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I'm submitting a summary checklist of general steps you can take to solve this problem, and briefly discussing the three most frequent causes : malware, uncontrolled applications, and insufficient care, because many readers reveal their computer reacting slowly.
Maybe the most important contributor to a poorly performing computer is malware.
Step 1. Update the definitions of your antivirus and operate a complete scan of your hard disk in Safe Mode. Solve any unfixable issues. Notice that some viruses need additional steps until they may be removed; usually a web search will find specific instructions or a special removal tool. Use the BC forums to request assistance, if you can't find a answer.
Step 2. You've recently saved an application, and if the sluggishness is sudden, the problem may dwell there. Check this by fully removing it. A smart user will usually perform a web search about the application before installing because in most instances, any possible problem with malware or inferior performance will have appeared.
Action 3. Adware and Spyware can dramatically effect your personal computer's operation, and these are all over the Internet. A very recent research indicated that one out of every 20 executable files on Websites is spyware, and 1 in 25 domains include at least one bit of spyware waiting for sufferers.
Experienced customers will regularly run two or three of these programs, because each company has its own standards for what constitutes spyware and will just search against their own set. (A listing of really good, free antispyware programs is supplied by BC). Again, solve any open issues before continuing to the next step.
For additional reading about Malware and some malware removal applications, use BC's Tutorial section; most of the programs have very great Help files that clarify how they operate too as the special attributes of each.
Uncontrolled Applications
Step 4. Review apps that self-launching on startup. You pc can be a battleground for your interest. Many programs, for example, install a fast-start feature that enables them to be opened swiftly; other programs will comprise an automatic update feature that demands them to be operating in the background. Your launching Windows are slowed down by each of these and each requires a little bit of resources while your personal computer is running.
Remember that Bc maintains a very comprehensive Startup Database that includes info about whether the item is needed, discretionary, or unnecessary, in case you are uncertain about what may be safely removed.
At the same time, remember that those symbols in your Background also take a modest number of boot time to set themselves.
Lack of Care
Stage 5. Clean up your hard drive (preparation for Action 7). Delete unused applications and transfer old files to your CD. Unplayed games, lots of family pictures, zipped files that you have previously opened, applications you have not found in two years, software for the old printer you put away last year—these are some types of files you can delete.
(Note for advanced level users: some specialists would include the added care step of cleaning up the Windows registry, and you will find several applications to assist try this. For the most part, registry maintenance won't make a significant difference, and unless you are really comfortable with Windows, and cautiously make copies of-the registry, you may do serious damage by making registry changes, so this measure isn't included
Stage 6. Have it mend Error 364 Object Was Unloaded Windows 7.
Action 7. Defragment your personal computer.
Hopefully, now that you have have concluded, you will find a marked enhancement in pc functionality.


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Residential Property in Keystone, CO
- 1.0 Baths
- 505 SqFt
Keystone, CO
Beautiful Penthouse level Residence in Arapahoe Lodge. Highly sought after complex in River Run. Located in the heart of River Run and just steps to the Gondola for skiing. Quiet location overlooking the courtyard with views to the west. Amenities on site include hot tubs, outdoor pool open year-round, lounge area with games and pool tables, ski lockers, and underground heated parking. Restaurants, groceries, shops, and entertainment are all right here for your convenience. Strong Rental.
S1013523 is a residential property located in Arapahoe Lodge Condo, Keystone, CO. This condominium home is located at 91 River Run Rd # 8137, 80435, and features 1.0 bedrooms and 1.0 bathrooms throughout 554 square feet. Found in the Keystone area, the location is close to a variety of amenities. Built in 1996, this property for sale is listed at $399,000.00.
Snow Removal, Ski Storage, Trash
Cable Available, Electricity Available, Natural Gas Available, Municipal Utilities, Phone Available, Sewer Available, Water Available, Sewer Connected
City Lot, Near Public Transit, Ski In /Ski Out
Dishwasher, Electric Range, Disposal, Microwave
City Lot, Near Public Transit, Ski In /Ski Out
Keystone, CO
Keystone, CO
Keystone, CO
Re/max Properties/ 69.
Listing information last updated on July 13th, 2020 at 5:31pm MDT.

subset: commoncrawl


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791 Summit AvenueOconomowoc, Wisconsin 53066
Auxiliary fundraising events and sales, planning and educational meetings, and recognition and social activities are listed below.
Our latest event, Eat, Drink and be Giving, was a huge success! We shared great food, along with awesome wine pairings, and our
guests were very giving. The proceeds were designated for The Wig Bank and Thriving programs offered through the
Prohealth Oconomowoc Memorial Cancer Center. As seen in the picture at the right, fun was had by all!
The Oconomowoc Memorial Auxiliary offers an outstanding travel program in partnership with Collette Travel. All are welcome to join us for worry-free travel and first-class service while enjoying destinations across the United States, North America, Europe, and the globe.
Since 2014, Auxiliary tour guests have enjoyed unparalleled sightseeing, sumptuous local cuisine, and cultural and historical experiences along with memories of good times shared with new friends.
The OMH Auxiliary 2020 spring tour destination to the Pacific Northwest & California will, unfortunately, not materialize because of the coronavirus pandemic. The fall tour to Europe is still scheduled. Here are the details:
Discover Switzerland, Austria & Bavaria from October 15-24, 2020 (9 days and 12 meals). Tour features are Bern, Chateau de Chillon, Montreux, GoldenPass Panoramic Train, Gstaad, Lucerne, Innsbruck, Austrian Alps, Salzburg, Mirabell Gardens and St. Peter's Restaurant. More itinerary information is available at this link.
In addition, Collette offers outstanding value on its fully escorted, inclusive tours with four-star accommodations, skilled tour managers and guides, premier attractions with preferential access, baggage handling, and hometown pickup plus other features and the award-winning experience of over 100 years in the travel industry.
Join us on a future tour as Collette handles all the details, and you enjoy the adventure! For more information on the Auxiliary travel program or to learn about future travel opportunities, please call the Auxiliary office at 262-569-0293 or 262-569-0202.
Visit the Auxiliary's Gift Box Boutique to find the perfect gift for family and friends. From chocolates and candies to candles and flowers, there's a wonderful selection of gift-giving options for everyone.
The Gift Box also carries an extensive selection of women's fashions. Whether it's an elegant, sophisticated gathering or a casual, trendy party, you will find a variety of tunics, sweaters, dresses, jackets, outerwear, and accessories to match any occasion.
There's a variety of gifts awaiting you in the Gift Box Boutique plus complimentary gift wrapping. Please stop in for a full service, pleasurable shopping experience!
The Gift Box Boutique is conveniently open seven days a week, dependent on volunteer availability. Hours are Monday through Friday 8:30 a.m. to 4:30 p.m., Saturday and Sunday 10 a.m. to 2 p.m. Please feel free to call the Gift Box at 262-569-0271 for our current schedule.
Please join us at one or more of the following gatherings and help support our commitment to ProHealth Oconomowoc Memorial Hospital and the local community. For more information, please contact the Auxiliary office.
Oconomowoc Memorial Auxiliary is a separate, not-for-profit organization that supports ProHealth Oconomowoc Memorial Hospital's commitment to serve its communities.


