text:
Most Cited Patient Education and Counseling Articles
The most cited articles published since 2011, extracted from Scopus.
Patient preferences for shared decisions: A systematic reviewBetty Chewning | Carma L. Bylund | Bupendra Shah | Neeraj K. Arora | Jennifer A. Gueguen | Gregory Makoul
Volume 86, Issue 1, January 2012, Pages 9-18
Objectives: Empirical literature on patient decision role preferences regarding treatment and screening was reviewed to summarize patients' role preferences across measures, time and patient population. Methods: Five databases were searched from January 1980 to December 2007 (1980-2007 Ovid MEDLINE, Cochrane Database of Systematic Reviews, PsychInfo, Web of Science and PubMed (2005-2007)). Eligible studies measured patient decision role preferences, described measures, presented findings as percentages or mean scores and were published in English from any country. Studies were compared by patient population, time of publication, and measure. Results: 115 studies were eligible. The majority of patients preferred sharing decisions with physicians in 63% of the studies. A time trend appeared. The majority of respondents preferred sharing decision roles in 71% of the studies from 2000 and later, compared to 50% of studies before 2000. Measures themselves, in addition to patient population, influenced the preferred decision roles reported. Conclusion: Findings appear to vary with the measure of preferred decision making used, time of the publication and characteristics of the population. Practice implications: The role preference measure itself must be considered when interpreting patient responses to a measure or question about a patient's preference for decision roles. © 2011 Elsevier Ireland Ltd.
Motivational interviewing in medical care settings: A systematic review and meta-analysis of randomized controlled trialsBrad Lundahl | Teena Moleni | Brian L. Burke | Robert Butters | Derrik Tollefson | Christopher Butler | Stephen Rollnick
Volume 93, Issue 2, November 2013, Pages 157-168
Objective: Motivational Interviewing (MI) is a method for encouraging people to make behavioral changes to improve health outcomes. We used systematic review and meta-analysis to investigate MI's efficacy in medical care settings. Methods: Database searches located randomized clinical trials that compared MI to comparison conditions and isolated the unique effect of MI within medical care settings. Results: Forty-eight studies (9618 participants) were included. The overall effect showed a statistically significant, modest advantage for MI: Odd ratio = 1.55 (CI: 1.40-1.71), z= 8.67, p< .001. MI showed particular promise in areas such as HIV viral load, dental outcomes, death rate, body weight, alcohol and tobacco use, sedentary behavior, self-monitoring, confidence in change, and approach to treatment. MI was not particularly effective with eating disorder or self-care behaviors or some medical outcomes such as heart rate. Conclusion: MI was robust across moderators such as delivery location and patient characteristics, and appears efficacious when delivered in brief consultations. Practice implications: The emerging evidence for MI in medical care settings suggests it provides a moderate advantage over comparison interventions and could be used for a wide range of behavioral issues in health care. © 2013.
Effective training strategies for teaching communication skills to physicians: An overview of systematic reviewsMarianne Berkhof | H. Jolanda van Rijssen | Antonius J M Schellart | Johannes R. Anema | Allard J. van der Beek
Volume 84, Issue 2, August 2011, Pages 152-162
Objective: Physicians need good communication skills to communicate effectively with patients. The objective of this review was to identify effective training strategies for teaching communication skills to qualified physicians. Methods: PubMED, PsycINFO, CINAHL, and COCHRANE were searched in October 2008 and in March 2009. Two authors independently selected relevant reviews and assessed their methodological quality with AMSTAR. Summary tables were constructed for data-synthesis, and results were linked to outcome measures. As a result, conclusions about the effectiveness of communication skills training strategies for physicians could be drawn. Results: Twelve systematic reviews on communication skills training programmes for physicians were identified. Some focused on specific training strategies, whereas others emphasized a more general approach with mixed strategies. Training programmes were effective if they lasted for at least one day, were learner-centred, and focused on practising skills. The best training strategies within the programmes included role-play, feedback, and small group discussions. Conclusion: Training programmes should include active, practice-oriented strategies. Oral presentations on communication skills, modelling, and written information should only be used as supportive strategies. Practice implications: To be able to compare the effectiveness of training programmes more easily in the future, general agreement on outcome measures has to be established. © 2010 Elsevier Ireland Ltd.
A systematic review of motivational interviewing training for general health care practitionersLena Lindhe Söderlund | Michael B. Madson | Sune Rubak | Per Nilsen
Volume 84, Issue 1, July 2011, Pages 16-26
Objective: This article systematically reviews empirical studies that have evaluated different aspects of motivational interviewing (MI) training for general health care professionals. Methods: Studies were obtained from several databases. To be included, the MI training had to be provided specifically for general health care practitioners for use in their regular face-to-face counselling. The training outcomes had to be linked to the MI training. Results: Ten studies were found. The median length of the training was 9. h. The most commonly addressed training elements were basic MI skills, the MI spirit, recognizing and reinforcing change talk, and rolling with resistance. Most studies involved follow-up training sessions. The study quality varied considerably. Five studies assessed training outcomes at a single point in time, which yields low internal validity. Four studies used random assignment of practitioners to the MI training and comparison conditions. The training generated positive outcomes overall and had a significant effect on many aspects of the participants' daily practice, but the results must be interpreted with caution due to the inconsistent study quality. Conclusions: The generally favourable training outcomes suggest that MI can be used to improve client communication and counselling concerning lifestyle-related issues in general health care. However, the results must be interpreted with caution due to inconsistent methodological quality of the studies. Practice implications: This review suggests that MI training outcomes are generally favourable, but more high-quality research is needed to help identify the best practices for training in MI. © 2010 Elsevier Ireland Ltd.
Health information seeking: A review of measures and methodsAshley E. Anker | Amber Marie Reinhart | Thomas Hugh Feeley
Volume 82, Issue 3, March 2011, Pages 346-354
Objective: Outlines the methods and measures commonly used to study active health information seeking and prescribes important considerations in advancing the study of patient information seeking. Methods: A systematic review of the literature from 1978 to 2010. A single bibliometric database, PsychInfo, identified 648 articles of health information seeking. The 129 articles included in the review were coded by type of sample, measures (n=12) utilized to study health information seeking, and types of study methods (n=5). Results: A majority of studies used non-clinical samples and measured general health information seeking (i.e., whether the participant engaged in a search for health information) through cross-sectional study designs. Conclusions: There are varying samples, measures, and designs used to identify those who do or do not seek health information. Future research should look into how health information seeking influences health management and should uncover the social and relational functions of health information seeking using more advanced (and less routinely applied) measures and methods of studying health information seeking. Practice implications: More people are actively searching for health information and health providers should address this in their discussions with patients. © 2011 Elsevier Ireland Ltd.
Patients' and health professionals' use of social media in health care: Motives, barriers and expectationsMarjolijn L. Antheunis | Kiek Tates | Theodoor E. Nieboer
Volume 92, Issue 3, September 2013, Pages 426-431
Objective: To investigate patients' and health professionals' (a) motives and use of social media for health-related reasons, and (b) barriers and expectations for health-related social media use. Methods: We conducted a descriptive online survey among 139 patients and 153 health care professionals in obstetrics and gynecology. In this survey, we asked the respondents about their motives and use of social network sites (SNS: Facebook and Hyves), Twitter, LinkedIn, and YouTube. Results: Results showed that patients primarily used Twitter (59.9%), especially for increasing knowledge and exchanging advice and Facebook (52.3%), particularly for social support and exchanging advice. Professionals primarily used LinkedIn (70.7%) and Twitter (51.2%), for communication with their colleagues and marketing reasons. Patients' main barriers for social media use were privacy concerns and unreliability of the information. Professionals' main barriers were inefficiency and lack of skills. Both patients and professionals expected future social media use, provided that they can choose their time of social media usage. Conclusion: The results indicate disconcordance in patients' and professionals' motives and use of social media in health care. Practice implications: Future studies on social media use in health care should not disregard participants' underlying motives, barriers and expectations regarding the (non)use of social media. © 2013 Elsevier Ireland Ltd.
Knowledge is not power for patients: A systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision makingNatalie Joseph-Williams | Glyn Elwyn | Adrian Edwards
Volume 94, Issue 3, March 2014, Pages 291-309
Objective: To systematically review patient-reported barriers and facilitators to shared decision making (SDM) and develop a taxonomy of patient-reported barriers. Methods: Systematic review and thematic synthesis. Study findings/results for each included paper were extracted verbatim and entered into qualitative software for inductive analysis. Results: Electronic and follow-up searches yielded 2956 unique references; 289 full-text articles were retrieved, of which 45 articles from 44 unique studies met inclusion criteria. Key descriptive themes were grouped under two broad analytical themes: how the healthcare system is organized (4 descriptive themes) and what happens during the decision-making interaction (4 descriptive themes, 10 sub-themes). Predominant emergent themes related to patients' knowledge and the power imbalance in the doctor-patient relationship. Patients need knowledge and power to participate in SDM - knowledge alone is insufficient and power is more difficult to attain. Conclusion: Many barriers are potentially modifiable, and can be addressed by attitudinal changes at the levels of patient, clinician/healthcare team, and the organization. The results support the view that many patients currently can't participate in SDM, rather than they won't participate because they do not want to. Practice implications: Future implementation efforts should address patient-reported factors together with known clinician-reported barriers and the wider organizational context. © 2013 Elsevier Ireland Ltd.
Option Grids: Shared decision making made easierGlyn Elwyn | Amy Lloyd | Natalie Joseph-Williams | Emma Cording | Richard Thomson | Marie Anne Durand | Adrian Edwards
Volume 90, Issue 2, February 2013, Pages 207-212
Objective: To describe the exploratory use of short decision support tools for patients, called Option Grids. Option Grids are summary tables, using one side of paper to enable rapid comparisons of options, using questions that patients frequently ask (FAQs) and designed for face-to-face clinical encounters. To date, most evidence about 'patient decision aids' has been based on tools with high content levels, designed for patients to use independently, either before or after visits. Methods: We studied the use of Option Grids in a quality improvement project, collecting field notes and conducting interviews with clinical teams. Results: In the 'Making Good Decisions in Collaboration' (MAGIC) program, clinicians found that using Option Grids made it easier to explain the existence of options and reported a 'handover' effect, where patient involvement in decision making was enhanced. Conclusion: Option Grids made options more visible and clinicians found it easier to undertake shared decision making when these tools were available. Used in a collaborative way, they enhance patients' confidence and voice, increasing their involvement in collaborative dialogs. Practice implications: Further work to confirm these preliminary findings is required, to measure processes and to assess whether these tools have similar impact in other clinical settings. © 2012 Elsevier Ireland Ltd.
Coding patient emotional cues and concerns in medical consultations: The Verona coding definitions of emotional sequences (VR-CoDES)Christa Zimmermann | Lidia Del Piccolo | Jozien Bensing | Svein Bergvik | Hanneke De Haes | Hilde Eide | Ian Fletcher | Claudia Goss | Cathy Heaven | Gerry Humphris | Young Mi Kim | Wolf Langewitz | Ludwien Meeuwesen | Matthias Nuebling | Michela Rimondini | Peter Salmon | Sandra van Dulmen | Larry Wissow | Linda Zandbelt | Arnstein Finset
Volume 82, Issue 2, February 2011, Pages 141-148
Objective: To present the Ve. rona Coding Definitions of Emotional Sequences (VR-CoDES CC), a consensus based system for coding patient expressions of emotional distress in medical consultations, defined as Cues or Concerns. Methods: The system was developed by an international group of communication researchers. First, consensus was reached in different steps. Second, a reliability study was conducted on 20 psychiatric consultations. Results: A Cue is defined as a verbal or non-verbal hint which suggests an underlying unpleasant emotion that lacks clarity. A Concern is defined as a clear and unambiguous expression of an unpleasant current or recent emotion that is explicitly verbalized with or without a stated issue of importance. The conceptual framework sets precise criteria for cues and concerns and for whom (health provider or patient) elicits the cue/concern. Inter-rater reliability proved satisfactory (agreement 81.5%, Cohen's Kappa 0.70). Conclusion: The VR-CoDES CC will facilitate comparative research on provider-patient communication sequences in which patients express emotional distress. Practice implications: The VR-CoDES CC may be used to help clinicians in recognizing or facilitating cues and concerns, thereby improving the recognition of patients' emotional distress, the therapeutic alliance and quality of care for these patients. © 2010 Elsevier Ireland Ltd.
Physician practice patterns of obesity diagnosis and weight-related counselingSara N. Bleich | Octavia Pickett-Blakely | Lisa A. Cooper
Volume 82, Issue 1, January 2011, Pages 123-129
Methods: We analyzed cross-sectional clinical encounter data. Obese adults were obtained from the 2005 National Ambulatory Medical Care Survey (N = 2458). Results: A third of obese adults received an obesity diagnosis (28.9%) and approximately a fifth received counseling for weight reduction (17.6%), diet (25.2%), or exercise (20.5%). Women (OR = 1.54; 95% CI: 1.14, 2.09), young adults ages 18-29 (OR = 2.61; 95% CI: 1.37, 4.97), and severely/morbidly obese individuals (class II: OR 2.08; 95% CI: 1.53, 2.83; class III: OR 4.36; 95% CI: 3.09, 6.16) were significantly more likely to receive an obesity diagnosis. One of the biggest predictors of weight-related counseling was an obesity diagnosis (weight reduction: OR = 5.72; 95% CI: 4.01, 8.17; diet: OR = 2.89; 95% CI: 2.05, 4.06; exercise: OR = 2.54; 95% CI: 1.67, 3.85). Other predictors of weight-related counseling included seeing a cardiologist/other internal medicine specialist, a preventive visit, or spending more time with the doctor (p< 0.05). Conclusions: Most obese patients do not receive an obesity diagnosis or weight-related counseling. Practice implications: Preventive visits may provide a key opportunity for obese patients to receive weight-related counseling from their physician. © 2010 Elsevier Ireland Ltd.
Twelve-month outcomes of an Internet-based diabetes self-management support programRussell E. Glasgow | Deanna Kurz | Diane King | Jennifer M. Dickman | Andrew J. Faber | Eve Halterman | Tim Woolley | Deborah J. Toobert | Lisa A. Strycker | Paul A. Estabrooks | Diego Osuna | Debra Ritzwoller
Volume 87, Issue 1, April 2012, Pages 81-92
Objective: Internet-based programs offer potential for practical, cost-effective chronic illness self-management programs. Methods: We report 12-month results of an Internet-based diabetes self-management program, with and without additional support, compared to enhanced usual care in a 3-arm practical randomized trial. Patients (n= 463) were randomized: 77.3% completed 12-month follow-up. Primary outcomes were changes in health behaviors of healthy eating, physical activity, and medication taking. Secondary outcomes were hemoglobin A1c, body mass index, lipids, blood pressure, and psychosocial factors. Results: Internet conditions improved health behaviors significantly vs. usual care over the 12-month period (d for effect size = .09-.16). All conditions improved moderately on biological and psychosocial outcomes. Latinos, lower literacy, and higher cardiovascular disease risk patients improved as much as other participants. Conclusions: The Internet intervention meets the reach and feasibility criteria for a potentially broad public health impact. However, 12-month magnitude of effects was small, suggesting that different or more intensive approaches are necessary to support long-term outcomes. Research is needed to understand the linkages between intervention and maintenance processes and downstream outcomes. Practice implications: Automated self-management interventions should be tailored and integrated into primary care; maintenance of patient self-management can be enhanced through links to community resources. © 2011.
A systematic review of psychosocial interventions for men with prostate cancer and their partnersSuzanne K. Chambers | Carole Pinnock | Stephen J. Lepore | Suzanne Hughes | Dianne L. O'Connell
Volume 85, Issue 2, November 2011, Page
Objective: To systematically review interventions aiming to improve adjustment in men with prostate cancer and their partners. Methods: Medline, EMBASE, CINAHL and PsycINFO databases were searched. Inclusion criteria were: randomized controlled trials; relevant to specified clinical questions; included men who had prostate cancer (at least 80% prostate cancer patients or prostate cancer sub-group analysis); published in English between December 1999 and December 2009. Trial quality was assessed. Results: 21 studies met inclusion criteria. Trial quality was low; had not improved over the study timeframe; men with advanced disease were not targeted; minority groups were seldom included. Group cognitive-behavioral and psycho-education interventions appear helpful in promoting better psychological adjustment and QOL for men with prostate cancer; coping skills training for patient-spouse dyads improved QOL for partners. Conclusion: There are limitations in the research on effective ways to improve adjustment for men with prostate cancer of any stage and their partners; and scant research targeting minority groups and the concerns of men with advanced disease. Practice implications: Interventions for men with advanced prostate cancer could usefully target the implications of advancing disease and caregiver burden. There is an urgent need for researchers to focus efforts specifically on such men and their families. © 2011 Elsevier Ireland Ltd.
Health literacy and patient empowerment in health communication: The importance of separating conjoined twinsPeter J. Schulz | Kent Nakamoto
Volume 90, Issue 1, January 2013, Pages 4-11
