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PEORIA, Ill. – After enjoying one of the best four-year runs in program history, Bradley Soccer turned its focus to the future with the announcement of an eight-man recruiting class that will join the Braves for the 2014 season. Two of the recruits, Daniel Gardner and Richard Olson, were rated as 4-star recruits by TopDrawerSoccer.com and were included in the IMG Academy Top 150 player pool.
The 2014 recruiting class will help fill the void created by the graduation of 10 seniors. Six of those senior helped Bradley win two Missouri Valley Conference Tournament titles and reach three NCAA Tournaments
"With the loss of 10 seniors that were so successful, obviously there were large holes to fill," said Bradley head coach Jim DeRose. "Our goal was to add depth to our returning core of players, in particular with lock-down defenders, and identify attacking players with great pace and athleticism that can threaten back lines. Another primary need was a central midfield player or two that can bring players into the game with good vision and penetrating passing ability. I believe we accomplished those goals and are very excited about this class."
2014 Bradley Soccer Recruiting Class
|High School
|Tommy Clark
|Granger, Ind.
|Saint Joseph
|Three Lions FC Elite
|Clark Emerson
|Grand Prairie, Texas
|Mansfield Lake Ridge
|Andromeda U18
|Daniel Gardner
|Waterloo, Ill.
|SLSC Metro U18 USSDA
|Andrew Lwanga
|Flossmoor, Ill.
|Chicago Fire Juniors South
|Grayson McGraw
|Washington, Ill.
|Peoria Notre Dame
|Central Illinois Soccer Academy
|Richard Olson
|Park Ridge, Ill.
|Maine South
|Sockers FC
|Matt Perry
|Zionsville, Ind.
|Zionsville Youth Soccer Assn.
|Jacob Taylor
|Dunlap, Ill.
|Central Illinois Soccer Academy
Bradley returns 18 players from its 2013 squad that finished 14-7-2 overall, won the Missouri Valley Conference postseason tournament title and advanced to the second round of the NCAA Tournament. The Braves lost 10 players to graduation, however, including Valley Player of the Year and team scoring leader, Wojciech Wojcik, and three-time All-MVC goalkeeper Brian Billings. Rising sophomore Christian Okeke, the 2013 MVC Freshman of the Year, is Bradley's top returning scorer after posting 16 points on six goals and four assists. Okeke is one of 10 returning players to score at least one point last season.
Playing with a short roster during the 2013 spring season, the Braves went undefeated (4-0-1) in five exhibition games.


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To some people, Memorial Day is just a holiday to begin the unofficial start of summer. It's a day off from work, and maybe a special time to spend with family and friends. But the true meaning of the holiday began as a way to remember those who have served our country, especially those who made the ultimate sacrifice to gain or protect the freedoms we now enjoy.
Over the years, the holiday has expanded as a time to remember loved ones and others who have departed this life. It even becomes a little showy with flowers and other adornments to symbolize how much the person meant to us. But then the question is this: Are there other ways to remember those who live in our hearts?
- A visit to the cemetery to decorate a gravesite is certainly requisite for most of us, but to truly honor the memory of someone, you can make a more personal difference.
- To honor a veteran
- Donate to one of the many worthwhile organizations that support our veterans such as: Wounded Warriors http://www.woundedwarriorproject.org/, Paralyzed American Veterans http://www.pva.org/site/c.ajIRK9NJLcJ2E/b.6305401/k.BCBB/Home.htm, Disabled American Veterans http://www.dav.org/, etc.
- Contact a local American Legion or VFW to find out what is needed and then donate to the need
- Contact a local veterans' retirement home, hospital, or military reserve to see what donations are needed
- Write a letter to a soldier stationed abroad
To honor a loved one or someone special (examples are not meant to be specifically stereotypical)
- To honor of a mother, donate a special toy to a preschool serving low-income families, or an item to a home for single mothers
- To honor a father, donate to sports activity fees for lower income children, or buy passes to the swimming pool or golf course to treat others
- Donate to the person's favorite charity
- Donate a favorite food of the deceased to a food pantry
- Make a special dish using the above and share with family or friends while you discuss the importance of that person's life to you
The bottom line to honor someone is simply to remember how they impacted your life. So whether you do that with flowers at the gravesite, donating to a cause in which the departed one believed, or caring for others in the spirit to honor those who have passed, make it personal. Memories are often the most important and valuable things we possess, and this Memorial Day you can make it your opportunity to demonstrate that through action. Oh, and happy start of summer!

subset: commoncrawl


text:
When it comes to Lawns and Landscaping, Green is the goal. Integrity Lawn Care is the trusted partner
you want for the very best in maintenance of your Lawn and Landscaping.
Integrity Lawn Care is a professional, full service lawn care and snow removal company that specializes in the premier care of both Commercial and Residential properties. With varying degrees of heat, periods of drought, and insects, your grass and landscaping is always under attack. Proper and regular care is the primary factor in your Lawn and Landscaping looking its best. Integrity Lawn Care is committed to making your life easier and you're Lawn more beautiful.
The fact is, the appearance of your lawn is a direct reflection of our service and we take that seriously.
As our name suggests, Integrity is the core of our business. Integrity Lawn Care is established and
committed to quality. We pride ourselves on small town service with big city capabilities.
Integrity Lawn Care is conveniently located in Middletown, Ohio and in addition to our Lawn / Landscaping services we also offers professional Snow Removal services during our winter months.
© copyright 2012


text:
Steve Smith's crying fan – a youngster named Gavin – deeply affected the veteran NFL wide receiver. After seeing the YouTube video of Gavin losing it when he was informed that his favorite player was cut by his favorite team, Smith went Twitter tracking to chase down his young fan.
According to Fox Sports on March 17, "When word came down that the Carolina Panthers were going to release wide receiver Steve Smith… one young fan couldn't contain his emotions."
Smith has since signed a three-year deal with the Ravens, so Gavin can still see his beloved player, if he doesn't mind watching him on a different team. Still, it appears as if Gavin's dad in the video was having a little fun, at the expense of his kids.
Not sure why parents insist on filming these moments and loading them for Internet posterity, but at least this viral video comes with a happy conclusion.
The veteran wideout, who caught wind of the video, took to Twitter:
I want to contact this kidCheck out "This Kid Is NOT Happy With The Carolina Panthers!" at http://t.co/KjwV3XZwDa — Steve Smith (@89SteveSmith) March 16, 2014
I need that kids info. If anyone knw him or how to get in touch pls help me... I need help finding Gavin. The crying kid — Steve Smith (@89SteveSmith) March 16, 2014
All is well though, as Smith's last tweet indicated:
I found Gavin. His dad and I got in contact. Once I'm back in town will hook up the Lil guy...... everyone thank u for ur help — Steve Smith (@89SteveSmith) March 16, 2014
Kudos to Smith for taking the time to do this. It certainly is a pleasant surprise to see some trending news about an NFL star's off-field antics that do not involve the law.
Another feel good story that broke today:
Server's note to patron: Server's kind note to patron's generosity goes viral
Suggested Links
- Seattle helicopter: Helicopter crash near Seattle's Space Needle leaves 2 dead
- See it: Dramatic river rescue of Washington man stuck in frigid Yakima River
- Lego robot Rubik's Cube: Watch as robot solves Rubik's Cube in record 3 seconds
- New armored spiders: New species of armored spiders discovered in Chinese caves