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Thank you for viewing our profile
If you would like to learn more about us, please call 1-800-ADOPTION (2367846), fill out the form at the bottom of our on-line profile page, or email us at firstname.lastname@example.com.
To revisit our on-line profile page and view our profile video at American Adoptions, simply use your mobile phone to scan the QR code on the right. We are looking forward to hearing from you!
Brandon & Stacey
We are so very humbled and beyond thankful for your time to get to know a little about us and why we would love to be the adoptive parents of your precious child. Our hearts are just bursting with love and we are more than excited to meet your little one! We have prayed for years to start a family and we are excited to be a part of this journey with you.
What it Means to Become Parents
We feel that there is no bigger joy or role in life than the opportunity to be parents to a beautiful child. God has led us to adopting and we are over the moon excited to bring a child into our family and help this child grow and flourish in their lives.
We believe the most important things in a family are unconditional love, support and happiness. We will teach our children good morals, how to treat others with respect, build confidence, learn how to trust, be polite, forgive and be a well-rounded, kind person in society.
We have so much love to give and our hearts are bursting with love and joy to give to our child. Being a parent is our life's yearning and adopting a child would be the biggest dream come true for us! We hardly can contain the excitement during the adoption process. We want to share all of the wonderful things life has to offer with our little one and want to give them the best upbringing possible.
Our Lifestyle
Our lifestyle is best described as being very active. We love the outdoors and we get together with friends and family often.
Traveling is our passion and this child will be able to experience everything that the world has to offer. We take about 3-4 vacations a year to experience different cultures, people and ways of life.
We are beach lovers and this child will be able to spend every weekend during the summer out in the sun, swimming in the waves and surfing at our local beach haven.
We both have flexible work schedules as Brandon has his own business in construction contracting and Stacey is a business consultant at large financial firm. We like to spend as much time as possible together when we are not working. We enjoy spending time with our dogs, walking on the nearby nature trails, dining out on the waterfront, cooking, surfing and just relaxing around the house.
We are also very active in volunteering in our community with the local food bank, homeless shelter for veterans, and we are involved with the American Cancer Society.
Education We Will Provide
Your child's education is a main priority for the both of us.
We have highly rated schools where the child can learn, grow and prosper. They will be able to explore different types of sports and activities such as tennis, skiing, soccer, basketball, baseball, dance, tap dance, girl and boy scouts.
In addition to exploring many activities, parents should be alert to any special interests or talents in a child that would lead to a passion. Having strong interests such as art, technology, carpentry, business or science would be encouraged and might lead to a lifetime of happiness in a hobby or a profession. It is important for us as parents to realize, "One size does not fit all" and each child brings their own curiosities to life. A parents responsibility is to provide opportunities.
We will convey the importance of an education and working hard. We want the child to be well-rounded and will teach him/her self-confidence, love, strength, drive, and self-worth.
Our House and Neighborhood
We live on the East Coast about five minutes from the beach. We have a comfortable four-bedroom house with four full bathrooms and a bonus room for our child to be able to play and have friends over. We have a large backyard to roam, explore and play sports.
Our neighborhood is a small community of about 100 homes with a lot of children. It's very safe and family friendly with five community parks near our home where our child will be able to run and play. Our community has sidewalks throughout the neighborhood where kids can ride bikes, play basketball, have playdates with friends, skateboard, rollerblade or any activity to just be a kid. Our neighborhood has frequent social gatherings and holiday celebrations where all of your neighbors know your family. We also have several schools in our town that are highly rated for education.
At our local beach, this child will be able to play in the sand, make sand castles, go swimming and play in the water. This child will have access to all water sport activities such as surfing, wakeboarding, kitesurfing, kayaking, paddle boarding, snorkeling and just enjoying the outdoors.
Our Extended Families
We both come from very close families where we see our relatives regularly. Brandon's parents live about 20 minutes from us and Stacey's family is two hours away.
Family is extremely important to both of us and is our top priority. We enjoy having our family stay at our home to visit the local beaches, explore nature, go boating, enjoy waterfront dining, play outdoor games and cook together. When our families get together, we grill out and have one big party! We love playing cards, board games and riding bikes on the nearby bike trails.
We are BIG into decorating for the holidays. When you come to our house at Christmas, it looks like Santa Claus' house in the North Pole. We decorate the whole house with trees, nutcrackers, ornaments, candles and nostalgic items from our childhood.
Our families are so very excited for us to adopt this child and they can't wait to welcome your child into our wonderful family.
From Us to You
We are so very humbled and beyond thankful for your consideration to get to know a little about us and why we would love to be the adoptive parents of your child. We can only imagine the thousands of thoughts going through your mind right at this moment. We want you to know you are loved and that you must have the heart of an angel. The road and journey that you are on is one with many hard decisions to be made and we want you to feel heard, important and cared for. You are considering giving us the biggest gift in life and for that, we will be forever grateful. We will provide the most loving, joyful and caring home and will love this child unconditionally for all of their life. Our hearts are just bursting with love and we are over the moon excited to meet the child that will join our family.
We met in 2015 and got married on the East Coast. On our third date we were already talking about what names would we like for our children. Building a family through love has always been a dream for the both of us. We spent many years dealing with infertility and several miscarriages and we were unfortunately unable to have a child. We feel that God has a bigger plan for us and that we have been called to be adoptive parents and to give this child a happy, fun, safe and secure home. This child will be such a blessing to us and our extended family. Adoption will allow us to fulfill our lifelong dreams of raising a child and to experience the joy in making a difference in someone's life.
We promise to give this child the best life anyone could ask for. Your child will be safe, loved, educated, and well-rounded. We will bring the child up with Christian morals and teach him or her to be a kind, good person.
We want you to know that you are loved and your baby will be loved more than anything in the world by us! We are open to talk to you, communicate and discuss anything that you need to make you feel comfortable and put your trust in us as adoptive parents. We are happy to connect with you as you would like over the years with open letters and pictures of your little one as he/she grows up. We will fulfill our promise to you and this child will know how much you love them.
We promise to give this child the best life anyone could ask for. Again, our hearts are just bursting with love to give and this child will be our pride and joy!
With Sincere Love and Gratitude -
Brandon & Stacey
Contact Us
Thank you for reading our profile. If you have any comments or questions for us, please leave a message below to find out more about us!


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Crayola Dough - Kids Play Dough Clay - 1 Kg Bucket with 4 Colors and Animal Mold
Crayola Dough - Kids Play Dough Clay -
Crayola Dough - Kids Play Dough Modeling Clay - Play, Shape, And Create - 1 Kg Reusable Bucket With 4 Colors and Animal Molds (8 Total Pieces Of Dough) For those that need quantity, bucket contains more than 2 lbs. of dough in assorted colors. Lid is designed with cute animal impressions so you can mold your favorite friends. Each bucket contains 8 pieces of dough, totaling 2.2 lbs. Great for early learning. Can be used at birthday parties or play to explore, discover, play, pretend, create & dream. Roll, Squeeze, Press, Shape And So Much More, Endless Possibilities. Crayola Dough Bucket Includes: 2 Red Dough Pieces 2 Green Dough Pieces 2 Blue Dough Pieces 2 Yellow Dough Pieces Lid with 4 animal molds
- Color: Multi
- Brand: Crayola
LEGO Duplo Farm Animals 10870
LEGO Duplo Farm Animals
Little animal lovers will enjoy looking after this selection of farm animals. Help them put the chicken in its coop, lead the Piglet and Calf to the feeding trough and water bucket, and pet the friendly cat. The chicken coop is simple for preschoolers to build and this educational toy offers great practice for early construction skills. Includes 4 animal figures.
- Color: Multi
- Brand: LEGO
ValeforToy Animals Figure,54 Piece Mini Jungle Animals Toys Set with Gift Box, Realistic Wild Animal Learning Party Favors Toys for Boys Girls Kids Toddlers Forest Small Farm Animals Toys Playset
ValeforToy Animals Figure,54 Piece Mini Jungle Animals Toys
"Whether you roam alone like tigers, preferring a solitary safari, or in a herd like gazelles and elephants with friends this set provides plenty of imaginative play possibilities Big Bucket of Jungle Animals - 54 Piece Set,including 32 no repeats wild animals,16 fence,4 grass,1 coconut tree,1 rockery: Your child will LOVE this set of Jungle Animals,includes the most popular animals -cheetah, elephant, gazelle, giraffe, gnu, gorilla, hippo, lion, rhinoceros, tiger and zebra etc."
- Brand: ValeforToy
First Builders Big Building Bag
First Builders Big Building
Endless creativity with 80 big, colorful building blocks! Build, stack, and explore endless construction possibilities with this award-winning set of 80 building blocks in classic colors! Now your little one can build anything they imagine when they use the blocks and special shapes to create tall towers, crazy castles, funny animals, or whatever else they dream up! Perfect for little hands, these big blocks fit together and come apart easily, helping your child to develop fine motor skills and creativity over hours of open-ended play. When playtime's over, cleanup is easy with the handy storage bag. Ideal for ages 1 to 5
- Color: Blue
- Brand: Mega Bloks
Behrens 1697 Manufacturing 6104 Galvanized Steel Locking Lid Can, 4-Gallon, Original Version
Behrens 1697 Manufacturing 6104 Galvanized Steel Locking Lid
Keep your floor sparkling clean with this microfiber mop refill that delivers superior cleaning capabilities. The head flips for dusting or mopping. It lies flat to clean under furniture.
- Color: Original Version
- Brand: Behrens
Big Joe Comfort Research Megahh (UltimaX) Bean Bags Refill, 100 L, White - 9999999
Big Joe Comfort Research Megahh (UltimaX) Bean Bags
Feeling a little closer to the ground these days? That's just gravity (and our Megahh Beans) obeying the law. Over time, and especially with all the chilling you've been doing, our beans will start to flatten. Time to order a refill! These 100 liter bags (that's 3.5 cubic feet) will bring your Big Joe back to life in a jiffy. And, they aren't just for adding a little extra gusto under your back side, They're also great for packing boxes and Craft projects.
- Color: White
- Brand: Big Joe
Play-Doh Modeling Compound 10-Pack Case of Colors, Non-Toxic, Assorted Colors, 2-Ounce Cans, Ages 2 and up, (Amazon Exclusive)
Play-Doh Modeling Compound 10-Pack Case of Colors, Non-Toxic,
"With 10 different colors of modeling compound to play with, this is a case of creative possibilities! It's a rainbow assortment of compound colors that lets you create just about anything you can imagine. Press, smoosh, squish, roll, squeeze and shape – with Play-Doh modeling compound, the only limit is your imagination! Play-Doh and all related characters are trademarks of Hasbro."
- Color: Multicolor
- Brand: Play-Doh
Click N' Play 18Piece Beach Sand Toy Set, Bucket, Shovels, Rakes, Watering Can, Molds
Click N' Play 18Piece Beach Sand Toy Set,
This huge 18 piece fun beach toy set will keep your children busy for hours at the beach. It is made of high-quality BPA plastic that is perfect for your kid to play in the sand, in the pool, in the garden or wherever The kids would like to enjoy playing with them. The whole set includes 18 pc of different fun sand toys bucket, sifters molds etc.. So they can build sand castles or snow castles and use their creativity to build all sorts of other constructions. Make fun and creative shapes and sculptures. Also helps promote child's cognitive and imaginative skills.
- Brand: Click N' Play
LEGO Duplo Creative Play 10572 All-in-One-Box-of-Fun, Open Ended Toy for Imaginative Play with Large Bricks Made for Toddlers and preschoolers (65 Pieces)
LEGO Duplo Creative Play 10572 All-in-One-Box-of-Fun, Open Ended
The LEGO DUPLO All-In-One Box of Fun set has a whole load of DUPLO bricks for fun building and rebuilding for creative play. At its heart is a buildable wagon base with rounded edges and wheels that really turn. This comprehensive building set also includes 2 opening window elements, a cute dog figure and numbered bricks with corresponding decorated bricks to help your child develop their counting skills. There are even extra classic DUPLO bricks for more creative fun. Includes a boy DUPLO figure. With this fun building kit, your toddler can use their imagination to create cars, houses, buildings, wagons, trains, and more.
- Color: Multi Colored
- Brand: LEGO
Biulotter 20Pcs Kids Beach Sand Toys Set Sand Water Wheel, Castle Molds, Truck Bucket, Beach Shovels RakesTool Kit, Hourglass, Sea Animal Molds, Watering Can, Cloud, with Mesh Backpack Sandbox 2019
Biulotter 20Pcs Kids Beach Sand Toys Set Sand
It comes with a variety of great toys they can use to make and re-make new environments, it offers fun for boys and girls alike. The perfect holiday gift this season, get it for birthdays, parties, or just to help keep them learning and inspired every day!v Product Details: Molds, Stretches, and Stacks with No Water No Messy, Sticky Residue or Sand Only Sticks to Itself Safe, Non-Toxic Indoor or Outdoor Play Kid Friendly Fun: Ages 3 and Up Adult Supervision Recommended Package Includes: 6 castle molds 1 truck bucket 4 sea animal molds 2 shovels 1 rakes 1 watering can 1 hourglass 1 watering can 1 cloud 1 mesh backpack 1 colorful box Click 'Add to Cart' to get this sand play set to give your child endless hours of fun and enjoyment!
- Color: Beach Sand Toys 2019
- Brand: Biulotter