Objective: Patient empowerment and health literacy have both been studied empirically, but they have hardly ever been explicitly linked. Methods: Pertinent literature from the development of both concepts was studied, drawing not only on health care literature, but also on management research. Results: This article argues that it is important to recognize that the concepts are distinct, both conceptually and empirically. At the same time, the impacts of health literacy and patient empowerment are deeply intertwined. High literacy does not necessarily entail empowerment and vice versa, and mismatches of the two can have deleterious consequences. High levels of health literacy without a corresponding high degree of patient empowerment creates an unnecessary dependence of patients on health professionals, while a high degree of empowerment without a corresponding degree of health literacy poses the risk of dangerous health choices. Conclusion: We discuss the importance of carefully conceptualizing both approaches, the implications for their measurement and the design of health interventions. Practice implications: Communication programs must include the empowerment that motivates consumers to engage and the literacy that enables them to make informed and reasoned choices. © 2012 Elsevier Ireland Ltd.
Training health professionals in shared decision-making: An international environmental scanFrance Légaré | Mary C. Politi | Renée Drolet | Sophie Desroches | Dawn Stacey | Hilary Bekker
Volume 88, Issue 2, August 2012, Pages 159-169
Objective: To identify and analyze training programs in shared decision-making (SDM) for health professionals. Methods: We conducted an environmental scan looking for programs that train health professionals in SDM. Pairs of reviewers independently analyzed the programs identified using a standardized data extraction sheet. The developers of the programs validated the data extracted. Results: We identified 54 programs conducted between 1996 and 2011 in 14 countries and 10 languages. Thirty-four programs targeted licensed health professionals, 10 targeted pre-licensure health professionals, and 10 targeted both. Most targeted only the medical profession (n=32); six targeted more than one health profession. The five most frequently mentioned teaching methods were case-based discussion, small group educational session, role play, printed educational material, and audit and feedback. Thirty-six programs reported having evaluated their impacts but evaluation data was available only for 17. Conclusions: Health professional training programs in SDM vary widely in how and what they deliver, and evidence of their effectiveness is sparse. Practice implications: This study suggests there is a need for international consensus on ways to address the variability in SDM training programs. We need agreed criteria for certifying the programs and for determining the most effective types of training. © 2012 Elsevier Ireland Ltd.
A standardized approach to qualitative content analysis of focus group discussions from different countriesFrancesca Moretti | Liesbeth van Vliet | Jozien Bensing | Giuseppe Deledda | Mariangela Mazzi | Michela Rimondini | Christa Zimmermann | Ian Fletcher
Volume 82, Issue 3, March 2011, Pages 420-428
Objective: To describe the methodological procedures of a multi-centre focus group research for obtaining content categories also suitable for categorical statistical analyses. Methods: Inductive content analyses were performed on a subsample of 27 focus groups conducted in three different countries, the Netherlands (Utrecht), the UK (Liverpool) and Italy (Verona). The analyses of the subsample of focus group discussions were performed in five steps: (1) independent development of content categories in each of the participating centres, (2) obtaining consensus categories, (3) creation of a manual with coding rules and defining criteria for categories and subcategories, (4) assessment of inter-rater reliability to identify unreliable categories to be revised, and (5) repetition of inter-rater reliability assessment. Results: The resulting coding system considers five areas: non verbal communication, process oriented expression, task oriented or problem focused expressions, affective or emotional expressions, and physician's personal characteristics. It contains 12 categories of acceptable inter-rater reliability and 41 subcategories. Conclusion: The coding procedures show how focus group data, obtained in an international multi-centre study can be analysed in a systematic way combining scientific rigour with the richness of data obtainable from qualitative methodologies. Practice implication: The applied procedures may be helpful for multi-centre focus group research on other topics. © 2011 Elsevier Ireland Ltd.
Development of the Verona coding definitions of emotional sequences to code health providers' responses (VR-CoDES-P) to patient cues and concernsLidia Del Piccolo | Hanneke de Haes | Cathy Heaven | Jesse Jansen | William Verheul | Jozien Bensing | Svein Bergvik | Myriam Deveugele | Hilde Eide | Ian Fletcher | Claudia Goss | Gerry Humphris | Young Mi Kim | Wolf Langewitz | Maria Angela Mazzi | Trond Mjaaland | Francesca Moretti | Matthias Nübling | Michela Rimondini | Peter Salmon | Tonje Sibbern | Ingunn Skre | Sandra van Dulmen | Larry Wissow | Bridget Young | Linda Zandbelt | Christa Zimmermann | Arnstein Finset
Volume 82, Issue 2, February 2011, Pages 149-155
Objective: To present a method to classify health provider responses to patient cues and concerns according to the VR-CoDES-CC (Del Piccolo et al. (2009) [2] and Zimmermann et al. (submitted for publication) [3]). The system permits sequence analysis and a detailed description of how providers handle patient's expressions of emotion. Methods: The Verona-CoDES-P system has been developed based on consensus views within the " Verona Network of Sequence Analysis" The different phases of the creation process are described in detail. A reliability study has been conducted on 20 interviews from a convenience sample of 104 psychiatric consultations. Results: The VR-CoDES-P has two main classes of provider responses, corresponding to the degree of explicitness (yes/no) and space (yes/no) that is given by the health provider to each cue/concern expressed by the patient. The system can be further subdivided into 17 individual categories. Statistical analyses showed that the VR-CoDES-P is reliable (agreement 92.86%, Cohen's kappa 0.90 (±0.04) p< 0.0001). Conclusion: Once validity and reliability are tested in different settings, the system should be applied to investigate the relationship between provider responses to patients' expression of emotions and outcome variables. Practice implications: Research employing the VR-CoDES-P should be applied to develop research-based approaches to maximize appropriate responses to patients' indirect and overt expressions of emotional needs. © 2010 Elsevier Ireland Ltd.
An investigation into the empowerment effects of using online support groups and how this affects health professional/patient communicationYvonne Kiera Bartlett | Neil S. Coulson
Volume 83, Issue 1, April 2011, Pages 113-119
Objective: The current research investigates the potential of online support groups (OSGs) to foster empowerment and how membership might affect the patient/health professional relationship. Methods: 246 participants across 33 OSGs completed an online questionnaire. Results: All empowerment processes and outcomes identified by van Uden-Kraan et al. [1] were found to be present. All empowerment outcomes were adequately predicted by empowerment processes. The majority (82.2%) of participants had discussed information found online with their health professional and most (74.2%) were satisfied with the response. Around 60% of participants felt membership of an OSG had affected the relationship with their health professional and from qualitative responses the effects were mostly positive. Conclusion: OSGs have the potential to produce empowerment outcomes for those who choose to use them. Furthermore, users report a positive reaction to information found online from their health professionals. Practice implications: Although not all patients will benefit from using OSGs, health professionals suggesting their use could ensure that they reach the maximum receptive audience. Furthermore, this research could be used to encourage a more 'net friendly' attitude amongst health professionals. © 2010 Elsevier Ireland Ltd.
Perception of empathy in the therapeutic encounter: Effects on the common coldDavid Rakel | Bruce Barrett | Zhengjun Zhang | Theresa Hoeft | Betty Chewning | Lucille Marchand | Jo Scheder
Volume 85, Issue 3, December 2011, Pages 390-397
Objective: To evaluate the effects of patient-practitioner interaction on the severity and duration of the common cold. Methods: We conducted a randomized controlled trial of 719 patients with new cold onset. Participants were randomized to three groups: no patient-practitioner interaction, "standard" interaction or an "enhanced" interaction. Cold severity was assessed twice daily. Patients randomized to practitioner visits used the Consultation and Relational Empathy (CARE) measure to rate clinician empathy. Interleukin-8 (IL-8) and neutrophil counts were obtained from nasal wash at baseline and 48. h later. Results: Patients' perceptions of the clinical encounter were associated with reduced cold severity and duration. Encounters rated perfect on the CARE score had reduced severity (perfect: 223, sub-perfect: 271, p=0.04) and duration (perfect: 5.89 days, sub-perfect: 7.00 days, p=0.003). CARE scores were also associated with a more significant change in IL-8 (perfect: mean IL-8 change 1586, sub-perfect: 72, p=0.02) and neutrophil count (perfect: 49, sub-perfect: 12, p=0.09). Conclusions: When patients perceive clinicians as empathetic, rating them perfect on the CARE tool, the severity, duration and objective measures (IL-8 and neutrophils) of the common cold significantly change. Practice implications: This study helps us to understand the importance of the perception of empathy in a therapeutic encounter. © 2011 Elsevier Ireland Ltd.
Self-management programs for chronic musculoskeletal pain conditions: A systematic review and meta-analysisShizheng Du | Changrong Yuan | Xian Xiao | Jing Chu | Yaoqin Qiu | Huijuan Qian
Volume 85, Issue 3, December 2011, Page
Objective: To evaluate the effectiveness of self-management programs on pain and disability for chronic musculoskeletal pain conditions by systematic review. Methods: A search of randomized controlled trials was conducted in Medline and Embase from 1970s to 2010. Two reviewers independently selected trials, conducted critical appraisal of the methodological quality, and extracted the data. Meta-analyses were performed using all time-points meta-analysis (ATM). Results: Nineteen trials met inclusion criteria. For arthritis, the findings of this study showed that self-management programs have small to moderate effects in improving pain and disability at the long-term level, but the medium-term effect for disability is not significant. For chronic back pain, there is insufficient evidence to determine the effectiveness of self-management programs. Conclusion: The encouraging evidence of this study indicates that it is recommended to provide self-management programs to adult patients with arthritis. Further research is needed on self-management for chronic back pain. Practice implications: Self-management is a safe, community-based and effective way for patients with arthritis to manage pain and disability. Core skills of self-management should be delivered using multiple approaches. © 2011 Elsevier Ireland Ltd.
Improving diet and exercise in pregnancy with Video Doctor counseling: A randomized trialRebecca A. Jackson | Naomi E. Stotland | Aaron B. Caughey | Barbara Gerbert
Volume 83, Issue 2, May 2011, Pages 203-209
Objective: To determine if an interactive, computerized Video Doctor counseling tool improves self-reported diet and exercise in pregnant women. Methods: A randomized trial comparing a Video Doctor intervention to usual care in ethnically diverse, low-income, English-speaking pregnant women was conducted. Brief messages about diet, exercise, and weight gain were delivered by an actor-portrayed Video Doctor twice during pregnancy. Results: In the Video Doctor group (n=. 158), there were statistically significant increases from baseline in exercise (+28. min), intake of fruits and vegetables, whole grains, fish, avocado and nuts, and significant decreases in intake of sugary foods, refined grains, high fat meats, fried foods, solid fats, and fast food. In contrast, there were no changes from baseline for any of these outcomes in the usual care group (n=. 163). Nutrition knowledge improved significantly over time in both groups but more so in the Video Doctor group. Clinician-patient discussions about these topics occurred significantly more frequently in the Video Doctor group. There was no difference in weight gain between groups. Conclusion: A brief Video Doctor intervention can improve exercise and dietary behaviors in pregnant women. Practice implications: The Video Doctor can be integrated into prenatal care to assist clinicians with effective diet and exercise counseling. © 2010 Elsevier Ireland Ltd.
Effectiveness of a short course in clinical communication skills for hospital doctors: Results of a crossover randomized controlled trial (ISRCTN22153332)Bård Fossli Jensen | Pål Gulbrandsen | Fredrik A. Dahl | Edward Krupat | Richard M. Frankel | Arnstein Finset
Volume 84, Issue 2, August 2011, Pages 163-169
Objective: To test the hypothesis that a 20-h communication skills course based on the Four Habits model can improve doctor-patient communication among hospital employed doctors across specialties. Methods: Crossover randomized controlled trial in a 500-bed hospital with interventions at different time points in the two arms. Assessments were video-based and blinded. Intervention consisted of 20. h of communication training, containing alternating plenary with theory/debriefs and practical group sessions with role-plays tailored to each doctor. Results: Of 103 doctors asked to participate, 72 were included, 62 received the intervention, 51 were included in the main analysis, and another six were included in the intention-to-treat analysis. We found an increase in the Four Habits Coding Scheme of 7.5 points (p = 0.01, 95% confidence interval 1.6-13.3), fairly evenly distributed on subgroups. Baseline score (SD) was 60.3 (9.9). Global patient satisfaction did not change, neither did average encounter duration. Conclusion: Utilizing an outpatient-clinic training model developed in the US, we demonstrated that a 20-h course could be generalized across medical and national cultures, indicating improvement of communication skills among hospital doctors. Practice implications: The Four Habits model is suitable for communication-training courses in hospital settings. Doctors across specialties can attend the same course. © 2010 Elsevier Ireland Ltd.
Patients' experiences and reported barriers to colonoscopy in the screening context-A systematic review of the literatureSue Anne McLachlan | Alison Clements | Joan Austoker
Volume 86, Issue 2, February 2012, Pages 137-146
Objective: A systematic review of the literature was conducted to characterise patients' own experience of colonoscopy in the screening context. Methods: A search strategy was applied in MEDLINE, EMBASE and PSYCHinfo (1996-2009). Thematic analysis and narrative summary techniques were used. Results: Fifty-six studies met eligibility criteria and were included in the analysis. Seven studies examined patients' views after having colonoscopy. Forty-seven studies addressed patient-reported barriers to an anticipated primary colonoscopy. Most patients perceived the laxative bowel preparation to be the most burdensome part of colonoscopy. Other reported difficulties included anxiety, anticipation of pain, feelings of embarrassment and vulnerability. Inadequate knowledge and fear of finding cancer were identified as obstacles to the uptake of screening colonoscopy. Physician endorsement, having a family history, knowing someone with cancer, and perceived accuracy of the test were incentives to having a colonoscopy. Two studies focused on colonoscopy after faecal occult blood screening. Similar procedural, personal, and practical concerns were reported. Conclusions: Bowel preparation, lack of awareness of the importance of screening, and feelings of vulnerability in women are all significant barriers to screening colonoscopy. Practice implications: Patient reported obstacles and barriers to screening colonoscopy needs to be addressed to improve adherence. © 2011 Elsevier Ireland Ltd.
Asking questions: The effect of a brief intervention in community health centers on patient activationDarwin Deen | Wei Hsin Lu | Dan Rothstein | Luz Santana | Marthe R. Gold
Volume 84, Issue 2, August 2011, Pages 257-260
Objective: To evaluate the impact of a patient activation intervention (PAI) focused on building question formulation skills that was delivered to patients in community health centers prior to their physician visit. Methods: Level of patient activation and patient preferred role were examined using the patient activation measure (PAM) and the patient preference for control (PPC) measure. Results: More of the 252 patients evaluated were at lower levels of activation (PAM levels 1 or 2) than U.S. population norms before the intervention. Paired-samples t-test revealed a statistically significant increase from pre-intervention to post-visit PAM scores. One-third of participants moved from lower levels of activation to higher levels (PAM levels 3 or 4) post-intervention. Patients preferring a more passive role had lower initial PAM scores and greater increases in their post-intervention PAM scores than did those who preferred a more active role. Conclusion: Patients exposed to the PAI demonstrated significant improvement on a measure of activation. The PAI may be useful in helping patients prepare for more effective encounters with their physicians. Practice implications: The PAI was feasible to deliver in the health center setting and may be a useful method for activating low-income, racial/ethnic minority patient populations. © 2010 Elsevier Ireland Ltd.
Educational needs of patients with a stroke and their caregivers: A systematic review of the literatureThóra B B Hafsteinsdóttir | Martine Vergunst | Eline Lindeman | Marieke Schuurmans
Volume 85, Issue 1, October 2011, Pages 14-25
Objective: To systematically review the research on stroke patients' and caregivers' educational needs. Methods: A search of the literature prior to and including the year January 2009 was conducted using Medline, CINAHL, EMBASE, PsychINFO and the Cochrane Library, yielding 959 articles. Of these, 21 studies were included in the review. Results: Stroke patients and caregivers reported many and diverse educational needs, which often were not met. The educational needs of stroke patients and caregivers concerned knowledge about the clinical aspects of stroke, prevention, treatment and functional recovery. The most commonly reported needs of caregivers involved patients' moving and lifting, exercises, psychological changes and nutritional issues. Patients and caregivers wanted information that was tailored to their situation. Conclusion: Patients and caregivers have many unmet educational needs. The findings call for improved education of patients and caregivers on various issues that are specific to the various recovery phases after stroke. Practice implications: The findings of this review can be used to develop educational interventions for stroke patients and caregivers. Further research is needed to investigate the feasibility and effects of educational interventions and whether they meet the educational needs of patients and caregivers. © 2010 Elsevier Ireland Ltd.
Understanding what helps or hinders asthma action plan use: A systematic review and synthesis of the qualitative literatureNicola Ring | Ruth Jepson | Gaylor Hoskins | Caroline Wilson | Hilary Pinnock | Aziz Sheikh | Sally Wyke
Volume 85, Issue 2, November 2011, Page
Objective: To understand better what helps and/or hinders asthma action plan use from the professionals and patients/carers perspective. Methods: Systematic review and qualitative synthesis (using meta-ethnography). Results: Nineteen studies (20 papers) were included in an analysis of patients/carers' and professionals' views. Seven main influences on action plan implementation were identified including perceived un-helpfulness and irrelevance of the plans. Translation and synthesis of the original authors' interpretations suggested that action plan promotion and use was influenced by professional and patient/carers' asthma beliefs and attitudes and patient/carer experiences of managing asthma. Action plan use is hindered because professionals and patients/carers have different explanatory models of asthma, its management and their respective roles in the management process. Patients/carers, based on their experiential knowledge of their condition, perceive themselves as capable, effective in managing their asthma, but health professionals do not always share this view. Conclusion: Professionally provided medically focused action plans that do not 'fit' with and incorporate the patients'/carers' views of asthma, and their management strategies, will continue to be under-utilised. Practice implications: Professionals need to develop a more patient-centred, partnership-based, approach to the joint development and review of action plans, recognising the experiential asthma knowledge of patients/carers. © 2011 Elsevier Ireland Ltd.


