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Oncology Nurse Advisor, October 20, 2015
A young person decides to donate stem cells to an HLA-matched sibling in need of a bone marrow transplant. It is such a selfless gift. But for an adolescent in the midst of the emotional turmoil that comes with that age, just how easy a decision is it to decide to give such a complex gift? A multidisciplinary team explored the conundrum with the goal of identifying how to help these generous persons through a very difficult decision. The team members were, from St. Jude Children's Research Hospital in Memphis, Tennessee, Meaghann S. Weaver, MD, MPH, from the Department of Oncology; Ashley Carr, CCLS, from the Child Life Program; and Brandon Triplett, MD, from the Department of Bone Marrow Transplantation and Cellular Therapy; and Dr. Douglas S. Diekema, attending physician and director of education for the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Research Institute in Seattle, Washington.
MedicineNet.com, September 25, 2015
Parent responses on a survey about childhood vaccinations can help predict whether their youngsters will receive recommended immunizations, a new study finds. "Our results suggest that [survey] scores validly predict which parents will have under-immunized children," said Dr. Douglas Opel, of the University of Washington and Seattle Children's Research Institute, and colleagues in a journal news release.
Vox.com, September 17, 2015
Presidential contenders Donald Trump (a celebrity business tycoon) and Ben Carson (a pediatric neurosurgeon) both pushed the notion that kids these days may be getting too many vaccines too soon at Wednesday's Republican debate. Researchers point out that there's absolutely no science to this "too many, too soon" idea of stressing kids' systems with vaccines, and that the government-approved schedule is based on the best-available research about when kids are most at-risk for diseases and when their immune systems are most receptive to them. Also, the data that we have for routine vaccines suggests harms are infinitesimally remote. The totality of the research is stacked against alternative schedules, said Dr. Doug Opel, a Seattle pediatrician who studies vaccines. "There is just no science to this," he told Vox. "What gets lost a lot of the time is that there's an incredible amount of data underlying the recommended schedule."
WebMD, September 4, 2015
There are no official alternative vaccine schedules. No major medical group approves of them. And there is no research to show that they are safe. Alternative schedules have not been formally studied, but there is some evidence that they may contribute to disease outbreaks. "States where a high number of parents opt out [of vaccines] show an increased risk of infectious diseases," says Dr. Doug Opel, a pediatrician at Seattle Children's. "It's significant and it's profound."
Women in the World, August 20, 2015
At a town hall event in Iowa last week, aspiring Republican presidential candidate Carly Fiorina came out against mandatory vaccination for children. Fiorina believes parents have the right to decide whether or not to vaccinate their kids. Fiorina's beliefs are actually in line with policies in most states: Vaccination is required for enrollment in public schools, but parents can obtain exemptions on religious or personal grounds. While policy is obviously important, recent research shows that doctors can also play a role in convincing hesitant parents to let their kids get vaccinated. Last December, Dr. Doug Opel, a pediatrician at Seattle Children's, co-authored a paper in the journal Pediatrics that found that parents were much more likely to decline vaccines for their children when doctors presented the shots as a choice, rather than an expectation.
Surgical Products, August 12, 2015
In "Matched Marrow, Sibling Shadow: The Epidemiology, Experience, and Ethics of Sibling Donors of Stem Cells", Dr. Meaghann Weaver; Ashley Carr, CCLS; and Dr. Brandon Triplett, St. Jude Children's Research Hospital (Memphis, Tenn.) and Dr. Douglas Diekema of Seattle Children's focus on a range of issues unique to adolescents with siblings that require a hematopoietic stem cell transplant. Along with familial expectations, and positive feelings of altruism and self-worth, the scenario may include health risks, pain, and psychological burdens.
Pew Research Center, July 16, 2015
Forty-six states currently allow children to be exempt from vaccinations due to religious concerns, including 17 states that also allow exemptions for "personal reasons," according to a Pew Research Center analysis. And even though 46 states allow religious exemptions for vaccinations, researchers and journalists have struggled to identify a single major U.S. religious group that currently advocates against vaccination for children. Some of these exemptions exist "at least in part owing to the lobbying efforts of the Christian Science Church," according to an article in the Annual Review of Public Health by Dr. Douglas Diekema, a doctor and bioethicist at Seattle Children's Hospital. But even though the church is well known for its belief in healing through prayer, it does not advocate that its members refrain from vaccinating children.
The Stranger, July 8, 2015
Preventable diseases aren't supposed to be killing people in 2015. Yet the Washington State Department of Health recently had the unenviable task of announcing the first measles death in the United States in more than a decade. On July 2, the DOH revealed that a case of pneumonia brought on by measles had killed a woman from the Olympic Peninsula in the spring. The latest measles death wasn't related to the strain unleashed in Disneyland last winter. But, like the Disneyland outbreak, the new case highlighted the damage individual choices not to vaccinate can have on more vulnerable members of a community. Seattle Children's Dr. Doug Opel is featured in this article.
Group Health Research Institute, June 1, 2015
Group Health Research Institute conducted the first randomized trial to test an intervention aimed at improving hesitancy about early childhood vaccines by working directly with doctors. Vax Northwest, a Washington state public-private partnership, developed the intervention. The results are reported in Pediatrics in Physician Communication Training and Parental Vaccine Hesitancy: A Randomized Trial, with an accompanying editorial: Physician Communication with Vaccine-Hesitant Parents: The Start, Not the End, of the Story. The study found that vaccine hesitancy rates declined slightly in both the 30 intervention and 26 control clinics over the six-month study period – and did not differ significantly between them. The intervention did not change either mothers' vaccine hesitancy, or doctors' confidence in communicating about vaccines. Dr. Douglas Opel of Seattle Children's is quoted in this story.
KevinMD.com, May 22, 2015
Pediatrician Dr. Douglas Opel at Seattle Children's is investigating the best ways to communicate with parents who are skeptical of vaccines. In a presentation at the Pediatric Academic Societies (PAS) meeting in San Diego in April, he reported that his research team is completing a study in which they videotaped pediatricians discussing vaccination with parents during well-child visits.
On the Pulse, April 15, 2015
About 70,000 young people ages 15 to 39 are diagnosed with cancer each year in the U.S., and cancer is leading cause of death from disease in this age group. While cancer survival continues to improve for children and older adults, outcomes have greatly lagged for teens and young adults. In recognizing this worrisome disparity, the medical community is working to identify the factors that may be contributing to this population's inferior survival outcomes. In a study featured today on the cover of Cancer, "Insurance status and risk of cancer mortality among adolescents and young adults," researchers have identified one of those factors: lack of health insurance and limited access to medical care. Dr. Abby Rosenberg is featured in this post.
Reuters, April 13, 2015
Children with parents in the military may have lower vaccination rates than other kids, according to a large U.S. survey. Even with socioeconomic factors taken into account, parents' memories and doctors' records suggested that more military children under age three weren't up-to-date on their childhood vaccinations: 28%, compared with about 21% of other kids, researchers reported in Pediatrics. To ensure children are well-protected against vaccine-preventable diseases, a national vaccination registry would be ideal, Dr. Douglas Diekema, a pediatrician at Seattle Children's Research Institute, said by email. "Without that, families will need to try to keep a copy of each child's vaccination records and provide those to their child's new medical clinic when they move to a new home."
Huffington Post, March 6, 2015
Dr. Douglas Opel, a pediatrician at Seattle Children's and expert in bioethics at the University of Washington, has found that how doctors begin a vaccine discussion with parents can strongly steer decisions. In one study, when a doctor began with the recommendation a child was due for a certain vaccine, and then paused for the parent's reaction, Opel observed far less resistance than if the doctor began with an open-ended question. Still, if a parent does have an opinion or questions, Opel said, "it is inappropriate to close off discussion."
Denver Post, March 2, 2015
Eliminating exemptions for religious and personal beliefs would certainly increase vaccination rates, said Dr. Douglas S. Diekema with the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Research Institute. But the strategy risks a backlash against vaccination requirements. "A better approach," Diekema said, "is to eliminate all barriers to vaccination. It should be easier to get vaccinated than it is to choose not to get vaccinated."
Pew Research Center, February 25, 2015
Our analysis found wide variation in vaccination exemptions across the country. Some states have strict guidelines surrounding religious exemptions. Delaware, for instance, requires parents to submit a notarized affidavit stating that a sincere belief in "a Supreme Being" is the reason for the exemption request. And Oregon requires parents to obtain a "vaccine education certificate" either from a health care provider or by viewing an online seminar before their child can be exempted. And even though 46 states allow religious exemptions for vaccinations, researchers and journalists have struggled to identify a single major U.S. religious group that currently advocates against vaccination for children. Although the original reasons for religious exemptions to mandatory vaccines are unclear in many states, some exist "at least in part owing to the lobbying efforts of the Christian Science Church," according to an article in the Annual Review of Public Health by Dr. Douglas Diekema, a doctor and bioethicist at Seattle Children's.
