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Trip Report for our visit to Poland, Budapest and Amsterdam. This trip was born of my husband's interest in all things cold war and iron curtain. He is also 50% Polish. Though he has no tangible connection to that heritage I do think those "roots" were a contributing factor to his interest. I also have some Polish but really I am a mongrel.
Our fist plan was to take award flights to Amsterdam, then hop on a Lot flight to Gdansk. However the Gdansk service was discontinued. The only way then to visit Gdansk would require us to back track which wasn't very appealing so we decided to save it for a future visit during the mild weather months. Now that the trip is behind us I can confidently say that we will definitely be back, we LOVED Poland.
Our itinerary:
2 Nights Warsaw
4 Nights Krakow
1 Night Train
4 Nights Budapest
4 Nights Amsterdam
*I warn you and apologize in advance that I'm long winded and a real crap proofreader*
On Thanksgiving day we flew from Detroit to Warsaw via Amsterdam. After landing on Friday we took a taxi to Hotel Bristol, seeing some gloomy beat up looking communist architecture along the way. As we approached the hotel the commie Warsaw faded behind us as Old Town Warsaw ushered us in. What a contrast to see.
After arrival we unpacked, opened a bottle of wine and while relaxing we ended up napping until around 6:30. Then up, showered and off to find dinner. DH had selected Podwale 25 for dinner so we set out for it on foot. It was packed with a line out the door so we decided to go back to an interesting looking bar we had passed to get a drink and let the crowd thin at the restaurant. Somewhere along the way we saw the Little Insurgent monument.
The bar was Bar and Books and it was fantastic. Great atmosphere, great music, great drinks. I was glad the restaurant had been packed or we would have missed this awesome little bar. After two drinks we went back and got right in with a table in back at Podwale 25. A major revelation was had: Bigos. How did I not know about Bigos before? It was so delicious! We also had pierogi and duck and my husband got some insanely big entree that was served on a 2 foot wooden plank. Our table looked like it was set for an eating contest. But I didn't care. The restaurant was really casual and festive and kinda gimmicky but in a good way and our food was delicious. We were off to a very good start. Back to the hotel for a nightcap and off to bed.
Sight seeing Saturday. We walked to the Palace of Science and Culture and went up to the observation deck. Then we walked along the Royal Route and went into Holy Cross Church. I loved this church, it's my favorite of any church any where so far. Next we taxi'd to the Warsaw Rising Museum where we spent 2-3 hours. Back to hotel to get ready for dinner at Różana which was another perfect hit. DH was on a roll. Another major revelation was had: Bison Grass Vodka, wow, so good.
Sunday we wandered around old town a bit and had lunch at a cozy little spot called Ceprownia. Then we caught a taxi to make a pit stop at the Uprising Monument before continuing on to the Gestapo Headquarters Museum. This is a serious and grim museum. It does a fantastic job of transporting you to this dark time and place as well as recognizing some of the many heroic people that were incredibly brave in the face of threats, persecution, torture and death. I'm very glad we made it to this museum, it makes quite an impression.
After this we stopped for some pierogi at one of the restaurants we'd been seeing that seemed to be like a pierogi bar of sorts. Then we trained to Krakow.
Sleep, Eat & Drink recap:
Hotel Bristol in Old Town. Beautiful place, historical building, excellent service & location. Nice wine bar, good selection. http://www.hotelbristolwarsaw.pl/en
Bar & Books http://www.barandbooks.cz/warsaw/
Podwale 25 http://www.podwale25.pl/
Restaurant Rózana http://restauracjarozana.com.pl/en/
Ceprownia http://www.ceprownia.pl/
Zapiecek Pierogarnie http://www.zapiecek.eu/main.html
See & Do recap:
Rising Museum http://1944.pl/en/
Gestapo Headquarters Museum http://www.tripadvisor.com/Attraction_Review-g274856-d274992-Reviews-Gestapo_Headquarters_Museum-Warsaw_Mazovia_Province_Central_Poland.html
Arriving in Krakow we took a taxi from the train station to Hotel Wentzl, which is right on the main square. After unpacking we went out and got some soup from one of the market booths and had a couple beers at one of the outdoor cafes and off to bed.
We had a lazy Monday morning before joining the free walking tour of old town. I was happy with the tour, it was a great orientation and the guide had lots of humor and charm. We headed to Kazimierz for dinner at Starka, where we had one of our best meals. Highly recommend this restaurant for ambiance as well as food/service.
Since we liked the free old town tour on Monday so much we decided to take their Kazimierz tour on Tuesday. A different guide this time and also very good. The tour ends at Schindler's Factory with an option to join a tour of the museum inside. We just went in on our own. I had no idea how big this museum was and how much content there was to cover. Between the walking tour and the museum visit it made for a full day of sight seeing for us. For dinner we were in the mood for Italian and headed to Mamma Mia for pizza which was good, but the pasta dish we ordered was not.
Wednesday we went to Auschwitz, we arranged the tour through our hotel the day before. A minivan picked us up along with 4 others to drive us out and put us in the hands of our guide. She was very good. This day happened to be the most miserable weather of our entire trip and I was glad that I bought a new coat and good boots for the trip. It was incredibly muddy and slippery, I was worried for a few older folks that weren't as easy on their feet in that mud but thankfully everyone did okay. There isn't much to say about Auschwitz that hasn't been said already and better than I could. I learned before going that many people do the tour from Auschwitz to Birkenau and then return to Auschwitz on their own to see the content that the tour doesn't cover. And it is true, you do miss quite a bit on the tour. We did not return though, as it was getting dark after the tour concluded. If you are on the fence about going while you are in the area, go. It felt as relevant as ever in current times and would do us all well to have the vivid reminder.
After getting dropped off back at the hotel we went to the square and browsed the Christmas market stalls. There were a few things I would have liked to buy for myself and as gifts however I just didn't want to be bogged down with stuff moving through the rest of the trip. Kraków had the best of the markets we saw in my opinion.
Back to Kazimierz for dinner at Introligatornia Smaku. Very good herring appetizer but the rest of the meal was unmemorable. After this we went to Alchemia for drinks, I really loved this bar. There was a lot of hype on TA/Yelp so I had my doubts about it but this was one time that the hype was fit for the place. Great spot.
Thursday-last day on Kraków. The plan was to pack up, checkout, buy & print our train tickets to Budapest on the hotel guest computer/printer and head to the Wawel Castle for an hour or two before returning to the hotel to meet our Nowa Huta guide.
We were unable to buy train tickets online, I think because we were too close to departure & they cut off online sales at a certain point. I thought nothing of this and wanted to just buy them on the spot later when it was time to travel. I really wanted to still head off to Wawel castle. DH did not agree so we walked to the train station to buy the tickets instead of visiting Wawel castle. Our first hiccup of the trip, not bad for 7 days and two cities in, IMO.
Tickets in hand we returned to the hotel to meet our guide (from Mike's Crazy Guides) and head off to Nowa Huta in a clay colored Trabant. My goodness are these things death traps! She took us first to the main road leading to the factory in Nowa Huta and stopped for us to get out at a big map of the city and explained the design and general story of the city and factory. The tour continued on to an old disco where we had vodka shots, looked at a "then and now" photo album and heard about the Solidarity movement, the time of martial law and Lech Walęsa's political career. A visit to a commie apartment followed, where we watched propaganda films, caught a glimpse into home life during communist times and discussed current politics in Poland all while snacking on pickles and vodka. The last stops were to the church for a quick duck inside to see the arc of Jesus and we ended the tour with dinner at a traditional milk bar. This was a fantastic, unique and fascinating tour. Our guide was spectacular, a very bright young woman. I cannot recommend it enough. I can't think of a better way to end our stay in Poland.
Sleep, Eat & Drink recap:
Hotel Wentzl. Convenient location right on main square with great views out over it. Nice, clean, big room, huge bathroom. Very quiet hotel. http://wentzl.pl/en/
Starka http://www.starka-restauracja.pl/eng/
Trattoria Mama Mia http://mammamia.net.pl/en/
Introligatornia Smaku http://www.introligatorniasmaku.pl/
Alchemia http://en.alchemia.com.pl/
See & Do recap:
Free walking tours http://freewalkingtour.com/krakow/
Nowa Huta tour http://www.crazyguides.com/
Occupation Museum http://www.mhk.pl/exhibitions/krakow-under-nazi-occupation-1939-1945
Auschwitz-Birkenau http://auschwitz.org/en/museum/news/
Up next: Bewitching Budapest!
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Late fall 2015 visit to Poland, Budapest and Amsterdam
Trip Report for our visit to Poland, Budapest and Amsterdam. This trip was born of my husband's interest in all things cold war and iron curtain. He is also 50% Polish. Though he has no tangible connection to that heritage I do think those "roots" were a contributing factor to his interest. I also have some Polish but really I am a mongrel.
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The overnight train from Kraków to Budapest was a 10 hour hell ride. Not because of the stops, I actually liked those, it reminded me of being rocked to sleep as odd as that sounds. The problem was that the thermostat was set at precisely raging hellfire inferno degrees. It was HOT. Relentless hot, dry, forced air blasted us with no escape. My husband hardly slept at all which was lucky for me because with him awake he could keep our compartment door open to the hall to at least get a little more circulation.
