial killer a man is forced to return to the dungeon of horrors to help save a woman now his captive. With a group of mercenaries behind him, he leads them into the house of deadly traps.
Josh Stewart (Arkin), Emma Fitzpatrick (Elena), Christopher McDonald (Mr. Peters), Lee Tergesen (Lucello), Tim Griffin (Dre), Andre Royo (Wally), Randall Archer (The Collector), Shannon Kane (Paz), Brandon Molale (Lin).
The Collection doesn't waste much time before giving us some sexy people followed quickly by a gruesome horror scene that sets the tone for the rest of the film. As the plot develops we find there really isn't much to it, but that doesn't matter. This one is about horror pure and simple and in that respect it does well. Reminiscent of the Saw franchise, The Collector is very good at scaring the hell out of his victims and building traps. And he does both constantly throughout the film.
Acting was decent for the most part. Stewart, though his character wasn't explained well, did a nice job for his part. Fitzpatrick also did well though her shirt half off throughout the film was a large part of her contribution. McDonald played a bit part in this one and could have been used for more. The remainder of the supporting cast did fairly well, including Archer who was appropriately creepy.
Camera work, sets, and backgrounds were fairly well done with a solid feel and good attention to detail. Effects were largely physical and felt quite realistic. CGI was minimal but good and supported the film well. Dialogue was used only as needed to keep things moving and felt somewhat bland. Sound and soundtrack were both good.
Overall The Collection is a well done horror flick with plenty of scares, blood, and gore. Horror fans will likely enjoy this one despite the somewhat thin plot. Those who like plenty of gore will enjoy this the most.
With some sexuality, foul language, blood, gore, violence, gore, and did I mention…gore, save this one for older teens and above.
Released: 2012
Reviewed: 11.9.13
Star rating: 3 out of 5
Genre: Horror, Slasher, Serial Killers
copyright ©2013 Dave Riedel
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