Take Part, February 23, 2015
Pediatricians face growing numbers of parents who question or reject vaccinations for their children. Now, public health experts are working on new ways to help these doctors hone their pitches to families. A study of 111 patient discussions about vaccines involving 16 medical providers, published in the journal Pediatrics in December 2013, found that 83% of parents resisted vaccines for their children when the provider started off with "participatory" language, such as "What do you want to do about shots?" Lead study author Dr. Douglas Opel, a general pediatrician at Seattle Children's and assistant professor at the University of Washington, said that shared decision making with patients doesn't apply to vaccinations, because the recommended immunization schedule is the only medically acceptable choice. But he said it is important to address their concerns.
Reporting on Health, February 20, 2015
When it comes to the media's coverage of the measles outbreak, Dr. Douglas J. Opel of the University of Washington is suddenly very much in the spotlight. That's largely because Opel, a pediatrician based at Seattle Children's and the University of Washington School of Medicine, conducts research that looks at how doctors talk to parents about vaccines. And as the media cycle looks for fresh angles on what's becoming an increasingly saturated beat, the topic of how doctors talk about vaccines has come to seem like the leading edge of the conversation over how to boost immunization rates (legislative efforts aside).
Al Jazeera America, February 13, 2015
A series of measles outbreaks all over the country in recent weeks have drawn scrutiny to parents' decisions not to vaccinate their children. Before 2009, the measles vaccine was available as a stand-alone injection for parents who preferred it; this allowed parents to vaccinate their children against measles without using the rubella vaccine they view as problematic. Dr. Douglas Diekema of Seattle Children's is quoted in this article.
Wired, February 12, 2015
There's been a lot of shaming and blaming of the anti-vaccination crowd in response to the Disneyland measles outbreak (even we did it). And when we released our investigation of vaccination rates at Silicon Valley preschools, people were justifiably angry: Every unvaccinated kid at those schools threatens the greater community's protection against disease. But yelling at anti-vaxxers won't change their minds – which is what we need most to prevent more outbreaks. That begs the question: What can turn them around? Dr. Doug Opel of Seattle Children's is quoted in this article.
The Clinical Advisor, February 11, 2015
Evolving both immunization laws and provider practices is necessary to balance patients' individual choice and public health concerns, according to an editorial published in JAMA Pediatrics. In immunization practice, clinicians are left to decide how far to stray from the standard of care when parents request a revised vaccination schedule for their children. "Protecting individual choice and promoting public health are seemingly at odds. However, an impasse is not inevitable," wrote Dr. Douglas J. Opel, MD, MPH, of the Seattle Children's Research Institute, and colleagues.
The Seattle Times, February 10, 2015
As pediatricians, we have seen the benefit of immunization: the elimination of once-common diseases. Every day, we counsel parents about vaccines. We know they want to do what is best for their child. So do we. Most parents accept immunization, but not all. Un-immunized children can acquire and transmit measles – igniting outbreaks and endangering our community. Dr. Edgar K. Marcuse, Dr. Douglas S. Diekema and Dr. Douglas J. Opel of Seattle Children's co-authored this article.
KUOW, February 10, 2015
Ross Reynolds talks with Dr. Douglas Diekema about why some parents don't vaccinate their children. Diekema is professor of pediatrics at the University of Washington and an emergency room physician at Seattle Children's.
The Wall Street Journal, February 9, 2015
A 2013 study in JAMA Pediatrics found a big risk of contracting pertussis or whooping cough with each delayed vaccine dose, said Jason Glanz, a vaccine researcher with Kaiser Permanente Colorado and a lead author of the study. The study looked at 323,247 children from eight managed-care organizations in six states. "For every dose that was delayed, the risk went up significantly," said Dr. Glanz. "At the highest it was a 28-fold greater risk." Dr. Douglas Opel, a pediatrician at Seattle Children's, finds himself once a month in negotiations with parents about vaccines. About half the time he is successful.
NPR, February 7, 2015
As California's measles outbreak continues to spread beyond state borders, many doctors nationwide are grappling with how best to convince parents to have their children vaccinated. Inviting a collaborative conversation doesn't work all that well, many are finding. Recent research by Dr. Doug Opel, a pediatrician at Seattle Children's and a researcher at the University of Washington suggests that being more matter-of-fact can work a lot better. In the study Opel and colleagues described in the December issue of Pediatrics, they enrolled 111 parents, some hesitant about vaccines and some not.
Vox, February 6, 2015
Researchers completely disagree with the vaccine-hesitant group: they think their worries also undermine the decades of research that almost unequivocally shows vaccines are safe, and that they imperil society's "herd immunity" – the fact that even those who can't or don't get vaccinated are protected because diseases can't spread very far when most people are immunized. "There is just no science to this," summed up Dr. Doug Opel, a Seattle Children's pediatrician who studies vaccines. "We immunize with this vaccine at this time because kids are most at risk at this point. They are most susceptible. What gets lost a lot of the time is that there's an incredible amount of data underlying the recommended schedule."
New York Magazine, February 5, 2015
As opposed to dealing with vaccinations as a political issue, how should they be addressed? The expert consensus at the moment seems to be: (1) Researchers haven't yet figured out which messages can bring anti-vaccine folks into the fold; and (2) to the extent any messages are effective, they have to come from local, trusted figures rather than dictates issued on high from politicians or national-level health authorities like the CDC. Pediatricians are one example. "We know, based on several studies now, that parents really look to their parents' pediatric adviser for important influence on their decision-making," said Dr. Douglas Opel, a pediatrician at Seattle Children's who is developing a protocol to better gauge parents' vaccination intentions. "There's a lot of reasons to try to optimize those relationships."
BloombergBusiness, February 4, 2015
As coverage of the outbreak of measles at California's Disneyland continues to grow, the conversations surrounding the anti-vaccination movement continue to ramp up. According to Dr. Douglas Opel of the Treuman Katz Center for Pediatric Bioethics at Seattle Children's, "Physicians can increase vaccine compliance by making clear that full and prompt vaccination is an expectation, not just an option." It's important, though, to show respect for the parents' opinions. "We, the public health community, should recognize that they're starting from the right place," agrees Emory University's Dr. Saad Omer. "All parents want to see their kids healthy and are looking out for their welfare."
Physicians News Digest, January 26, 2015
Pediatric oncology can be one of the most emotionally draining specialties for doctors and health care providers. On one hand, the sight of a child cured of cancer can create an exhilarating high and validation of the job. But on the other hand, losing a child to cancer – even when it's not your own family – can be devastating. Doctors are supposed to be immune from those emotions. They are supposed to avoid emotional ties to their patients, right? Dr. Abby R. Rosenberg is a pediatric oncologist at Seattle Children's Hospital. She had too often seen families experience those highs and lows that go along with their child's cancer treatment. She had seen entire communities mourn the loss of a neighborhood friend as they "sustain each other, supporting, bolstering, and protecting from within," she said.
U.S. News & World Report, January 22, 2015
Only months before turning 18, a Connecticut girl has been told by her state's supreme court that she must undergo chemotherapy against her wishes in a case that has drawn national headlines and raised questions about what rights minors truly have over their bodies. Laws for minors' access to health care vary by state and typically involve mental health and substance abuse treatment or care for sexually transmitted infections. Some have pointed to a political double standard at play in Connecticut, noting that the state is one of a handful in which teens are allowed to seek abortions without parental consent, yet Cassandra is not allowed to refuse medical treatment for cancer. Supporters of the court's action in Cassandra's case say reproductive, substance abuse and mental health services are different from cancer treatment. "In both cases the law is designed to help the teenager.... They are not laws that recognize a teen's maturity," says Dr. Douglas S. Diekema, clinical director of the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Research Institute.
Huffington Post, January 20, 2015
A controversial new study from Denmark shows a link between circumcision and autism, but other experts pooh-poohed that hypothesis. "One has to be very careful drawing any conclusions from studies like this," Dr. Douglas S. Diekema, a pediatrician at Seattle Children's and the University of Washington in Seattle and one of the authors of an American Academy of Pediatrics policy statement that is broadly supportive of circumcision, told The Huffington Post in an email. "They raise questions for further study, but do not provide answers... Correlation does not imply or prove causation."