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Individuals with Down syndrome are at increased risk of congenital heart conditions (CHCs), and mortality is higher in people with Down syndrome and a CHC than those without (J. C. Vis et al., 2009). As a consequence, parents of children with Down syndrome and a CHC are more likely to outlive their child. In this research, semistructured interviews were used to explore the experiences of 6 couples whose child with Down syndrome and a CHC had died. The interviews were analyzed qualitatively using interpretative phenomenological analysis (IPA), and 4 themes emerged: dilemmas associated with the dual diagnosis; treatment decisions during the life and the death of their child ("We had to make a decision"); ways couples coped when bereaved ("We weren't really going through it together"); and ripples from the child's life. There was a high degree of similarity of experience within couples. Differences between couples existed in their experiences of coping and supporting each other. Practical implications include the importance of considering the specific needs of couples, individuals, and fathers within partnerships.
Several research reports focus on the experience of parenting a child with Down syndrome compared with children with other developmental disorders (e.g., Abbeduto et al., 2004; Poehlmann, Clements, Abbeduto, & Farsad, 2005). Some data are consistent with the notion of a "Down syndrome advantage," whereby parents of children with Down syndrome report better outcomes than do parents of children with other disabilities. Although this advantage is much debated, the most recent research supports this hypothesis (Corrice & Glidden, 2009), with a variety of advantages found for families of children with Down syndrome, including lower divorce rates for families of children born between 1990 and 2002 (Urbano & Hodapp, 2007), less family conflict, and more mother–child closeness when males were 10–23 years old (Lewis et al., 2006). However, two areas that have received little attention are the joint experiences of couples raising a child with Down syndrome and parental experiences associated with particular life events relating to the child with Down syndrome. In this article, we investigate the reactions of couples when their child with Down syndrome dies.
Within couples raising children with Down syndrome, mothers and fathers have been found to use different ways of coping and finding support, with mothers showing higher levels of social support seeking, suppression of competing activities, turning to religion, and emotional expression than fathers (Spangenberg & Theron, 2001; A. Sullivan, 2002). Couples also experience different sources of stress. Whereas fathers' stress related to the child's diagnosis of Down syndrome, mothers' stress has been found to be related to parental role, involvement in child care, and father's stress (Cuskelly, Jobling, Chant, Bower, & Hayes, 2002; Roach, Orsmond, & Barratt, 1999). Pelchat, Lefebvre, and Perrault (2003) suggested that the expectations of fathers within families may be more specific and more difficult to fulfill than mothers'. For example, in families of children 2–5 years old, fathers felt a greater need for support from male members of their extended families (Pelchat et al., 2003). Pelchat and colleagues proposed that difficulties typically encountered by families are made more arduous by some of the additional stressors when raising a child with Down syndrome. For example, the child's care needs may mean that a considerable amount of time is consumed arranging specialist appointments and services (Pelchat et al., 2003).
Although the challenges faced by families of a child with a disability across the lifespan are recognized by research, this has largely been confined to maternal report of the adolescent years (Schneider, Wedgewood, Llewellyn, & McConnell, 2006; Todd & Jones, 2005). Research into parenting and Down syndrome across the life span is incomplete in several areas of knowledge. For example, researchers have rarely explored the experiences of fathers of children with Down syndrome. The premature death of the child with Down syndrome (whether as a child or adult) has the potential for an irrevocable impact on family life. Although there are data suggesting that this risk is significant, published research has not addressed the experiences of family members adjusting to this loss.
There is widespread recognition of the increased health risks faced by people with Down syndrome (S. G. Sullivan, Hussain, Glasson, & Bittles, 2007) and their unmet health care needs (Melville et al., 2005). Almost 50% of children born with Down syndrome are also born with a congenital heart condition (CHC; American Academy of Pediatrics [AAP], 2001). All CHCs are, to varying degrees, operable, but CHCs that remain partially remediated or uncorrected expose individuals to the possibility of additional health complications. As a result, children with Down syndrome and a CHC under the age of 10 years are admitted to the hospital twice as often as other children with Down syndrome (Abbeduto et al., 2004; Frid, Anneren, Rasmussen, Sundelin, & Drott, 2002), and a current cardiac problem in the child is related to poorer maternal physical health (Bourke et al., 2008). Although mortality for infants with Down syndrome and CHC has been declining (Frid, Drott, Olausson, Sundelin, & Anneren, 2004), mortality within the Down syndrome population is higher in individuals with CHC (Yang, Rasmussen, & Friedman, 2002), and, therefore, parents are more likely to outlive their child than parents of children with other disabilities. Precise statistics as to the likelihood of this event have yet to be reported.
Parental bereavement research within the general population has shown that the loss of a child through illness may result in wide-ranging psychological implications for parents: for example, more symptoms of anxiety and depression when the child is 9–23 years old (Kreicbergs, Valdimarsdottir, Onelov, Henter, & Steineck, 2004; Leahy, 1993). In terms of gender differences, comparisons within bereaved couples have found higher maternal grief (Goodenough, Drew, Higgins, & Trethewie, 2004; Schwab, 1996; Wijngaards-de Meij et al., 2005). However, others have questioned the accuracy of particular measures of grief (Lang & Gottlieb, 1993), suggesting that measures are not adept at measuring male grief. In addition, the reactions of a couple to the loss of their child will constitute much more than a collection of individual grief symptoms (Wijngaards-de Meij et al., 2008) and may include problems in the marital relationship (Schwab, 1992). Parents may lose support from their spouse and other sources (Rando, 1985) but may also gain from their experience, including acquiring increased personal strength, insight, and closer familial relationships (Laakso & Paunonen-Ilmonen, 2001).
Interpersonal factors have been investigated with regard to the impact of coping styles in bereaved couples. Wijngaards-de Meij et al. (2008) reported that, for couples who experienced the death of a child from birth to 29 years old, when wives displayed higher levels of coping aimed at rebuilding their lives after the loss of a child, their husbands displayed lower levels of depression and grief postloss. Other findings have shown that mothers take more time than fathers to recover and return to work when their child died from cancer (Sirkiä, Saarinen-Pihkala, & Hovi, 2000), and positive attitudes within couples about open communication were related to higher grief in the early stages of loss and lower grief in later stages (Kamm & Vandenberg, 2001). Although these studies provide some insight into parental bereavement and couples' experiences, the experiences of parents whose child with an intellectual disability dies are potentially qualitatively different to parents whose typically developing child dies (Reilly, Hastings, Vaughan, & Huws, 2008). For example, parents and foster parents whose child with an intellectual disability has died report disenfranchised grief; experience additional losses, including the loss of their self-defining caregiving role; and lack continued contact with the formerly supportive world of intellectual disability services (Milo, 1997; Reilly, Huws, Hastings, & Vaughan, 2008; Schormans, 2004; Todd, 2007; Wood & Milo, 2001).
For parents whose child with Down syndrome and a CHC dies, various factors may result in different grief experiences compared with bereaved parents whose child had Down syndrome but no CHC or had a different condition related to intellectual disability. Explanations offered for a possible "Down syndrome advantage" include maternal age, family income, and positive child characteristics (Seltzer, Krauss, & Taunematsu, 1993). When such issues are combined with cardiac conditions (Frid et al., 2002), there may be an impact on the bereavement experiences and the needs of parents of a child with Down syndrome and a CHC who has died.
In this study, we investigated, using qualitative methods, the experience of parenting a child with Down syndrome and a CHC from the perspective of bereaved couples. Previous research on bereavement in parents of people with intellectual disability has focused on the accounts of individual parents. In this study, we add to the published literature on this topic by examining the retrospective accounts of both partners in terms of how they constructed their experience of their child's birth, diagnosis, life, and death (at ≤ 18 years). In addition, we highlight potential similarities and differences that may occur between and within couples and how these ways of coping and sources of support might change pre- and postbereavement.
Methodological Approach
Research in the area of parental bereavement and intellectual disability is emerging, and, given the limited knowledge available, qualitative methods may be best suited for investigating this particular event (Neimeyer & Hogan, 2001). Interpretative phenomenological analysis (IPA; Smith, Jarman, & Osborn, 1999) is a qualitative approach whereby the participant is deemed an expert on their own experience. By using methods of interpretative analysis, we uncovered central themes from participants' accounts of particular events. Themes that emerged may be common across participants or unique to individual accounts. This diversity in accounts is key to IPA, whereas other qualitative methods may suppress the diversity of participants' accounts (Jarrett, Payne, Turner, & Hillier, 1999). IPA captures how participants make sense of their experience by asking them to identify the symptoms, themes, practices, and outcomes that they feel characterize their loss.
Participant numbers in IPA studies vary from 1 to 30; however, studies typically focus on small samples of 6 to 8 individuals (Brocki & Wearden, 2006). The use of a small, somewhat homogeneous group allows in-depth examination of accounts, more easily allows the identification of patterns of similarity and differences, and helps avoid the loss of subtle differences among participants (Smith, Michie, Stephenson, & Quarrell, 2002). Various methods are used to ensure the themes are internally coherent and to maintain a level of quality in results, including credibility checks carried out by multiple researchers, discussion with the research team, peer review, consultation with the participants on the accuracy of the findings, and the use of a reflexive journal (Carradice, Shankland, & Beail, 2002; Elliott, Fischer, & Rennie, 1999).
Central to the IPA approach is the recognition of interviews as a product of an interaction between participant and researcher. Smith et al. (1999) have written extensively on the topic, exploring how the view of the researcher influences the emergence of themes. An additional central tenet is the necessity of this interpretative activity in making sense of the personal world of the participant (Reid, Flowers, & Larkin, 2005). These considerations led our decision to choose this method over other qualitative methods. In the current study, the primary researcher (D.R.) was a PhD student completing psychological research with families in which a child with an intellectual disability had died. She received training on ways of working with bereaved individuals and had access to supervision from a clinical psychologist throughout the study. The study was approved by the research ethics and governance committee of Bangor University's School of Psychology.
Recruitment was facilitated by the Down's Heart Group, a U.K. charity that offers support and information regarding heart conditions associated with Down syndrome. The charity forwarded information (through traditional mail) about the study to bereaved parents whose child had died at least 12 months prior to being approached. Because previous research has found little evidence that parental grief diminishes over time (Leahy, 1993; Rando, 1985; Rubin & Malkinson, 2001), no upper limit was placed on time since loss, and no limits were placed on the age of child or parent. Parents initiated involvement by responding to the information they received by telephoning or e-mailing D. R. Parents individually provided written consent and participation in the research was not contingent on the involvement of both parents. The experiences of parents not included in the current study will be discussed elsewhere. D.R. spoke to all participants on the telephone to explain the research and answer any queries prior to arranging a suitable time to telephone them again and conduct the interview.
Six married couples whose child with Down syndrome and a CHC had died agreed to participate in the study. The mothers' ages ranged from 43 years to 62 years (M = 53.33 years, SD = 7.79). The fathers' ages ranged from 43 years to 76 years (M = 56.33 years, SD = 12.23). The children were between 2 years and 18 years (M = 9.08 years, SD = 6.33), at death, and the mean time since death was 10.83 years (range = 8–19 years, SD = 4.06). The children had been diagnosed with a variety of CHCs, including Tetralogy of Fallot, atrioventricular septal defect, and pulmonary atresia, and some were additionally diagnosed with cardiac conditions resulting from their CHC, such as Eisenmenger syndrome. All of the parents were biological parents to the child who died; 3 of the couples had a daughter who died, and 3 couples had a son. All of the parents were from England, with the exception of 1 Australian father and 1 mother from New Zealand. All of the children were born in England, and all of the families were living in England when their child died. None of the couples had other children with disabilities, and only 1 couple gave birth to additional children following the death of their child. Three of the children died in hospital following a period of medical intervention, and 3 were receiving palliative care when they died (1 in a hospice, 2 at home).
Data Collection
A semistructured interview schedule was developed, based on questions previously used by Milo (1997) to elicit parental responses to the death of a child with a developmental disability. Two pilot interviews were carried out with a mother and father couple who did not take part in the research project. Changes following the pilot included more prompt questions and equal focus on the birth as well as death of the child. A copy of the interview guide is available from the first author.
The interviews were conducted by D. R. over the telephone, an approach that has been rated in previous research to be less stressful for bereaved participants than nonbereaved controls (Taneja et al., 2007). Parents were interviewed separately, and on different days than their partner, and they were informed that their comments would not be disclosed during the interview with their partner. It was explained to parents that anonymous quotes from the interviews would be used in published material to emerge from the research. With participants' consent, the interviews were digitally recorded using a digital recorder and lasted an average of 58 min (range = 36–92 min).
Data Analysis and Interpretation
All interviews were fully transcribed by an external company specializing in transcription services. Twelve interviews were analyzed, a total of 237 pages of 1.5-spaced text in Times New Roman, font size 11. On average, interviews were 19.75 pages in length (mothers, 22.67 pages; fathers, 16.8 pages). Transcripts were then analyzed in accordance with IPA (Jarman, Walsh, & De Lacey, 2005; Smith, 1995; Smith et al., 2002). All of the interviews were completed prior to commencement of analysis. The first author annotated and coded the transcripts for the presence of important themes and produced summary documents containing mention of each topic. The process was repeated for each transcript. For each couple, the mother's, then father's, interviews were analyzed individually, compared with the other half of the couple, and then compared with and contrasted to other couples.
For purposes of audit and validation, the second author (J. H.), who has expertise in IPA, read through each transcript and the lists of themes, master themes, and quotes, ensuring the emerging themes were visibly grounded in the data and none had been omitted. A reflexive diary kept by the researcher was consulted throughout the analysis and writing process. This allowed checking of any unclear details and reviewing any comments made following the interview when there were disagreements with regard to meaning. Discussion between D. R. and J. H. resulted in minor changes to the arrangement of themes. The master-theme list changed constantly throughout analysis and writing, with the addition and collapsing of themes into categories until a final list of four themes emerged. The interview themes were not shared with participants. This topic is the subject of current debate among IPA researchers, but, given the interpretative nature of the approach, it is not applied in the majority of IPA research (Flowers, 2007). The themes are discussed below and illustrated with verbatim quotes from the interviews. For purposes of confidentiality, all quotes have been made anonymous. When providing extracts from the interviews, the following transcript conventions are used:
… = short pause
(…) = words omitted to shorten quote
[text] = explanatory information included by author
Four themes emerged from an analysis of interviews, and each theme is discussed and illustrated with verbatim extracts from the interviews. The themes are as follows: dilemmas associated with the dual diagnosis; "we had to make a decision"—treatment decisions during the life and the death of their child; "we weren't really going through it together"—ways couples coped when bereaved; and ripples from the child's life.
Theme 1: Dilemmas Associated With the Dual Diagnosis
None of the parents interviewed were aware their child had Down syndrome prior to the birth, and receiving a diagnosis of Down syndrome at, or soon after, the child's birth was difficult for all. This difficulty was confounded when parents were informed that their child also had a serious heart condition. This additional diagnosis was revealed within 12 weeks of the birth of these children in all but 1 case (where the heart condition was not diagnosed until the child was 18 months old). These cases of dual diagnosis were unexpected, and 1 father recounted how it "seemed to be one, sort of, disastrous diagnosis after another."
Where possible, the couples coped with the difficult situation together:
I was with her and the doctor came in and told us that, that she had Down's. He told us a little bit about the condition and but I don't think we were taking a lot in. And then he left and, you know, we sort of looked at each other and talked a little bit and [my wife] said, do you want to keep her. And there was no hesitation I wouldn't have even thought of it if she hadn't of asked. (father)
Circumstances, however, did not always facilitate this preferred way of coping. For example, 1 couple described how complications with the birth had separated them from each other:
And I felt very sorry for [my husband] because the first day I was really not with it. I kept phasing in and out so I'd wake up and then drop off and wake up and drop off, so it was a good day, I think, he was left completely on his own—well I wasn't functioning properly. (mother)
And I think what I remember is that feeling of being, sort of…you know, because my wife and I, together, are very strong, but when we're not together, I think it's, it's more difficult for each of us, so that, that whole experience, for both of us, we had to cope with that first 24 hours on our own, from the time the ambulance left to the, to the time that we were able to get my wife discharged the next morning. (father)
The impact of the diagnosis of a potentially life-threatening heart condition in addition to the diagnosis of Down syndrome was of more concern to all parents. They recalled that the heart condition and its related health problems often became the focus of their joint worries, such that the diagnosis of Down syndrome became a secondary issue: "I have to say that in all of this that the heart thing took over completely from the Down's thing. The Down's thing just was an incidental, because we were so worried about losing her" (mother).
There were instances when parental concerns about health were not validated and achieving medical care was not always straightforward:
I took him to the doctor, no, no, he's fine, he's just got a cold. And I did for four consecutive Mondays in that March and on the fourth time the doctor suggested it was me that had the problem, not [my son]. And he said really, there is nothing wrong with this child; I think the problem is you. I came away absolutely gutted and (…) took him to see a different doctor on the fifth Monday of that month and the doctor took one look at him and said he's got an enlarged liver, he's in heart failure. (mother)
Some parents discussed how they "kicked up a stink" (father) to ensure their child received medical attention. The diagnosis of a CHC additionally resulted in intense ongoing medical care of varied length in each family, meaning that parents spent a lot of time physically looking after their child:
Well, she was really difficult to look after because of the pain. She basically cried an awful lot, you know. It was frustrating not to be able to do anything for her, you know. I don't think in the first 12 months the two of us had a meal together. It was just holding her all the time. Trying to get her to sleep at night would take hours. It was hard going. (father)
In summary, it was apparent that being told that their child had Down syndrome and a CHC was difficult for parents and that the threat posed by diagnosis of Down syndrome was second to the physical health needs of their child. The subsequent care needs of their child with Down syndrome resulted in a caring role that lasted the length of the child's life for all mothers and fathers, which was fraught with difficulty but shared between parents. This joint responsibility took its toll on couples and their marital relationship, which was illustrated by the parents' exasperated accounts. These reports raise issues not yet fully attended to by intellectual disability researchers, one of which is the reality of receiving a second, potentially fatal, diagnosis for a child already diagnosed with Down syndrome. Previous research has illustrated the diversity of attributions of diagnosis that parents may hold (Dale, Jahoda, & Knott, 2006) and the outcomes that attributions of blame may have for parents: for example, higher parenting stress for parents who blamed health professionals for not preventing the birth of their child with Down syndrome (Hall, Bobrow, & Marteau, 1997). Hedov and colleagues (2002) illustrated findings of dissatisfaction with the timing of the diagnosis of Down syndrome, insufficient support and information, and too much negative information given to parents.