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College Hockey:Late Thriller Ends In Tie For MSU, SCSU
MANKATO, Minn. — On a night when scoring was at a minimum, Minnesota State was able to answer a late St. Cloud State goal as the two teams battled to a 1-1 tie.
Husky forward Brian Schuster scored at 16:52 of the third to put SCSU (1-0-1 WCHA, 2-1-1 overall) up 1-0. But only 33 seconds later, defenseman Peter Runkel scored to tie the game for the Mavericks (0-1-1 WCHA, 0-3-1 overall), played in front of 4,215.
But besides the last 3:08 of regulation, the game was owned by the goaltenders. St. Cloud's Jason Montgomery and MSU's Jason Jensen each made 30 saves, most while standing on their heads.
"I thought there were some plays by both teams, some good goaltending by both teams, and all in all I thought it was a really good college hockey game," said MSU coach Troy Jutting.
SCSU head coach Craig Dahl agreed, saying, "I thought it was a pretty good game all the way around."
Schuster's goal finally put an end to Jensen's hot streak in the third. Schuster took the puck, stickhandled through the MSU defense, and beat Jensen for his first goal of the year.
But back came MSU. After being down 5-0 the night before and coming back to tie in regulation, everyone knew the Mavericks had the ability to bounce back.
Runkel, one of three seniors on the team, followed up the play and fired the puck from the top of the right faceoff circle. His shot bounced off several players and landed into the net. He was credited with his first goal of the season, which Dahl called a "pinball goal." His tally sent the two teams into their second overtime in as many nights.
"I have really no idea how it went in," Runkel said. "I kind of just shot it, and I don't think it was very hard. I think it was just bouncing around. A couple guys on our team claim it went off their sticks, but I don't really care as long as it goes in. But I couldn't tell you how it went in."
Asked if he was surprised, Dahl said, "I was more surprised last night."
Besides the final two goals, there was plenty of other excitement to keep fans on the edge of their seats at the end of the game.
After Runkel's score, Maverick sophomore Grant Stevenson fired a shot that hit the left post and bounced down in the crease. Teammate Jon Dubel rushed the net and was shoved down from behind. Dubel, Montgomery, and the puck all went into the net, but the referee ruled the net had moved before the puck went in.
In overtime, Mike Doyle, SCSU's overtime scorer the night before, had a chance to score early on but was unable to do so. Later on, MSU's Chad Clower was unable to put in Joe Bourne's blocked shot as the puck sat in front of the net.
The two goaltenders played strong for the rest of the extra period as the game ended in the 1-1 tie.
In the first, Jensen and Montgomery set the stage as each goalie frustrated the opposing offense.
MSU jumped out with a lot of pressure early on. The Mavericks came close on a two-on-one rush 2:47 into the game as sophomore Brad Thompson attempted to beat Montgomery five-hole. However, the freshman goalie was up to the task and allowed no rebound.
Jensen was equally strong on his end of the ice. After helping the Mavericks kill a SCSU power play, Jensen stoned two St. Cloud players. T.J. McElroy's shot from the point was stopped by Jensen, followed by a sprawling save by the sophomore to keep Jonathan Lehun's backhander from finding the goal.
The goalies carried their dominant play into second to keep the game goalless.
Freshman Brock Becker came up with a big play early in the period as he caught a clearing attempt in midair and found himself all alone against Montgomery. However, his shot was stopped with a quick pad save, and teammate B.J. Abel was unable to put the rebound in with a wraparound attempt.
Jensen matched the play as he made sensational stops on Matt Gens, Colin Peters and Matt Hendricks on the power play 7:00 minutes into the second.
The third period featured a flurry of chances by both teams. Doyle hit the right post halfway through the period, while MSU's Dana Sorenson nearly tipped a shot past Montgomery 14:53 into the third. But it was ultimately Schuster and Runkel who would add the only offense of the game in the tie.
Jutting said he thought his team had the capability to come back in the game, so he wasn't all that surprised by Runkel's goal.
"The only thing I said was, 'Hey, we came back last night. It's not time to panic right now, it's time to keep playing and we'll get it.' Fortunately, it came right away."
"The biggest thing with this team right now that I've seen so far is our character," Jutting continued. "They don't give up. They work hard, and they come every day to do their job."
Both coaches had praise for their goaltenders after the game as well.
"I thought he played really good," Dahl said of Montgomery. "He's played two games now in his college career, and both have been on the road. I thought he made some really nice saves today, and he likes those kinds of games where he can see some shots in tight. He did a really good job."
"I was seeing the puck really well tonight and moving around good," Montgomery said. "I thought it was exciting and was just a great a great hockey game. It was fun to be a part of it."
On the other end, Jutting also had praise for his goaltender, who stopped 48 of the 50 shots he faced this weekend.
"I think Jensen had an unbelievable weekend. You get that type of goaltending and you have a chance to win all the time."
Up next for the Mavericks is a home series against Bemidji State. The Huskies travel home for a nonconference series of their own against Rensselaer.
The following is a self-policing forum for discussing views on this story. Comments that are derogatory, make personal attacks, are abusive, or contain profanity or racism will be removed at our discretion. USCHO.com is not responsible for comments posted by users. Please report any inappropriate or offensive comments by clicking the "Flag" link next to that comment in order to alert the moderator.
Please also keep "woofing," taunting, and otherwise unsportsmanlike behavior to a minimum. Your posts will more than likely be deleted, and worse yet, you reflect badly on yourself, your favorite team and your conference.


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The New Orleans Saints aren't expected back in their Metairie headquarters until Tuesday morning, and Coach Sean Payton figured he knew how some might spend the time off.
"Guys aren't going to be leaving the country, but if a guy wants to go see Miami play Ohio State..." he said.
About an hour after Payton's press conference, Saints safety Malcolm Jenkins was spotted in the locker room, wearing an embroidered Ohio State warmup jacket. He was on his way to Columbus, he confirmed.
As it so often does, the college game intruded this weekend into an NFL locker room. There are some big games around the country Saturday - it's quite possible, for example, that safety Roman Harper may be spotted in Tuscaloosa, clad in Crimson on the eve of Alabama's showdown with Penn State. Meanwhile, some less enticing matchups made trips to Los Angeles or Lincoln unattractive to one time Trojan defensive lineman Sedrick Ellis and former Cornhusker linebacker Scott Shanle.
"We're playing Idaho," Shanle snorted, when asked about Nebraska's opponent.
But, as Payton was no doubt aware, the Miami/Ohio State game had already sparked some discussion in the Saints locker room.
Jenkins and fellow Buckeye Will Smith said their teammates who once were Hurricanes have been oddly quiet about the game, a silence they attributed to some alleged universal understanding Miami has "no chance" against Ohio State. An exception, they said, was linebacker Jonathan Vilma, who Smith and Jenkins said had the temerity to voice the opinion Miami would emerge victorious.
That was hardly surprising - Vilma will tell anyone who cares to hear it that he and Miami were "cheated" out of a national championship when the 2002 season ended in a double-overtime thriller in the BCS Championship game won by Ohio State 31-24. In an ESPN article on line this week, Vilma was identified as one former Miami Hurricane who spent time around the program this past off-season preaching revenge to current players.
And in any event the notion they weren't taking a vocal stance was nonsense, other Hurricanes claimed.
"Yeah, right," tight end Jeremy Shockey said with a grimace. "That's just Will trying to play, 'Mr. Nice Guy.'"
So he thinks Miami will win?
"C'mon, please," Shockey said. "You know Miami's going to take it."
In the locker next to Shockey, tight end Jimmy Graham said he refused to be muzzled by his rookie status. The fact he played for Miami last year meant he possessed the most accurate inside dope and it all pointed to a convincing Miami win in The Horseshoe, Graham said - and he would alert Jenkins and Smith to their alma mater's upcoming demise.
Told that word the Buckeye would win had reached neither Shockey or Graham, Jenkins and Smith affected an air of breezy confidence.
"Oh, yeah, Ohio State," Jenkins laughed, when asked for a prediction as he left Friday. "I mean, who else would I predict? "


text:
Research and Instruction
Research and Instruction Request Form
Welcome to the Research and Instruction page where you will find information about our program. The Research and Instruction Team looks forward to working with you!
- Assessment of Student Learning Outcomes
- Research and Instruction Offerings
- Research and Instruction Program Mission and Goals
Research and Instruction Unit
Christina Chester-Fangman
Coordinator of Research & Instruction and Associate Professor
Phone: 931-221-1267, Office: 221
Email: chester-fangmanc
Ross Bowron
Emerging Technologies Librarian
Phone: 931-221-7381, Office: 220
Email: bowronc
Nancy Gibson
Distance Education Librarian and Associate Professor
Phone: 931-221-6166, Office: 217
FCC Phone: 931-221-1490, Office 215
Email: gibsonn
Philenese Slaughter
Instruction Librarian and Assistant Professor
Phone: 931-221-7741, Office: 319
Email: slaughterp
For more information about the Research Instruction Program, please contact Christina Chester-Fangman at 931-221-1267 or email chester-fangmanc.


text:
Public Safety Announcement
October 1, 2015 Special PVCC Public Safety Active Shooter Meetings In light of the shootings at Oregon's Umpqua Community College today, PVCC Public Safety is convening the campus community employees to have a dialogue and update on what to do in an active shooter situation on campus and emergency management. Conducted by PVCC Public Safety Officers? and members of the College Incident Management Team. Date: Friday, October 2, 2015 Time: 11 a.m.-1 p.m. Location: KSC1000A Date: Monday, October 5, 2015 Times: 11 a.m.-1 p.m. and 1-3 p.m. Location: KSC 1000A Department of Public Safety Paradise Valley Community College PVCC's Public Safety Department is committed to enhancing the safety of our students, faculty, staff, and campus visitors. PVCC Public Safety police officers will, upon request, provide classroom training and awareness focused on mitigating violence on college campuses. This will include a review of scenarios and responses to potential on-campus incidents. WHO DO I CALL | WHEN? Emergencies – Call District Response Center 480-784-0911 [Ex: crime in progress, medical emergency, weapons, threats, traffic accidents] Dialing 911 directly will delay response! Non-Emergencies – Call PVCC Public Safety 602-787-7900 [Ex: lost/found property, key requests, door lock/unlock, parking] Now is also a good opportunity to draw your attention to the safety, security, and emergency measures currently in place: MEMS RAVE Alerts – PVCC participates in the Maricopa Emergency Management System (MEMS). All employees are automatically enrolled in the email alert notification system (RAVE). You are also encouraged to sign up to receive cell phone text alerts and to keep your contact information updated in HCM (formerly HRMS). You MUST enter your cell phone to receive emergency text messages. Check your HCM self-serve website to assure the correct cell/mobile number is listed. Here's how to check and/or add your mobile phone number as the primary contact number: Log onto your self-serve web site Click on Personal Information Click on Phone Numbers If your mobile phone number is not listed: Click on Add Phone Number Click on the down arrow From the drop down box, click on Mobile In the column marked * telephone, add your mobile telephone number in the box. In the column marked Preferred, check the box to indicate your mobile telephone number is your preferred contact Click on Save to save the information. Planning –The College Incident Management Team (CIMT) has put a comprehensive set of emergency response procedures in place to deal with crisis situations. The plan is reevaluated on an annual basis with the goal of keeping PVCC as prepared and responsive as possible. The campus team and the District-wide emergency preparedness team meet on a regular basis to review best practices and implement new processes and procedures. Website – You will find pertinent and useful information on the college Public Safety website including daily crime log, emergency procedures, location of emergency phones, and the campus emergency operations plan. Threat Assessment – Early reporting and intervention is vital. Visit the campus Threat Assessment website to learn about threatening behavior, and to access the threat assessment reporting form. Union Hills Campus: Access Control – Public Safety has the ability to lock down our buildings from the Public Safety office control center. In addition, all classrooms are equipped with thumb turn latches on the inside of the door so they can be easily locked from inside the classroom. Cameras –There are 112 CCTV cameras installed throughout campus. Direct line phones – There are 20 blue light Emergency Phone boxes on the campus that connect directly to Public Safety at the push of a button. A blue light will flash and a dispatcher will answer, ask your location and respond to your call – 24/7. Classroom intercoms – Public Safety has the capability of voice notifications throughout the entire campus including classrooms. Safe Zone –Public Safety and the Library are considered Safe Zone areas for teenagers in need (for example homeless, in crisis, feeling unsafe, runaway). Escort – On campus late? A Public Safety officer will accompany you to your car; just call 7-7900 from a campus phone or 602-787-7900. Campus Public Safety office hours: 7:30 am – 10 pm, Monday-Friday |Fall & Spring semesters Monday – Thursday | Summer semester Public Safety staff will still patrol the campus during closed hours. At times outside of these office hours, calls to our office phones are forwarded to the Central Communications Center for response as follows: o If your request is an emergency or an incident that needs a police or fire department response, the dispatcher will immediately respond by sending the required assistance to your location. o If the request is an operational need to assist with the mission of the college, such as facility access, a Public Safety aide or police officer will be dispatched when available. o Callers with non-urgent issues may be directed by the Central Communications Center to visit the PVCC Public Safety webpage for information, or will be directed to contact our office during normal business hours. Calls for service will be prioritized and responded to as soon as possible, based upon the urgency of the call and our personnel/staffing on duty Black Mountain: Access Control – Public Safety has the ability to lock down buildings from the Public Safety office control center and from Black Mountain directly. In addition, all classrooms are equipped with thumb turn latches on the inside of the door so they can be easily locked from inside the classroom. Cameras –There are nine CCTV cameras installed throughout the site. Classroom intercoms –Black Mountain has the capability of voice notifications throughout the entire campus including classrooms. Escort – On campus late? A Public Safety officer will accompany you to your car; just call 3-2911 from a campus phone or 602-493-2911. Watch for more upcoming tips and information from Public Safety.
Emergency PreparednessMaricopa Emergency Management System (MEMS)
Public Safety Announcement
MEMS Alert
Keep your contact information updated in my.maricopa.edu – especially mobile devices and e-mail addresses.