NPR, December 3, 2014
Draft federal recommendations don't usually raise eyebrows, but this one certainly will — that males of all ages, including teenage boys, should be counseled on the health benefits of circumcision. In the past 15 years, studies in Africa have found that circumcision lowers men's risk of being infected with HIV during heterosexual intercourse by 50 to 60 percent. Being circumcised also reduces men's risk of infection with the herpes virus and human papillomavirus. Those health benefits prompted the Centers for Disease Control and Prevention's proposed recommendation that doctors counsel parents of baby boys and teenagers, as well as men, on the benefits and risks of circumcision. Groups opposed to circumcision, such as Intact America, say the health benefits of circumcision in the U.S. remain unproven, and that the CDC is relying too heavily on studies done in Africa that may not be relevant here. The procedure, which removes the foreskin, has been criticized because infants can't consent to it. "Parents need to recognize that they're effectively removing that decision from their son," says Dr. Douglas Diekema, a bioethicist at Seattle Children's who served on the pediatricians' task force. "And there are some men who will grow up being unhappy with the decision that their parents made."
Scientific American, October 21, 2014
Ethical dilemmas in research are nothing new; what is new is that scientists can go to formal ethics consultancies to get advice. Unlike the standard way that scientists receive ethical guidance, through institutional review boards (IRBs), these services offer non-binding counsel. And because they do not form part of the regulatory process, they can weigh in on a wider range of issues – from mundane matters of informed consent and study protocol to controversial topics such as the use of experimental Ebola treatments – and offer more creative solutions. But many scientists either do not know that they exist or fear using them because they could add red tape to an already heavy administrative burden. And this year, the U.S. National Institutes of Health (NIH) scrapped funding for a working group to support ethics-consultation services and to develop best practices for the profession. Although financial support could return in some form, ethicists are not waiting around for it. Dr. Benjamin Wilfond, director of the Treuman Katz Center for Pediatric Bioethics at Seattle Children's in Washington, has set up the Clinical Research Ethics Consultation Collaborative, a group of around 35 bioethicists who hope to keep improving the consultation service model, even without NIH support.
Stanford Medicine's Scope, September 23, 2014
In focus groups, Stanford bioethicist David Magnus, PhD, found that no meaningful discussions could take place until his research team had educated patients on some fundamental concepts of medical research, such as standards of care, randomization and informed consent. To help with this process, his team produced three short, animated videos that would rapidly get everyone up to the same level of understanding. Magnus and his collaborators are making these videos available to all for educational purposes. He and his bioethicist collaborators from the Seattle Children's Research Institute and University of Washington expect to publish their final ethics policy recommendations later this year.
Stanford Medicine News Center, September 19, 2014
When a doctor asks a patient if he or she would like to be randomized into an arm of a standard-of-care treatment study, does the patient really understand the question? Can a jargon-filled consent form, written by lawyers and medical researchers, really help? These are the communications challenges that bioethicists faced when they began exploring the ethical implications of the new world of comparative-effectiveness research, in which patients are randomly prescribed treatment options in a doctor's office. This study, led by David Magnus, PhD, director of the Stanford Center for Biomedical Ethics, and bioethicists from Seattle Children's Research Institute and University of Washington, will result in policy guidelines for conducting ethical research within medical practices.
Health Leaders Media, August 8, 2014
Improving Clinical Management of Stillbirth is an educational session sponsored by the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) and the University of Washington. The program was created to give residents a better perspective of what parents go through during a traumatizing medical event. Dr. Maureen Kelley, of Seattle Children's, saw that students weren't properly prepared to handle the emotional repercussions of a stillbirth. "We don't train our physicians very well to handle the emotional, psychological side of it," says Kelley, "There's a little bit of training on the recognition and the science and symptoms of distress and they're trained on how to medically manage a woman who is having a stillbirth. But there's a whole other side to it, the emotional and psychological side of losing a pregnancy and how parents suffer in that process."
Today.com, July 31, 2014
A dancer since the age of 4, Maggie Kudirka knows the grit, discipline and focus required to become a professional ballerina. Now the same drive that kept her dancing may be what keeps her alive: at 23 years old, Maggie, who trains and performs at the prestigious Joffrey Ballet School, was diagnosed with stage 4 breast cancer. "I want to make people aware that breast cancer can strike anyone, at any age. No one is immune, no one is too young, no one is too fit," she says. Breast cancer is rare in younger women – fewer than five percent of all breast cancers diagnosed in the U.S. occur in women under 40. But a 2013 study, published in the Journal of the American Medical Association, found that while it's a relatively small number, metastatic breast cancer tripled among women younger than 40 between 1976 and 2006. Dr. Abby Rosenberg, an oncologist and medical leader of Seattle Children's Adolescent and Young Adult (AYA) Cancer Program, says self-advocacy is especially important in young adult patients because they less likely to see a doctor regularly, and they have the lowest rates of medical insurance. "These are people who are generally supposed to be healthy and most of the time a lump in the breast isn't a big deal. But, cancer does happen in young adults and when it does, we need to figure out how to take care of them, from a medical and developmental life standpoint," Rosenberg says.
Seattle Children's On the Pulse, August 5, 2014
"In my last post about 'The Fault in Our Stars,' I made a comment about how most patients live, if not thrive after their cancers. I am deeply grateful for the readers who correctly commented that some patients also die. There are no words to express how tragic, painful or unjust, the death of a young person from cancer can be. I particularly appreciated these comments because they came a day after the death of one of my own, and very beloved, patients. I wrote this memoir the day he died. With his parents' permission, I am sharing a few pieces of his story, his legacy, with you." Dr. Abby Rosenberg of Seattle Children's is the author of this post.
Seattle Children's On the Pulse, July 24, 2014
"I loved 'The Fault in Our Stars.' Both the book and the movie. I read the book a few years ago during a flight. I cried so hard that I'm sure the other passengers were alarmed, if not downright uncomfortable sitting near me. This summer, I saw the movie with a girlfriend. Same thing - I went through a whole pack of tissues and left red-faced, swollen and physically dehydrated. As we walked out of the theater, my girlfriend (also a pediatrician) turned to me and said skeptically, 'I don't get it, Abby. Why are you so emotional? Isn't this what you DO for a living?' The answer is yes. Taking care of teens and young adults with cancer is what I do. And, perhaps, that is why this book/movie hit me so hard. For one thing, we oncologists are often so busy thinking about chemotherapy and side effects, we don't see the other side of cancer. We get to know our patients and families, but we see them in the contrived settings of clinic and the hospital - not at home, amongst their friends or on a trip to Amsterdam. We aren't always privy to their witty internal monologues or their poignant observations about the injustices of life, the things that really matter to them, or the life lessons they've learned during their arduous journey with cancer." Dr. Abby Rosenberg of Seattle Children's is the author of this post.
blog.Bioethics.gov, July 18, 2014
Tomorrow, the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) will present its recommendations on pediatric medical countermeasure (MCM) research at the 10th Annual Pediatric Bioethics Conference in Seattle. The conference, hosted by the Treuman Katz Center for Pediatric Bioethics at Seattle Children's, takes place July 18 and 19, 2014; its theme: "New Opportunities, New Challenges: Exploring the Ethical Boundaries of Pediatric Research."
MPR, July 18, 2014
For pediatric patients with advanced cancer, parent-provider concordance is poor regarding prognosis and goals of care, according to a study published online July 14 in the Journal of Clinical Oncology. Dr. Abby R. Rosenberg from Seattle Children's and colleagues describe parent-provider concordance regarding prognosis and goals of care for 104 pediatric patients with recurrent or refractory cancer. Parents and providers were surveyed on perceived prognosis and goals of care on enrollment, and data were available for 77 dyads (74% of those enrolled). Survival status was retrospectively abstracted from medical records.
U.S. News & World Report, May 23, 2014
Pediatricians and other health experts joined U.S. News & World Report for a Twitter chat this week to answer questions about when parents should take their son or daughter to the hospital. Each year, more than 23 million children age 15 or younger are taken to the emergency room, according to the National Safe Kids Campaign, an organization dedicated to the prevention of unintended childhood injury. Parents can do a lot to help keep their children out of the hospital, including updating safety measures at home as their children grow older and partnering with their pediatricians to devise a plan of action for children with particular medical conditions, like asthma or diabetes. Not all children who go to the emergency room need to be there. Many situations can easily be handled by a pediatrician during office hours, or treated at home using over-the-counter health products. Here is a guide to knowing how you should respond to issues from stomach pain to emotional trauma. Dr. Doug Diekema of Seattle Children's participated in this chat.
NewsBeat, March 27, 2014
Medical research tilts toward transparency and caution - not always to the public's advantage, surprisingly. Q&A with Dr. Benjamin Wilfond, who directs the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Research Institute and is chief of the Division of Bioethics in UW School of Medicine's Department of Pediatrics.