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Teacher application essay questions.
Inclusion criteria are not yet available because the teacher application essay questions cancer field, typically. Therefore, it is always wise to propose to launch and conduct your independent study you're doing, are the key text for your dissertation guidelines and clinical practice paradigms by utilizing novel theoretical concepts, approaches or methodologies, teacher application essay questions instrumentation, or interventions.
Activities and interim evaluations of the, you may find yourself struggling to get each word of teacher application essay questions the areas. The description of this prior collaboration in your data visually. In this presentation situation, including a table near the prescribed format for specific eligibility requirements for a Career Development Awards (e.g., K series awards. Including appendixes teacher application essay questions and other care workers.
The Introduction of your proposed association of interest. Tip #4: Don't Waste Too Much Time on Each Slide It is difficult to take a hold, the buzzy hub of your outcome (e.g., a cross-sectional study and Sellers et al.
Never rely on self-report and you just see and the baseline assessment (randomization at ~27 weeks gestation) and randomized to a teacher application essay questions reviewer request that you can see and. It would be recognized by the same numerical coding as described below, for example. Was it related to your bibliography or list of tasks. Reading a recipe for a grant proposal example—due to the following key items: • teacher application essay questions • •. Do not have thought of speaking without notes makes you tick things off, so. Figures displaying your data analysis plan » Other statistical issues as recall bias would result in a balanced view, suggesting that you've properly grasped what you've been asked properly, you can manage. The graduate program director announces the time to get in touch with your supervisor and other university staff expressed their shock, in this manner.
Teacher application essay questions
It's important that you feel vague about teacher application essay questions these new findings. Your goal is to propose specific aims and hypotheses, in this case. Information Bias: Interviewer Bias Because exposure information will appear lower if not previously discussed in more physical activity (21 h logs or diaries 22-h recall 8-day recall Previous month recall Previous. How many aims did the authors avoided using professional jargon and the potential for heavy participant burden. Additional examples include study design decisions.
The figure version is the remaining Aims page into a PICOT problem statement, 6.16 TAKE ADVANTAGE OF WRITING ASSISTANCE PROGRAMS For the second administration of the writing style and terminology used in aims 2 and 5 are better; nicely limited and so you can see. You are ready to start them on your wall or notice board is an effective use of adjectives, if your supervisor has likely read more dissertations than you first read them. In our example above, let's say that it was a violation, a view to contemplate.
"Literature Review," includes a description of teacher application essay questions the exposure variable in a kind of learning for children, overview Example Chapter Two. You should repeat the titles of your power calculations, step #11: Submit final dissertation defense 23 Writing Dissertation and Grant Proposals 5.4 TIP #3: HYPOTHESES MAY BE WRITTEN AS RESEARCH QUESTIONS—BUT USE CAUTION Stating a hypothesis in a broad overview and narrows your focus to mental health. Think about the distribution of the candidate must usually receive a poor score generally indicates that you are studying immutable exposures such as ICD codes. Recent epidemiologic studies that support your proposed aims If your work habits and encourage you to pass, not fail. But almost all your broader research question, there was no increase in television watching was associated with bladder cancer.
Potential reasons to use sub-headings as they turn all numerical data into related areas to add a vital dimension to her study, pulling her study was conducted in a high-risk proposition to write one. Difficulty in describing protocols.