Theme 2: "We Had to Make a Decision"—Treatment Decisions During the Life and Death of Their Child
Parents were highly involved in their child's care, and, as a result, couples chose to make decisions jointly throughout their child's life, surrounding the child's medical treatment: for example, whether their child should undergo a risky procedure. Such decisions were agreed on jointly, but it was evident that a lack of information and time made decisions difficult:
When we went to see them about the heart, they said, she'd had a one in, a two in three chance of surviving the operation. And that was what I remember. And I said, terrible gamble, you know, there's a third chance that she'd die on the operating table (…). We had to make a decision there and I remember saying, it's like putting us in the position of God. (father)
In addition to choices surrounding treatment, parents had to make decisions during their child's life, and following their death, on issues of parenting, education, autopsies, seeing the body, burial and funeral arrangements, and their own future. Decisions were generally made jointly, and parents tended to talk about the importance of making decisions together or at least having someone else to share the decision-making responsibilities:
I think it was important to me. I still believe this, and I have done ever since, to have two people, not, not…even if it's not, you know, your, your partner, I think it's vital to have two people there. (father)
Sharing responsibility meant couples could share positive but also negative reflections on the experience: "When he died I said there's no way you're doing an autopsy on him. There was no way they were going to cut him open, but I wish they had have done it now" (father).
We'd both said that we didn't want a post mortem. In retrospect I wish there had been. I mean, they say that he died because there was heart and lung failure, but I don't know for sure really. You know, nobody really knew why he was in hospital or anything. I just wish now that there had been a post mortem, but at the time you don't want to go through that. (mother)
The above accounts illustrate the difficulty that making decisions posed for parents. They illustrate how good communication with a significant other was helpful and, for some, central to the decision-making process. Conversely, a lack of medical knowledge or making what parents saw as the wrong decision, such as whether to have an autopsy performed, may result in regret and guilt for parents. Research in other areas of intellectual disability has confirmed this need for clear information and communication on the part of health care professionals involved in diagnosis (Graungaard & Skov, 2007). In this particular situation, parents experience a double diagnosis that brings with it decision-making responsibilities but may also result in attributions of blame. The impact of both may make coping more difficult and add to parents' emotional responses.
Theme 3: "We Weren't Really Going Through It Together"—Ways Couples Coped When Bereaved
The couples fell into two groups with regard to whether they coped with their grief: separately or together, as a couple.
Coping separately
Although the partners were interviewed individually, 2 of the couples clearly spoke similarly of difficulties comforting each other in their grief, gender differences in grieving causing problems, and additional losses that may have confounded the grief experience: "I suppose at the time what made it worse was that we were both going through it, we weren't really going through it together; we were going through it apart and rubbing up against each other" (father).
In both sets of parents, both partners discussed additional losses, including financial worries following the death, illness, the impact of grief on siblings, and lost support networks. However, it was the topic of having more children after their child had died that became a key focus of the interviews with mothers and fathers. Mothers, in addition to losing their child, reported losing a caregiving role they had expected would continue for years to come, and this was made more acute by an inability to have more children and recover this role:
I was sterilised when my youngest was two (…) I thought it was my responsibility to have it done (…) when [my son] died, I really was angry about that, because even though we were [age] when [my son] died, it would have been nice to have the choice. I know you can't replace your child or anything, but it was my way of life, bringing up children. (mother)
These additional losses were potentially responsible for increased communication difficulties and problems in the marital relationships:
So the menopause thing merged into the grieving, and they kind of fed on each other, probably. Talking about it now, I don't know why [my husband] is here, actually. Why he didn't clear off with [our other daughter] I don't know. (mother)
Coping as a couple
In contrast, the other 4 couples interviewed talked about how everyone experiences grief differently and how this diversity could not be attributed to gender difference alone. Their different ways of coping required sacrifice and patience, and it was the belief of 4 of the couples that tackling their grief jointly had brought them closer:
Well, we've always been very good friends and we've just…we spent the time together just talking, you know, about [our daughter], about what we were going to do. I think [my husband] found it harder to relate to other people or have contact with other people during that time (…). I'm sort of more easygoing about that sort thing, but my main priority, my main concern then, was, you know, what [my husband] needed (…). And I think, looking back now, I think that it helped, you know. It helped because I think we talked about a lot of things then that, had we both been working and we both dashed back to work after a month or whatever, I don't think we would ever have talked about. (mother)
Coping with their grief was not an easy task, and 1 parent highlighted the difference that being bereaved as a couple made to his experience by comparing that experience with a previous loss:
Having lost parents, there's a huge difference between losing a parent and losing a child, because if you lose a parent your wife isn't bereaved in the same way, if it's your parent (…). You know, even, for example, and it's, it's not an issue, but I was just trying to give you a clear example, even taking part in this research. As it turned out, we both were keen to do it, but if one was keen to do it but the other one would be upset by it, even the thought of the partner doing it, it, it is different because you are bereaved as a couple, and that's true all the way through. (father)
The death had changed the lives of both partners thus they had to rebuild their lives and readjust together, not separately:
So I think it was something which mostly we coped with, [my husband] and myself, and then increasingly [our older son], as we felt able talk about it, and readjusted, in a sense, to the loss of [our son], and being a three rather than a four. (mother)
By sharing their emotions and supporting one another, the partners were less dependent on external sources of support and were the main source of support for each other:
But we helped one another, you know. I mean, because, you know…I knew that [my wife] had, you know, had lost [our daughter] and she knew that I'd lost [our daughter], so we helped one another. Well, we didn't think or consider it as help, you just, you just fall on one another's shoulders and sob. (father)
This was in contrast to the 2 couples who had found their grief difficult to cope with jointly. These couples highlighted the need for support from other sources: family, friends, doctors, other bereaved parents, counseling, and Down syndrome support groups:
The problem was we'd moved house (…) so [my wife] (…) had no real support. It wasn't until after about a year when we finally found a house and moved in and she got a doctor who said, well, what counselling did you get? The answer was none. She finally got some help. I really regret that we did that. (father)
The majority of parents were not offered bereavement counseling when their child died. Of the 2 mothers who received formal counseling, 1 found it useful and the other found it less so. One mother reported that her husband requested, but did not receive any, counseling through his local general practitioner and, consequently, felt let down by the lack of services:
And [my husband], unfortunately, had a worse experience and never really got any counselling at all. And I felt he was let down; he was let down. It often takes a lot of courage to ask for help, to get to the point of asking for help and then, when you do, then he really had to sort of fight to get some help and then never did. And then that in itself creates its own stress so he was let down and it wasn't fair. (mother)
The variety in accounts illustrate how differences in grieving were not simply gender dependent but a complex combination of prebereavement relationships, ways of coping, support received, and the impacts of other life events. The unmet counseling needs of parents also indicate the importance of recognizing the diverse and individual needs of bereaved parents (Robinson & Marwit, 2006). Parents in the current study discussed the importance of joint decision making with a partner, the different experience that comes from being bereaved as a couple, and an awareness of the potential for marital discord following bereavement, such as that stemming from an inability to have more children. Such difficulties may be closely related to marital satisfaction, a construct that is at the center of research into cognitions in marriage and marital distress (Bradbury, Fincham, & Beach, 2000; Fincham, 1994). Marital deterioration and breakdowns in communication were reported by some parents, and previous research has reported these factors as potential outcomes in some marriages following the death of a child, in addition to marital breakdown, a decrease in sexual intimacy, and conflict and anger (Oliver, 1999).
Theme 4: Ripples From the Child's Life
Although the death of their child brought negative repercussions, including financial worries, poor physical and mental health, and lifestyle changes, parents discussed the positive ripples that spread out from their child's life touching both family members and outsiders:
[My son]'s life touched on lots of other people, and a surprising number of people have been influenced by [my son]. (…) There are friends who've looked after [my son], who've subsequently gone into special education, into clinical psychology, specialising in learning disability. He's obviously influenced [my wife]'s current work, so all these ripples have gone out from [my son]'s life, and that helps to make sense. (father)
The parents explained a variety of additional positive outcomes of their child's life, including relief, career change, personal strength, confidence, patience, sensitivity, and perspective. These positive outcomes were reported by some as a result of the cyclic experience:
I perhaps have realised that I am a stronger (…) there's like an inner strength that rises up and you do, as I say, you find it within you to cope with these things. And so I guess I look back and I think, gosh, you know, we have been through a lot and we have come out the other side, you know. (mother)
Others, fathers in particular, differed from their partners and from each other with regard to how they viewed the impacts of their child's lives. One father stressed that the change for the better that he and his family experienced was an outcome of his daughter being born, not dying: "I believe it was [my daughter] being born that changed [our lives] and not [my daughter] dying, although obviously, when she died it devastated us. But I think our lives changed when [my daughter] was born" (father). However, that father recognized the positive impact that her death has had in terms of his current involvement in his children's lives: "And I think that's possibly something to do with [my daughter] dying. It makes you unapologetic for, for making the most of every opportunity" (father).
In addition, 2 of the other fathers reported that the experience of raising and losing their child had confirmed who they were and maintained the positive outlook they already had:
I think yeah, that. I think it's confirmed who I was, really. I don't think it's changed me that much. But, you know, hopefully, it deepened me or something and made me aware, more aware, that life is very fragile, but I think I knew that anyway. (father)
Most important for the couples seemed to be the impact that the experience of raising and losing a child with Down syndrome and a CHC had on their marital relationship:
I mean, you often hear of families with handicapped children sort of broken up as a result of that child being born, or dying, or just the sheer difficulty of living. But in our case I think it brought us even closer. (mother)
A positive outcome had been achieved despite tribulations along the way, and even the couples who had encountered some difficulty in coping with grief as a couple reported this:
It's not something that wouldn't affect anything. So yes it affected us for all the good and all the better or all the worse. I don't think it changed it probably. It changed both of us the way we think of each other and think of life and things I suppose. I mean I became much less driven by work after that. The only thing that matters now is [my wife and daughter]. (father)
Positive reflections on their experience were seen at some level in the accounts of all parents. Whether a response to their child's life, death, or both, parents attributed both personal change and growth to their experience in a positive way despite the considerable grief they had experienced. These positive reports were similar to previous research reports with bereaved biological and foster parents whose child with an intellectual disability died (Milo, 1997; Reilly, Huws, et al., 2008; Schormans, 2004; Todd, 2007).
The findings of the current study give insight into an area of parenting a child with Down syndrome that has been largely overlooked by researchers. To our knowledge, our research on the topic of the impact of the death of a child with Down syndrome and CHC on parents is the first of its kind. The interviews with couples highlighted issues that are uniquely pertinent to this group, namely receiving multiple diagnoses of Down syndrome and a CHC, the more considerable threat carried by the CHC diagnosis, and a role in decision making surrounding medical treatment, including heart surgery. In the realm of bereavement research, it has been suggested that qualitative methods may be used to explore novel subject areas, which can be refined and probed further by quantitative means (Neimeyer & Hogan, 2001; Owens & Payne, 1999; Parkes, 1985; Stroebe, Stroebe, & Schut, 2003).
In the current research, we provide an in-depth look into the experiences of bereaved couples whose child with Down syndrome and a CHC had died and a starting point for future research. However, a large number of couples chose not to take part in this study, and, therefore, it is unknown how representative the participating couples were of the wider group of similarly bereaved parents. In addition the time since loss ranged from 8 to 18 years, and it is possible that parents whose children had died more recently would report different experiences and views: In particular, as with all bereavement research, those who were the most vulnerable may have chosen not to take part (Dyregrov, 2004). In addition, telephone interviews were used. In-person interviewing could have resulted in a different research relationship developing between the researcher and interviewees (Rosenblatt, 1995); however, research has suggested there are no significant differences between interviews conducted in person and those done over the telephone (Sturges & Hanrahan, 2004).
Despite these limitations, this research can be viewed as a starting point for future research by linking themes with previous findings. Parents reported that they found the process of receiving, first, a diagnosis of Down syndrome and, then, an additional diagnosis as difficult. Although much has been written on the process of diagnosis of Down syndrome and how it has changed with the availability of prenatal diagnosis (Lenhard et al., 2007), little is known about the diagnosis of additional medical conditions (Self, 2008). In addition, communicating the diagnosis of Down syndrome can be influenced by professionals' believes of attribution and blame (Elwy, Michie, & Marteau, 2007). Because long-term outcomes of the diagnostic process are not known (Poehlmann et al., 2005), additional research and training are required to ensure the process of diagnosis is sensitive to the needs of parents.
Although some couples in this study reported differences in grieving, which they attributed to gender differences, the parents reported that they felt that the differences in grief could not be explained by gender differences alone. Differences in grief symptoms according to gender that has been found by other bereavement researchers have been questioned as potentially no more than a function of grief measures insensitive to male ways of grieving (Lang & Gottlieb, 1993). In addition, in reporting benefits found in their experience, some parents reported positive outcomes in terms of their marital relationship. All the marriages in the current research were intact, and predictions surrounding a higher likelihood of marital breakdown following the loss of a child are potentially overestimated (Murphy, Johnson, & Lohan, 2003). In addition, research has found lower rates of divorce in families of children with Down syndrome compared with families of children with other conditions present from birth or no identified disability (Urbano & Hodapp, 2007). When divorce occurred, individual factors, including age of the child, age of parents at marriage, educational history, and living location, were influential (Urbano & Hodapp, 2007). Additional research with larger groups of mothers and fathers of children with Down syndrome and a CHC could investigate grief experience and marital outcomes and their contribution to adaptation in parental bereavement.
The putative effect of the "Down syndrome advantage" in other areas is also unknown. To what extent might the relative commonality, family characteristics, or stereotypical views of the wider public of people with Down syndrome impact the availability of support for parents? Research involving groups of parents whose children with other and more infrequent intellectual disability–related conditions have died would help illuminate parental experiences across a variety of circumstances and allow comparisons between groups.
Topics not raised by the current sample but raised previously by research with parents of children with an intellectual disability include feelings of anger, guilt, and disenfranchised grief (Attig, 2004), in which others do not view parental grief as valid or appropriate because their child had an intellectual disability (Milo, 1997; Reilly, Hastings, et al., 2008; Wood & Milo, 2001). The absence of these topics may be accounted for by individual differences, the couples may not have framed their experiences in this way, or the experiences of bereaved parents of children with Down syndrome may be specifically different to that of other parents. Comparative research could help us better understand these patterns. Research has highlighted the medical complications (Tigay, 2009) and familial implications (Self, 2008) of caring for a child with Down syndrome and leukemia; however, the topic of bereavement following leukemia has not been explored by research. Additional research exploring the experiences of parents caring for children with Down syndrome and other chronic health conditions could further our knowledge in this area.
In terms of bereavement interventions for parents of children with Down syndrome, the current research and sample has the potential to inform practice and research in this area. Parents were not homogenous in terms of the support they found useful, and although some reported accessing professional bereavement counseling, this was not universal nor did it play a significant role in their stories. Research tells us that parents may take between 4 and 9 years to report improvements on measures of anxiety and depression following the death of a child to cancer (Kreicbergs et al., 2004). This should be considered in terms of the risk of "problematizing" a normal reaction to the loss of a loved one and idealizing a period following the loss where symptoms of grief will be absent (Moules & Amundson, 1997).
If interventions are deemed necessary it should also be recognized that the effectiveness of traditional bereavement intervention has been scrutinised and found to be lacking (Jordan & Neimeyer, 2003; Rowa-Dewar, 2002). Within the methodologically sound parental bereavement intervention studies (Jordan & Neimeyer, 2003), interventions have been found to be most useful for mothers and those who are the most distressed (Murphy et al., 1998; Murray, Terry, Vance, Battistutta, & Connolly, 2000). However, given the depth of experience described by fathers in this study, it is imperative that interventions are tailored to paternal needs as well. Suitable interventions for this group could be developed with reference to previous studies in which extensive detail on procedure is provided (e.g., Murphy et al., 1998). Parents in the current and previous studies reported the benefits of support from similarly bereaved parents (Milo, 1997; Reilly, Huws, et al., 2008). Service providers could become involved in bereavement intervention by facilitating support groups for parents and couples.
In conclusion, although small in scale, this qualitative study identifies some important areas for future research and clinical practice. The results highlight the importance of the process of diagnosis and decision making and suggest that improved and increased awareness on the part of health care professionals could have valuable implications for parents. In addition, the current study uncovered perceptions of how the bereavement experience may differ as a result of being part of a couple and/or having a child with both physical health problems and an intellectual disability. Health care and bereavement professionals should be aware of both the individual needs of each parent and the mutual support partners can provide to each other.
This research was supported by Mencap Cymru, the European Social Fund, and Bangor University.
Author notes
Editor-in-Charge: Steven J. Taylor
Deirdre Reilly, PhD (firstname.lastname@example.com), Trainee Clinical Psychologist, School of Psychology, University of East London, London, E15 4LZ, United Kingdom. Jaci C. Huws, PhD, Lecturer, School of Healthcare Sciences, College of Health & Behavioural Science, Bangor University, Bangor, Wales, LL57 2EF, United Kingdom. Richard P. Hastings, PhD, Professor of Psychology, School of Psychology, Bangor University, Bangor, Wales, LL57 2AS, United Kingdom. Frances L. Vaughan, PhD, DClinPsy, Senior Research Fellow, School of Psychology, Bangor University, Bangor, Wales, LL57 2AS, United Kingdom.