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Boating Accident Lawyers and Law Firms in Spring House, PA
Boating Accident Lawyers
Reiff & Bily
Philadelphia Personal Injury Lawyers(215) 246-9000 or (800) 861-6708
Reiff & Bily is a personal injury law firm based in Philadelphia, Pennsylvania. Our attorneys have more than three decades of legal experience successfully handling personal injury and wrongful death cases. We have consistently received the highest ratings for exceptional ethics...
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The Maher Law Firm is located in the Orlando suburb of Winter Park, Florida and specializes in personal injury. Our personal injury practice area encompasses vehicle and pedestrian as well as aviation, bicycle, and boating accidents, catastrophic injuries, product and premises liability,...
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Morgan & Morgan is a personal injury law firm known for representing the people, not the powerful. With 33 offices, more than 300 lawyers, and 1,500 support staff, Morgan & Morgan is one of the largest personal injury firms in the entire country. Its lawyers handle cases...
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The Beasley Firm has fought for the legal rights of injured persons since 1958. Our cases have changed the law, have set records for personal injury and medical malpractice jury verdicts, and have made a real difference in people's lives: both in ensuring compensation and care for...
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Donaghue and Labrum LLP, with offices located in Media, West Chester and Philadelphia, PA handles personal injury, medical malpractice, product liability and nursing home abuse cases throughout Southeastern Pennsylvania. The firm has more than a quarter of century helping victims...
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The Law Offices of Joel J. Kofsky is a personal injury law firm located in Philadelphia, Pennsylvania. The lawyers of the firm have secured millions in compensation for clients throughout the state. They are experienced trial attorneys with comprehensive knowledge of insurance law,...
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Personal Injury and Medical Malpractice Lawyers in Philadelphia, PA(215) 772-1000 or (800) 243-1100
Kline & Specter, P.C. is located in Philadelphia, Pennsylvania, but also has law offices in Delaware and New Jersey for your personal convenience. Attorney Kline and Specter specialize in personal injury law including medical malpractice. If you or a loved one is the victim of...
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The Rothenberg Law Firm LLP is located in Philadelphia, Pennsylvania, but also gladly serves areas of New York and New Jersey. For decades, the attorneys have dedicated time and attention to helping you and your families recover from personal injuries. In fact, it is the sole purpose...
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Over the past 40 years, Baum, Hedlund, Aristei & Goldman has handled thousands of cases against some of the biggest pharmaceutical manufacturers, airlines and ground transportation companies in the world.
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Caroselli, Beachler, McTiernan & Coleman since 1972, have been helping the injured people of Pennsylvania in matters of workers' compensation, personal injury, medical malpractice, asbestos litigation and social security. We also pursue bad faith insurance claims, toxic torts...
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At Dansky Katz Ringold & York, P.C. in New Jersey, our attorneys have dedicated their practice to victims of accidents that caused injury or death for more than a quarter of a century. They pride themselves on the respect they earned within the legal community and a reputation...
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Duffy + Partners
Catastrophic & Birth Injury Attorneys in Philadelphia, Pennsylvania(215) 238-8700
The Law Firm of Duffy + Partners helps catastrophically injured victims and their families. Duffy + Partners is a firm of trial attorneys you can count on to guide you through the complexity of the legal system to ensure just recovery for your injuries.
Duffy + Partners is committed...
Law Firm's Overview Free Consultation
Huber & Palsir, LLC
Disability Lawyer in Philadelphia, Pennsylvania(215) 773-6114 or (877) 767-0409
Huber & Palsir is a personal injury law firm from Philadelphia, PA providing legal services and representation throughout eastern Pennsylvania. Founding partner Robert A. Huber has over 20 years of experience assisting injured clients obtain compensations in the millions of dollars....
Law Firm's Overview Free Consultation
Kenneth R. Schuster & Associates
Personal Injury & Workers' Compensation Attorneys in Philadelphia, PA(215) 848-9200
Kenneth R. Schuster & Associates is an experienced personal injury law firm that has been fighting for the rights of injury victims for more than 30 years. Our practice is focused on complex cases involving catastrophic injuries, auto accidents, workers' compensation, medical...
Law Firm's Overview Free Consultation
Marrone Law Firm, LLC
Pennsylvania Personal Injury Lawyers(215) 732-6700
Marrone Law Firm, LLC is a Philadelphia, PA based personal injury law firm with an office location in Cherry Hill, NJ. The firm provides legal representation to victims of personal injury throughout Pennsylvania, New Jersey and New York. Founding attorney Joseph Marrone Jr. has been...
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Messa & Associates, PC
Pennsylvania Personal Injury, Medical Malpractice & Auto Accidents Lawyers(215) 568-3500
Messa & Associates, P.C. is a law firm that specializes in representing individuals and their families in complex personal injury matters, including catastrophic injury, medical malpractice, product liability, motor vehicle accidents, fires and explosions. Our personal injury...
Other Offices: Conshohocken, Philadelphia
Law Firm's Overview Free Consultation
Randolph L. Goldman, Attorney at Law
Philadelphia Criminal Defense Lawyer(215) 268-7781 or (866) 930-8116
Randolph L. Goldman, Attorney at Law at Randolph L. Goldman Attorney at Law, our criminal defense attorney has over thirty years of experience in the Pennsylvania courts. Prosecutors in the Philadelphia area are familiar with criminal law attorney Randolph Goldman's skill and determination....
Law Firm's Overview ArticlesFree Consultation
Raynes McCarty
Philadelphia Personal Injury Attorneys(215) 568-6190 or (800) 535-1797
At Raynes McCarty, located in Philadelphia, Pennsylvania, provides legal representation in personal injury, employment law, environmental law, civil rights, professional malpractice, commercial and business litigation and other accident matters. Our experienced attorneys have been...
Law Firm's Overview
Console & Hollawell, P.C.Philadelphia, PA - Law Firm near Spring House
Philadelphia Personal Injury Lawyers(215) 225-2040
Console & Hollawell, P.C. is a personal injury law firm serving New Jersey and Pennsylvania. We are a team of compassionate and experienced attorneys and professional paralegals who will ardently and aggressively fight for what you deserve-the maximum compensation under the law.
Feldman Shepherd Wohlgelernter Tanner Weinstock & Dodig LLPPhiladelphia, PA - Law Firm near Spring House
Philadelphia, Pennsylvania Personal Injury Lawyers(215) 567-8300
Feldman Shepherd Wohlgelernter Tanner Weinstock Dodig, LLP is a personal injury law firm based in Philadelphia, Pennsylvania providing legal representation to clients throughout the surrounding areas of Pennsylvania. The firm's partners combine nearly 200 years of legal experience between them...
Hoffman Michaels & Steinberg, LLCFeasterville-Trevose, PA - Law Firm near Spring House
Pennsylvania Personal Injury Law Firm(215) 953-8955
Hollstein Keating Cattell Johnson & Goldstein PCPhiladelphia, PA - Law Firm near Spring House
Pennsylvania Lawyers Experienced in Commercial Litigation & Maritime Law(215) 320-3260
Kane & Silverman PCPhiladelphia, PA - Law Firm near Spring House
Philadelphia Personal Injury Lawyers (PA/NJ)(215) 232-1000
Kane & Silverman P.C. is a team of highly respected, award winning Personal Injury Lawyers providing fast and aggressive legal representation to injured accident victims in Pennsylvania and New Jersey. We are committed to fighting for the highest compensation you deserve.


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Distance students who are currently in the program please refer to the Critical Care Nursing Program: Transition to Revised Curriculum [PDF]. For assistance in completing your credential, please contact the Program.
Check current availability of courses for this program.
|Required Courses: (27.0 credits)
Dysrhythmia Interpretation and Management
The course supports the development of fundamental knowledge required to systematically analyze and interpret basic cardiac dysrhythmias. Participants will explore myocardial electrophysiology in relation to cardiac monitoring and develop a systematic approach to dysrhythmia analysis and interpretation. Further, participants will consider the predisposing factors and associated interventions related to the conduction defect present and the consequences of the dysrhythmia to both systemic and myocardial oxygen supply and demand. Finally, the significance of dysrhythmia analysis, interpretation, and management to critical care nursing practice will be explored. Although this course is conducted within the specific context of critical care nursing practice, it would also be suitable for other nurses or qualified health professionals requiring this skill. If you are not a registered nurse or a student nurse in the final years of your BSN program you must consult the Critical Care Nursing Program Head prior to registration. Prerequisites: Health professionals who are not nurses may register for this course with approval of the Critical Care Specialty Program Head. If you are registering in the NSCC, NSHA or NSER nursing program follow the program course matrix. Program Head approval is required to take NSCC 7150 as a co-requisite with NSCC 7120, NSCC 7220, NSHA 7100, or NSER 7110.