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Physiological, biochemical, and histological ...
|Section title
|Physiological, biochemical, and histological approaches to examining sea lice-salmon interactions
|Section author(s)
|John F. Burka, Gary A. Conboy, David E. Sims, David J. Speare, A. Mustafa, N. W. Ross
|Book title
|Disease resistance and immune response: Symposium proceedings
|Book editor(s)
|Chris Secombes, Anthony E. Ellis, Don MacKinlay, American Fisheries Society, Physiology Section
|Start page
|End page
|Cytokine genes in fish -- Environmental effects on the ontogeny of non-specific and specific defenses in turbot larvae -- Antibacterial proteins in skin mucus from rainbow trout -- Interferon-induced genes in the rainbow trout -- IPN recombinant vaccines -- DNA vaccination during low temperature and partial starvation -- Protective efficacy of VHSV DNA vaccination in rainbow trout -- Use of poly(DL-Lactide-CO-Glycolide) microparticles as adjuvants in Atlantic salmon -- The effect of environmental salinity and host species on the pathogenesis of Loma salmonae -- Effect of food deprivation on BKD and furunculosis -- Comparison of physiological and biochemical parameters in rainbow trout, coho, and Atlantic salmon following infestation with sea lice -- Physiological, biochemical and histological approaches to examining sea lice-salmon interactions.
Using APA 6th Edition citation style.
Times viewed: 561


text:
5 Jan 01:14 2011
Left Outer Joins without expressions
Bruno René Santos <brunorene <at> holos.pt>
Hello all, Is there any way to create a left outer join without using an actual path on the query expressions? I tried something like this: query.addPrefetch(HoTiposFechoContas.TO_HO_TABLE_PROPERTY + "+").setSemantics(PrefetchTreeNode.JOINT_PREFETCH_SEMANTICS); but cayenne raises an exception because of the concatenated '+' sign. Regards Bruno -- -- Bruno René Santos | brunorene <at> holos.pt <mailto:brunorene <at> holos.pt> | Gestor de Projectos | Analista | Programador | Tech Hunter Holos - Soluções Avançadas em Tecnologias de Informação S.A. Parque de Ciência e Tecnologia de Almada/Setúbal . Edifício Madan Parque Rua dos Inventores . Quinta da Torre . 2825 - 182 Caparica . Portugal Phone: +351 210 438 686 . Fax: +351 210 438 687 . Web: www.holos.pt This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient or the person responsible for delivering the email to the intended recipient, be advised that you have received this email in error and that any use, dissemination, forwarding, printing, or copying of this email is strictly prohibited. If you have received this email in error please notify Carlos Fazenda by telephone on +351 210 438 686(Continue reading)