We arrived on time in Budapest and our prearranged driver was waiting at the train station holding a sign for us. We had been advised not to take a taxi from the station by our tour guide so I arranged the driver and after the crappy overnight train ride I was sure glad I did. He whisked us off to the Brody House hotel, near the Hungarian National Museum. There was some construction on the street so we had to park far away and negotiate our way through the broken pavement. Once in the building there was some confusion over where the reception was in relation to our room and our poor, dear driver ended up hiking up & down several flights of stairs with our suitcases! Better him than us, he was a godsend and key to me not having a minor meltdown that morning.
Finally in our room I showered while DH rested for a few minutes. He was really struggling. We were running behind for our meeting time with Anna of Our Budapest tours. I texted her to ask if we could push it 20 minutes later but she was already at our hotel, having arrived a bit early. She was very sweet & told us to take our time & get some coffee/pastry and she would wait. So that's what we did.
I had hired Anna for a Budapest communism tour on Ginnyjo's recommendation. It was another excellent tour. We started off at the Magyar Radio Building which was very close to our hotel. Then to the epicenter of the 56 revolution fighting. We continued on to the parliament & embassy area, several very interesting monuments and finally to a little old fashioned bar. We got something to drink & continued to chat about the more recent history as well as the current state of politics in Hungary. I was less familiar with Hungary's history and figures than Poland, so I was glad to have read Anne Applebaum's Iron Curtain before the trip, it gave me a helpful frame of reference for following along with Anna. She was great, she was patient with our grogginess and she shined a light on some things that surely would have been missed by us without her. Loved this tour, definitely a highlight.
By the end of the tour DH & I were hitting a wall. Tired & a bit out of sorts we took a few wrong turns trying to find our way back to the hotel and we were turning irritable. We decided to stop somewhere for a drink to use wifi & find someplace to eat an early dinner. We decided on Vidam Etterem, a very traditional no-fuss place not far from our hotel that was supposed to have very good goulash. We split goulash & fried chicken which was just the warm & comforting meal that we needed. A revelation was had: Eros Pista ("Hot Steve" a hot paprika spread). Salty as hell, so a little goes a long way but oh is it good. Another revelation: the Hungarians are very kind. When we first entered the host was visibly pained to tell us that he was full and didn't have a table for us, you could tell he felt terrible not to be able to seat us. Upon seeing this a long table of 6 people said we could sit with them. And they interrupted their meal and conversation to get up and let us squeeze into seats at the end of their table that was tightly wedged into a little cove in the wall. I had my fingers crossed neither of us would have to use the restroom & make them get up again!
Back to the hotel. We were so tired but in that weird way where you're over-tired but not sleepy. So we watched a couple Sopranos episodes on the laptop before falling asleep.
The next morning brings us to the second hiccup of our trip. We overslept and missed the meeting time for our Taste Hungary tour. I blame the person in charge of the thermostat on that train for this. Fortunately the company was very accommodating & let us reschedule for Monday. I had put the food tour in the front of our stay purposely so that we'd know what & where to eat & drink for the following days, so I was a bit bummed but life goes on.
We decided to head over to Buda to check out the Castle District. On the way we stopped at the Bronze Shoes Memorial and then walked the chain bridge. Even on a grey day these buildings, monuments, ornamental structures are really something. I enjoyed just being there and taking in all the different vantage points.
I found a lady's wallet in the public restroom at the Fisherman's Bastian. My husband became obsessed with tracking down the owner down & saving her trip. I wanted to turn it in to a secure authority but DH really went to task with it. We sat down to get a drink & wifi at a little tourist cafe. We opened the wallet & learn the owner is Italian, from Campania. We checked Facebook, Twitter, Google, etc. for her name & nothing. I spotted a group of Italian tourists (all with basset hounds, some kind of club or something-we'd continue to see the basset hound gang all over the city during our stay) and approached them to see if they could help at all. They looked in the wallet, told me she is a lawyer & that I could try contacting her bank to let them know & they would contact her. We finally took it to the Italian embassy. Not the big serendipitous and heroic tale that my husband was hoping for.
Back to our hotel for the first of many cocktail hours at the Honesty Bar, which was the self serve bar in our hotel where you just record what you consume. We got ready for dinner and set off on foot to find something, which proved to be a challenge with no reservation on a Saturday night. I had thought that DH had a reservation handled, so after being turned away for the third time I got a wee bit hangry. DH pulled me towards a totally depressing pizza counter and basically forced a few bites and a Coke on me to stabilize my dwindling spirit. Truly horrible "pizza" but mission accomplished. I took a minute to refer back to a thread here and review Ginnyjo's restaurant suggestions to me. I gave a call to Nightingale and they tell us to come on by. Nightingale was nice and warm, good home-style food, very friendly people. It felt a bit like eating in someone's home. We started with a goose crackling appetizer which totally reset the palate after that pizza-like product we ate. I can't remember our entrees exactly but it was essentially like going to Grandma's for your favorite casserole on a cold day. That good and that warm and cozy of a feeling. After dinner we tried a ruin pub but they were just too packed on a Saturday night, so we found a low key place called Garzon Cafe for a nightcap.
The next day we headed straight to Momento Park via taxi. We started inside the trailer, we read through the material hung on the walls and watched the secret police training video that was playing in the side room. We stopped at the gift stand to buy a guide of the park and a few pieces of kitsch memorabilia then walked through the monuments. So cool to have these saved for revisit, we loved it.
Next we head to the House of Terror museum. We did the audio tour and I'm very glad that we did. Another fantastic museum, very informative, very touching. I appreciated the ending, which I had not read about before the trip. A down side of being the sole trip planner is not much comes unexpected and sometimes you can't help but be primed for disappointment. So it was nice to experience the last part of this museum in an unexpected way.
I had a big and dirty appetite by evening, I think from all the Saturday cocktails and the time spent outside in the cold icy mist at Momento Park combined with not eating all day. We had walked by a food truck court called Karavan a few times on previous days and I could not get it out of my head, I HAD to have it. I had to have pad thai and lángos and a hamburger and pierogi and tacos and kielbasa and whatever else they were slingin' in that food truck park. I had to have all the food from all the stalls. This is so not DH's thing, he doesn't like this style of dining but he thew me a bone and agreed to go. I walked in with my big eyes and rumbling tummy, did a quick reconnaissance and decided to start with pad thai. Half my dish of pad thai and one beer later I was full and sleepy. So much for my smorgasbord dreams.
Our last day and our best day in Budapest. We start the day with our food tour with Taste Hungary, finally! We met at Central Market Hall and began with shots of Unicum and traditional pastry. We begin our walk upstairs, our guide telling us all about traditional Hungarian food and specialties. We sample several different dried sausages, one made of horse meat which was the one I liked best. The guide told a funny story of a pervious tour member that was vegetarian so she did not want to sample the meat, except for the horse because a horse had kicked her once when she was young. We continued downstairs, walked the spice and produce counters and got some info on how and where to buy quality products to bring back home. We left the market and headed to a soup cafe for a hot cup to go, then to an artisan chocolatier called Rózsavölgyi which was excellent. Next comes the centerpiece of the tour, lunch a Belvárosi Disznótoros. Holy smokes is this place good. We had a huge assortment of food. Sausages, duck, pickled vegetables, beets, breads, condiments and the best horseradish I've ever had. Everything was incredible. Next stop was at one of the oldest cafes in Budapest, Auguszt Cukrászda. And finally we end at the Tasting Table for a wine tasting which was another highlight. The manager/sommelier Ferenc was a nice guy, happy to answer any question. The owner of Taste Hungary, Gábor stopped in towards the end and he was also incredibly nice, teasing us for oversleeping and missing our first appointment. And of course I cannot remember our main tour guide's name but she was also awesome and very interesting. Fantastic tour run by fantastic people.
Now that we'd wet our whistles we kinda felt like keeping it going a bit so we had some wine back at the Honesty Bar, which was just a stones throw away from the Tasting Table. After the wine break we decide to go check out hero's square, we take off on foot but end up catching a taxi at some point. Next we go by the opera house but did not go inside. Back to hotel to rest for a while then shower and head out to the river for our farewell cruise on the Danube that our hotel booked for us the day before. It was kinda boring and very touristy but sometimes there is a lot of comfort and happiness in that. And we had not seen the Parliament building lit up at night from the river/Buda side yet, which is something that must be seen when in Budapest. Such a magnificent sight.
Dinner tonight is at Borkonyha Wine Kitchen which I was super excited about. Timing was just right coming off the cruise, we walked into the restaurant 2 minutes before our reservation. The goose liver appetizer and the dessert along with the wine parings stole the show for me, they were just divine. The salads and entrees were also very good. Very good service.
Back to our hotel for the last night cap at the Honesty Bar which was kind of sad. I loved Poland just as much as Budapest but Budapest left me feeling that I barely scratched the surface. Lots of layers there. I didn't feel quite ready to go yet. But that is the best, isn't it? That is what you want out of a great meal, to be left wanting one more bite. And we did miss a lot, we could have used at least 3 more days for just a first visit, there is a lot of ground to cover there. Knowing what I know now it would have been better to take a couple nights from Amsterdam and give them to Budapest. But no regrets. We will be back.