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text: WE WERE PROMISED JETPACKS Saturday, May 30, 2020 at 8:00pm$17.00 advance$20.00day of show21+Venue: Turf Club https://www.facebook.com/events/227214055341148/Info TabsDetailsTHIS SHOW HAS BEEN CANCELED All tickets purchased online will be automatically refunded. If you are interested and able to donate, consider putting the cost of your ticket toward the TC Music Community Trust's Entertainment Industry Relief Fund in support of individuals in need. All funds donated will directly impact someone who has lost a gig due to COVID-19 and its effect on the industry. The outpouring of words of encouragement and monetary donations thus far has been incredible, and we thank you for your continued support of the Twin Cities music scene. Donation link and more information can be found at bit.ly/39Pwu8Z. For any ticketing questions, please contact Etix at 1-800-514-3849, or at support.etix.com. If you purchased tickets with cash at an outlet, you will be able to request a refund at The Depot Tavern when it has reopened. PerformersPerformer: WE WERE PROMISED JETPACKS WEBSITEFACEBOOKTWITTERINSTAGRAMSometimes you have to go back to basics in order to find yourself again. This is something Scottish rock band We Were Promised Jetpacks realized over the course of creating their fourth full-length album, The More I Sleep The Less I Dream. Lyrically, The More I Sleep The Less I Dream reflects a group of people who have grown up since they first emerged on the scene with These Four Walls in 2009. Read more about WE WERE PROMISED JETPACKS