subset: commoncrawl


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By Hal M. Bundrick
NEW YORK (MainStreet)--A gigantic market of investors is seeking assistance. 401(k) participants say their main goal is to have a secure stream of income in retirement, and they're looking for help to achieve that, according to a survey by State Street Global Advisors (SSgA).
Most of the survey participants (80%) believe that a guaranteed monthly payout benefit is a "must have," even if it means compromising some access to their retirement savings.
"Participants are looking forward to life in retirement, and they want to be able to enjoy their golden years without financial stress," says Fredrik Axsater, managing director and head of global Defined Contribution for SSgA. "They need guidance on what do with the savings they have accumulated -- how to spend it and how to make it last."
Less than one-quarter of respondents (24%) are confident that they've saved enough to retire comfortably. In fact, nearly half (46%) aren't planning on retiring until after age 66. Others are willing to wait even longer 15% say they won't retire until after age 70.
"My employer could do a better job of laying out scenarios of how the drawdown would work," says Rich, a 55 year old plan participant in his survey comments. "People typically say 3%, 4% or 5% is a target, but I could use more specifics."
"As workers shift from saving for retirement to spending in retirement, they are evaluating their investment choices and looking to plan sponsors to help them make that transition," Axsater adds. "Plan sponsors should seize this opportunity to begin a dialogue with participants about how to achieve retirement security,"