Sleep, Eat & Drink recap:
The Brody House Hotel. Fantastic place. Great location. Beautiful building, full of art everywhere. Great breakfast. Sweet people. Well stocked Honesty Bar and good music. No elevator. http://brodyhouse.com/
Vidam Etterem http://www.tripadvisor.com/Restaurant_Review-g274887-d3358326-Reviews-Vidam_Etterem-Budapest_Central_Hungary.html
The Nightengale http://www.opengastro.hu/fulemule-etterem-budapest/contact-eng/
Karavan Food Court http://www.streetfoodkaravan.hu/contact-eng/
Rózsavölgyi Csokoládé http://www.rozsavolgyi.com/en/index.php
Belvárosi Disznótoros http://www.belvarosidisznotoros.hu/about/
Auguszt Cukrászda http://www.auguszt.hu/en
Tasting Table http://tastehungary.com/tasting-table-shop/
Borkonyha Wine Kitchen http://www.borkonyha.hu/?lang=eng
Garzon Cafe http://www.funzine.hu/venues/garzon-cafe/
See & Do recap:
Transfer Service www.airporttransfersbudapest.com
Commie Tour with Anna https://ourbudapesttours.wordpress.com/
Momento Park http://www.mementopark.hu/
House of Terror Museum http://www.terrorhaza.hu/?language=eng
Culinary Walking Tour http://tastehungary.com/
Amsterdam is coming up next. This was a rather uneventful few days but that is how I planned it.
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Nice report!
It's a shame you couldn't make it work to start in Gdansk. I did exactly what you might have done a few years ago - took a Eurolot flight directly from Amsterdam to Gdansk - and it worked out well for me. Too bad Eurolot has folded.
Which did you prefer - Warsaw or Krakow? I enjoyed Krakow (didn't visit Warsaw), but I also found it very touristy, especially around the old town. In some ways I liked Wroclaw better, but Wroclaw isn't "original" because it was bombed/rebuilt after World War II whereas Krakow is well preserved, plus Krakow is so historically important to Poland's history.
Your story about the overnight train to Budapest reminds me why I have never wanted to take an overnight train! It's a shame there isn't an easier, more affordable way to connect between the two cities.
Budapest is a big, complex city, harder to get your arms around in a short time, I felt, compared to places like Krakow and Prague.
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Thanks Andrew!
Hard to say which I preferred. It's a bit apples & oranges, plus we were in Warsaw for such a short time. Warsaw definitely felt like a real, working city more than Kraków-which is touristy indeed, but we had more conversations with locals in Kraków (mostly because we had more time to) so that helped ground it if that makes sense.
I've seen a fair amount of people talk negatively about Warsaw but my short stay showed me nothing negative. And the history & the fight there is endearing to me (of course Kraków too). I'd probably return to Warsaw sooner than Kraków. We loved the visible contasts in Warsaw and the story it tells.
"Budapest is a big, complex city, harder to get your arms around in a short time.." Yes, exactly, good way to put it. I would also return to Budapest sooner than Kraków.
Yes it's a bummer not to have service between Amsterdam-Gdansk. But I try to just look at it as a reason to return to a country we loved. I'd like to do a Baltic trip starting in Estonia & ending in Poland the next time we visit, it would be nice to see it during the mild months.
That train! We'd probably fly if we had to do it over.
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I'm planning a trip to the Baltics right now, probably for May-June. I considered re-visiting Poland too but I just won't have time. I'd love to return to Poland as well.
I think there may be a bus between Krakow and Budapest a few times a week - a long ride, no doubt, and I don't like bus rides, but I'd probably prefer that to a night train. I'd fly if there were direct flights that weren't outrageously expensive.
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Well I will be keeping an out for your Baltic recap in that case. I visited your Poland reports and pictures which were helpful to me. It actually made it hard for us to pass up Wroclaw on this last trip. Anyhow I owe you a thank you!
I personally would try the night train again but I know my husband would not. If my second try was as bad as the first then I'd probably give up on it for a while. I'm not to keen on long bus rides either.
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Keep an *eye* out and not *too* keen I meant!
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Thanks - glad my report helped! Although I decided to visit other cities instead of Warsaw on my Poland trip, it's always kind of bugged me that I missed it. A reason to go back!
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Nice report, thanks, limmy. I also liked Warsaw a lot and wished I had had more time there. Krakow I loved, though, yes, it's crowded with tourists because there is so much to see and do, and so much that is quite beautiful. I really enjoyed going for runs in the morning in the Planty and by the Castle and into the outlying neighborhoods. Had great food throughout Poland, too!
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Thanks leely2. I loved Kraków too, it might have sounded like I didn't so much. Since we stayed so much longer than Warsaw I had more of a sense of "mission accomplished" and don't feel drawn to return soon. Not that we saw everything, we didn't, but I was satisfied with what we did.
Oh man, I miss the food in Poland! I got a bigos recipe from a Polish coworker but I haven't made it yet.
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This is fantastic! Even though your time in Budapest was "uneventful" it is still great to hear your experience. I'm most excited about Budapest on our Christmas Markets trip coming up, so your input is so appreciated! Did you travel first or second class on the train? Would you recommend second class for a trip from Prague to Budapest, roughly 4 to 6 hours?
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Also, what would you bring back from Budapest, if you could go back n grab a souvenir? What was special?
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Hi Tiffan - Re: train class. As we purchased our tickets at a counter in the train station with virtually zero shared language between us and the clerk (we really did use hand gestures and other non verbal aides to do this) I am unaware of a first/second class option even existing. I just hopped on the polerail website to double check and I don't see any first vs second class sleeper ticketing. What they call second class is a seat, instead of any type of bed. Couchettes are automatically in shared compartments and sleepers can be booked privately (but also shared if I understand correctly). Sorry I'm not of much help! You're traveling between Prague and Budapest so your train & options wouldn't necessarily be the same anyway. Go to seat61, you'll be able to suss it out there.
Souvenirs though- I can comment on that! Food and drink. Very little Hungarian wine is imported to my home country (US) and I tasted some really nice and unique wines. I wish I brought some home. Also Unicom, paprika, Pista (maybe other regional condiments that I'm forgetting now) and art. From what I gather there is a pretty young and dynamic art scene in Budapest. There was one particular piece hung at our hotel (Brody house-highly recommend) that really made an impression on me. That hotel is also a bit of an art gallery and most or maybe all of the print art is available for purchase through a sister company called Brody art studios. At the time, I couldn't figure out where in my house I might put this print. But I haven't stopped thinking about it since and I regret not just going with my gut and buying it there.
We only visited the Christmas stalls near to St. Stephens Basilica, nothing of great uniqueness there that I saw. But we were past our Christmas market intrigue by then, there's probably better xmas marketing to be had elsewhere in Budapest.
Budapest is really layered and fascinating, I hope you enjoy it
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Learn to love and appreciate exercise! Working out doesn't always have to be hours on the treadmill. Allow me to help you meet your fitness goals through a variety of intense but fun workouts. Learn skills that you can use throughout your life so you can maintain your accomplishments. Beginners, work with me to learn correct form to improve strength training. Advanced athletes, improve even further with endurance drills and advanced weight lifting skills. Workouts are designed specific for each person and their fitness level.
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text: Regulatory Fairness Hearing on Food Import and etc. 7/31 –Thursday 8:30 AM – 1:30 PM Cupertino, CA National SBA Ombudsman Brian Castro, will convene a regional hearing to hear testimony from small business owners, representatives of trade associations, and other members of the small business community regarding federal regulations and enforcement and compliance actions impacting America's small businesses. RSVPs should be made to Yvonne Lee, SBA Regional Advocate at (415) 744-8493 or by email at email@example.com by July 24, 2014. Those wishing to testify must register and provide written statements in advance. Anyone desiring confidentiality may request that his or her name not be released and may submit written testimony in lieu of a public appearance at the hearing. Those wishing to put testimony on the record on a confidential basis may do so by offering it in writing in advance. All SBA programs are extended to the public on a nondiscriminatory basis. Reasonable arrangements for persons with disabilities will be made, if requested at least 2 weeks in advance. Contact: email@example.com or call 202-205-6178.


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GraphicRiver Rendering of Bacteria and Virus 4081979
Stock Vector \ Conceptual \ Abstract
Bacteria \ Illustrations \ Infections \ Illness \ Medicalrendering
Stock Vector - Rendering of Bacteria and Virus 4081979 by Nobi_Prizue @ GraphicRiver
Stock Vector \ Conceptual \ Abstract
rendering of bacteria and virus, vector illustration eps10
Layered: No; Graphics Files Included: JPG Image, Vector EPS; Minimum Adobe CS Version: CS.
Futuristic DNA; Abstract Technological Background; Headphones Illustration Graphic Concept; Computer Mouse Illustration; Abstract Wave Background; Abstract Syringe Icon; Molecule Icon Set.
Keywords: abstract, attack, background, bacteria, bacterium, biology, blood, business, cancer, cell, cgi, close, death, design, diseases, electron, epidemic, eps10, experiment, genetics, health, hiv, human, ill, illness, illustrations, infections, life, macro, medical.


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Traveling Luck for South Santa Fe Windmill, Texas, United States
Where is South Santa Fe Windmill?What's around South Santa Fe Windmill?