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|Home > RNJ > 2006 > May/June > CPAP Devices: Encouraging Patients with Sleep Apnea
CPAP Devices: Encouraging Patients with Sleep Apnea
Continuous positive airway pressure devices (CPAP) used at night prevent apnea, hypoxia, and sleep disturbance. Although CPAP is more effective than placebo in improving sleepiness and quality of life measures in people with obstructive sleep apnea, patients often prefer a less-effective oral appliance. This article examines help-seeking experiences in support groups of individuals with sleep apnea who use CPAP devices. To understand patients' experiences and difficulties using CPAP, an urban medical center and a rural hospital shared data collected from 17 individuals with sleep apnea who use CPAP for treatment and attend a support group. Four related themes emerged including (a) becoming motivated to persist with help from the group, (b) accommodating to the device, (c) listening and telling stories to gain practical knowledge, and (d) implementing a support group as a caring community. Healthcare providers could recommend support groups on CPAP use while nurses guide discussion, provide technical information, and promote empowerment.
Obstructive sleep apnea (OSA) with daytime impairment occurs in 1 in 20 adults and asymptomatic OSA occurs in 1 in 5 adults (Young, Peppard, & Gottlieb, 2002). Inadequate sleep has implications for safety, job productivity, and quality of life (QOL), as well as development of hypertension and cardiovascular morbidity. Individuals diagnosed with sleep apnea are often treated with continuous positive airway pressure (CPAP) devices that are used at night to prevent apnea, hypoxia, and sleep disturbance (Likar, Panciera, Erickson, & Rounds, 1997; White, Cates, & Wright, 2004). Although CPAP is more effective than placebo in improving sleepiness and QOL measures in people with OSA, patients prefer a less-effective oral appliance to CPAP, which suggests that CPAP is not the ideal treatment for patients (Young et al., 2002).
Self-reported compliance to CPAP has been reported to be 50%–85% (Likar et al., 1997) and measured compliance rates have been reported to be 60%–70% (Verse, Pirsig, Stuck, Hormann, & Maurer, 2003). Therefore, supporting individuals with sleep apnea who use CPAP devices is an ongoing concern for healthcare providers. Support groups have been initiated to assist coping but have not been studied from the participant's perspective. This study examines the shared support-group experiences of individuals with sleep apnea who use CPAP devices.
Review of the Literature
More than 40 million Americans suffer from inadequate sleep or lack of nonrestorative sleep that can interfere with daily activities (Flemons & Tsai, 1997). Men have a 2–3-fold greater risk than women, and prevalence appears to increase steadily with age in midlife, leveling off at age 65 (Young et al., 2002). The adult population (i.e., 2%–4%) that is affected by sleep-related breathing disorders experience snoring, mild obstructive sleep hypopnea, and severe obstructive sleep apnea that lead to cessation of respiration and SaO(2) desaturation (Ferguson & Fleetham, 1995).
Mechanisms and Management of Obstructive Sleep Apnea
OSA is defined as periodic decrease or cessation of breathing due to occlusion or narrowing of the upper airway during sleep (White et al., 2004). Clinicians rate OSA severity by the number of obstructive apnea/hypopnic episodes per hour of sleep or the Apnea-Hypopnea Index (AHI), 5/hr = mild, 15/hr = moderate, and 30/hr = severe (Young et al., 2002). OSA interrupts deep restorative sleep that leads to morning headaches and daytime sleepiness (National Institutes of Health, 1995). Daytime sleepiness and impaired cognitive function may contribute to motor-vehicle and job-related accidents (Young et al.).
The goal standard for treatment of OSA involves using CPAP devices that act as a pneumatic splint to keep the airway open (Verse et al., 2003; White et al., 2004). CPAP consists of a flow generator that is attached to tubing and a tight-fitting mask held in place by elastic headgear. By maintaining the airway, hypoxia and apnea are relieved and the patient has more restorative sleep and less sleep fragmentation. This is viewed as a life-long treatment that emphasizes the importance of patient compliance.
In a systematic review of CPAP effectiveness compared with placebo, CPAP had significant improvements in subjective and objective measures of sleepiness, oxygenation, and positive effects on QOL, health status, and mental health (White et al., 2004). Research indicates that CPAP use is effective in improving daytime function, perceived health status, and QOL in patients with moderate to severe OSA (Ballester et al., 1999; Engleman, Sascha, Deary, & Douglas, 1997; White, et al., 2004). Use of CPAP correlated with better resolution of sleepiness and greater improvement in daytime function, nocturnal symptoms, and decreased incidence of traffic accidents (Engleman et al., 1996).
OSA treatment includes behavioral approaches (weight loss, smoking cessation, and alcohol reduction), as well as surgical removal of anatomical abnormalities and oral appliances. Surgical modifications have been shown to be effective in less than 50% of patients, mostly those with less-severe sleep apnea (Sher, Schectman, & Piccirillo, 1996) and are still considered experimental (White et. al., 2004). Oral appliances or mandibular- advancement devices are used to bring forward the jaw to advance the base of the tongue, thereby increasing the diameter of the upper airway—a common site of occlusion (Lim, Lasserson, Fleetham, & Wright, 2005). Oral devices are effective in 50%–70% of patients with a 50% compliance rate yet how to predict success of the devices in particular patients is not known (Verse et al., 2003). In evidence-based reviews CPAP is still more effective than oral appliances (Lim et al., 2005; White et al., 2004). These newer management approaches are being studied with varying results indicating the need for careful evaluation and long-term follow-up of each individual's situation (Sonnad, Moyer, Patel, Helman, Garetz, & Chervin, 2003).
Health Effects of OSA
Long-term effects of OSA have been documented. Nieto et al. (2000) reported hypertension rates between 43% to 67% in individuals with high AHI scores. There is also some evidence of a hypercoaguability state in OSA increasing the prevalence of vascular disease (von Kanel & Dimsdale, 2003). Ferguson and Fleetham (1995) identified multiple clinical consequences of OSA including systemic hypertension, pulmonary hypertension, and right-heart failure. In addition, OSA can contribute to decreased cardiac function, ischemic disease, cardiac arrhythmias, secondary polycythemia, and neurological effects (e.g. as excessive daytime sleepiness). Psychological effects include decrease in cognitive functioning, irritability, depression, sexual dysfunction and learning and memory problems that affect interpersonal relationships at work and home. Snoring and sleep apnea were highly associated with excessive daytime sleepiness and subjective work performance problems such as absenteeism, difficulties concentrating, potential for nonintentional injuries, and increased risk of traffic accidents (Ulfberg, Carter, Talback, & Edling, 1996; Wright, Johns, Watt, Melville, & Sheldon, 1997).
Compliance Interventions
In spite of the effectiveness of CPAP in reducing symptoms, studies of patients' self- reported compliance rates were 50%–85%, especially in the initial 1–3 month period. However, objective studies of compliance by actual registration of time on machines demonstrated an overestimation of self-reported use (Likar et al., 1997). Efforts to improve compliance included group-education sessions and intensive support (Hoy, Mennelle, Kingshott, Engleman, & Douglas, 1999; Hui et al., 2000; Likar et al.).
Likar et. al. (1997) studied attendance at a group clinic designed to encourage patient compliance that led to increased measurable compliance (measured by use/5 hrs per night). The pulmonary nurse instructed patients regarding diagnosis, machine use, and cleaning. Then the nurse adjusted the CPAP units and masks before the patients went home. Patients were also encouraged to contact the nurse or home-care vendors with questions. Subsequently, the 2-hr clinics were held every 6 months and included nurse assessment of symptoms, initiation of treatment plan, and resolution of equipment problems. The patients were encouraged to ask questions and compare experiences, which led to an atmosphere of encouragement and support. All participants increased the amount of CPAP usage hours per night.
Hoy and colleagues (1999) compared an intensive support group with a standard support group. The standard support included teaching about needs and benefits of CPAP, acclimation to the device, and set-up with telephone support to identify and resolve problems. The intensive support included additional home visits to encourage partner involvement. This study showed that patients in the intensive group were empowered and were more apt to comply. Self-motivated patients who had partner involvement and were proactive in seeking solutions to problems showed better compliance.
The Hui et al. (2000) study compared a basic care group with an augmented care group and found no differences in compliance between groups except the augmented group had a greater improvement in QOL during the study. In this study, the participants had an initial teaching program by the nurses and a trial CPAP of 30 min to acclimatize the patients to their unit. This was followed by frequent follow-ups. The augmented group received additional education and more frequent follow-ups to sort out technological problems and encourage use. Both groups had a high level of compliance (70%) and both programs had greater support than most typical sleep centers' support.
In another study of CPAP compliance in older male patients, of the 64% who were compliant, 95% attended the CPAP patient education and support group (Russo-Magno, O'Brien, Panciera, & Rounds, 2001). In this study, the patients were encouraged to attend a support group similar to the group studied in the Likar et al. study. It was noted that patients who had resolution of initial symptoms were more compliant.
QOL, including physical, emotional, and social health, is impaired by OSA; however, it is improved with CPAP treatment (D'Ambrosio, Bowman, & Mohsenin, 1999). Therefore, there is a need to encourage individuals with OSA to use CPAP devices. Expert nurses may facilitate the learning needs of CPAP patients and family members by teaching machine management and by practicing illness severity monitoring and by recognizing problems, such as depressive symptoms, oxygen deficits, and cardiovascular symptoms (Smith et al., 1998). Support-group settings offer the opportunity for nurses to provide for the educational needs of patients as well as facilitate sharing patients' experiences. There are no studies that examine support-group experiences from a phenomenological interpretive perspective of CPAP users. This current study proposed to examine support-group experiences of individuals with sleep apnea who use CPAP devices. The goal was to determine the shared meanings of seeking help by attending a CPAP support group and to describe difficulties the group members encounter while accommodating CPAP treatment.
The support groups were held at two institutions, a general hospital in an urban area and a rural hospital. The general hospital had a sleep center where sleep studies were conducted and sleep apnea was diagnosed. The urban support group was started by a clinical nurse specialist (CNS) in May 2001 to offer education and guidance to meet the needs of individuals with sleep apnea who use CPAP. The group was marketed by ads in local newspapers and television, community billboards, personal invitations, brochures and word of mouth. The group was held monthly at the hospital, and met for 2 hours. The CNS facilitator began the meeting with an educational lecture provided by specialists in sleep apnea, physical therapy, pharmacology, respiratory therapy, and representatives of the sleep center who brought new products for evaluation. The second hour included patient sharing where the facilitator encouraged introductions of attendees, when they had been diagnosed, and how long they had been using CPAP. Open discussion and sharing followed questions and answers to facilitate problem solving. On average, 6 to 12 individuals and supporters attended the meetings.
At the rural site, the group was newly formed by two patients, one of whom was an RN. The nurse leader (also a CPAP user) recognized the need for information and support and approached a rural hospital administrator for sponsorship and access to a meeting room. This group met monthly to discuss issues regarding using the CPAP device. Invited speakers gave up-to-date information on OSA and CPAP topics. This open group was not associated with a particular sleep center.
Both support groups promoted educational exchange to support adherence (compliance) and helped with lifestyle changes (Zrebiec 2003). Support-group elements included a common bond of shared problems and needs, sharing with others' experiences to provide models for others to consider, learning from others' experiences, and expressing emotion (Zrebiec). The leader initiated the group process, clarifying, elaborating, and summarizing information (Napier & Gershenfeld, 1985). In addition, nurse leaders provided emotional support to assist patients in crisis and helped them develop new ways to cope (Napier & Gershenfeld). The urban support group had the advantage of a CNS leader to encourage patient sharing to make patients feel accepted while empowering patients to self-advocate. The CNS also provided technical information, corrected misconceptions after group members discussions, encouraged group cohesion, and facilitated referrals for patient problems. The rural group was a self-help format (Napier & Gershenfeld), yet the nurse leader served as a resource person.
Membership in the support groups was voluntary. The functions of the groups were to provide support, informational teaching, and empowerment (Townsend, 2000).
Research Design and Methodology
The methodology for this study was Heideggerian hermeneutics (Hiedegger, 1927/1962), a phenomenological approach whereby researchers uncover the common meanings of individuals' experiences through analysis of semi-structured interviews. Data were collected during a 12-month period. The researchers described the study to the participants after support-group meetings and invited them to sign up for an interview. They obtained institutional review board approval and individual consent prior to the interview. A semi-structured interview was used in which open-ended questions allowed participants to describe what was most important to them. They were invited to tell a story of when the support group helped. Then they were prompted to expand on elements of their stories. Each interview lasted approximately 45 minutes to 1 hr and was audiotaped and transcribed. The research team analyzed the final edited transcripts.
Data were analyzed according to the 7-stage hermeneutical process described below (Diekelmann, Allen, & Tanner, 1989; Diekelmann & Ironsides, 1998). The research team consisted of the principal investigator and three researchers with masters level preparation in qualitative research procedures. Stage one: Each interview transcript was read as a whole and each researcher wrote an interpretive summary. Stage two: Themes were identified with excerpts from the text. Stage three: Themes were discussed for similarities and differences at weekly meetings. Further clarification of interpretations were reached by returning to the original text of the interview. Stage four: The researchers reread all text to link themes across texts. Group consensus on themes common to all interviews was reached during further meetings. These common themes were called relational themes. Stage five: The researchers then identified and described a constitutive pattern that showed the relationship between relational themes across all texts. Stage six: Results were presented to a participant support group for discussion and validation. Stage seven: The principal investigator produced a final summary report that was supported by verbatim quotes.
Of the 17 informants, 12 were male and 5 were female. The average age was 58.4 (SD = 11.13) with a range from 40–73 years. The average years of education was 15.32 (SD = 2.5). The informants had used CPAP an average of 2.5 years (SD = 2.3) with a range from 1 month to 7 years with the average usage of 7.2 hours per night (SD = 1.6) range of 3–11 hrs. Twelve informants attended the urban group and five attended the rural. Time attending the support group was from 1 month to 2.5 years (average 1 year). Urban and rural support group demographic comparisons are shown in Table 1. The rural group was newly established and had less veteran CPAP users, yet the stories about sharing experiences (self-help) were similar. The following four relational themes and one constitutive pattern have been identified and are summarized in Figure 1. Although the individual themes help in understanding the experience of a CPAP support group, in actuality the themes are interwoven in the actual encounter.
Theme One
Motivation to persist through initial and recurring frustration with help from the support group was the first theme. Informants told stories of dealing with disruptive symptoms of sleep apnea including frightening experiences such as falling asleep while driving. They also told of the "constant fatigue," "feeling the need to sleep," and "awakening exhausted in the morning." These symptoms triggered the need for seeking a diagnosis by polysomnography. With the hope for a "cure" by using the CPAP, these informants told of the difficulty of adapting to the CPAP device. These difficulties drove informants to seek help from the support group. This theme includes stories of the frustration and imposition of the device as well as the difficulty in becoming motivated to persist with using the CPAP device.
Many of the frustrations voiced during the interviews included discomfort with wearing the device. It was "really uncomfortable" and "constrictive." The mask and machine gave them feelings of "suffocating or drowning." One person summarized:
This is absurd, sleeping with this gear on my head, it is so unnatural.…You have all this equipment, you have to take care of it, clean it, wear it.…It's a nuisance. I have to plug it in, fill it, and make sure it is clean. Sometimes you just want to go and jump into bed…you just can't do it. You'll be up in 15 minutes because you can't breathe.
Other frustrations included minimal initial education and training, ill-fitting masks, and the struggle to stay motivated and persist in wearing the mask.
Yet some informants felt a profound change. One said, "I felt immediately better; I haven't felt this good in years. It was like night and day; it saved my life." Another related, "It felt like I had slept for a week, my energy improved, and each day got better."