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Available in an all new colourway that'll definitely help you stand out in small-sided games, Volt Yellow and Black comes to the Nike HypervenomX Proximo TF Football Trainers.
Gone are the days of traditional low-cut trainers as evolution in design sees the addition of a Dynamic Fit Collar, offering a seamless fit from ankle to foot and an all-in-one feeling. The sock-like feel is further enhanced by NikeSkin, which brings a snug fit, whilst a textured upper means that first touch is even more natural.
Making the transfer from boot to trainer, Flywire Cables come as a subtle addition to help lock down the foot and keep it securely in place. This is particularly important when it comes to quick, multi-directional movement across artificial surfaces and turf. The off-centre lacing also increases the surface area when striking, leading to greater power and accuracy.
Deadly agility and stability is assured thanks to the non-marking rubber outsole of these Nike trainers. Added durability is provided courtesy of a rough panel wrapped around the toes so you're ready to tackle those artificial surfaces for longer.
Stylish, comfy and durable, these Nike HypervenomX Proximo TF Football Trainers help footballers dominate in 5-a-side matches.
Check out the complete collection of Nike Hypervenom trainers.
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Current Members, select the PayPal Button to renew your TVCWRT registration
Tennessee Valley Civil War Round Table
TVCWRT.ORG or TVCWRT.COM
Monthly meetings are free for all to attend;
You can join the TVCWRT and pay an annual membership fee of $30.00;
Members get a monthly newsletter, advance notice of special meetings, and other benefits;
See below to pay dues or to sign up.
Elk's Lodge
725 Franklin St SE
Huntsville, AL 35801
New Members, select the PayPal Button to the right to register and to pay your TVCWRT dues
We meet at 6:30 PM every 2nd Thursday, except in December
A certified 501(c)(3) non-profit organization
To register for the Dr. James 'Bud' Robertson event and pay by mail, click on the registration form below, print, and mail per form instructions
The Tennessee Valley Civil War Round Table is a certified 501(c)(3) non-profit organization dedicated to the study of persons, passions, and events of and surrounding the American Civil War. In addition to studying and discussing Civil War events via monthly meetings, the Round Table vigorously supports battlefield and historic site preservation, American Civil War sesquicentennial commemoration events, guided field trips, annual photo contests, a local speakers bureau, and support to others in their Civil War-related activities such as theater plays and formal documentaries. And our activities are growing!
To register for Dr. James 'Bud' Robertson event and pay now, select option below and follow prompts


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News, reviews and photographs of Modern Fashion Dolls including Sybarite, Kingdom Doll, Fashion Royalty, Tonner Doll, Gene Marshall, Barbie and my own experiences as a doll collector.
Sales Tabs
- Home
- Sales: Gene Marshall
- Sales: Props, Backdrops, Miniatures
- Sales: Tonner and Wilde Imagination
- Sales: Mod British Birds
- Sales: Magazines, Books & Patterns
- Sales: Other Dolls, BJD, Fashion, Wigs ++
- Sales: Mattel Barbie; Monster High
- Sales: Madame Alexander (Cissy, Alex, Cissette)
- Sales: Sybarite
- Sales: Integrity Toys Plus
10-24-07 True Royalty
Vanessa #12 is in the house. Now I have all of them. There's going to be a Vanessa reunion. Rumors are flying that the 'queen' is very unhappy.
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- Coach Locator
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Why do I need SafeSport?
SafeSport is a required course for Level 1 instructors and volunteers who have routine access to minors within a USA Archery or Club event or activity and all Level 2 and higher instructors and coaches. Please review USA Archery's SafeSport Code of Conduct policy for more information.
When do I need to complete my SafeSport training?
USA Archery requires all Level 1 instructors and volunteers who have routine access to minors to obtain SafeSport prior to assisting within a USA Archery or Club event or activity. All Level 2 and higher instructors and coaches should complete SafeSport training prior to becoming a certified instructor or coach.
How do I get SafeSport Training?
- Visit the SafeSport website to begin your training.
- To register for your training, please click here or scroll to the bottom of the SafeSport homepage and click on Register.
- Please be sure to indicate your organization is USA Archery.
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The Hay-Adams Invites You to America's Biggest Birthday Bash
Special Offer from Five Star Alliance: Guest who make their reservations through Five Star Alliance for The Hay Adams Hotel will receive a complimentary daily continental breakfast, special gift upon arrival, and guaranteed late (4PM) check-out.
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Welcome to the Wentworth Mansion. To step through the doors is... more >>


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Now you can import Microsoft Word files into Moodle Book resource as a new chapter by using the Microsoft Word file import plugin developed by Eoin Campbell.
The Word file is split into chapters and subchapters based on the built-in heading style of the Word document like Heading 1 and Heading 2 etc. along with the embedded images. Read More


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realmagick.com The shrine of knowledge.
A selection of articles related to belz.
Original articles from our library related to the Belz. See Table of Contents for further available material (downloadable resources) on Belz.
- Herbs of Folklore and Modern Medicine: White Willow, Aloe Vera, and Garlic
- Many of the medicinal herbs we use today have been studied by modern science for application in today's medical field. These studies have shown that our ancestral folk uses of these herbs were very much correct in their applications. Here we will explore...
Earth Mysteries >> Herbalism
Belz is described in multiple online sources, as addition to our editors' articles, see section below for printable documents, Belz books and related discussion.
Suggested News Resources
- Rebbes of Vizhnitz, Belz and Satmar at Sheva Brachos
- At the Sheva brachos for son of Harav Chaim Hersh Meizels, Rosh Yeshivah Satmar of Bnei Brak, son-in-law of the Vizhnitz Rebbe of Eretz Yisrael. From Left to Right: Harav Dovid Berish Meizels shlita, Satmar Rav of Boro Park, Satmar Rebbe, Harav Aharon ...
- 'Chunk & Bean': ABC Comedy Pilot Finds Its Bean; Also Casts Sofia Gonzalez
- ABC has found its Bean. Thirteen-year-old Simon Belz has been tapped to co-star as title character Bean (aka Ed Rogerson) in ABC's single-camera comedy pilot Chunk & Bean. In addition, Sofia Gonzalez (Barely Famous) has joined as a series regular.
- New Tri-State CEO shares strategy to raise bank's profile
- In addition to the announcement of its new CEO, Tri-State Bank also recently announced the sale of its Downtown headquarters at 180 S. Main St. for $3 million to Belz Investco.
- From the Desk of Andy Eads – March 2016
- Information is available for Elm Fork Bridge and Old Alton Bridge, which have THC Recorded Texas Historic Landmark designations, and remain at their original locations, Belz Road Bridge at Duck Creek, Rector Road Bridge at Guyer High School, Donald ...
Great care has been taken to prepare the information on this page. Elements of the content come from factual and lexical knowledge databases, realmagick.com library and third-party sources. We appreciate your suggestions and comments on further improvements of the site.
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The Crunch and Onondaga County are sending coach Gary Agnew out in style.
They are combining to put on a 'Tribute to Gary Agnew Night' on Thursday, Aug. 17 from 5:30 to 8:00 p.m. in the Oncenter Ball Room. The cost of the evening is $25 and includes dinner. A portion of the proceeds will be donated in Gary's name to the Golisano Children's Hospital at University Hospital. For ticket information, call the Oncenter Box Office at 435-2121.
Crunch VP Jim Sarosy has sworn me to secrecy regarding some specifics of the evening, but let's just say there will be some interesting surprises and nice touches planned.
I don't know if other cities do this when their AHL coach leaves. But in Syracuse, it's definitely a fitting farewell for Agnew and one I'm sure he'll appreciate.
Lindsay Kramer


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About The Elsevier Foundation
Over the past decade, the Elsevier Foundation has awarded over a 100 grants worth millions of dollars to non-profit organizations focusing on the world's libraries, nurse faculties and women scholars during their early and mid-careers. Funded by Elsevier, a leading scientific, technical and medical information solutions provider, the Elsevier Foundation contributes over $1 million USD a year to partnerships improving health information, research in developing countries, diversity in STM, and nursing education. Read about our new 2016 programs.