Wikipedia near South Santa Fe Windmill
Where to stay near South Santa Fe Windmill
The timezone in South Santa Fe Windmill is America/Rankin_Inlet
Sunrise at 07:35 and Sunset at 17:40. It's light
Latitude. 35.5814°, Longitude. -102.8814°
Weather near South Santa Fe Windmill; Report from Dalhart, Dalhart Municipal Airport, TX 72.1km away
Weather :
Temperature: 12°C / 54°F
Wind: 3.5km/h West/Southwest
Cloud: Sky Clear
Weather :
Temperature: 12°C / 54°F
Wind: 3.5km/h West/Southwest
Cloud: Sky Clear
Satellite map around South Santa Fe Windmill
Loading map of South Santa Fe Windmill and it's surroudings
Geographic features & Photographs around South Santa Fe Windmill, in Texas, United States
- Local Feature;
- A Nearby feature worthy of being marked on a map..
- South Santa Fe Windmill (0km)
- Old Santa Fe Windmill (2.3km)
- Minneosa Windmill (3.9km)
- Division Windmill (4.2km)
- West Chavez Windmill (4.9km)
- Smitty Windmill (5.1km)
- Van Tyle Windmill (8.2km)
- Poison Oak Windmill (8.8km)
- Old Wildcat Windmill (9km)
- Freeze Out Windmill (10.3km)
- Three-Way Windmill (11.1km)
- Cottonwood Windmill (11.7km)
- Spring Creek Ranch (11.7km)
- East Windmill (11.9km)
- New Wildcat Windmill (12km)
- East Chavez Windmill (12.6km)
- Coots Ranch (14.2km)
- Bravo Ranch (15.2km)
- Chavez City Ruins (15.2km)
- Wooden Tower Windmill (15.3km)
- Little Nelson Windmill (15.8km)
- South Romero Windmill (16km)
- well;
- a cylindrical hole, pit, or tunnel drilled or dug down to a depth from which water, oil, or gas can be pumped or brought to the surface.
- Little Pasture Well (3.3km)
- East Well (3.8km)
- Bull Springs Well (6.2km)
- Trujillo Well (8.2km)
- Big Forker Well (9km)
- Petition Well (10.2km)
- Twelve Section Well (10.6km)
- Corner Well (12km)
- Coots Well (12.7km)
- Middle Pasture Well (12.8km)
- Trap Well (13km)
- West Pasture Well (13.4km)
- Jonah Well (13.4km)
- House Pasture Well (14km)
- Bottom Pasture Well (14.6km)
- Bull Pasture Well (14.7km)
- Pasture Well (15.9km)
- reservoir(s);
- an artificial pond or lake.
- Little Forker Tank (7.3km)
- Van Tyle Tank (8.1km)
- West Bull Spring Tank (10.4km)
- Red Tank (10.4km)
- Red Tank (11.2km)
- Horseshoe Tank (11.9km)
- stream;
- a body of running water moving to a lower level in a channel on land.
- Spring Creek (5.5km)
- Hay Creek (6.5km)
- Horse Creek (14.3km)
- Minneosa Creek (15.2km)
- Trujillo Creek (15.7km)
- spring(s);
- a place where ground water flows naturally out of the ground.
- Chisum Spring (9.7km)
- Charvez Spring (11.7km)
- Chavez Springs (12.5km)
- Bull Spring (13.2km)
- valley;
- an elongated depression usually traversed by a stream.
- Sidle Canyon (13.9km)
- Sidle Canyon (13.9km)
- Chisum Canyon (14.1km)
- populated place;
- a city, town, village, or other agglomeration of buildings where people live and work.
- Knoblaw (4.7km)
- Corner Windmill (6.3km)
- dam;
- a barrier constructed across a stream to impound water.
- Thousand Dollar Dam (8.5km)
- lake;
- a large inland body of standing water.
- Windmill, Lake (7.5km)
Wikipedia entries close to
South Santa Fe Windmill
- Adrian, Texas city city o
- Channing, Texas city city o
- Hartley, Texas city city o
- Vega, Texas city city o
- Logan, New Mexico city city o
- Lovington city city m
- Dalhart, Texas city city o
- San Jon, New Mexico city city o
- Dumas, Texas city city o
- Texline, Texas city city o
- Tucumcari, New Mexico city city o
- Bishop Hills, Texas city city o
- Cadillac Ranch
- Grady, New Mexico city city o
- Cactus, Texas city city o
- Hereford, Texas city city o
Airports close to South Santa Fe Windmill
Dalhart muni(DHT), Dalhart, Usa (72.1km)
Tucumcari muni(TCC), Tucumcari, Usa (99.5km)
Amarillo international(AMA), Amarillo, Usa (143.5km)
Cannon afb(CVS), Clovis, Usa (175.5km)


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Guillermo del Toro to Co-Direct His Own 3D Stop-Motion 'Pinocchio'
by Ethan Anderton
May 10, 2012
Source: Variety
Over a year ago we got our first look at Guillermo del Toro's new spin on the classic story of Pinocchio. The brilliant director revealed their collaboration on a stop-motion animated version of the story with The Jim Henson Company & Pathe back in 2008 and the concept art looked positively astounding. At the time Gris Grimly, who illustrated the 2002 take on the story, was directing with Mark Gustafson, but now Variety has word that del Toro himself has decided to co-direct, his first animated film, with Gustafson with an eye towards shooting once he's completely done with Pacific Rim sometime next summer. More below!
Gustafson served as animation director on The Fantastic Mr. Fox, so he's in good company for his first outing with stop-motion animation in a feature film (though he has executive produced Puss in Boots, Kung Fu Panda 2 and the forthcoming Rise of the Guardians. Set between World War I and World War II, the story will follow Pinocchio embarking on a series of adventures and proving himself to be as indestructible as his love for his father. Del Toro says, "It was when everyone was behaving like a puppet, except for puppets." Grimly's touch will still be on the film as he wrote the story with del Toro and the Hellboy director's frequent collaborator Matthew Robbins who also wrote the screenplay.
Apparently del Toro is planning a re-design for the film, so some of that original concept art work might be out of date now, but I have no doubt the designs will still be amazing. In addition, while no casting decisions are official, del Toro reavealed he's considered Tom Waits for the role of Pinocchio's father and Donald Sutherland for the role of the fox. The filmmaker said, "Little by little, I realized that I should direct," mainly because of the influence the original 1940 Disney animated film had on del Toro as a child, so this will be nothing short of a passion project. I can't wait for this project to come together, and hope this is the start of many more animated projects from Guillermo del Toro.
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Jesus R.
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Joined on April, 2012
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ExperienceAfter school tutoring for N.H.S. in High School, various tutoring to fellow colleagues at the Virginia Tech Math Emporium. SAT scores: 680 Math, 540 Writing, 540 Reading. A brief list of the courses I have taken are: Algebra I, Geometry, Algebra II/Trigonometry, Functions/Analytic Geometry, Calculus I-II, Linear Algebra, Vector Geometry, Differential Equations, Multivariable Calculus, Foundations of Physics I-II, General Chemistry, English I-II, Spanish 1-4, and AP Spanish 5(fluent in Spanish).
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Avengers Assembe #9 (Preview)
in Comic Previews Comment
- Story by
- Kelly Sue DeConnick
- Art by
- Stefano Caselli
- Colors by
- Rain Beredo
- Letters by
- VC - Clayton Cowles
- Cover by
- Jason Keith and Steve McNiven
- Publisher
- Marvel Comics
• Kelly Sue Deconnick (CAPTAIN MARVEL) and Stefano Caselli (AMAZING SPIDER-MAN) team up to tackle the titanic tales YOU DEMANDED! And in continuity to boot?!
• Two scientists. Two giant egos. One wears a tank. One is a tank. Tony Stark and Bruce Banner are SCIENCE BROS!
• When a fellow bigbrain goes missing, wanna bet who can find him first? It's Amazing Race, Avengers-style, as Iron Man and Hulk form their teams and embark on a global manhunt with the ultimate prize at stake…bragging rights!


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Givaudan Seeks to Bottle Lady Gaga for 'Expensive Hooker' Scent
The Swiss fragrance company is working to collaborate with the U.S. singer when she launches her first scent, which Lady Gaga has said would recreate the tones of an "expensive hooker." Competition for major brands is fierce and ingredient suppliers have to re-pitch when celebrities launch new perfumes, Chief Executive Officer Gilles Andrier said today.
"Fragrances from celebrities are usually very competitive because the first couple of years are very big," Andrier said in an interview. "Even if you win Lady Gaga, it would be a portion of the business we have to win every year.
Ever since Elizabeth Taylor annexed her fame to a perfume called ''Passion'' in the 1980s, celebrity fragrances have gained a footing in the scent market, which researcher Global Industry Analysts predicts will be worth $33 billion by 2015. Collaborating with names such as Lady Gaga would bring a boost to Givaudan's fine-fragrance unit, which hardly grew last year.
Givaudan has to re-win about 30 percent of its existing fine-fragrance business each year, equal to 100 million Swiss francs ($108 million) to 120 million francs, the CEO said. After a slow start to 2011, fragrance demand picked up in the remainder of the year following a ''strong pipeline of new wins'' across all major customer categories, Andrier said.