Others informants' changes were subtler. "My sleep is more restful" and "I have more spurts of energy, and I am not nodding off during the day." Most informants agreed that they felt somewhat better after beginning to use the CPAP device. One man related that he had a decrease in blood glucose readings and an increase in energy. He also hoped to decrease his stroke risk and increase his sexual function. In spite of these improvements, the informants related the struggle with using the CPAP device.
The informants' stories often depicted this struggle to persist despite lifestyle changes, such as "not being able to sleep without it" or "not able to just go to sleep" and "not hearing the rustling of the trees on a nice summer night because the pumping cuts that out." Another related that, "I was tired of being tired.… Just to keep your life in some kind of order because without it there is no order, no rhythm. I can't do it. I am exhausted today. CPAP is a great thing, however not real comfortable. It is a trade off."
The support group helped CPAP users problem solve and gain hope and perspective. They also gained knowledge of the physical effects of sleep apnea. They wanted to avoid strokes and other bodily harm. As one related, "To keep myself healthy I need to follow the rules." It was a personal decision to persist. As another individual said, "Some say they can't stand this. I hate this, and some say, well this is what I gotta do and do it.… Once again you choose your attitude." Another said, "The biggest thing is to stay with it. The benefits outweigh [the negatives]."
Theme Two
Experts relate accommodating to the device. Informants that had been using CPAP for a longer time learned how to accommodate the device into their lifestyle. The word accommodation was used instead of compliance or adherence because it implied the give and take required to integrate CPAP use into their lives and to become motivated to persist throughout the adjustment period. They became motivated to give up being able to just go to sleep, hearing the night sounds, and for some, sleeping with their partners. The expert CPAP user had experience with ongoing problem solving. For example, they persisted through problems with the mask fitting and machine maintenance. Users learned to accommodate using CPAP. Their motivations for attending the group differed from the newer users as they wanted to help others and gain information about new products. They also used techniques such as changing sleeping position to accommodate the tubing, as one person related:
I have a peculiar nasal structure that if I turn my head slightly I get this swishing sound of the air escaping, so I trained myself to sleep on my back and hold the hose with my left hand so it doesn't move.
Informants described problem solving and modifications needed to make it work, e.g., obtaining chin guards to keep the mouth from opening and providing escape of air, or emitting loud air noises. One individual summarized, "You learn to get used to the masks, the straps, the whistles, and the air blowing in your eyes."
The experts also knew what do with machine maintenance, "You have this hardware and you have to go through this ritual: getting hooked up, getting your nose cleared out, filling the machine, and remembering to clean it." Experts also relayed their experience and advice regarding traveling with the CPAP device e.g., concern about differing electrical voltages in other countries, boarding an airplane, and sleeping while traveling.
One expert related his concern for lack of follow-up by the home healthcare companies. "I really wish the reimbursement system was set up so that it pays for follow-up." The experts learned to judge when they needed a new evaluation for CPAP changes. For example, one informant described how his symptoms recurred. "My memory was starting to slide back, so I called the office to see the doctor." Another person suggested to others, "Persevere, you've got to stay with it, if the mask isn't right, change it." This means taking ownership of the problem and realizing the need to try different masks to see what will work best. Some told how insurance companies had refused to pay for heated humidifiers and other equipment. One informant argued with his insurance company, "You could be spending $50 a month on my blood pressure medicine or $150 a year on my CPAP machine."
Experts also learned that proper sleep hygiene promotes better sleep. They suggested bedtime rituals, avoiding watching television, and learning that "monotonous tasks help put you to sleep." They also discussed knowledge of their own circadian rhythms when they experienced time changes or traveled in different time zones. One individual suggested using over-the-counter Melatonin supplements to help readjust body rhythm.
These experts learned to become their own healthcare advocates. They encouraged others, "Don't be afraid to call and make complaints." Another said, "For a long time doctors wanted to keep control over the care…that has changed, technology is different, self-monitoring is easier to do." Support group users related, "You can't give up… too many give up real quick. If you've got a problem [OSA], I've seen the results of tackling my problem and how it has helped me, and they can do it, too."
Theme Three
Listening and telling stories to gain practical knowledge was the focus of theme three. The informants said that listening to others' stories helped with continuing difficulties by providing ideas and practical advice. Many had little instruction from the homecare companies on machine maintenance. One admitted he felt like he "fell through the cracks" of the healthcare providers and had many unmet needs.
Others told stories of initial OSA symptoms to encourage others to keep trying and to realize that the CPAP device was something they needed to wear. One informant related this story. "One woman hit 3 cars, she fell asleep [while driving]. It was a real wake-up call because everyone is in denial; no one has anything wrong with them." Others told of "blacking out during the day in the middle of a conversation" or "feeling like losing my memory" or "losing a job because of it."
They shared experiences so as not to feel like they were the only one with problems, as one woman humorously told of her difficulties:
It [CPAP device] is not attractive, it is not natural, and you have all these straps on your head.… Now picture me. I've never worn a hat in my life, now I have this hat on my head. I am sweating. I have a strap that has to be on your face pretty tight and you wake up with marks on your face, or if it's too loose it slips off your nose and air is blowing everywhere else and you wake up from the noise. It's very uncomfortable.…When I first started, automatically your mouth would drop open and you have air going through your mouth—up your nose and out your mouth. They give you a chinstrap, so now you have another strap. It's hysterical.
By sharing stories, group members gained practical knowledge for understanding how to maintain a healthy life with CPAP. This information facilitated accommodation to the device and necessary lifestyle changes. One man liked to tell this story to encourage others to continue machine maintenance, especially to keep the filter clean.
We were out of town; the only motel that we could get was a smoking room. I had just cleaned my machine. The next day I checked my filter that is usually pure white. This thing was black, just from one night. That is how much it filters, how much it takes out of the air. You relate a story like that and people realize that this [machine maintenance] is important.
Theme Four
Support groups are communities that provide information and encouragement to persevere. One man said, "It's a pep talk. After the first meeting I went right home, put the machine on, and had a good night's sleep." Another described the group as a "gathering of common folks with common experiences and a very uncommon resolve."
You know other people are experiencing this and it's not just you. You get questions answered that you don't want to ask. What's going to happen if I'm in a relationship, all hooked up to these wires and tubes.…What is it like to be in bed with someone with this on?
In the group, members realized the importance of the equipment. They talked about new developments and products that might solve their everyday problems with poor-fitting masks. As one said, "You've got to be able to change equipment." Another said, "Try different things, keep asking, there are other options. That's why the support group [is valuable] because everyone has tried something different, and they can talk about it." The members also gain an awareness that some things do go wrong. One related, "You realize that there are some things that go wrong and people get through them and manage to work through it."
The members gained hope by seeing people who had survived for years. As one informant said, "You work through it. It's not the end of the world, so it helped a lot being with people who've been on it a long time." Veteran members gained by caring for others through sharing their experiences.
The informants were from two different groups—urban and rural. Their shared experiences were similar except there were fewer experts in the rural group and they had less input on newer products. They both valued the community atmosphere to share stories and learn from each other.
A few of the informants had access to the Internet community to gather information that was similar to support-group discussions. One explained, "I had gone on the Internet, seen pictures of a CPAP machine, went to the message boards and learned an awful lot from just reading the message boards." This informant also related that the Internet was more available and had similar information to the support group. The availability of the Internet would have helped another who did not "like to venture downtown" for the support group.
Others voiced that the support group helped them realize there were others with the same illness, difficulties, and questions. "It makes you realize that you're not the only one. Other people's problems are the same as mine." Expert device users told them, "Don't feel that it's your fault. Get it straightened out."
Only a few negatives were noted. One person had a negative attitude and was in denial. In another instance, the discussion was not properly moderated. As one informant said, "This one guy seemed like he had all the answers to everything. It would be nice to hear other people talk; he monopolized the discussion."
Constitutive Pattern: Empowering Experts with Information and Support
The themes of each interview revealed a constitutive pattern regarding the need of CPAP users to have adequate information and support. This was important with regard to their diagnosis, their relationships with those involved in their care, their usage of CPAP equipment, and ongoing advances in OSA treatment. Having access to information assisted the support group members to make decisions, overcome barriers to accommodating the device into their lives, and avail themselves of all means to utilize CPAP to maintain a stable, healthful state. The information and support allowed informants to become self-advocates and learn to persevere, which assisted in their problem solving with the devices and insurance companies. They obtained information about everyday problems by hearing others' stories. This communication between members armed them with knowledge to make informed choices and the practical means to face the barriers they encounter as OSA patients and CPAP users.
Discussion and Implications
Through hermeneutic interpretation of patients' narratives about seeking help through CPAP support groups, new understanding of the frustrations and need for empowerment to accommodate to the CPAP device emerged. The support group assisted the informants in learning from each other, facilitating the empowerment that assisted them in problem solving, and learning to cope with the cumbersome device. Discussion is organized by themes.
Theme One: Becoming Motivated
Although the literature confirms that compliance is a problem with CPAP use, it does not relate the difficulties and the need to persevere. Focusing on patient motivation may be useful information for nurses working with CPAP patients. Research studies of CPAP influence on bed partners' QoL indicate that CPAP use also improves the bed partners' and patients' QoL (Doherty, Keily, Lawless, & NcNicholas, 2003; Parish & Lyng, 2003). Unlike the results of the earlier research, this current study brings to light some of the problems that introducing the CPAP machine into the bedroom may entail (e.g., body image, machine and air noises), as well as some creative solutions.
Theme Two: Experts Accommodating to the Device
Expert users have a wealth of common-sense approaches to accommodating to the device. Nurses can encourage new users to access this information in support groups and online message boards. The patient experts also have knowledge of how to monitor their symptoms and can provide for that learning need as identified by Smith et al. (1998). New patients may gain hope by witnessing other patients living with the device and coping with the difficulties. This hope is a therapeutic benefit of support groups (Townsend, 2000).
Theme Three: Listening and Telling Stories
There is a need for practical information to provide context for understanding required changes in lifestyle. Healthcare providers need to understand this context in order to identify possible interventions. Stories of everyday life with CPAP may provide insight into understanding the issues. Nurses can listen to expert patients' stories to gain insight into the everyday difficulties.
Theme Four: Support Group as Community
Nurses may recommend support groups to their CPAP patients, as well as refer them to Internet-based support groups. Increasing knowledge decreases obstacles and improves accommodation to the device. This information assists patients' self-management by providing needed product information, advice on how to persist, and a forum to ask questions of expert CPAP users. The nurses' role in the support groups was to facilitate discussions, clarify misconceptions and offer referrals. The urban group had a longer time to develop experts and had more resources (i.e., CNS) than the rural group, yet informants from each group described benefits from the group discussions.
These CPAP support groups had similar therapeutic features to Yalom's (1985) 11 curative factors achieved through interpersonal interactions in a support group. The curative factors were the instillation of hope (being able to persist and use CPAP), universality (realizing that one is not alone and that others have similar problems), imparting information (listening to stories of daily coping), altruism (mutual sharing and concern for each other), corrective recapitulation (resolving problems with CPAP through feedback and exploration), development of socializing techniques (developing new social skills in dealing with healthcare providers and payers), interpersonal learning (learning though others' responses to you), group cohesiveness (sense of belonging and using humor to cope), catharsis (expressing both positive and negative feelings), and existential factors (taking direction in their own lives and accepting responsibility for their QoL).
These support groups had similar features to the compliance interventions described in the literature. They had nurses as resource persons to help understand machine usage and support (Hoy et. al., 1999; Hui et. al., 2000; Likar et. al., 1997) and encouraged them to ask questions and compare experiences (Likar). The support groups encouraged patient empowerment and self-motivation (Hoy et al.) What was different in the current study was the value given to the patient experts and their stories in encouraging learning and empowerment. The patient expert was a valuable resource for new patients. Nurses can use them as allies in the learning process. Nurses can also initiate support groups by learning group leadership skills found in most psychiatric nursing texts (Townsend, 2000) or literature on group theory (Napier & Gershenfeld, 1985).
A Web site developed with the support of a local hospital or educational institution could serve as a supplementary resource for newly diagnosed patients. In this study several informants explained similarities to the CPAP support-group information and benefits of online supports. Currently 54% of the United States has Internet access (National Telecommunications and Information Administration, 2002). Nurses with computer skills could develop Web sites with content input from support-group members. This Web site could then complement the monthly support-group meetings. Nurses could then play a valuable role in assisting patients in evaluating the Internet information.
Future research could examine the motivations to persist with CPAP use and how to encourage accommodation to the device in people who do not attend a support group. An intervention could be designed implementing knowledge from support groups and features from this study to facilitate accommodation of CPAP into a person's lifestyle.
The author thanks Judy Tomasini, MS RN, and Constance Pasternak, MS RN, on the research team for their assistance and the group members who shared their stories.
About the Authors
Suzanne Steffan Dickerson, DNS RN, is an associate professor at State University of New York at Buffalo School of Nursing. Address correspondence to her at 914 Kimball Tower, 3435 Main Street, Buffalo, NY 14214-3079 or email@example.com.
Mary C. Kennedy, MS RN, is a cardio/pulmonary clinical nurse specialist at Kaleida Health, Buffalo General Site, Buffalo, NY.
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Body of 'apparent stowaway' found in U.S. Air Force plane that traversed Africa
The body of an "apparent stowaway" was found in the wheel well of a U.S. Air Force plane that traveled around Africa before returning to an American base in Germany, a Pentagon spokesman said Tuesday.
The deceased "adolescent black male, possibly of African origin" turned up during a "detailed post-flight inspection" of the C-130 at Ramstein Air Base on Sunday night, according to Pentagon spokesman Adm. John Kirby.
The body didn't affect the plane's flight, nor was it visible during "standard" inspections before and after flights, he said.
RELATED: Teen OK after riding in wheel well of plane flying to Hawaii
Since taking off from Ramstein, the C-130 had stopped in Senegal, Mali, Chad, Tunisia and Italy over an eight-day stretch, said Air Force spokeswoman Erika Stecker.
Where and when did the adolescent male get on the plane? Authorities stated Tuesday that they don't know -- though the fact that the aircraft stopped in parts of Africa now dealing with a deadly Ebola outbreak raises cause for concern.
The World Health Organization had confirmed more than 800 Ebola cases in West Africa, which includes Senegal and Mali, as of July 23, but suspects there have been many unreported infections and there may be more like 1,200 cases.
Kirby said that lab tests of samples taken from the apparent stowaway's body came back negative "for communicable diseases."
"The cause of death, as well as the other circumstances surrounding this incident, remains under investigation," said the Pentagon spokesman.
The C-130 was "supporting Africa Command operations" during its various stops, Kirby said.