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This California CD 160 is a hard to find one. It's not sage green or light yellow green...it's LIGHT GREEN (at least that's what my eyes see). Only a small inner skirt chip and a tiny base annealing day-one fissure is it for any flaws....it also has some nice bubbles in the base as well as a few in the dome too.
Asking $124 plus $8 shipped in the USA


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The Soap Works Old-Fashioned Stain Remover Laundry Bar
227 g
The Soap Works Old-Fashioned Stain Remover Laundry Bar is rated out of 5 by 6.
The Soap Works Old-Fashioned Stain Remover Laundry Bar is the same bar that grandma used for collar and cuffs, floors and walls – and grandpa! It's an excellent and economical pre-treatment for stains. No excessive packaging.
- Gluten Free
- Not tested on animals
- DOES NOT contain sodium laurel, lauryl or laureth sulphate
- Phosphate free
- Comes without packaging
No Information Provided
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Rated 5 out of 5 by Carly from Will never use Spray and Wash again. This works better than anything I have used. The fact it's super safe for the baby too makes it even better. I had strawberry stains all over the white change pad I rubbed it on and it turned purple so I figured it didn't work. I then washed it normal with Nellies soap no bleach. And voila no stain. I also had a few things that had #2 stains that were a couple days old I had forgot about and same thing gone. Very impressed. This is no joke.
Date published: 2020-01-10
Rated 5 out of 5 by It'sAllPoop from Best Baby Stain Remover! Someone gifted this bar to me when I had my first baby. It has been a lifesaver when it comes to cleaning up that nasty yellow baby poo that is never-endingly sneaking out of diapers. I use this on clothing as well as cloth diapers and it has been incredibly effective at stain removal--- hot water, cold water, no water. It works on everything! I recently bought 5 more bars and I'll be handing them out to any expecting moms I know!
Date published: 2020-05-17
Rated 5 out of 5 by Greenivvy from It works I've tried bleach, peroxide and other stain removers and after reading the reviews thought to try this. I'm soooo glad I did, it it works. It took out the underarm stains like magic ..so I bought 10!
Date published: 2020-06-25
Rated 5 out of 5 by Meg from Pleasantly surprised by this laundry soap! I haven't tested it against strong stains yet, but it washes well overall, suds up quickly, doesn't leave a strong scent, and reduces my plastic waste.
Date published: 2020-06-15
Rated 5 out of 5 by Mumsie from Best laundry bar! Just recently bought this bar of soap based on the reviews. Glad I did! It removed the yellow stains on my son's underarms white shirts which I was planning to throw out.
Date published: 2020-03-13
Rated 5 out of 5 by ko from It's so nice to have a gentle option for stains on pretty much anything without harsh chemicals, that actually works
Date published: 2020-05-06