Lady Gaga's first signature scent will be introduced in 2012. Her perfume campaign and commercial is being shot this weekend, to be edited into a ''special song,'' she said on Twitter on Feb. 14.
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so excited!!! commercial is going to be shot by kline and it's going to be to 'scheisse' apparently


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Hatstand Opera really are a 'go-anywhere' opera company, having performed in venues as diverse as top London hotels including the Grosvenor and the Savoy, ruined castles, on top of office blocks, beside Impressionist paintings at the National Gallery, on Nelson's column in Trafalgar Square, at numerous private homes and gardens of all shapes and sizes, on outdoor festival stages, and even in a Hampshire pig field (minus pigs!).
Hatstand Opera's success is built on almost 20 years of touring the UK with opera highlight shows, performing to audiences ranging from opera newbies to opera fanatics, aged 18 to 80+.
So, if you have an unusual venue or event where opera could delight and entertain your guests, call Hatstand Opera first. They have the knowledge, the experience, and the the imagination to make your event sound great!


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Translation of evidence-based guidelines into clinical practice has been inconsistent. We performed a randomized, controlled trial of guideline-based care suggestions delivered to physicians when writing orders on computer workstations.
Inner-city academic general internal medicine practice.
Randomized, controlled trial of 246 physicians (25 percent faculty general internists, 75 percent internal medicine residents) and 20 outpatient pharmacists. We enrolled 706 of their primary care patients with asthma or chronic obstructive pulmonary disease. Care suggestions concerning drugs and monitoring were delivered to a random half of the physicians and pharmacists when writing orders or filling prescriptions using computer workstations. A 2 × 2 factorial randomization of practice sessions and pharmacists resulted in four groups of patients: physician intervention, pharmacist intervention, both interventions, and controls.
Adherence to the guidelines and clinical activity was assessed using patients' electronic medical records. Health-related quality of life, medication adherence, and satisfaction with care were assessed using telephone questionnaires.
During their year in the study, patients made an average of five scheduled primary care visits. There were no differences between groups in adherence to the care suggestions, generic or condition-specific quality of life, satisfaction with physicians or pharmacists, medication compliance, emergency department visits, or hospitalizations. Physicians receiving the intervention had significantly higher total health care costs. Physician attitudes toward guidelines were mixed.
Care suggestions shown to physicians and pharmacists on computer workstations had no effect on the delivery or outcomes of care for patients with reactive airways disease.
In 2001, the Institute of Medicine documented the gap between recommended and actual practice of medicine in the United States (Institute of Medicine 2001). Many proven interventions were not routinely being used. Reactive airways diseases, asthma and chronic obstructive pulmonary disease (COPD), are an example. They are common, morbid, and costly conditions (McFadden and Gilbert 1992). Despite widely accepted evidence-based treatment guidelines (Canadian Thoracic Society Workshop Group 1992; National Asthma Education Program Expert Panel Report. Executive Summary: Guidelines for the Diagnosis and Management of Asthma 1994), many physicians do not prescribe such treatments to patients who might benefit from them (Cabana et al. 2001).
The Institute of Medicine has also stated that electronic medical record systems are "an essential technology for health care" (Institute of Medicine, Committee on Improving the Medical Record 1991) that could improve medical practice (Johnston et al. 1994; Tierney 2001). However, clinical information systems are expensive (Dambro, Weiss, and McClure 1988), potentially intrusive (Krall and Sittig 2001), and have not always improved care (Johnston et al. 1994). We have previously shown that computer-based interventions can increase preventive care (McDonald et al. 1984; Tierney, Hui, and McDonald 1986; McDonald et al. 1999; Tierney 2001) and reduce costs (Tierney, Miller, and McDonald 1990; Tierney et al. 1993). We have had less success affecting chronic management of renal disease (Harris et al. 1998) or heart disease (Tierney et al. 2003; Subramanian et al. 2004). We assessed whether guideline-based care suggestions delivered via physicians' and pharmacists' computer workstations could improve the outpatient management and outcomes among patients with asthma or COPD.
This study was approved by the University Institutional Review Board (study #9211-26) and took place in Indiana University Medical Group-Primary Care (IUMG-PC), an inner-city primary care practice-based research network (Tierney et al. 1991). This study utilized four hospital-based academic practices where 25 faculty general internists and more than 100 internal medicine residents cared for approximately 13,000 patients during 50,000 annual visits. These practices have separate nursing and clerical staff but share paper and electronic medical records (McDonald et al. 1999). At the beginning of each academic year, new physicians were randomly assigned to practices of departing physicians (Tierney et al. 1991). Physicians were assigned to half-day sessions in a single practice: faculty attended 2–5 half-day sessions per week while residents attended one half-day session per week. Prior studies have shown no systematic differences in practice patterns or clinical outcomes between the four practices (McDonald et al. 1984; Tierney, Miller, and McDonald 1990). Each physician cared for an assigned panel of patients. Faculty and residents practiced side by side. Residents briefly presented each patient to a faculty physician yet made all diagnostic and therapeutic decisions for their patients.
This study also included outpatient pharmacists. We separately randomized the 11 full-time and 9 part-time pharmacists to intervention or control status.
Patients were eligible if they were at least 18 years old, had either previously visited the study practices in the past year, and had either (1) the diagnosis of asthma or COPD recorded during any inpatient, emergency, or outpatient visit; (2) emphysema recorded as a reading on any prior chest radiograph or CT scan; or (3) two or more prescriptions for inhaled β-agonists, corticosteroids, ipratropium, or cromolyn, or oral β-agonists or theophylline. Prior studies (Murray et al. 1995) and repeated internal audits have shown that 95 percent of patients visiting these study practices receive all of their medications from the hospital's outpatient pharmacy.
This study used a 2 × 2 factorial design to study the relative and additive effects of separate physician and pharmacist interventions. We randomized all half-day sessions to intervention or control status via a coin flip. Because faculty physicians practiced in more than one half-day session per week, this procedure resulted in a few physicians having sessions with both intervention and control sessions. A biostatistician blinded to their names switched sessions so that the number of intervention and control sessions per practice were equal and all physicians practiced only in sessions with the same study status. To minimize contamination, all physicians in each half-day session shared the same study status. Patients shared their assigned primary care physicians' study status.
As patients were enrolled, they were randomly assigned by computer to receive all of their outpatient drugs from intervention or control pharmacists. Randomizing both practice sessions and patients resulted in four groups of patients: physician intervention only, pharmacist intervention only, both pharmacist and physician interventions, and no intervention (controls).
The investigators used published evidence-based guidelines for managing asthma (National Asthma Education Program Expert Panel Report. Executive Summary: Guidelines for the Diagnosis and Management of Asthma 1994) and COPD (Canadian Thoracic Society Workshop Group 1992) to generate patient-specific care suggestions. We determined eligibility for care suggestions using data in patients' electronic medical records: current medications, prior vaccinations, spirometric data, and evidence of recent exacerbations of their reactive airways disease (i.e., hospitalizations or emergency room visits). Peak expiratory flow was not routinely measured in study practices.
The care suggestions were reviewed by a panel of local general internists, pulmonary specialists, and pharmacists. Each care suggestion displayed to the physician or pharmacist explained the rule with a link to the annotated guideline with references. Panel members could independently accept each rule as is, with minor modifications, or major modifications, or reject it. Rules with major modifications or rejected were adjudicated during an expert panel meeting.
The final rules were programmed into physicians' computer workstations that have been in continuous use in this practice since 1984 (McDonald et al. 1999). Care suggestions focused on: (1) performing pulmonary function tests, (2) giving influenza and pneumococcal vaccinations, (3) prescribing inhaled steroid preparations in patients with frequent symptoms of dyspnea, (4) prescribing inhaled anticholinergic agents in patients with COPD, (5) escalating doses of inhaled β-adrenergic agonists for all patients with persistent symptoms, (6) prescribing theophylline for patients with COPD and continued symptoms despite aggressive use of inhaled anticholinergic agents, β-agonists, and steroids, and (7) encouraging smoking cessation. (Leucotriene inhibitors did not become widely available until after this study ended.)
The goal of this study was to assess the effects of patient-specific care suggestions, not their effects as an educational tool. Therefore, we presented the asthma and COPD guidelines to Medicine and Pharmacy Grand Rounds. We also met with all physicians and pharmacists and gave each a printed summary of the final asthma and COPD management guidelines that were the standard of care in this practice. The printout also listed the Consensus Panel members and summarized the process for developing the rules.
When patients presented for usual care, the physician received the patient's paper chart along with a computer-generated paper encounter form that included a list of active medications. Any study care suggestions for which a patient was eligible that day were printed at the bottom of the medication list. After the patient visit, the physician wrote orders on a workstation. No hand-written orders were allowed. Because patients' electronic medical records lacked symptom data and emergency and inpatient visits to outside hospitals, both intervention and control physicians were required to enter the severity of the subject's dyspnea (none, mild, moderate, severe) and number of exacerbations in the previous month. We required no further actions from control physicians, and no care suggestions were given although care suggestions were generated for all patients. Care suggestions were only presented to intervention physicians, both on their paper medication lists and on their computer workstations. The workstation displayed "suggested orders" on the main workstation screen (see online-only appendix at http://www.blackwellpublishing.com/products/journals/suppmat/HESR/HESR00369/HESR00369sm.htm). The physician was required to view all care suggestions (see online-only appendix at http://www.blackwellpublishing.com/products/journals/suppmat/HESR/HESR00369/HESR00369sm.htm), which contained three separate windows. The window at the bottom middle of the screen contained the actual suggested orders. The upper left window listed possible actions for each order ("order" or "omit"). The upper center window contained a short note explaining each care suggestion. Physicians could display the guideline and supporting references by hitting the "help" key.