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There are several different ways to play this market Trevor and I've experimented with all of them on my server before making this post. Thank you for the tip btw, it's excellent!
Ok here goes:
1. You can post a dozen of these rods at 2-5 gold each and get bought out by the normal sellers who are trying to get upwards of 30 gold per rod.
2. You can compete with the primary sellers and only post 1-3 rods for a copper below the lowest price.
3. You can mix it up and do either strategy every other day depending on who else is selling and for how much.
I found that #3 worked the best, be flexible and figure out the demand on your server as well as how many people are selling.


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Bicycle Made Entirely Out Of LEGO Bricks
In other loosely related 'things with wheels' news, here's a model of a bicycle made entirely out of LEGO bricks that was spotted by LEGOmaniac (and Flickr user) Brickapolis on display at North Carolina's Brickmagic modular plastic block festival. As you can see, it completely defies the laws of physics. Nice try guys, but I know a bunch of LEGO blocks glued to a real bike when I see one! Also, looks like the back tire's valve cap fell off. You might wanna pick that up before I decide to put it in my mouth.
Hit the jump for a couple more shots of the impressiveness.
Brickapolis' Flickr
I'd Ride That: Man Builds Full-Size LEGO Bicycle [obviouswinner]


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If you follow TV-related news, you've probably seen several stories about the future of Jay Leno's 10 o'clock show in just the past few hours.
First, there was this radio interview with Scott Jones of the website FTVLive.com, claiming NBC was pulling the plug on the struggling show.
In response, NBC issued a statement saying it was still behind Leno, and was committed to improving the show's ratings for its affiliates, which were losing viewers for the local newscasts which aired following Leno.
That was this morning. At 3:50 this afternoon, TMZ -- citing, like the FTL story, anonymous sources -- reported that Leno would move back to his old 11:35 p.m. time slot following the Winter Olympics. The only question, according to the TMZ story, is whether NBC would give Leno a half-hour show, followed by the Tonight Show with Conan O'Brien, or just can Conan altogether.
A few hours later, the New York Times posted a story by TV reporter Bill Carter confirming that NBC has had discussions with Conan and Leno about their timeslots. The story also says NBC executives did not deny moving Leno to the 11:35 slot.
That's all in the span of less than 12 hours. Who knows what the next 12 will bring?
Update: Now the New York Times is saying that NBC wants to keep Conan, with his show starting at midnight.