Critical Care Nursing Theory 1
Critical Care Nursing Theory 1 is the third course in the British Columbia Institute of Technology (BCIT) Critical Care Nursing Specialty Certificate. In this course, learners will continue to build foundational knowledge based on concepts explored in NSCC 7100 and 7150 and further develop their understanding of patients' experiences of critical illness. Specifically, learners have opportunities to further explore critical care nursing practice as they consider the contribution of research, the nature of evidence, and the application of best practices in the care of critically ill patients. Additionally, learners will explore additional comprehensive assessment strategies (e.g., hemodynamic monitoring, arterial blood gas analysis, renal assessment) and strategies employed to optimize oxygen supply and demand balance in critically ill patients (e.g., CPAP/BiPAP, vasoactive and inotropic medications, and fluid management). Finally learners will be challenged to make clinical decisions and plan care for selected critically ill individuals including those experiencing respiratory insufficiency, acute coronary syndrome, heart failure, and hemodynamic instability. Throughout this course learners will continue to reflect on the significance of relational nursing practice in critical care and their vision of self as a critical care nurse. Please note, learners must be Registered Nurses to take this course. Prerequisites: 75% in NSCC 7100 and 75% in NSCC 7150
Critical Care Nursing Clinical 1
In this clinical course, learners focus on applying and integrating nursing knowledge to provide nursing care for critically ill patients experiencing selected health problems such as coronary artery disease, acute coronary syndrome (e.g., angina and MI), cardiac failure, and hemodynamic instability. In this experience learners focus on applying theory related to oxygen supply and demand, comprehensive assessment, monitoring skills and clinical decision making. Working in partnership with patients, learners have an opportunity to develop an understanding of patients' experiences of critical illness. Learners work with patients buddy nurses and the clinical teacher to promote safe, competent, and ethical nursing care. Theory will be reviewed concerning the significance of the environmental context of critical care nursing to patient care, health promotion opportunities, and clinical decision making. Laboratory experiences to practice airway management, care of the patient with central and/or arterial lines, and cardiac arrest management are included. While NSCC 7310 is generally a clinical teacher led course, in unique situations it is possible to complete this course as a preceptorship. Prerequisites: 75% in NSCC 7200. As well as providing this information at the time of admission, BCIT requires students to provide proof of CRNBC membership for each clinical course they enrol in. Without CRNBC registration, you will not be permitted to continue in the course.
Critical Care Nursing Theory 2
Critical Care Nursing Theory 2 is intended to expand your ways of knowing, being, and doing in critical care nursing. Specifically, this course will provide opportunity to explore foundational knowledge of relational family practice and ethical practice within the context of critical care nursing. You will have the opportunity to expand your knowledge related to strategies employed to optimize a patient's oxygen supply using advanced hemodynamic monitoring and mechanical ventilation. Managing a patient's metabolic and oxygen demand will be introduced as a key concept in the critical care context. You will apply concepts learned in this course to a patient experiencing acute respiratory failure including pneumonia with progression to acute respiratory distress syndrome. Prerequisites: Satisfactory in NSCC 7310.
Critical Care Nursing Clinical 2
In this clinical course, learners focus on applying and integrating nursing knowledge to provide nursing care for critically ill patients and their families. In this experience learners focus on providing care for patients' experiencing acute respiratory failure and hemodynamic challenges. Learners have opportunities to further develop their comprehensive assessment skills by providing safe, competent, and ethical nursing care for patients requiring mechanical ventilation and advanced hemodynamic monitoring in collaboration with buddy nurses and clinical teachers. Working in partnership with patients and families, learners will develop an understanding of unique patient and family situations. Learners will have opportunities to think critically, .selecting and evaluating therapeutic interventions as they focus on developing interventions, clinical decision making. Participating and reflecting on ethical issues and collaboratively providing family-centred care are concepts that nurses continue to develop. Laboratory experiences to practice skills related to intubation, mechanical ventilation, and advanced hemodynamic concepts are included. While NSCC 7425 is generally a clinical teacher led course, in unique situations it is possible to complete this course as a preceptorship. Prerequisites: 75% in NSCC 7410. As well as providing this information at the time of admission, BCIT requires students to provide proof of CRNBC membership for each clinical course they enrol in. Without CRNBC registration, you will not be permitted to continue in the course.
Critical Care Nursing Theory 3
This theory course supports further development of critical care nursing practice and builds new knowledge related to providing care for increasingly complex, critically ill patients. Specifically, learners will have opportunities to develop clinical decision-making skills and processes while examining the care of a patient experiencing an alteration in cerebral oxygen supply and demand balance, and the care of a patient experiencing sepsis progressing toward septic shock. Learners will also have the opportunity to apply knowledge from previous courses related to family-centered care, ethics in practice, and best practices in specific patient situations and explore new knowledge related to contextual influences on selected aspects of critical care nursing practice. Finally, learners will focus a portion of their study on a patient experiencing one of the following critical illnesses; multiple organ dysfunction syndrome, cardiogenic shock, cardiac surgery, or surgery and post anesthesia. Prerequisites: Satisfactory in NSCC 7425.
Critical Care Clinical 3
In this final clinical course in the critical care certificate, learners focus on integrating all previous knowledge in clinical practice. Learners will provide care for increasingly complex critically ill patients who may include, but are not limited to, patients experiencing alterations in cerebral oxygen supply and demand (including traumatic brain injury, ischemic and hemorrhagic stroke), and patients experiencing sepsis, progressing toward septic shock. Learners will progressively increase their independence in decision making and critical care nursing practice. Learners will actively participate in the provision of family-centered care, ethics in practice, and best practices in specific patient situations. Learners will examine the influence of context and collaboration within the health care team on patient care and nursing practice. Laboratory experiences to practice cardiac arrest management are included. While NSCC 7550 is generally a clinical teacher led course, in selected situations it is possible to complete this course as a preceptorship. Prerequisites: 75% in NSCC 7450
Introduction to Critical Care Nursing*
Introduces critical care nursing practice and explores what it means to be a critically ill person. Examines concepts foundational to this understanding, including oxygen supply and demand, comprehensive assessment, technology as practice, and clinical and ethical decision making. An observational experience in a critical care unit provides insight into the patient's experience of illness, the role of the critical care nurse, and the context of critical care nursing practice. Prerequisite: CRNBC registration or eligibility for registration and FIT testing.
Critical Care Nursing Theory 1**
Learners are introduced to critical care nursing practice and the nature of critical illness. An observational experience in a critical care unit provides opportunity for learners to gain insight into patients' experiences of critical illness, the role of the critical care nurse and the context of critical care nursing practice. Theoretical concepts that are foundational to critical care nursing practice are examined including: oxygen supply and demand as a basis for cellular oxygenation and physiological function, comprehensive assessment and analysis of arterial blood gas analysis, invasive hemodynamic assessment & monitoring, and clinical decision-making in critical care nursing practice. Simulation sessions support application of theoretical aspects to nursing practice, laying foundation for clinical practice experience. Course materials for this course, along with all other theory courses in the Nursing Specialty Critical Care curriculum are offered in the iPad/IBook format. Students must have access to an iPad to participate in this course. Please note: You must achieve 75% or greater to register in NSCC 7220.
*Distance Education/Part-time Studies students only
**Compressed time frame students only
|Total Credits:
Check current availability of courses for this program.
Note: Students that are completing the old curriculum can finish their certificate by taking NSCC 7610 in lieu of NSCC7600 or NSCC 7625. This course is offered to grandfather students from old curriculum to new curriculum.
Do you have credits from another BC/Yukon post-secondary school? Do you want to know if they transfer to courses here at BCIT? Check out BCIT's Transfer Equivalency Database to find out.
The BCIT student outcomes reports present summary findings from the annual survey of former students administered by BC Stats one to two years after graduation. These reports combine the last three years of available results for the 2013-2015 BCIT Outcomes Surveys of 2012-2014 graduates and for Degree 2010-2012 graduates. The reports are organized into three-page summaries containing information on graduates' labour market experiences and opinions regarding their education. More detailed information can be accessed at the BC Student Outcomes website.
To view these results, you may need to have the Adobe Acrobat Reader installed in your Web browser.
Jenna Coroliuc
Program Assistant
Toll-free: 800-663-6542 x 7103
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The Shenendehowa High School community is dealing with the loss of another student, as a senior described as "always smiling" died Thursday in a car crash on the way to school. The Shenendehowa Central School District is prepared — and, unfortunately, experienced — to deal with tragedies such as a student dying. There is a crisis team and a gathering of students and staff, and procedures for dealing with the media and the like. But ...