Patients could also present without appointments. If the patient's assigned physician was present, that physician usually cared for the patient and the intervention protocol was followed. In all other cases, the care suggestions were only displayed if both the patient and physician were assigned to intervention status. Throughout the study, all physicians received other messages, reminders, and suggested orders, mostly drug interaction warnings and preventive care suggestions not related to this study's target conditions (McDonald et al. 1984).
All prescriptions were sent electronically to the outpatient pharmacy computer system that printed labels for pill bottles. For all enrolled subjects, any study care suggestions were sent electronically to the outpatient pharmacy's Pharmacist Intervention Recording System (Overhage and Lukes 1999) in which outpatient pharmacists recorded all prescription problems and interactions with patients. For patients randomized to the pharmacist intervention, instead of printing the pill bottle labels the system printed a message indicating that there were care suggestions that should only be viewed by an intervention pharmacist who could respond to them, if desired, and then fill the prescriptions. These suggestions were identical to those presented to the primary care physician. Care suggestions were only displayed when both the pharmacist and the patient were in the pharmacist intervention group. Notably, patients were eligible for the pharmacist intervention whenever they presented to the outpatient pharmacy, not just after primary care visits and not just with prescriptions for asthma or COPD.
When viewing care suggestions, the pharmacist had three options: do nothing, discuss them with the patient, or discuss them with the physician. However, during the first 2–3 months of this study, physician discussions rarely occurred. Pharmacists found paging or calling physicians difficult and time consuming. We therefore added an electronic mail option that allowed intervention pharmacists to send care suggestion to the patient's physician, adding text as desired. The physician received a notice of the electronic mail message after logging onto any workstation but was not required to read or respond to it.
We used data from patients' electronic medical records (McDonald et al. 1999) to generate weekly lists of eligible patients with primary care appointments. A research assistant approached potential subjects in the practice's waiting room, escorted the patient to a private area, explained the study, and invited the patient to participate. Agreeable patients signed an informed consent statement and were scheduled for 45-minute telephone interviews to collect demographic information, income, educational level, and smoking history. At enrollment and during close-out 12 months later, we also administered the SF-36, a measure of health-related quality of life (McHorney and Ware 1995). To assess disease-specific quality of life, we administered he McMaster Chronic Respiratory Disease Questionnaire (CRQ) (Guyatt et al. 1987) for patients with COPD or the McMaster Asthma Quality-of-Life Questionnaire (AQLQ) (Juniper et al. 1993). We also administered the American Board of Internal Medicine's patient satisfaction questionnaire (Webster 1988), a measure of physicians' communication abilities that had been previously validated in this practice (Dexter et al. 1996). We assessed pharmacy satisfaction with a locally developed questionnaire (Weinberger et al. 2001). Medication adherence was assessed using surveys developed by Inui, Carter, and Pecoraro (1981) and Morisky, Green, and Levine (1986). We also assessed medication compliance with the medication possession ratio (Steiner et al. 1988), which uses refill data from patients' pharmacy records and correlates well with other adherence measures (Choo et al. 1999).
A research assistant telephoned the patient at the beginning of his or her twelfth study month to administer the close-out interview. If no telephone interview could be held during the twelfth month, a research assistant attempted to interview the patient during visits made during the thirteenth and fourteenth months after enrollment. We extracted information from patients' electronic medical records, including evidence of compliance with the study care suggestions, hospitalizations, emergency department visits, and direct health care charges. To assess the degree to which physicians' attitudes toward guidelines may have affected their response to the intervention, we also administered a questionnaire to study physicians (after their Grand Rounds on guidelines but before the study started) that included a questionnaire created by Tunis et al. (1994). This questionnaire was originally developed with data from 1,513 generalist and specialist internists. It assessed personal attitudes toward guidelines; no correlations were made with practice behavior.
The unit of analysis for all outcomes was the patient. Because we intervened on the physician and pharmacist, differences between study groups were assessed using random effects generalized linear models (for continuous variables) and generalized estimating equations (for categorical variables) to account for correlations of outcomes among patients treated by specific physicians. We did not adjust for the intervention pharmacist because there was no one-to-one assignment of pharmacists to patients. The primary outcome was adherence to the guideline-based care suggestions. If a patient were eligible for same care suggestion on multiple visits, it was considered as one care suggestion. Adherence occurred when the indicated action was taken any time after it was first suggested and before patient close-out. We used analysis of variance to compare adherence to the care suggestions between the four study groups and Student's t-tests to assess the separate effects of the physician and pharmacist interventions. We used Poisson's regression with an overdispersion parameter to compare the numbers of outpatient and emergency visits and hospitalizations between study groups. After creating overall and subscale scores for the SF-36, AQLQ, CRQ, and the physician and pharmacist satisfaction surveys, we used analysis of covariance to compare these scores between study groups, including baseline scores and indicators for ceiling and floor effects as covariates. We analyzed charges and medication possession ratios using Wald-type tests for log-normal data containing zeroes (Zhou and Tu 1999). We used logistic regression to compare results of the Inui measure of medication adherence and analysis of covariance for the Morisky instrument, including baseline scores and indicators for ceiling and floor effects as covariates.
Because our main focus was to improve patient-centered outcomes, data from a prior study (Dexter et al. 1996) indicated that we needed 500 patients for 80 percent power to detect one unit change in the standard error of measurement for each subscale score of the SF-36 (Wyrwich, Tierney, and Wolinsky 1999). Anticipating 25 percent attrition of subjects during the study, we sought to enroll 700 patients.
Between January 1, 1994 and May 1, 1996, 1,730 potentially eligible subjects kept scheduled primary care visits (Figure 1). Of these, 1,181 (63 percent) were contacted and agreed to be interviewed, 865 (73 percent) of whom agreed to participate and signed informed consent statements, and 706 (82 percent) completed baseline interviews, were enrolled, and were randomized. Of the 274 physicians practicing in the study practices during this 3-year study, 133 practiced in half-day sessions randomized to intervention status and 141 practiced in control sessions. A quarter of physicians were faculty general internists, the rest internal medicine, or medicine–pediatrics residents.
There were no significant demographic or clinical differences between the four patient groups (Table 1). Two-thirds were women, 60 percent were caucasian, and two-thirds had COPD rather than asthma. The mean age was 51 years. Approximately two-thirds of each group completed a 12-month interview. More than 80 percent of patients in each study group had at least one scheduled visit to their primary care physician during their year in the study (mean of almost five visits). The mean number of study care suggestions per patient was just under three.
Table 2 shows the number of subjects eligible for each care suggestion and the fraction ordered during the study. There were no differences between the four study groups in either adherence to the care suggestions, combined or individually. Post hoc power analyses showed that it would take 145 subjects per group to have 80 percent power to detect a 50 percent increase in adherence to the care suggestions (from 32 percent to 48 percent, a 16 percent absolute increase) found in the control group.
There was also no consistent effect on quality of life (Table 3). The only significant difference in any SF-36 subscale was a significantly improved Role Physical subscale in the group receiving both interventions. There were no differences in the CRQ subscales. For the AQLQ, patients with asthma receiving the pharmacist intervention had significantly improved scores in the emotion subscale.
There were no intergroup differences in medication adherence or in patients' satisfaction with their physicians or pharmacists (Table 3). Nor were there any differences in emergency department visits or hospitalizations for any cause or for reactive airways disease in particular (Table 3). Patients in the group receiving only the physician intervention had significantly elevated total health care charges, possibly because of just a small number of extremely high-cost hospitalizations (Table 3).
Physicians' opinions of practice guidelines were mixed (Table 4). They generally felt that guidelines were a good educational tool, a convenient source of information, and intended to improve the quality of care. Yet many physicians felt that guidelines represented oversimplified "cookbook" medicine, were often too rigid to apply to individual patients, hampered physician autonomy, and were used to decrease health care costs.
Additional analyses were performed to ensure that the lack of significance was not because of the analytic methods chosen. Analyses of quality of life and satisfaction data were repeated after categorizing the changes from baseline into "better,""no change," and "worse" using the standard error of measurement (Wyrwich, Tierney, and Wolinsky 1999). Direct health care charges, number of hospitalizations, and number of emergency department visits were also analyzed using Kruskal–Wallis nonparametric tests. These results of these analyses were similar to the primary analyses and are not presented.