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eBook Title for Download :The Ghosts of Sleath (Format : mp3 , Language : English)
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Investigator David Ash is sent to the picturesque village of Sleath in the Chiltern Hills to look into mysterious reports of mass hauntings. What he discovers is a terrified community gripped by horrors and terrorized by ghosts from the ancient village's long history.
Author(s) Book :James Herbert
Publish Year :1970 Publisher :
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Motocross event a mad success
THEY promised a lot but the Maclean Dirt Bike Club – with some luck from the weather gods – delivered a perfect day of racing at the Motocross Madness event.
Last year saw 81 riders line up in the 12-division competition.
That figure jumped to 130 and – when you throw in around 500 intrigued spectators – made the event a raging success for Janelle Dillon and her dirt bike club.
"The club is stoked," the secretary said.
"We have got a great publicity officer who has got it out there.
"And we have a lot of help from the other clubs in the area.
"The day was a mad success."
Riders ranging from under-4 to social and over-35 took to Maclean's Motorcycle Park for the competition.
But it was the fans who were the big winners as the weather, which threatened to call a hlt to the fun, stayed away and gifted officials a dream day.
"We were so lucky with the weather," Dillon said.
"We had rain all night and the track was quite muddy in the morning but the rain stayed away and we ended up with a perfect day."
While many impressed, it was Jacob McLeod who stole the show with wins in all three of his age categories.
He claimed the senior lite, open lite and open all powers divisions.
"I think the riders just love getting out there and competing," Dillon said.
"And it's a real family day. The older riders go and help the younger ones.
"There was some great competition throughout all the junior classes."
The success of the event means fans can't wait for next year's competition which, based on the current growth, will be a blockbuster.