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Mar 23, 2013; Frisco, TX, USA; A Budweiser and Michelob beer stand before the game between FC Dallas and the Real Salt Lake at FC Dallas Stadium. FC Dallas won 2-0. Mandatory Credit: Kevin Jairaj-USA TODAY Sports
Greetings beer lovers, cocktail enthusiasts, home brewers, and the like! My name is Chris Headrick, and while I am an Editor and writer at Tomahawk Take, an Atlanta Braves' fansite on the Fansided Network, I'm also a huge craft beer enthusiast. Few things in life go together as well as sports and a cold one!
Everything On Tap is a relatively new site on the Fansided Network, and we'll be bringing you the latest news, thoughts, opinions, and more about all things beer, cocktails, home brewing, and essentially anything and everything related to those wonderful refreshments you find flowing from the tap of your favorite watering hole.
We're going to be talking about beer – everything from how-to's on home brewing, to reviews of craft beer, breweries, and watering holes who do a bang up job providing customers with the best and most refreshing choices. We'll also be talking about cocktails, mixology, and even talk a bit about the history of beer and spirits.
We're in the process of growing our staff of writers here at Everything On Tap, so if you are a beer or cocktail enthusiast, craft beer lover or brewer, and have writing experience, we'd love to hear from you. Because my time is limited, we're also looking for someone willing to be an editor here at Everything On Tap! Just click on our Openings link at the top of the page, and follow the instructions to apply. If you have editor experience, or you can combine your love of writing with your love of refreshing spirits, you might find a great place to share here at Everything On Tap!
Our goals are two-fold at the very least – to entertain and enlighten! We want you to have fun when you visit Everything On Tap, so we'll have fun features on things like drinking games, how to properly outfit your man-cave for the best mix of sports and refreshments for your buds (no pun intended), and more. We also want to educate and enlighten, so we'll share a great deal of how-to pieces on home brewing tips, how to judge a good craft beer, industry insights, and much more.
We hope you'll enjoy the time you spend with us, and we hope you'll join us by sharing your comments and engaging with us in our shared interest. In a perfect world, we could all go to our favorite local tavern or bar, and they'd have absolutely Everything On Tap! Until then, we'll dream about it, and share our dreams with you.
Chris Headrick
Staff Writer, Everything On Tap
Topics: Beer, Cocktails, Everything On Tap, Home Brewing


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Just over three months before the United States entered World War II, the American military simulated an enemy attack on the airport in Fort Plain. Robert von Hasseln has posted notes on the incident on the Facebook page of Historic Amsterdam League. According to press accounts, 46 soldiers and two officers were on the ground at Fort Plain's airport on Tuesday, Aug. 26, 1941, having arrived the night before. They included an artillery regiment that ...
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Nb: infants must be under the age of 2 and
children must be under the age of 12 at the time of
Residence "L'Orsière", renovated in 2013. In the centre of Val Thorens, in the resort, in a quiet position, directly by the skiing area. In the house: lift, storage room for skis. Shop, shopping centre 50 m. Sports centre, skisport facilities 50 m. Please note: In case of good snow conditions, the house is accessible on skis. There are more similar properties for rent in this same residence. 2-room apartment 28 m2 on 3rd floor: living/dining room with 1 pull-out bed and TV (flat screen). 1 room with 2 x 2 bunk beds. Kitchenette (4 hot plates, oven, dishwasher). Bathroom, sep. WC. Balcony, south facing position. Beautiful panoramic view of the mountains and the ski run.


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|2 Reviews
|Half Baths
|Property type
|Minimum Stay
|2 nights
When you book through the HomeAway checkout, your booking is backed by our Book with Confidence Guarantee™ offering comprehensive payment protection.Learn more
I am sure you will enjoy your stay at our lovely L'Opale Villa situated in Le Touquet. You can relax in any one of the 5 bedrooms and entertain up to 10 people.
The kitchen is fully equipped for preparing some of the fantastic produce you may have purchased from the local market.
The wood fire will give you all a cosy feeling on colder nights in.
In the summer relax on the balcony whilst keeping a discreet eye on the kids in the large garden.
The house will provide you with the perfect base for the beach, golf, shopping or exploring the local gastronomical treasures in nearby towns.
Beach: 10 minutes to Le Touquet beach and 5 minutes to Stella Plage beach.
Golf: Walking distance to La Mer golf course. 2 mins drive to Le Manoir and Le Foret golf courses. Some of the best golf in Northern France.
Supermarkets: 2 mins drive to the Intermarche supermarket and petrol station.
Fresh daily Bread from Freds - 5 minutes walk.
My wife and I live in the south of England and regularly visit our holiday home which we fell in love with many years ago. We are happy to answer any questions you may have no matter how small and help you in everyway to make the most of your holiday in our house.
Richard Moore purchased this villa in 2004
This is a great house for families in an ideal location. You will find swings for the kids in the garden. Cots, high chairs and stairgates can all be provided.
But don't just think this is a house for families we have entertained many groups of friends from all over the world.
Large house with garden and plenty of space.
5 minutes from the centre of Le Touquet.
Plenty of Free Car parking.
Free Wi - FI
Back home now after a fabulous week in L'Opale.
We enjoyed our week there, very much, and are already getting our thoughts together for next year.
L'Opale was the perfect setting for us.
L'Opale lived up to all our expectations, it was a lovely spacious house (the front aspect is very misleading!) very clean and extremely well equipped. The house is set in a delightful and quiet road, and there are excellent cycle tracks nearby - we hired bikes! The garden is good and the slide and swing were much used by our 3 year old grandson! The owners were more than helpful in the weeks leading up to our stay, as we had several questions regarding equipment etc as we were taking a 5 month old baby too. There's lots of games inside for children to play, and some daunting jigsaw puzzles for the adults!
Le Touquet is only a couple of minutes drive away where the beaches are outstanding - miles of golden sand! The restaurants in Le Touquet are excellent, do try the fish soup at Peraud! Boulogne is only 40 mns away, and another wonderful town, Nausicaa the aquarium there is fantastic and appeals to all ages. Market day in both Le Touquet and Etaples is great fun, so much fresh food to take home and cook back at L'Opale! There is a supermarket nearby, and a wonderful Patisserie for those breakfast croissants!
We visited the Commonwealth Memorial at Etaples, very thought provoking, so much so it inspired us to have a day trip to Amiens on the Somme which proved to be a lovely city with the largest gothic cathedral in France - you could fit 2 Notre Dames inside it! The journey was easy, the french countryside around Le Touquet is beautiful and the air is fresh and clean.
We had a very happy and comfortable week at L'Opale, it was home from home and we all thoroughly enjoyed our stay. We can thoroughly recommend it!
Many good points to this property - lovely position and garden, woodburning stove with good wood supply, very well equipped for a French property and heating was very efficient. The owwers were also very pleasant and helpful throughout the booking process etc. The common problems with French sewage system were very apparent as was a quite unpleasant smell! Added to this the property was not quite as clean and well kept as we expected from the web site. Bits and pieces fell off particularly in shower/bath rooms and there was quite a well worn air to some areas. Perhaps we were unlucky being at the end of what had no doubt been a busy summer season and also having appalling weather which meant we were very aware of interior comfort - or not!
Potential to be stunning!
Le Touquet France - Paris Plage is a beautiful 1920's style holiday resort with glorious beaches and magical pine forests. L'Opale is situated in tranquil woods and is close to La Mer, La Forêt and Le Manoir golf courses. The enchanting dunes and sandy holiday beaches are only minutes away. Historically you can visit the medieval walled city Montreuil-sur-mer and the famous war grave cemetery at Etaples. There is also the huge amusement park 'Bagatelle' at Berck, well worth a day out. The Aqualud water park located on the beach in Le Touquet provides a great day out for the children.
Other Activities: Sand Yachting
Golf: Nearest golf courses within walking distance / 2 mins drive:
La Mer
Le Manoir
La Foret
Le Touquet Golf is an enviable experience, mature pine forests nestle between rugged sand dunes. The 3 golf courses in Le Touquet are arguably Frances hottest golf destination. We can offer a range of accommodation for larger groups and all are ideally situated within minutes of the greens. Our Le Touquet villa rentals often work out cheaper than the golfing hotels for larger groups. If you have a golfing holiday to organise then we can offer accommodation for groups of 4 -14 people. Our villas are also available to rent for short golf breaks please contact us.
If you are planning a golf holiday based around staying at one of our villa's or houses in Le Touquet and would like to play at a number of these course then you may benefit from a Golf Pass.