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2008 Royal Tokaji Aszu 5 Puttonyos Red Label
"High-toned aromas of apricot, white raisin and spices. Supersweet but with bracing but harmonious acidity energizing the pure apricot flavor. At once sweet and salty on the back end, boasting superb retention of pure fruit. Showed…
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Vinous - 92pts
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Blandy's Sercial 5 Year Old
"Lively and rich, with a hazelnut nose and apricot, pear and almond flavors. Long, spice- and mineral-filled finish. Quite fresh-tasting." Reviewed by: Wine Spectator - 90 pts
Wine Spectator - 90pts
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Schmitt Sohne Funf 5 Riesling
"It's light, fruity and well-balanced with a fresh, clean finish. With an easy-to-open screw-top, Fünf Riesling is an everyday wine for wine lovers and casual fans alike." Reviewed by: Producer
Limited Please Call - Check All Stores »
2004 Patricius Tokaj Aszu 5 Puttonyos
"Shows some mature notes of caramel, hard candy and apple tart, backed by a vivid structure. Complex and elegant, with the acidity keeping this fresh and light-weight. Drink now through 2018. 3,300 cases made." -Bruce Sanderson,…
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The Wine Advocate - 90pts
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Blandy's Malmsey 5 Year Old
"Sweet, and full of caramel and butterscotch flavors, without the complexity and length. A good introduction to Malmsey."
Wine Spectator - 86pts
Limited Please Call - Check All Stores »
2007 Royal Tokaji Aszu 5 Puttonyos Red Label
"Sweet, with luscious apricot, peach compote and golden raisin held up by a well of latent acidity that drives the spice, chalk and candied lemon zest notes on the long finish."
Wine Spectator - 92pts
Limited Please Call - Check All Stores »
Blandy's Bual 5 Year Old
"A light coffee/deep amber colour. The nose is quite restrained at the moment with touches of walnut, cigar box and dried lemon peel. Good definition but it is quite light. Hints of dark chocolate inflecting the…
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The Wine Advocate - 88pts
Limited Please Call - Check All Stores »


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- CSCAA Scholar All-American honoree
2014-15: Earned Pac-12 Second-Team All-Academic honors…Had the fastest time on the team in the 200 breast (2:09.32) and second fastest in the 100 breast (59.97)…Earned All-American Honorable Mention at NCAAs in the 200 breast finishing 14th and the 400 medley relay taking 12th...Finished 25th in the prelims of the 100 breast at NCAAs…At Pac-12 Championships, she took fourth in the 100 breast (1:00.40) and fifth in the 200 breast (2:10.54), earning "B" cuts in both events…Earned "B" cuts in the 100 breast and 200 breast at the Texas Invitational with fourth place finishes…Took first in both the 100 breast and 200 breast against Cal, Missouri/OSU/NAU/NMS, UCLA, WSU and Wisconsin.
2013-14: Earned three honorable mention All-America honors…Was named Pac-12 First-Team All-Academic…Her time of 2:08.36 in the 200 breast at the NCAA Championships ranks third in school history…Opened the season with victories in the 100 breast, 200 breast and 400 medley relay against Utah…Opened the home schedule with victories in the 100 and 200 breast against UNLV…Schoettmer also finished first in the 100 and 200 yard breaststroke to help the Wildcats to a slim victory over UCLA…Helped the Wildcats take down rival Arizona State with a pair of victories in the breast events while also part of the winning 200 medley relay team…Once again, Schoettmer earned a pair of victories in the breast events and a win in the 200 medley relay in the nationally televised meet against Oregon State, New Mexico State and Northern Arizona…Took fourth in the 200 breast and fifth in the 100 breast at the Pac-12 Championships.
2012-13: CSCAA Scholar All-American honoree…Finished 8th in the 100 breaststroke at the Pac 12 Championships…Earned a 1st place finish with her team in the 200 medley relay against UCLA…Garnered a victory in the 100 breast stroke and a first-place in the 200 breast stroke against Hawai'i…Won the 200 breast stroke against Washington State...Finished 27th in the 200 breast and 37th in the 100 breast at the NCAA Championships.
Prep: Four-time letterwinner in swimming at Center Grove High School...Team captain in 2012...Was named Indiana Swimmer of the Year...All-Conference member 2009-2012...All-State 2009-2012...County Athlete of the Year...Metropolis Interscholastic Conference Academic Award winner...Sectional Champion in 100 breaststroke, 200 IM...State finalist in 200 IM... State champion in 100 breaststroke...School record holder in 200 medley... State runner-up 2010, 3rd place 2011, 4th place 2012...Also lettered in track.
Personal: Born on December 11, 1993...Daughter of Dave and Amy Schoettmer...Has a younger sister, Tori...Majoring in Anthropology
Personal Bests
100 Breast - 1:00.34
200 Breast - 2:08.36


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Vintage Silverbell Vari-Mold For Sale
|Current Bid: $ 10.00
It is a complete Silverbell Vari-Mold by La Point Enterprises. It has the mold, test casting, ladle, both mold adapters (for different shaped and weight sinkers), both instruction booklet and pictoral sheet, and storage case. It will cast, according to the instructions, weights from 1/10 oz to 4 oz. I think it dates from the 1960's. The instructions have some tears, and bag some age spots. It also has a little rust discoloration on the sheet metal ladle, but it appears to have been stored, not used, or used very little.
Click HERE for more information about this item.


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Jan 21, 2011 10:51 AM
Folks, in case you weren't aware, Roger Ebert isn't just that guy who reviews movies. Roger Ebert is a national treasure. When he writes about film, you learn about the art and the industry as well as the flick that happens to be the topic, and he writes so well that you can spend hours reading reviews of things you've never seen and possibly don't want to see.
He's been through hell in real life and we're lucky to still have him. If you're not yet a fan, pick up a copy of Awake in the Dark (a collection of his best reviews, interviews, and essays, $12) and start watching "Ebert Presents At the Movies" tonight.
If you've got a product or service that you'd like to promote on Outblush, click here to find out about our advertising opportunities.
Outblush is a blog for girls who love to shop. Our staff digs up the best clothes, home stuff, beauty items, and more. New items are posted every day — bookmark us and check out:


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Chiefs of Signal
1880 - 1947 1947 - Present
Major General Harry C. Ingles
1943 - 1947
MG Harry C. Ingles likened communications, in the hands of the commander, to a rifle in the hands of an infantryman ‑ each was a weapon used to accomplish certain objectives.
As Chief Signal Officer from 1 July 1943 until 31 March 1947, Ingles was responsible for providing every commander with the communications to control his forces. His years as Chief Signal Officer included some of the most challenging times of World War II.
During Ingles' tenure in the branch's highest position, Signal troops landed in France on D‑Day by parachute with the 101st Airborne and afoot with the 294th and 286th Joint Assault Signal Companies on Omaha and Utah Beaches, respectively. The 165th Signal Photographic Company also landed with the first infantry elements at Omaha Beach. Its commanding officer, Captain Herman Wall, was the first Signal Corps casualty of the Normandy invasion.
Ingles, who was born in Pleasant Hill, Nebraska, on 12 March 1888, graduated from West Point in 1914, and served in World War II in both Panama and the European Theater of Operations before becoming Chief Signal Officer. After its phenomenal buildup for the war, he saw the Corps lose its aviation communications‑electronics responsibilities to the Army Air Forces, in 1944, and radio‑intelligence to the Army Security Agency, the following year. The loss of these activities reduced the Corps personnel by one half. However, the expanding military communications‑electronics field quickly restored its losses and greatly enlarged the Signal Corps.
Before Ingles retired in 1947, the Signal Corps was assimilating the new technology by, among other things, breaking all previous records by transmitting a nine‑word radioteletype message around the world in 9.5 seconds (April, 1945). On 10 January 1946, Signal Corps engineers, in Project Diana, made the first radar contact with the moon, using a modified SCR‑271 long range radar set.


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So as an alternative to Recursive scp without following links or creating a giant tar file? (this could be an emergency since the remote files could be deleted any time soon), I'm thinking of deleting all my symbolic links. But then I would like to batch-export them all somewhere so that I can restore them once I'm done with the scp file copying.
You could make a tar archive containing the symbolic links only. Assuming GNU utilities (so non-embedded Linux or Cygwin):
Another approach is to generate a shell script that would recreate the symlinks. Here's a Perl approach (while this is doable with only POSIX utilities, it's difficult to handle special characters correctly).
Don't remove the symbolic links. Exclude them from the copy, or make a symlink-less copy of the directory tree, as illustrated in my answer to your other question.


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College Hockey:Kurtz joins Penn State athletics office
Longtime St. Cloud State athletics director Dr. Morris Kurtz joined Penn State on April 1 as the school's special assistant to operations. Kurtz will assist associate athletic director Joe Battista and the NCAA Division I men's and women's hockey programs as they move into Pegula Ice Arena and the Big Ten for the 2013-14 season.
The following is a self-policing forum for discussing views on this story. Comments that are derogatory, make personal attacks, are abusive, or contain profanity or racism will be removed at our discretion. USCHO.com is not responsible for comments posted by users. Please report any inappropriate or offensive comments by clicking the "Flag" link next to that comment in order to alert the moderator.
Please also keep "woofing," taunting, and otherwise unsportsmanlike behavior to a minimum. Your posts will more than likely be deleted, and worse yet, you reflect badly on yourself, your favorite team and your conference.


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Simply Delicious! Appetizers and Desserts
Beautiful Beginnings and Elegant Endings from A-Z
Edited by Laura R. Knott
Quick and easy appetizers and desserts listed from A-Z
Laura Knott is the owner of Simply Delicious Desserts, LLC, in Hot Springs, Arkansas, which specializes in custom cakes, desserts, and catering. She has recently retired after 27 years of teaching, and is pursuing her next career: cooking, creating wedding cakes, and writing cookbooks.
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Items Included In This Sale
- Size: 7
- Style: With Heel
- Color: White
The white satin strappy women's dress shoe features a rhinestone embellishment and lightly padded footbed. The adjustable strap has a buckle closure. Approx. 2" heel height. These were just worn once on my wedding day and were reasonably comfortable to stand/walk in for 8 hours. I added an adhesive cushion to the footbed for a bit more support, but it could be removed. There are very faint water marks at the base of the heel, but they are hardly noticeable unless you are holding them up close. Definitely would not be noticeable under a full length dress.
- Terms of Sale: All Sales Final
- Location: Pleasanton, CA
- Will Ship to: Anywhere at Seller Expense
- Payment Methods Accepted: Escrow.com
Please read our BUYER'S GUIDE before purchasing a dress online.