We had hoped to show that computer-generated care suggestions would enhance adherence to evidence-based guidelines and have salutatory effects on patient-centered and clinical outcomes. Unfortunately, none of this occurred, which surprised us, given our previous success with interventions to increase preventive care (McDonald et al. 1984; Tierney, Hui, and McDonald 1986; McDonald et al. 1999) and reduce costs (Tierney, Miller, and McDonald 1990; Tierney et al. 1993). Yet the workstations have been an effective medium for delivering interventions to affect physician ordering behavior (Tierney et al. 1987; 1988; Tierney, Miller, and McDonald 1990). It is possible that providers will accept a computer's advice about preventive care and costs but may be less open to a computer's suggestions about managing chronic illnesses. A prior study of a similar computer-based intervention to improve physician adherence to local and national guidelines for heart disease was also ineffective (Tierney et al. 2003). Another study used computer-generated reminders as part of a comprehensive management program for patients with chronic renal insufficiency. Despite mandatory consultation by nephrologists and a renal nurse, social worker, and dietician, there were no improvements in the processes or outcomes of care (Harris et al. 1998). In fact, chronic disease management programs have had mixed effects in affecting the processes and outcomes of care (Ferguson and Weinberger 1998). To date, the promise of computer-based decision support has not been realized. We have recently shown that including patient symptoms, their severity, and changes from the most recent primary care visit in patient-specific, computer-generated care suggestions had no effect on the processes or outcomes of care for veterans with heart failure (Subramanian et al. 2004). Additional work is needed to improve the timing and content of such interventions. A recent review of computer-based decision-support systems found them to be effective in affecting preventive care but had less effect in chronic disease management and little evidence of improvement in patient outcomes (Mitchell and Sulllivan 2001). The content, timing, and presentation of such decision-support tools need to be improved. Expertise in human factor engineering (Norman 2002; Bates et al. 2003) may be particularly useful in designing interventions that physicians can and will use to improve the translation of evidence-based guidelines into everyday clinical practice.
Although physicians and pharmacists had to view each suggestion, they could easily erase them from the screen by hitting the "escape" key. In a busy practice, the care suggestions could have been seen as a nuisance. Automatically deleting them may have become routine. We have strong evidence from two prior studies that this may have been the case. We found no effects of preventive care suggestions presented to residents on Wishard Hospital's inpatient medicine service (Overhage, Tierney, and McDonald 1996). The same intervention was repeated on the same service several years later by Dexter et al. (2001), the only major difference being that the "escape" key was disabled. Each care suggestion had to be dealt with in some way, either by complying with it or explaining why it was inappropriate. The effects were dramatic: adherence increased by a factor of 45 over the rate found by Overhage. The key, then, is to find a balance between the hassle factor of an intervention that cannot be avoided and the patient benefits of adhering to evidence-based practice guidelines. It would seem to require clinician leadership to find the correct balance, or providers themselves could decide which care suggestions should require their input and response.
The majority of patients in this study were middle-aged women with COPD, as defined using standard criteria. Yet the line between asthma and COPD among aging adults is blurred, and many patients with COPD have a reactive component to their lung disease that is amenable to pharmacotherapy. The strongest evidence for use of stepped care is among patients with asthma, which were in the minority in this study. This may have tempered providers' enthusiasm for following the care suggestions.
Although pharmacists could not directly respond to care suggestions, they could have discussed them with the patients and/or physicians. In a work-sampling study performed during our intervention (Murray et al. 1999), Murray et al. found that intervention pharmacists spent significantly more time than control pharmacists discussing information with patients, advising and informing them, and solving problems. Intervention pharmacists spent significantly less time checking and filling prescriptions and working alone, and they spent significantly more time than control pharmacists interacting with other pharmacy personnel, patients, and physicians and nurses. Hence, there were dramatic effects of the intervention on pharmacist–patient interactions that did not impact on patient care, outcomes, or satisfaction.
Communication between physicians and pharmacists in this study was practically nonexistent. This is unfortunate, because as time for clinical encounters continues to shrink, these two groups of providers could have complementary roles in enhancing pharmacotherapy and monitoring for adverse outcomes (Singhal, Raisch, and Gupchup 1999). Further work is needed to increase the collaboration of physicians and pharmacists and to define the role of computer-based interventions for improving the quality and outcomes of patient care.
This study was performed in academic practices where three-quarters of the physicians are residents. Results might not be generalizable to the everyday practice. However, we have previously used this practice-based research network to develop and test computer-based interventions (McDonald et al. 1984; 1999; Tierney, Hui, and McDonald 1986; Tierney et al. 1988; 1993; 2003; Tierney, Miller, and McDonald 1990; Overhage, Tierney, and McDonald 1996) that others have then tested more broadly (McPhee et al. 1991; Shea, DuMouchel, and Bahamonde 1996).
Although the Institute of Medicine believes electronic medical records are essential to improving the quality of care (Institute of Medicine, Committee on Improving the Medical Record 1991; Institute of Medicine 2001), expensive and sometimes intrusive innovations need to be thoroughly tested in rigorous trials before broad implementation. Electronic medical record systems should be useful in enhancing evidence-based practice. However, in this study, providing patient-specific care suggestions for asthma and COPD management did not improve decision making or patient outcomes and cannot be recommended at this time. Additional research, especially with respect to chronic disease management, is required if computer information systems are to help bridge the quality chasm (Institute of Medicine 2001).
This work was supported by grant number HS07763 from the Agency for Healthcare Research and Quality. We thank the physicians, nurses, clerks, and administration of the IU Medical Group-Primary Care for their continued support of clinical research in general and this project in particular.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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We recognise the importance of a personal touch and the care required when transporting live animals. Whether it's your pet, an exotic animal or livestock, at RJ Cargo we provide the care and attention required to guarantee your animals a safe and smooth journey to their destination.
We provide the highest levels of comfort, safety and hygiene for your animals either on-board our passenger flights, or on our dedicated cargo flights. For the transportation of horses, we offer custom-built stalls have systems in place to ensure a fast processing time and high level of care in-flight from our professional 'load-masters'. We can provide advice on all the required documentation and transportation containers to meet international regulations.
We have a special quarantine area available at our terminal in case an animal shows symptoms of a disease. Storage of live animals is not available and animals need to be collected upon arrival. For imports into Jordan, an import licence from the Ministry of Agriculture is required.
To find out more information about transporting live animals, please don't hesitate to contact RJ Cargo offices at Queen Alia International Airport, Amman. Our expert staff are always happy to assist you.


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Samsung Galaxy S5 gets a price drop in India
There is a new price for the recently launched Samsung Galaxy S5 in India. Its been the recent trend where the newly launched phones gets a price correction within days to weeks of launch. Samsung Galaxy S5 joins the list.
The phone was initially launched for Rs 51499 in India, is now available for Rs 46781 at Flipkart. This might be due to the launch of HTC One (M8) today in India.
The competition will be intense and we expect it to trigger further price corrections.
To recap, Samsung Galaxy S5 comes with 5.1″ FHD Super AMOLED Display, Exynos-5 Octa-Core processor, 16MP Rear Camera, 2GB RAM and runs Android (KitKat).
Source: Flipkart


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My skincare range is cruelty free, vegan and vegetarian and contains organic or wild harvested ingredients.
Everything else is fair trade which may include leather items.
Frequently Asked Questions
Can I see prices in my country's currency?
Yes. The site displays prices in all major currencies by clicking on the "Change Shop Currency" drop down menu to the left of this page. You can place your order in your currency, however your card will be charged in Pound Sterling.
I don't have a credit card. Can I pay by bacs or money transfer?
If you live in the UK you have a wide choice of payment options. You can pay via credit card or debit card, through Paypal, Google Checkout or Sagepay.
If you live anywhere else in the world you can pay by credit or debit card, via Paypal or Google checkout or via Sagepay. Or use Paypal's bank transfer system - you don't need a paypal account.
How long does delivery take?
Our turnaround time currently is 4-5 business days. You will receive an email confirming that your order is being processed and held in a queue. Once it has been packed and shipped you will receive a dispatch email. If weather conditions or exterior circumstances influence the delivery of your order then please add at least 1 week for UK deliveries and at least 2 weeks for international deliveries.
Is your website reading impaired people friendly?
We recommend you use Text Aloud, a software that enables you to have text from our website read to you. Text Aloud is a fantastic software program for people who are sight impaired (blurred vision but not totally blind), suffer from dyslexia or eye strain. We use it in the office if we get bored reading page long instructions :-). You can download a free trial version here: http://textaloud.en.softonic.com/. It is easy to install and integrates itself into your browser of choice. You simply highlight the first word of the text you want to hear (obviously this doesn't work for completey blind persons but we trust that you already have the right equipment to access websites from your computer...) and click on "speak" in the toolbar and the text is read back to you.
When do I receive your 5% loyalty discount?
We now have a loyalty scheme whereby you receive points for every order you place. From 20 points upwards you can redeem these against any product from our range.
How do you justify the fair trade aspect of your business?
Sabine has been looking into membership of various organisations such as the FLO, BAFTS, WFTO and so on. We are currently considering membership of BAFTS and WFTO however due to the nature of our business they find it difficult to classify Cebra - we import AND we produce our own range (the skincare for example) and the above mentioned organisations sofar only offer either the one or the other membership. In the meantime we continue to source raw materials and finished products from a) fairtrade importers that are already members of a fairtrade organisation and b) direct suppliers from countries such as Ghana, Nigeria or Kenya. For example we now support a number of African co-operatives run by local people who supply a wide range of raw materials to skincare producers. In addition we source raw materials for our Cebra ethical skincare range from members of Phytotrade Africa but we also put emphasis on supporting local UK based farmers and suppliers for our essential oils for example. We buy finished items from Kokskraal Handicraft, an initiative based in South Africa that support local Xhosa men and women; African crafts from Global Exchange and baskets from Swahili Imports and Baskets of Africa (both are members of the Fairtrade Federation). In short - we support a wide range of businesses and direct suppliers that we have vetted for their fairtrade ethos and principles and that we visit in person where possible.