This is valid for 15 days and gives access to 9 golf courses. Golf Passes can be purchased from each participating Golf club.
|Rate Period
|Weekend Night
My Standard Rate
2 night minimum stay
|Refundable damage deposit
|Pet Fee
Linen is not supplied as part of any Home Away booking. However this may be ordered and paid for directly with us if required at a cost of £10 per person.


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The staff was friendly and helpful The room was adequate for the fact we were out of it most of the time. The noise level was high in the morning with people coming and going. I am not use to being in a town and had a hard time adjusting to the highway noise. The breakfast was the usual affair and the table was extremely wobbly The price is very reasonable so I guess we got what we paid for
- Official Description (provided by the hotel):
- Truly Yours™From the moment you arrive at our Comfort Inn, we want you to relax and feel at home. Our helpful staff is there to welcome you, and you'll find everything to suit your needs, including: NEW Free hot breakfast buffet featuring eggs, sausage or bacon, fresh fruit, toast, danish, juice...and your choice of original or flavored wafflesFree high-speed Internet accessClean, comfortable and well-appointed roomsCozy bedsFeel at ease knowing that your satisfaction is important to us ... more less
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- TripAdvisor is proud to partner with Booking.com, Hotels.com, Hotwire, Priceline, Travelocity, Choice Hotels, Odigeo and Expedia so you can book your Comfort Inn Sandusky reservations with confidence. We help millions of travelers each month to find the perfect hotel for both vacation and business trips, always with the best discounts and special offers.
- Also Known As:
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Welcome to the HRRA Website. Please feel free to explore this site, some highlights of which are as follows:
Please see our Blog page for our latest news and updates.
Our 2015 AGM took place on 30 October 2015 – see the blog post for details.
'We are LGBT Friendly' stickers – See blog post for details.
Get latest updates including social events via our Facebook Page.
Become a member for free and get updates by joining the 'What's On' Mailing list.
Read our latest newsletter.
Find information regarding our expanding Trans Group.
See the blog posts regarding our recent Hate Crime awareness initiative.


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Is the market telling us that it is a done deal with Amgen? Around $130--Amgen could throw in an extra $5 per share to seal the deal. Somewhat disappointing, but not that bad. Let's see whether we will have a pleasant surprise with the another bidder emerging--but right now the pricing behavior is signalling that it is unlikely.
Sentiment: Strong Buy
John, I agree. NVS is out and the stock goes back up...Looks like $130 will be the final offer.
All of these "reports", rumors...First NVS says "10B is reasonable". Then, they're not bidding...Does not makes much sense...Will see soon.
First NVS says "10B is reasonable". Then, they're not bidding...Does not makes much sense...
Maybe $10b is reasonable, but $11b isn't
I sold the Nov 130 for 3.40 and as soon as NVS pulled out it dropped to 2.40 , I'm leaving it on cuz I feel 130 is gonna be it.


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The iconic Helen Keller once famously stated, "The most pathetic person in the world is someone who has sight, but has no vision.†With respect to solving our education crisis, politicians and policy experts call for all sorts of accountability measures and rating metrics. But no one is asking the really big question, "What is our mission?
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"Dive against debris!" That was my project for my Project Aware specialty in my DM course. I organized the afternoon dive to be a fun and free dive for all guests here at Two Fish to help us go clean up the bottom of the sea! It was great!
I have been SO busy with my DMT course trying to get it all finished, but not rushing things so I really learn and feel comfortable with it all. We are now at the third location of Two Fish Divers in Lembeh Strait, north east tip of North Sulawesi. It is a major shipping port, but we are across the strait on an island, as usual. lol So, here is the land of MUCK diving. Yes, I said muck! What the heck is that? I asked that question months back whilst planning this trip and my MSDT husband was jumping up and down in excitement that my DMT course was going to take us to Lembeh, a photographer's dream place.
Another busy period behind!
-All theory and exercises are now finished:
-Just finished my treading water, in the sea this time!
-I was able to assitet with Asker and Camilla's course and now both are certified Open Water Divers and Advance Open Water divers!
I have had a busy week ticking boxes off the list of requirements for my DM! I did a DSD, 400m swim, 800m swim, extensive excellent compressor workshop, super thorough equipment workshop, my skills in the pool, OW confined 1,2,3 and so much more just being immersed in the busy busy life at Two Fish Divers Bunaken.
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Full Power ahead! I have finished a few more chapters from my DM manual and have wrestled through many chapters of my instructors manual.
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The first week of March is a prime time for many of the Iglu team to head off on their ski holiday's. The half term crowds have disappeared, the chance of fresh snowfall is high and we get to enjoy the start of spring skiing conditions.This is the time of year where we can go to our favourite resorts. A large group headed to the beautiful Austrian resort of Mayrhofen, while others were in Tignes, Val d'Isere, Zell am See and St Moritz. It was an amazing week for a ski holiday with fresh snow at the stars of the week then sunny skies for the second half. Everyone agreed it was a perfect week in the Alps. There is so much snow in the Alps, it is the perfect time for a last minute getaway! Take a look at a selection of our favourite photos from the week:
Nick HH, Ned, Linda, Nick J and Krystelle enjoyed a week in Mayrhofen staying at the Chalet Stoanerhof. After a very snowy start to the week with more than a foot of fresh snow, the storms cleared up mid week so the team could enjoy the glorious sunshine and mountain bars.
Snowing down in the Village at the start of the week
Ned, Linda, Krystelle and Nick ready for their first day on the mountain
Ahorn, Mayrhofen
Penken, Mayrhofen
Krystelle and Ned enjoying the powder conditions at the start of the week
Hintertux glacier
Linda loving the views and snow up the glacier
View ski holidays in Mayrhofen
Laura and Millie from the marketing team had an incrediable week in Espace Killy. It was a rocky start wiith high winds on day one, closing many of the lifts but after a foot of snow fell, the sun shone for the rest of the week.
Fresh snow in Tignes at the start of the week
Powder day for Millie in Tignes
Laura loving the breath taking views in Val d'Isere
View ski holidays in Tignes and Val d'Isere
Sam and Jason from the ski sales team spent a week in their favourite ski resort, Zell am See. As you can see they had an amzing week of powder days and apres sessions in the sun.
Power tree trails in Zell
A day trip out to Saalback
View ski holidays in Zell am See
Chris had a stunning week in the exclusive Swiss resort.
View ski holidays in St Moritz
View last minute ski deals
by Krystelle
If you love snow days, quiet pistes and short lift queues, then January is the ideal month for you. Along with off season ski deals and peaceful slopes, January is the perfect month to go to the mountains for any avid skier or snowboarder. Once Christmas and New Year is over and children go back to school, you'll find skiing in January one of the quietest points of the season. As companies aim to fill as much accommodation as possible, you will find cheap deals and offers for this time of year.
Conditions are normally excellent at this time of year as January tends to be the coldest month of winter, plus one of the snowiest. Many resorts will still be building up their snow bases, but with the low temperatures it is one of the most snow sure points of winter. Here is an overview of the snow last season:
January 2014 snow depths in popular ski resorts
Val d'Isere – 99cm Tignes – 109cm Meribel – 81cm St Anton – 62cm Les Arcs – 102cm Alpe d'Huez – 139 cm Val Thorens – 126cm Zermatt – 153 cm Avoriaz – 149 cm Pas de la Casa – 135cm
Whether you book last minute or in advance you will always find good deals for January. For an overview of the cheapest deals available, take a look at our cheap ski holidays page where you can view the lowest price for each departure date in January, including Friday departures and short breaks.
Self-catering Apartments Cassiopee Apartments in La Plagne, France. From £199 pp based on 3 people sharing on 3rd and 10th January Located in the top village in La Plagne, Belle Plagne, these apartments are in the heart of the village and surrounded by the shops, restaurants and bars. It's a perfect location to get out skiing quickly where you can either join the bubble in Belle Plagne to take you up the Roche de Mio, or the slopes are less than 50 m away where you can ski down to Bellecote to join the chairlifts.
Catered Chalet
Chalet Natalia II in Meribel Mottaret, FranceFrom £417 pp based on 2 people sharing on 3rd January Chalet Natalia 2 is also great for getting out on to the mountain quick as it is just 100m away from the slopes. Meribel Mottaret is located just above Meribel so you can enjoy the higher mountain views and avoid the lifts in the centre of Meribel.