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The loss of tax revenue from shuttered General Motors and Chrysler dealerships only adds to the financial woes of Illinois governments. McHenry County will likely be particularly hard hit. A First Electric Newspaper analysis finds it's suffered double the level of closings of the other Collar Counties on a percentage basis.
Matching 242 new car dealers in the five counties surrounding Chicago against announced and likely (the rest of Pontiac) closings reveals McHenry County has lost 5 of its 25 dealerships, 20 percent. The next worst-hit has been Kane County with a 14 percent loss. DuPage lost 9 percent, Will 8 percent and Lake only 7 percent.
The closing of Huntley Chevrolet will increase the Kane County figure. Although the lot is within Huntley limits it's over the line from McHenry County.
To some degree the tax revenue impact of dealership closings is academic. U.S. auto sales are down 37 percent from their peak so even surviving dealerships aren't generating much in the way of tax revenue. The question is remains, what will the erstwhile customers of defunct dealers do now? Will they remain brand-loyal within the county or county-loyal but turn into Ford fanatics? Or will they take their car business and sales tax dollars to Lake, Cook and Kane counties?
McHenry County Finance Committee Chairman Mark Munaretto believes a large part of McHenry County's current $1 million tax shortfall is due to poor car sales. He estimates sales tax receipts from McHenry County car sales were in the $3-4 million range before the bottom dropped out. The question on his mind, he said, is how much will revenue with return with a recovery."With the loss of these dealers I don't know if we can ever return to the previous levels," he said.
The problem of dealer closings and tax loss is magnified at the muncipal level. Crystal Lake has been particularly hard-hit with the loss of two dealerships. Algonquin and Lake in the Hills have come through unscathed thanks to the former's having only one car dealer, Rosen Hyundai, and the latter none at all.
Algonquin President John Schmitt said his village has neither sought car dealers nor discouraged them. "We've talked to several over the years. For one reason or another they haven't chosen to locate here."
Much the same applies to Lake the Hills, according to Village Manager Jerry Sagona. "We would welcome car dealers to the friendly confines of Lake in the Hills if they were interested in locating here," he said.


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The Westmoreland County coroner said Lauren Thompson, 30, of Jeannette, was in a Jeep Wrangler that hit a hydrant when the driver lost control on Route 819 in Hempfield Township. She was a longtime employee at Dino's Sports Lounge in Latrobe.
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New York metal miscreants, Prong are set to return this spring with their ninth slab of ear-triturating sonic mayhem. Today the band announced the title of the album, revealed the track listing, and offered details on a special Record Store Day single.
"Ruining Lives" will be the follow-up to Prong's acclaimed 2012 release "Carved Into Stone" and continues to show the band on an upward trajectory, proving that despite having a long, illustrious career Prong can still make records that matter and re-invent themselves without negating their roots.
With vocalist and guitarist Tommy Victor in the producer's chair and Steve Evetts (Hatebreed, Sick Of It All, Sepultura) once again coming in to put his trademark shine on the record, "Ruining Lives" has turned out to be a monster of an album. From the first riff-assault of the opener "Turnover", the album takes you on an angst-filled roller coaster ride that marries some very old school, "Beg To Differ" elements with post-punk, industrial metal, hardcore thrash, all the while retaining a modern and current feel. Fans of the bands legendary, genre-defining "Cleansing" era and new fans alike will be thrilled.
Tommy Victor said of "Ruining Lives":
"This is the fastest written and recorded Prong album ever and it has more great songs than any previous Prong record. I am particularly proud of the vocal performance and I think we captured some outstanding sounds on this album. There's a little bit of a throwback element here. 'Ruining Lives' is almost a 'Force Fed' type of song. The album is a hybrid between NY Hardcore and some very modern, song-oriented work. You will find some 'Rude Awakening' but also some solid, crushing riffs. I feel we have captured the best elements of Prong on this album. 'Come To Realize' is something new – we have never approached this kind of time signature. It really is math-metal meets pure hardcore with a crazy-ass riff. What's exciting about the whole album is you have your hooks, your riffs and something innovative that makes the album very current. This qualifies as the hybrid nature of Prong: marrying post-punk, industrial metal, hardcore thrash and modern elements – all of that with hooks and not just a bunch of screaming."
The new album, "Ruining Lives" will be released now through SPV/Steamhammer in the US/Canada on May 13th as a limited digipak version including a bonus track and poster, as a double gatefold colored vinyl version including a bonus track and the CD in cardboard sleeve, as a standard version and download.
On April 19, Prong will release an exclusive single for the "Record Store Day" celebration with the new track "Turnover" on side A and a pig remix version of "Revenge Best Served Cold" by Raymond Watts on Side B. The single is limited to 3.000 copies and comes in a green/white marbled vinyl version. The worldwide digital release of this single is April 21.
Track Listing DigiPak:
2.The Barriers
3.Windows Shut
4.Remove, Separate Self
5.Ruining Lives
6.Absence Of Light
7.The Book Of Change
8.Self Will Run Riot
9.Come To Realize
10.Chamber Of Thought
11.Limitations And Validations
12.Retreat (Bonus Track)
Suggested Links
- Whitechapel announce new album, Our Endless War for April release
- Renowned industry vets join forces in new management venture, Breaking Bands LLC
- Ohio metal quintet, Miss May I ready 'Rise of the Lion' for April release
- Cavalera Conspiracy studio update on new album
- Carnifex interview: Scott Lewis discusses Die Without Hope, new guitarist


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You were looking outside on a summer night while your close friend, and crush, Ivan watched TV. You waited and kept looking for a long time, you always wanted to look at fireflies though it was tough for you when you always forget to look but this time you wanted to see them for yourself.
You didn't realize that you butt was in the air shaking a little from excitment and Ivan blushed crazy, he didn't know how cute you butt was until now.
"________, what are you looking for out there? Fireflies?" Ivan asked you as he turned to you and wrapped his arm around your waist. You blushed a little but you didn't mind at all.
"Da" You said, you looked at the navy bluse sky then, you felt your eyes getting droopy, you would nod off but you would force yourself to stay up. You gave in and you fell into Ivans body and you snuggled close, you felt yourself go into a deep slumber.
Ivan only looked at you and saw you sleep.
"Why do you always look cute while your sleeping" Ivan thought as he rubbed your cheek, he looked out the window and saw the fireflies. He smiled as he looked at you, he picked you up and opened the front door and made his way to the rocking bench that he had at his house and let you feel the moon's light on your face.
You opened your eyes to see the fireflies, you jumped off Ivan because you ran into the feild where the fireflies were. Ivan could smile at the look to see you happy, he went inside and grabbed a jar for you.
He ran over to you and picked you up in the air and spun you around a little, you started to laugh a lot.
"Here...take this jar and you can catch a firefly and we can keep him here for and hour, alright?" Ivan said, he would do anything to make you happy but he can only control himself for a time until he will break and go into his mad state. You weren't scared of him, you practically saved his life when Natalia was harrassing him.
Nothing phased you and thats why Ivan likes you, he never told you anything about that because he would be scared that you would leave him alone. When you finally caught one, went ran over to Ivan and tackled him.
"Look Ivan!!!! I caught one!!!!" you said and accidentally kissed him, you realized and pulled back jumped off and scooted away.
"I-I-I...I'm sorry..." You said hiding yyour frace from Ivan, he looked over at you and he got up and picked you up.
"Theres an issue, I really like you, will you become one with me?" Ivan said as he put you the bed, you blushed and then giggled.
"Da!" you said and kissed him once more before going into a pleasureable state
----The Next Morning----
You woke up to the sun kissing your face, you wrinkled your nose from the warmth and you rolled over to feel something. You opened your eyes to see Ivan staring at you as you slept. You blushed a little and smiled up at him, you snuggled closer to him.
"Good Morning Ivan..." You said as you kissed his nose, he kisseed you and hugged you tightly, you loved this feeling that was coming around...it was love. Ivan put you on top of him and you snuggled into his neck, and wanted to sleep but Ivan started to groped your butt and you gave a squeek and you pinched his nose.
You both started to laugh and you kissed eachother passionately. You ran to Ivan's dresser and put on one of his boxers and tank top, you ran around the house for 5 minutes and Ivan grabbed you and both of you fell on the bed laughing.
"Ivan...I really love you." You said as you kissed him passionately, you held on to him because you cared so much about this man you couldn't bare it.
"I love you too, ________" Ivan said to you as you ploped you onto the bed, he pulled downthe boxers and looked up at you again.
"Wanna become one wiht me again?" Ivan asked sweetly
"Da" You said in reply to your Russian lover.
Russia x Reader - Fireflies by MysticKyuubi24Watch
©2012-2016 MysticKyuubi24
This is a request for and I got the inpriation from the song Fireflies by Owlcity (one of my fav bands in the world) and I don't do much of Russia readers and so I want to try doing this since people like my last one I did so...yeah.
I hope you guys enjoy, if theres some incorrect spelling, grammer, etc. tell me and i'll fix it immedately, thank you.
Link to the cute Russia: [link]
I hope you guys enjoy, if theres some incorrect spelling, grammer, etc. tell me and i'll fix it immedately, thank you.
Link to the cute Russia: [link]
Cutest Story Ever! So Kawaii! Sugoi Sugoi!
When I saw the title I thought of Owl City's 'Fireflies'
I love this story it is so cute!!! X3
I love Owl City especially "Fireflies" while I was reading this I was thinking about them indeed! You made a very good and sweet job,"little one"! hahaahaha
2nd to last line, you spelled 'with' wrong (-_-... realy?)
Thanks! Now, I'll do a reader x country for you, if you want one.
Germany...it has to be germany or prussia, you choose ^_^
i loved it
i LOBE your icon profile picture its fluffy da? ^J^
thank you ^u^
Glad you did ^_^
Ahhhh~ so cute
This is amazingly cute, but I just thought i'd let you know, a little after the "the next morning" part, you spell kissed, 'kisseed'.