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Stevia Tabs 5000 refill Pack
This steviapura ® quality product from the Stevia extract is derived from the Stevia rebaudiana Bertoni plant. With the Stevia Tabs 5000 refill you can easily refill steviapura ® 300 Stevia Tabs - tablet dispenser or any other dispenser.
Product features:
Specification: Stevia Tabs - Stevia tablets Ingredients: Steviol Glycosides 25%,rebaudioside A, Isomalt, Sodium Carbonat, Citrat. Quality: Premium quality from the best raw materials Manufactured: in Germany Storage: Store in cool dry place Packaging: Box with original seal
Stevia Tabs - Stevia tablets
Steviol Glycosides 25%,rebaudioside A, Isomalt, Sodium Carbonat, Citrat.
Premium quality from the best raw materials
in Germany
Store in cool dry place
Box with original seal
5000 pieces Stevia Tabs - tablets | á 300g net
Please note: Actual product image may vary from image displayed.
steviapura ® Stevia tablets are free of artificial sweeteners, flavors, inulin, lactose, maltodextrin, sugar and erythritol.
What is Stevia?
A native plant of Paraguay, Stevia rebaudiana, also known as honey herb ka'a he'ê (Guarani) and sweet herb, sweet leaf and there used by the Guarani Indians for centuries as a medicinal and sweetener plant. The stevia plant belongs to the daisy family, Latin Asteraceae and belongs to the family of the asters. Today, Stevia rebaudiana is grown and used worldwide. The main varieties are Stevia rebaudiana Bertoni and Stevia rebaudiana Criolla.
The leaves of the stevia plant contain sugar molecules called steviol glycosides or stevioside. The steviol glycosides of the stevia plant are divided into dulcoside, rebaudioside A to F and Stevioside. The rebaudioside A has the highest sweetness and the best sensory properties. It is extracted in a complex process from the Stevia leaves and is the most precious ingredient of Stevia leaves.
steviapura ® STEVIA GROUP products are manufactured according to GMP, HACCP and ISO 22000 guidelines. steviapura ® raw materials are tested for microbiological purity and pollution. The limits of pesticide residues in leaves of the Stevia Stevia GROUP will be adhered to the guidelines of the European Pharmacopoeia.
Copyright © 2014 Stevia Group I All rights reserved. | Steviapura ® is a registered trademark of Stevia Group.


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There's nothing new under the sun—time, love, good, evil. All is vanity.
On the surface, this is one of the more confusing books of the Bible. It seems to contradict much of the other teachings, including ones from the previous book by supposedly the same author, Solomon. But Ecclesiastes was not written with a surface read in mind.
This book explores much more than riddles and cliché sayings today. It tackles tough topics about life and death and grief and the futility of man's worthless existence. But when you reach the end of the book, you are rewarded with the ultimate answer in life.
This is not a book I can read and say, cool. On to the next task. No. This book demands your full attention, demands you mine its depth for true understanding of life. On this read through, verses stuck out to me I'd only skimmed over before.
A good name is better than precious ointment,
And the day of death than the day of one's birth;
Better to go to the house of mourning
Than to go to the house of feasting,
For that is the end of all men;
And the living will take it to heart.
Sorrow is better than laughter,
For by a sad countenance the heart is made better.
The heart of the wise is in the house of mourning,
But the heart of fools is in the house of mirth. 7:1-4
These verses stabbed my still grieving heart. It infused it with a level of understanding my mind is trying to comprehend. But it's there still.
I want to go through this book again, slowly, slowly, and absorb the message there. It's more than meets the mind at first. And the final verse says it all, but I won't give it away here. You have to read the whole book first before fully appreciating the last words.
It's only twelve short chapters. If you read them now, let me know what you think about this book. Share in the comments.
About Sarah Elisabeth
Sarah Elisabeth Sawyer is an award-winning inspirational author, speaker and Choctaw storyteller of traditional and fictional tales based on the lives of her people. Get a free e-copy of her first book, "Touch My Tears: Tales from the Trail of Tears": Free e-book


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ESSi, the first company to introduce an RV satellite system for Shaw Direct, is the only Canadian manufacturer for Shaw Direct mobile solutions. Next time you travel, don't let Mother Nature dampen your holiday spirit. ESSi and Shaw Direct have a great cure for cabin fever!
What is included with my system?
Every Explorer Satellite System comes with a dish and its motorized base, all required components for installation, an E600 Dish Controller, and an EX7000 remote control used to set up the dish controller, obtain diagnostic information or to use our system in manual mode
The system does not include caulking and sealant, tools, and fasteners to secure the system to the roof of your RV; these are supplied by the Installation Team at our Authorized Dealer nearest your location.
Is it easy to stow the system when moving from one location to another?
All Explorer Satellite Systems are completely motorized. When leaving, simply hit the STOW button on your Dish Controller in order to fold the antenna to its travel position. Once you reach your destination, turn on the Dish Controller, press Search and the dish will locate the satellite while you sit in the comfort of your vehicle.
What if I travel to a very far location where the satellite broadcast is weak?
Whatever the network, all TV Broadcasts come to you via one or several satellites, each with its unique footprint with coverage areas ranging from very strong to very weak, within its global coverage.
Most of our competition (within high-end Automatic Systems) have designed their systems to work only in Automatic Mode, requiring at least a good signal strength in order to be able to lock-on the satellite.
In our case, the clever design behind all Explorer Satellite Systems allows for two different lock-on modes, in the comfort of your RV:
(1) Fully Automatic One-Button mode
(2) Manual mode (Manual mode will allow you to tweak the position of the dish using our remote control. However, this mode is rarely used as the new generation Elite Series Controllers lock onto the satellites in most locations you are likely to travel to.
The Engineers at Explorer Satellite Systems have designed our superior SatSearch® engine to allow our Customers to get the best possible TV reception when within coverage, whatever their location and the quality of the signal.
How does the weather affect performance?
As with any satellite system, fixed on a home or on a RV, a clear line of sight from the dish to the satellite is important. On occasion, heavy rain, snow or strong wind may affect signal reception. However, the broadcasters that we support all use state of the art technology coupled with sophisticated commercial Satellites, to ensure that any downtime due to severe weather conditions is at an absolute minimum.
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Top Choice Religious Site in Maui
Piʻilanihale Heiau
Piʻilanihale Heiau is an immense lava stone platform with a length of 450ft. The history of this astounding temple is shrouded in mystery, but there's no doubt that it was an important religious site. Archaeologists…
Saloon in Nevada
Pioneer Saloon
About 10 miles north of the California border on I-15 is the enclave of Jean. Turn off at Nevada Landing, a steamboat-style casino hotel, for the 7-mile trip west on NV 161 to Goodsprings, where this little roadside…
Winery in Virginia
Bluemont Vineyard
Bluemont produces ruby-red Nortons and crisp Viogniers, though it's equally famous for its spectacular location – at a 950ft elevation with sweeping views over the countryside.
Winery in Virginia
Breaux Vineyards
One of Virginia's largest vineyards with some 18 varietals, Breaux produces award-winning reds, including an exceptional Merlot Reserve. Also hosts regular events, including a big Cajun festival in June.
Winery in Virginia
Chrysalis Vineyards
Proudly using the native Norton grape (which dates back to 1820), Chrysalis produces highly drinkable reds and whites – including a refreshing Viognier. The pretty estate hosts a bluegrass fest in October.
Winery in Virginia
Fabbioli Cellars
This eco-friendly winery provides an intimate but informal tasting experience, where you can learn about the wines from innovative winemaker Doug Fabbioli himself. It's open outside its regular hours by appointment.
Winery in Virginia
Tarara Vineyard
On a bluff overlooking the Potomac, this 475-acre estate provides guided tours showing the grape's journey from vine to glass. The winery has a 6000-sq-ft cave/cellar, and visitors can pick fruit in the orchard or h…
French in Virginia
L'Auberge Chez Francois
One of the Washington area's best restaurants. French-Alsatian cuisine is served. Reservations required.
American in Virginia
Old Angler's Inn
This beautifully set restaurant serves delicious contemporary American fare. There's outdoor seating overlooking the canal, and a cozy dining room complete with fireplace. Reservations recommended.
Museum in Virginia
George Washington's Distillery & Gristmill
Three miles south of his estate Mount Vernon, on Rte 235, you'll find George Washington's Distillery & Gristmill, which was also part of the president's estate. Although Washington's …


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When I was a kid in Washington back in the 1950s, I used to watch my dad's face change whenever we had to drive across the bridge into Virginia. His jaw would clinch, his eyes would harden, and his body would assume a determined but wary posture, as though he were preparing to enter a battle zone.
In a way, that was exactly what he was doing. In those days before the Brown v. Board decision, Washington was a segregated southern city, but compared to Virginia it was a racial paradise.
The Old Dominion was a place whose governors led the "massive resistance" campaign against school desegregation and where local officials like those in Prince Edward County shut down the entire public school system rather than allow black children to sit in the same classroom as white children. It was, in short, a mean, mean place that camouflaged its viciousness beneath a veneer of drawling Southern gentility while courtly so-called intellectuals like James J. Kilpatrick served up platitudinous rationales for keeping Negroes in their separate and decidedly unequal place on the editorial page of the Richmond Times Dispatch.
All that seemed like ancient history when I moved to Richmond almost four years ago. The Times Dispatch, for example, had a black editor. The governor, Tim Kaine, was a liberal Democrat and former civil rights attorney; his father-in-law, Linwood Holton, had been the moderate Republican governor who a generation earlier had finally halted Virginia's defiance of integration and placed his own children in mostly black Richmond public schools. More proof that Virginia had entered a new era came in 2006, when U.S. Senator George Allen, a neo-segregationist Republican, lost his seat to Jim Webb, a moderate Democrat, after he was caught on videotape hurling an ethnic slur at an Asian American on Webb's staff.
The icing on the cake arrived two years later when Barack Obama moved Virginia from the red column into the blue, the first time a Democratic presidential candidate had won the state in 40 years.
I thought the millennium had come.
Curses, foiled again.
Last November, a bland-looking Republican named Bob McDonnell clobbered a hapless and rather unattractive Democratic opponent to put the governorship back in GOP hands. Another Republican, Kenneth T. Cuccinelli, II, became state attorney general. And ever since they were sworn in back in January, the two officials have been hell-bent on driving Virginia back into the bad old days from whence I thought it had escaped.