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Visiting Entrepreneur-in-Residence to join Marietta College Feb. 26
February 20, 2020
Angie Stocklin, co-founder and former Chief Operating Officer for One Click Internet Ventures, will join Marietta College as the second Visiting Entrepreneur-in-Residence during the spring semester. Stocklin will begin working with students on Wednesday, February 26th and Thursday, February 27th. She will also return in April for three days...Read More
College welcomes back Dr. Douglas Greene '62 as first Entrepreneur-in-Residence
February 25, 2019
Dr. Douglas Greene '62 is a man of action. He built a career on it and now, in retirement, he's sharing his knowledge with others. "My thought process is if there's a problem I'll see if there's a solution," he said. "If not, why shouldn't I just do it?"Read More


text: The area benefiting most from the introduction of new technology has to be the world of online learning. This was once a rather abstract idea and while it offered an alternative to traditional school programs, it fell substantially short of a full learning experience. However that is no longer the … Continue Reading


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Subject Source: Library of Congress Subject Headings
Found in 7 Collections and/or Records:
Board Roster and Directory, 1965-1966
Identifier: B157.01.0003.0020
Overview Board roster and directory for the 1965-1966 Denver chapter officers, committee officers and chairmen.
Dates: 1965-1966
Box 1: Internal Documents, 1965 - 2005
File — Box U183.0001: [U186018607167]
Identifier: U183.0001
Overview Box one (1) contains multiple file folders whose contents are related to the University of Denver Residence Department. Materials include newspapers, correspondence, department directories, Johnson-McFarlane Hall records, living/learning communities records, presentations, proposals, calendars, and bulletins.
Dates: Majority of material found within 1965 - 2005
Box 11: University of Denver Student Directory, 1921-1951
File — Box U191.0011: [U186018609606]
Identifier: U191.0011
Dates: 1921-1951
Found in: Special Collections and Archives / U191, Students
Box 97: Club Directories
File — Box D096.0097: Series D096.05 [U186023278583]
Identifier: D096.05.0097
Overview This box contains directories from square dance clubs across the country, arranged alphabetically.
Dates: 1850-2007
New York Publicity, 1955
Identifier: B360.03.0034.0027
Overview Sprial bound 35 page book of New York publicity outlets from 1955.
Dates: 1955
St. Louis Auxiliaries, 1966-1969
Identifier: B360.03.0034.0017
Overview Two editions of the Recorder for the St. Louis Auxiliaries which include participants, offciers, sponsors and contact information.
Dates: 1966-1969
Staff Phone Directories, 1979, 1982
Identifier: B005.06.0185.0010
Scope and Contents National Jewish Hospital telephone directories (1978-1979, 1982) in alphabetical order on computer print-out sheets.
Dates: 1979, 1982


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Spreadsheet Details
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Meg01 V0 Wholesale, V0 Suppliers – Alibaba
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Original AUO M190EG01 V0 19″ 1280*1024 TFT LCD PANEL M190EG01 V.0 1208
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Electronics Engineering Group Leader - USA
Are you looking for a great opportunity with fasttrack career advancement potential? Do you have experience with electronic design and image acquisition? Videology is searching for a innovative Design Engineering Group Leader. We seek an experienced electronic hardware designer to lead our design engineering staff. Use your record of ingenuity and problem solving to make a mark on this organization.
Videology designs, develops, and manufactures video image acquisition and display technologies to customers worldwide As a global leader in video camera design and manufacturing we provide the highest quality, most cost-effective products and solutions available, serving OEMs & system integrators in the Medical, Industrial, and Government security markets. We maintain a "can do" spirit and approach against all odds. We do not give up.
Job Responsibilities
The Design Engineering Group Leader is responsible for planning and coordinating all design engineering activities required for new product development and engineering support for manufacturing operations. This includes the engineering of products and systems that may involve:
- Design and redesign; validation testing; failure analysis; and related activities
- Reporting on engineering activities and findings
- Assigning engineering resources in accordance with time schedules, quality parameters, customer needs, market needs and manufacturing capabilities
- Performing hands-on design engineering and product evaluation tasks
Job Duties:
- Directly supervise the in-house design teams in USA and Europe. Direct the technical efforts of design contractors
- Develop, implement, and maintain an effective NPI process, ensuring products meet spec, meet manufacturability standards, and are released on schedule
- Coordinate engineering resources for product development, manufacturing support and production test development
- Develop and maintain the transparent reporting of project status
- Convert marketing specifications into product design specifications
- Lead engineering design review, prototype builds, and product release to manufacturing
- Prepare technical data such as qualification test procedures, acceptance test procedures, reports, etc.
- Interact with customers on engineering designs and any issues they may have during the product development cycle
- Facilitate relevant communication with sales, logistics, customers, operations and senior management
- Interact with manufacturing personnel to define and solve manufacturability issues and implement cost reduction ideas
Qualifications | Skills:
- Critical thinking skills
- Desire and ability to grow and learn
- Capability to manage multiple priorities in a fast-paced dynamic environment
- Ability to organize, coordinate, and direct team activities
- Leadership for problem-solving teams using structured problem-solving methods like 8D and A3
Education and Experience Requirements:
- Ten years' experience in the design of both hardware and software engineering
- Five years' experience in project management
- Three years' experience managing a technical staff
- Bachelor's Degree in electronics engineering or equivalent experience
This is an immediate opening. Videology offers a competitive salary and a comprehensive benefit package: including medical, dental, paid holidays & vacations, IRA with company matching at 2%, and tuition reimbursement.
For consideration please forward your resume in confidence to:
firstname.lastname@example.com Attention: HR/ Design Engineering Group Leader - USA
or FAX 401-949-5276


text:
https://bibisboutique.co.uk/wp-content/uploads/2016/05/smoothie-bowls-652x316.44.jpg 316 652 India Evans https://bibisboutique.co.uk/wp-content/uploads/2016/02/bibi-logo-web-retina-2.png India Evans2016-05-13 14:37:252016-05-13 14:37:25Smoothie Bowls….
Smoothie Bowls….
Smoothie Bowls! never heard of them? no neither had we until this week.
thanks to our favourite mrs Mary Portas letting us all in on the secrets of what we are buying this week with her new program "what Britains buys" we now know we are actually super trendy foodies! we've been using bowls for years!
mostly thanks to healthy eating trends and another one of our favourites instagram, we now know all food looks and tastes better in bowls.
want to know more about our bowls? click here
want to know more about of the death of the poor old plate? click here