What preservatives do you use in your skincare products and why?
We use mainly Preservative 12 which is a combination of Phenoxyethanol and Ethylhexylglycerin. This is as close to a natural preservative as one can get without compromising the vegan status of a product. Generally speaking we don't use preservatives in any products that don't contain hydrosols or water. Both ingredients attract bacteria once introduced to air no matter whether you store them cool and dark. In view of hygiene and general consumer safety we prefer to use Preservative 12 so that fungi and mould cannot develop. These can cause serious illnesses and death if not kept at bay. We do not use parabens or other ingredients that are deemed unsafe or dangerous and all our aromas are based on essential oils and organic plant extracts.
We can produce skincare products that are completely free from any preservatives, however these will have to be used within 2 - 3 weeks of opening and they must be kept in the fridge for storage. You may also not use your fingers but a stainless steel spoon and sterilize this after each dip into your jar or bottle. Please ask for price and details if you are interested in these skincare items. We would be happy to advise you further.
All oil based and non aqaueous products are free from preservatives. We use natural plant derived Vitamin E and vegetable glycerin derived from organic coconut to keep oxidisation at bay which can cause oils to go rancid.
Are the ingredients in your skincare organic? What about fair trade?
Sabine uses ingredients that come from organcially grown base materials and are harvested and produced without the use of chemicals. Whilst not every ingredient is certified organic - mainly because a lot of the co-ops we source materials from cannot afford organic certification - we strictly never buy or use anything that we know has been treated with insecticides or pesticides. We also make sure that all our suppliers receive a fair price and that all ingredients qualify as "fair trade" - again because of financial restrictions many suppliers cannot pay for certification, however our whole ethos is based on fair trade and we support small producers and small scale farmers every step along the way. Where Sabine has to use middlemen for certain ingredients, she makes sure that they comply with our policy and that the chain of supply is not made up of more than two middlemen. In most cases co-ops sell to registered IFAT or BAFTS wholesalers because they receive a higher price for the quantities they deliver to these wholesalers than for smaller quantities sold directly to end users and because the co-ops don't have the infrastructure like courier service and export facilities that would make selling directly to end users (i.e. us) feasible and achievable.
Palm Oil - What is your stance on this?
I no longer sell red palm oil and I don't use palm oil or palm oil derived ingredients in my skincare.
And how should I store your skincare products?
Please do not store oils in a very cold fridge unless advised on the website or on the label to do so. Oils in particular don't take kindly to very cold temperatures and may turn into butters and rancid upon warming up. The best temperature to store oils is between 15 and 25 degree centigrade, not near a heat source i.e. radiator and out of direct sunlight. Gels, creams and lotions on the other hand should be stored cool (but again, not in a cold fridge) and dark. A cupboard in your bedroom for example would be a good place, or a shelf in your larder. This helps to keep your skincare product as fresh as possible and prolongs its shelf life.
Are your products tested on animals?
My skincare contains only approved ingredients - either of organic certified, vegan or vegetarian origin. Everything is cruelty free including the ingredients. I only buy from reputable suppliers that have given written confirmation that their supplies are not tested on animals. The law in the EU has changed in any event and the sale of animal tested skincare is now illegal (of course what this being the EU several larger skincare manufacturers have obtained an exemption for certain porducts!). Animal tested ingredients are not appropriate for use in my skincare and as such I never buy them.
What about your product packaging?
All our skincare is now packaged in fully reusable and/or fully recyclable containers. We aim to source more recycled containers when they become available, however those are difficult to find in the UK and because we don't want to increase our carbon footprint, importing these containers from the US for example is currently out of the question. The best website for information about recycling plastics is: http://www.recoup.org/business/default.asp
Not only are all our aluminium containers lined with EPA which is a special resin that prevents leaking into skincare, all our containers are made from recycled aluminium and can be recycled again and again which is far more eco friendly than say HDPE plastic containers which indeed have a tendency to leak (ie. water bottles can still be made from HDPE and that means leaking of chemicals into drinking water!) especially if they are filled with hot substances.
As for other containers we use recycled PET jars and bottles and these have been proven to be leak resistant and far better for the environment too however some products such as melted shea butters can cause PET to warp - which is why we fill them into the aluminium containers as mentioned above.
We reserve the right to change packaging especially for our skincare if we feel it suits the prodcut better and if weather conditions deteriorate (i.e. during the summer). Images are for illustration purposes only.
How is my order packaged then?
We recycle as much as we can. Cartons for example are reused. If they are still in good order then we use them to package your orders in. They may not be in pristine condition, however they are perfectly fine and protect your goods - we just don't want to cut up the cartons and throw them in our recycling bin just yet if they can be reused. Smaller and less breakable items are either sent in small cartons, cardboard backed envelopes or a 100% bio degradable bag that starts to disintegrate once it has been expose to sunlight.
For wrapping we use either recycled corrugated cardboard or bio degradable bubble wrap. We may use shredded paper and wood wool which we buy from our local woodmill. We urge you though to reuse packaging as many times as possible as this helps to reduce the impact on our landfill sites. At the end of the day it's not the pristine state of the postal cartons that matters - it's the preservation of our natural environment.Frequently Asked Questions


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Mangalore University awards PhD to Vincent Alva
Mangaluru: It is befitting to bestow PhD to a person who is a continuous learner, a teacher par excellence, an organiser of high standards, a music lover, a dramatist, a renowned orator and role model to the youth and society at large.
Vincent Alva hails from Pamboor. He did his graduation at the Poorna Prajna College, Udupi and pursued his Masters Degree in English from Mangalore University. He began his teaching career at Pompei College, Aikala. Presently he is serving as Associate Professor of English at Milagres College, Kallianpur, Udupi.
He was the member of Karnataka Konkani Sahitya Academy too. His articles, stories and columns continually appear in print and electronic media. He has translated Jnana Pita Awardee, U.R. Ananthamoorthy's Novel Samskara into Konkani, which has been published by Karnataka Konkani Sahitya Academy.
He has been awarded PhD for the thesis entitled "Interpreting and interrogating Indian traditions: A study of the fictional works of Gita Mehta, Shashi Tharoor and Rohinton Mistry". He was successfully guided by Prof. D R Shashidhara, Department of English, Mangalore University.


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This text has been automatically translated. View original Text
Agriturismo " " LAKE is located in the Valley of Lago di Fimon, encircled from the Colli Berici (Berici Hills), in a context of considerable beauty. The nature trails and archaeological sites are within walking distance. Walking on foot or by bike you can reach magnificent places from where to admire the Lake and beyond. If you are interested in country life, you can follow us our little agricultural activity. You will be housed in a completely renovated building, particularly welcoming and surrounded by a large green space in front of the campsite. In spring summer – you can immerse yourself in our new swimming pool Our five rooms, the ' apartment and four pitches for camping, are excellent to spend quiet holidays in contact with nature. Accommodation in agritourism rooms with breakfast, apartment and camping.
Airport, Countryside, Downtown, Rural, Small town
Venice, Italy (VCE-Marco Polo) 60 miles
Da Vicenza OVEST Alla I° rotatoria fuori dal casello prendere la prima uscita (DIREZIONE PADOVA GRISIGNANO) dopo circa 4 km prendere la prima uscita alla PRIMA rotatoria II USCITA ed alla seconda consecutiva prima a DX direzione Longare-Noventa a circa 500 mt. si trova un semaforo prendere a destra e poi seguire le indicazioni Lago di Fimon noi siamo 1 Km. Prima del Lago sulla sinistra. Dal casello sono 9 Km. Tutti in pianura.
Historical interests, Lake, Museum, Nature area, Performing Theater
English, French, Italian
Siamo una famiglia accogliente.


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Take to the Sky & Customize your Dragon!
Vol. XXIV, No. 1
Cover art by Jeff Easley
I\'ve often imagined that most munchkins eventually become more sophisticated role-players. If it were only that
Our readers discuss issue #254, priestly magic, and more!
A collection of letters from our readers.
Nodwick and company swear they never found the treasure.
It\'s closing time at Pegasus Games.
Creating a Campaign: Time to map the players\' base of operations.
The Sage explains some recent advice, considers character abilities, and takes a look at dwarven rune magic in the
Fabulous draconic mounts for your AD&D game heroes.
Take your tired, old dragons in for a makeover.
The awesomely powerful champions of the dragon gods.
Who\'s afraid of a dragon named Puff? You can do better with this dragon name generator.
Evan after his disappearance, the good Doctor\'s work goes on.
Creeps on the Borderlands
West meets East when Priam Agrivar follows Ishi Barasume to the secrets of her past.
Learn how the bug-men found an ax to grind.


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When your organization becomes a TAtech Member, you and all of your colleagues join a worldwide community of talent acquisition solutions professionals. Here are some of the ways we interact with and support one another.
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