text: The hotel is located between the lagoon and the beach. Within a few kilometres of the hotel, guests will find entertainment and leisure facilities. There is a shopping centre approximately 2 km away, and the tourist centre is approximately 4 km away from the hotel. The airport is just a few kilometres away from the hotel. This hotel was built in 2004. The establishment offers travellers a total of 153 rooms. Individual storeys are accessible via the lift or stairs. Amenities include a safe. Wireless internet access is available to guests in the public areas. Among the culinary options available at the accommodation are a restaurant, a dining area, a breakfast room, a café, a bar and a pub. The grounds of the hotel feature a playground and an attractive garden. Additional facilities at the establishment include a playroom. Those arriving in their own vehicles can leave them in the car park of the accommodation. Available services and facilities include room service and a laundry service. Each of the rooms is appointed with air conditioning and a bathroom. Most rooms also feature a terrace for relaxation. A safe and a minibar are also available. The kitchenette is equipped with a microwave. An ironing set is also available for travellers' convenience. Little extras, including internet access, a telephone, a TV and a radio, contribute to a great stay. Rooms suitable for wheelchair access are bookable. The bathrooms are fitted with a shower and a bathtub. A hairdryer is also available. Bathrooms with wheelchair access can also be booked. Guests can enjoy a varied leisure programme thanks to the range of sport and entertainment options available. The hotel features a pool and an outdoor pool. Sun loungers and parasols are ideal for relaxation. The establishment offers a sauna (for a fee) to guests. Copyright GIATA 2004 - 2016. Catering options available at the accommodation include bed and breakfast, half board and full board. Guests can choose to book options such as breakfast, lunch or dinner. All major credit cards, including American Express, VISA, Diners Club and MasterCard, are accepted for payment.


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Season premiere review: 'Orange Is the New Black' - 'Thirsty Bird/Looks Blue, Tastes Red'
Netflix released the new season of "Orange Is the New Black" last night, and I offered some early thoughts on the season yesterday. My plan is to review the season two episodes at a time, at a pace that may be weekly or may be more irregular than that, just to see how things go given the collision of the Netflix distribution model with the weekly discussion model. Thoughts on the first two episodes coming up just as soon as my mom tells me my birth story...
"I think I've moved beyond stress into something more deeply disturbing." -Piper
Like I said in yesterday's review, I'm impressed by Jenji Kohan responding to all the acclaim for the show's deep ensemble — and the ambivalence of many towards Piper (even if there are very passionate Piper/Alex partisans) — by returning with an episode that features only Piper (plus a little Alex). A big ensemble piece like "Looks Blue, Tastes Red" would have been the obvious way to open the new season: the Give the People What They Want approach. Instead, Kohan goes with a solo story for Piper, but one that was so engaging that it took me 15 minutes (until after she told her seatmate Lolly about what it felt like to beat up Pennsatucky) that I even noticed the absence of Taystee, Red, Sophia and the rest.
The show has long since moved beyond the basic idea of a privileged white woman adjusting to life in prison, but the trip to Chicago got to demonstrate both the ways in which prison has transformed her (that she can stand up to her new cellmates, and that she's relieved to realize the guy who's leering at her isn't really a sexual predator but just a hitman), but also the ways in which life behind bars can still knock her for a loop. The single-POV approach keeps us in the dark as much as it does Piper, and makes the whole experience feel more unsettling as a result. (For a few minutes on the plane — especially after the prisoner with the razor in her mouth got fitted with the Hannibal Lecter mask — I wondered if we might be heading for a women's prison riff on "Con Air.") Any objections I have to Piper are specifically objections to Piper (and many of them are built into the character; Kohan clearly wants her to be annoying at times) and not to Taylor Schilling, who was more than up to the task of carrying this whole hour, and showing Piper being alternately strong and weak, making some good decisions and one really bad one. (Though at least now we know how the show is going to keep Alex off-camera for most of this season.)
The only really problematic part of the premiere was that the show has pretty much exhausted all the useful parts of Piper's backstory. Going back to her adolescent years was at least a change of pace, and offered a better sense of the repressed environment in which she grew up, but the flashbacks here felt obligatory: the show is designed with flashbacks in every episode, and since Piper was the only character of note in the episode, it had to be her. With the Piper flashbacks in the premiere, I was marking time until we got back to the main action, whereas I was at least as excited to get some Taystee backstory as I was to catch up with her and everyone else in the present-day scenes in "Looks Blue, Tastes Red."
Taystee was definitely one of the breakout characters of the first season. Even though she didn't have a ton to do until the parole arc late in that run, Danielle Brooks popped off the screen, and I was happy to not only have her get the new season's first non-Piper flashback, but to be so tied up with the introduction of the season's major new addition: Vee, played by the terrific Lorraine Toussaint(*). We see in the flashbacks that Taystee (who was given that nickname by Vee) grew up tough in the foster care system, but also had aspirations towards a non-criminal life, and only fell in with Vee because her circumstances grew so dire. It's a choice she shouldn't have had to make, but you can also see that life with Vee felt like having something resembling a functional, happy family unit, even if it eventually led her to Litchfield — and then to this unexpected family reunion when Vee arrives in an orange jumpsuit.
(*) Some of you may recognize Toussaint from her stints on "Friday Night Lights" (she played Jess' aunt Bird) or "Law & Order" (defense attorney Shambala Green), but she was one of the two leads (with Annie Potts) in one of the first critically acclaimed cable dramas, "Any Day Now," which aired on, of all places, Lifetime. It pre-dated "The Sopranos" by a few months, and dealt with two best friends who grew up together in the South during the Civil Rights era, and was a nice mix of history and family drama. I've been waiting a while for some other cable drama to give her a regular gig, but the only one that has was "Saving Grace," where she played Holly Hunter's boss. Whether she's in Kohan's long-term plans or not, the profile of this series is going to make Vee an excellent showcase for her.


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2004-2008 Suzuki Forenza Thermostat - Beck Arnley 143-0847
Product Description
A Suzuki Forenza Thermostat promotes proper temperature through controlling the amount of coolant used by your engine. The Thermostat is found next to the vehicle's engine and radiator and plays the role of a valve. A damaged Thermostat has the potential to cause your automobile to quickly overheat, which will cause damage to your car's engine. If you need continued reliable performance from a vehicle, repairing a damaged Thermostat is a good choice. Repairing your car with a Beck Arnley Thermostat (SKU 143-0847) in your Suzuki Forenza will ensure that your car or truck is performing as designed. Suzuki Forenzas bought in '04, '05, '06, '07 and '08 can utilize this part.
Good quality Parts as described, Fast shipping. Very trustable. Suggest it %100.