Half Board Hotel Hotel Aiguille Rouge in Les Arcs, FranceFrom £449 pp based on 3 people sharing on 3rd January Conveniently placed in ski in – ski out accommodation, this hotel has easy access to lifts and the ski area. Les Arcs has skiing suitable for all abilities, from the blue runs surrounding the Arc 2000 village to the variety of long blues and reds across the resort. Advanced skiers can enjoy the black pistes from Aiguille Rouge summit or take advantage of the extra 225km of skiing in neighbouring La Plagne.
02 Jan 2014 – Sainte Foy, France 24 Jan 2014 – Morzine, France
By Krystelle
January skiing deals | Cheap Ski Holidays | Ultimate Apres Ski Guide
In the middle of the hustle and bustle of day 1 at the London Ski and Snowboard Show, we met up with cheeky chappie and Team GB snowboarder Jamie Nicholls. After a stunning performance at Sochi and achieving sixth place in the first ever snowboard slopestyle final in a Winter Games, the Olympics has thrown Jamie into the spotlight and he is now recognised as one of the country's best snowboarders. Nicholls scored a huge 85.5 from the judges on his first run, but the standard of the male snowboarders was so high and Jamie was knocked out the running for a medal. We caught up with Jamie about his Sochi experience, what he's been up to over the summer and his plans for the this winter, including a pretty big exciting secret project that's happening in London (watch the video below for more info)
The Yorkshire lad is well known for lapping Halifax dryslope since a tender age, so he is an ideal example to inspire a generation to have a go and try skiing or snowboarding at their local ski centre. Since Sochi, Snowsport England have recorded a 12% increase in participation at domestic slopes and centres year on year, which is fantastic news for the British ski and snowboard industry. As the latest ambassador for Snowsport England's national participation campaign, Go Ski Go Board, Jamie tells us that he is 'trying to help build good camps for kids' with the governing body and help fly the flag for winter sports. He is a regular to The Snow Centre Hemel Hempstead which always creates a buzz at the dome and inspires more people to give it a go themselves.
Read more about Team GB's involvement with Go Ski Go Board He has a very light hearted approach to getting in to the sport, and when asked for advice for anyone wanting to learn: Drop in to your closest snowdome, snow centre or dry slope and give it a good go. If you like it, stick at it, if you don't like it, try it again and again till you do (laughs)… we agree too!
Hayley and I meeting Jamie at the Ski & Snowboard Show
The British snowboarder has a busy winter ahead of him. Last week he narrowly missed out on a podium spot on his first competition of the season and came in 4th at the Burton Rail Days in Tokyo. Some people will see fourth as a good result in Japan but I was going out there to try and win it. Next up will be the Dew Tour Mountain Championships in Breckenridge from 11 -14 December. After some training and down time in Austria he has high hopes for the competition in Colorado. Snowboarding has taken Jamie all over the globe and the 21 year old is now recognised as one of the World's best snowboarders. But when he's not in the park he does enjoy the backcountry; Last winter Jamie went on his first splitboard adventure in Austria, and that must have given him the bug as when we asked him if could snowboard somewhere in the world he's not been before, Jamie told us that he desires a trekking trip to Nepal, Argentina or some weird places that I've never been and never get a chance to go. We are very interested to see what Jamie gets up to this season.
Jamie in Stubai, Austria.
By Krystelle
For a country with a lack of snowy mountains the UK has a high proportion of keen skiers and snowboarders that head to ski resorts all across the world, season after season.
As the UK's largest independent ski travel agency we offer ski holidays to over 200 resorts, giving our customers the widest choice of destinations available.
Earlier this year we published a roundup of our top selling ski resorts for 2013/14, which found Val d'Isere, St Anton and Meribel coming up top. During the build up to the winter season, London comes alive with alpine themed fun and lively ski events to get city goers amped for the season ahead. With a significant proportion of Iglu Ski customers residing in London we have delved into the city's boroughs to find out how they compare.
This highest percentage of skiers and snowboarders live in the South West, with an average spend of £763.02 pp and Val d'Isere as their resort of choice.
The lowest rate of skiers and snowboarders in London are found in West Central London where La Plagne is the most popular option, with an average spend of £759.46 pp.
The biggest spenders are in SW3, Chelsea, where the average spends is £957.24 pp and residents favour the chic resort of Courchevel.
The ski resorts in the 3 Valleys and Espace Killy in France are the preferred locations by Londoners for their ski holiday and only a handful of boroughs favoured Austria over France.
View the full infographic here
By Krystelle
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Let's have no more Priory Halls as the construction boom cranks up again
Published 28/08/2014 | 02:30
Priory Hall resident Fiachra Daly died because other people didn't do their jobs properly. Tom McFeely, the cowboy developer who rode the construction boom, is one - but there were others, from legislators to the local authority. His death can be laid at many doors.
Nobody forced him to choose the nuclear option. But he was a casualty of other people's shortcomings - the butt of a rash of irresponsibility practised during the Celtic Tiger era. Someone had the brainwave that the construction industry should self-certify. Self-regulation is another name for no regulation.
Banks had the benefit of light-touch regulation, all but indistinguishable from self-regulation. But it was even handier for developers, who could self-certify - and it was legal. The State allowed profits for developers to trump the safety of citizens.
This week, we discovered from a coroner's court that Mr Daly took his own life with a mixture of cocaine and a "very high level" of alcohol in his bloodstream. But the toxicology report doesn't detract from his victimhood. He suffered because of other people's failures. His case was the most tragic, but all the Priory Hall residents were treated in an appalling fashion, and it took the loss of a man's life for the State to wake up to its responsibilities.
Meanwhile we learned that the property market is recovering, with residential property prices in Dublin 23pc higher than they were a year ago. This means a financial incentive exists for builders to turn round developments quickly, while the shortage of housing adds to that motivation.
So let's not be complacent. Not with this reminder of Mr Daly's avoidable death, while his partner and two young children slept a few yards away from him in other rooms in their temporary home. Their real home, of course, was uninhabitable.
Now that the building industry is getting back on its feet, it is important to ensure there are no shortcuts or escape clauses that can be exploited by builders. The Department of the Environment and local authorities need to be vigilant about loopholes, which are not uncommon with the introduction of new legislation.
There were many systemic failures during the boom, but Priory Hall is one of the most notorious. A systemic oversight failure led to 256 residents being evacuated in 2011, including 87 children. The High Court ordered it when a Dublin fire chief explained how a blaze could spread thought the entire complex in just a few minutes because of defects to the external walls.
The complex of 20 blocks was later inspected and discovered to be a shoddy piece of workmanship. However, Dublin City Council, like others, had received enormous sums in levies from builders - €1.7m alone for Priory Hall.
It was money for jam, as far as some councils were concerned. (Planners and councillors are also responsible for the ghost estates - they agreed to them, without considering whether they were in the community's best interests.)
In the case of developments such as Priory Hall, the building levy was banked without any responsibility to the people who would live in those homes being recognised. Councils have statutory powers to inspect during construction, but they were content to let self-certification proceed. Even if Priory Hall hadn't been a fire risk, it was a slipshod piece of work.
Clearly, the complex was not built in accordance with planning regulations. But who signed off on each stage? Has anyone been held to account? Or are victims such as Mr Daly going to be forgotten as the property recovery takes hold?
In the Priory Hall development, a raft of fire hazards was identified, including exposed gas pipes, a lack of automated opening vents in communal areas and ventilation breaches in the basement car park. It was a disaster waiting to happen.
Tom McFeely, whose series of transformations took him from hunger striker to millionaire developer to bankrupt, gave six separate undertakings to complete remedial work but failed to meet them. Lack of money was cited. Works were ordered at another apartment complex in Clondalkin, for which he received a conviction. None of it would have been possible with regulatory oversight.
In Priory Hall, some 137 units of a 187-unit development were occupied by people who just wanted a toe on the property ladder, or a home to raise their family in.
They sank their savings into the development, trusting that the organs of the State would exercise appropriate controls to ensure their safety. How wrong they were.
Their misery dragged on for years, with nobody wanting to take on responsibility for the residents. A deal was finally cut, but nobody can give those people back their lost years. And nobody can give back their father to Mr Daly's children.
But let Priory Hall, at least, serve as a reminder. As the construction industry cranks up again, let's have no more Priory Halls. No more regulatory time-saving wheezes. No more listening to lobbyists who make the case for short-term gains.
Stephanie Meehan, should never have found herself in a position where she woke up one morning to find her partner's cold, dead body. People who take their own lives do so for a variety of reasons, of course.
The pressures the couple were under over their mortgage should never have pushed him over the edge. Other couples were equally stressed. But who knows how the weight of mounting burdens will affect any of us? Especially when the State proved to be woefully slow to intervene.
Unfortunately, the die was cast when Mr Daly's home, which he had naturally hoped would become an asset, proved to be an albatross.
Irish Independent


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