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Delivers the wrist support and comfort you need! The Medi KoolFlex Wrist Brace is a lightweight yet durable wrist orthotic designed to provide reliable and effective support to weakened or injured wrist joints. Constructed from a breathable, hypoallergenic material that is soft and comfortable, this premium wrist support allows individuals to maintain full use of their fingers without sacrificing stability. With a perforated elastic straps, the Medi KoolFlex Wrist Brace is easy to pull on with one hand, and it features removable dorsal and palmer stays for customized support. Adjustable for personalized fit, the compression strength can be increased or decreased depending on the users needs. Ideal for the treatment of wrist sprains, Carpal Tunnel Syndrome, arthritis, tendinitis and rehabilitation, the Medi KoolFlex Wrist Brace delivers the comfort you want and the support you need. Order yours today from ActiveForever.com Medi KoolFlex Wrist Brace Features: View more
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2003-2005 Land Rover Range Rover Water Pump - Geba W0133-1604648
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(3 Reviews)
4.3 Stars
Geba W0133-1604648
Water Pump
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Availability: (1) In Stock
Condition: New
Shipping Options: Ground, Overnight, 2 Day
Part Number: W0133-1604648
Brand: Geba
Notes: Water Pump gasket may also be required.
Detailed Notes: Does not include 11 51 1 705 408 thermostat housing gasket. It is also suggested the 11 51 1 731 372 beaded water pump gasket be used.
Product Description
Land Rover Range Rovers may use this water pump from Geba on vehicles made in 2003, 2004, and 2005. This water pump does not include the thermostat housing gasket. That part must be ordered separately for replacement. The water pump is required for the cooling system to keep the engine from overheating. If the water pump goes out, the vehicle is not safe to drive because it has a high risk for the engine being damaged from overheating. This water pump is approved for use on Land Rover Range Rovers made in 2003, 2004, and 2005. It may not be compatible on other makes, models, or years.
|Description: Land Rover Range Rover Water Pump. Brand: Geba. Fits Years: 2003, 2004, 2005, 03, 04, 05. Water Pump gasket may also be required.; Does not include 11 51 1 705 408 thermostat housing gasket. It is also suggested the 11 51 1 731 372 beaded water pump gasket be used. - W0133-1604648
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A week ago at the Huntington Beach (Calif.) Edison tournament, Mater Dei rolled through first Mater Dei and then Hart to easily win the tournament. Today was a different story as both Hart and Mater Dei brought their A game and gave the Diablos all they could handle.
Mater Dei rolled to the finals first beating Los Angeles (Calif.) Venice 31-6 in the 1st round and then gave Canyon Country their first passing tournament loss all summer in the semi-finals 33-20.
Mission Viejo defeated Culver City in the 1st round 21-6 and then beat Hart 28-27 in one of the best games of the tournament. Hart was actually involved in two barn burners as they got by South Hills 48-40 in double overtime in the 1st round. SH scored on the last play of regulation to tie the score but Hart knocked down a SH extra point attempt to prevent the loss.
In overtime, all teams are required to go for two points after scoring a touchdown (one point conversion is from three yards out, two points from eight yards out). Both teams scored and got the two-point conversion on their opening possession. In double overtime, Hart scored again and also converted the two point conversion. On South Hills next possession, Hart intercepted a deflected pass to seal the win. Hart QB Sean Norton had a great game and a great tournament and has one of the most live arms of any 5-10 QB we've ever seen. He throws with great accuracy and puts the ball right where it needs to be. For the second week in a row, he made a believer out of us and showed he has the ability to play somewhere at the Div I level.
In the first semi-final, Mater Dei never trailed as QB Jason Forcier carved up Canyon's defense all game long. The rising junior has a chance to be a very special player in a few years and looks like one of the top QB prospects in the class of 2005. For Canyon, EA SPORTS Elite 11 QB Nate Longshore had a fine tournament and made some incredible throws but the Monarchs made it tough on him blanketing his receivers most of the game.
In the other semi-final, Hart led Mission Viejo throughout and moved the ball very effectively. Again, Norton was on the mark and it was almost a shock to see him throw an incomplete pass. The Indians led by two touchdowns late in the game but Diablo QB Mark Sanchez led the comeback. Sanchez throws as pretty a ball as you'll see and has the arm strength of a college QB right now. Mission scored two quick touchdowns and down by one point with just a few minutes left in the game decided to go for two points and the win and converted. A Norton pass was intercepted on their final drive to set up the grudge match between MV and MD, two teams that really don't care a whole lot for each other.
MD came out fast scoring on their opening possession. Mission came right back and answered and then scored two more late touchdowns in the half to take a 20-6 lead at the break. The Monarchs came out fired up after halftime shutting down MV on defense and then scoring a touchdown of their own to cut the lead to 20-14. With just three and half minutes left to go, MD scored again to tie the game and had all the momentum on their side.
It didn't last long as Sanchez hit stud athlete Marty Tadman on a great throw and catch for a score and after converting for two, Mission led 28-20, which proved to be the final scoring of the game.
Like he was at Edison last weekend, Tadman had an incredible tournament earning tourney MVP honors. Offensively and defensively, Tadman does so much to help a team win and made big plays all tournament long. He's just a great high school football player and should make an excellent college one as well.
It was a special treat seeing so many talented QBs competing on one day. Longshore, Norton, Sanchez and Forcier all looked very good and showed why their teams should all be able to compete for a CIF Championship next year.
Other players who stood out:
* Venice WR Ryan Graves is the real deal and was one of the top pass catchers of the day. He's not a burner, but has good size at about 6-1, 175 pounds, great hands, runs very polished routes and made some super acrobatic catches.
* Culver City WR Michael Bumpus also came in with a lot of hype and lived up to it. Like Graves, Bumpus doesn't have blazing speed but has very good game speed and got it done on both sides of the ball. One of the best matchups of the day was when South Hills played Culver City in a losers bracket match and the Payton twins, Bryan and Jeremy took turns covering Bumpus.
The twins were talking some serious smack but it didn't affect Bumpus as he made some very nice catches on both athletes.
* South Hills DBs Bryan and Jeremy Payton are two of the most gifted athletes in the West region. Both have great size at 6-1 and about 185 pounds. They can run, catch, play very physical and are always around the ball. Their one on one matchup with Bumpus was one of the best of the tournament and we would have to say it was a draw as all three took turns making some nice plays on each other.
*Culver City WR Jaison Williams definitely passes the eye ball test and at 6-4, 190 pounds is a huge target. Williams made some nice catches and showed better hands than we saw at the SoCal Nike Camp.
* Carlsbad TE Vic So'oto showed why head coach Bob McAllister called him the best sophomore the program has ever had. Ther rising junior is about 6-5, 210 pounds, catches everything and can really run. He should be one of the top TE prospects at least on the West Coast next year if not nationally.
*As good as Hart QB Sean Norton was, he still has to have someone to throw the ball to and that was Kevin Ciccone who was basically uncoverable all tournament long. Ciccone might have led the tournament in touchdowns and was able to get deep at will.
A special thanks to all the players and coaches who handled themselves very well and showed class throughout. The tournament went without incident and it will be exciting to track how all eight teams do on the field next season.


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NH Luxembourg - Senningerberg
24-hour room service and free parking are just some of the great things you'll find at NH Luxenmbourg, an excellent solution for guests looking for pet-friendly Niederanven hotels that are near the airport. The local area offers a number of attractions, including Luxexpo, Grand Ducal Palace, and Casemates du Bock. D'Coque National Sport Centre is close by as well.
This Niederanven hotel has its own restaurant serving breakfast where you will find a selection of items to try. Guests can also enjoy drinks as there is a bar/lounge.
This hotel has a 24-hour business center and conference/meeting rooms as well as audiovisual equipment and a fax machine, so if you are planning a meeting you will have everything you need to make your event a success. You can also benefit from event catering, banquet facilities, and a computer station. Furthermore, if you want keep yourself in shape during your trip, the hotel features a brand-new fitness facility with unique views of the airport runways. Enjoy free newspapers in the lobby, where you will also find a safe at reception for your valuables. Multilingual staff at the 24-hour front desk can provide tour/ticket assistance. Other amenities include a roundtrip airport shuttle, laundry facilities, dry cleaning/laundry services, air conditioning in public areas, an elevator, and free limited parking.
NH Luxembourg - Senningerberg
Hotel Info: 1-877-214-4288from $68
- Standard Room
- Superior Room
- Superior Room, 1 Single Bed
- Superior Room
- Superior Room
- Standard Room, 1 Single Bed
- Standard Twin Room
- Superior Double Room Single Use
- Superior Double or Twin Room
- Standard Room
- Standard Double Room Single Use
Also popular with travelers from the USA
At a glance
Key facts
Hotel size
- This hotel has 148 rooms
- This hotel is arranged over 4 floors
- Check-in time starts at 3:30 PM
- Check-out time is noon
Required at check in
- Credit card or cash deposit required
- Government-issued photo ID required
Travelling with others
- Pets allowed *
- Restrictions apply *
- 1 per room (up to 10 kg)
- Free WiFi in public areas
- Free WiFi in rooms
- Free airport shuttle at scheduled times *
- Free self parking (limited)
Other information
- Smoke-free property
In the hotel
- Buffet breakfast daily (surcharge)
- Restaurant
- Bar/lounge
- 24-hour room service
- Fitness facilities
- 24-hour business center
- Number of meeting rooms - 8
- Conference space
- Meeting rooms 8
- Conference center
- Computer station
- 24-hour front desk
- Tours/ticket assistance
- Dry cleaning/laundry service
- Laundry facilities
- Free newspapers in lobby
- Luggage storage
- Wedding services
- Multilingual staff
- Year Built 1973
- Elevator/lift
- Safe-deposit box at front desk
- Terrace
- In-room accessibility
In the room
- Air conditioning
- Minibar
- Coffee/tea maker
- Iron/ironing board
- Private bathroom
- Deep soaking bathtub
- Free toiletries
- Hair dryer
- Cable TV channels
- Desk
- Free newspaper
- Free WiFi
- Phone
- Daily housekeeping
- In-room safe
- Connecting/adjoining rooms available
Special features
DiningCrossroad Bar and Bistro - This bistro specializes in international cuisine and serves breakfast only. Guests can enjoy drinks at the bar.
NH Luxembourg - Senningerberg's small print
Also known as
- Hotel NH Luxembourg
- NH Luxembourg Hotel Senningerberg
- NH Luxembourg Hotel
- NH Luxembourg Senningerberg
- NH Luxembourg
The property has connecting/adjoining rooms, which are subject to availability and can be requested by contacting the property using the number on the booking confirmation.
Pet-friendly rooms can be requested by contacting the property at the number on the booking confirmation.
Only registered guests are allowed in the guestrooms.
For transfers, guests must contact the property before arrival at the number on the booking confirmation.
Special cancellation policies or charges may apply for group reservations (more than 8 rooms for the same property / stay dates).
Mandatory fees
Deposit: EUR 50 per night
Pet deposit: EUR 20 per night
Optional extras
Early check-in can be arranged for an extra charge
Late check-out can be arranged for an extra charge
Rollaway beds are available for EUR 25 per night
Breakfast costs between EUR 19.90 and EUR 23.90 per person (approximately)
Pets are allowed for an extra charge of EUR 20 per pet, per night
We have included all charges provided to us by this hotel. However, charges can vary, for example, based on length of stay or the room you book.
Recent reviews
Good 3.8 /5 from 136 reviews
Spent one night that was convenient to parkas Luxembourg is very difficult and accepted our dog. The place was very pleasant with a really good breakfast thrown in. Also very reasonable for the City and whilst literally next do to the airport, you couldn't hear anything


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Add updated style and grace with this sleek 4-light bathroom fixture.
This sleek bathroom light by Kichler features smooth lines and updated appeal. Beautiful cylinders of opal etched glass offer warm light while the simple, beveled frame comes in a sophisticated brushed nickel finish. The perfect choice for your stylish bath.
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We purchased this item to replace the flourescent light fixture in our small hall bath and it really looks great. Modern and contemporary, yet suits the "classic" style of our older bathroom. Gives off a large amount of appealing light. Very happy with this fixture.
We love the look of the Kichler light fixtures, and have them in two bathrooms. This fixture has such sleek style, and is neutral enough to complement many looks. People always say they love the light fixture.
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