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The NHS Explained: How the Health System in England Really Works
Duration 4 weeks
Weekly study 2 hours
Learn Free
Extra benefits From $59 Find out more
Learn how healthcare is delivered in the NHS
The National Health Service (NHS) is a source of British national pride placed above the BBC, the British Olympic team, and the Royal Family. It affects the lives of millions of people.
But have you ever wondered how many people it takes to keep a nation healthy? Or how much money it costs to run the NHS? Or why hospital waiting times are always in the headlines?
This course will help you understand what keeps the fifth largest employer in the world running. You'll explore the challenges facing the system, and how to ensure the NHS is fit for the future.
What topics will you cover?
- How the NHS in England is structured
- How different services work together to deliver health care in the NHS
- How funding flows through the system
- How well the NHS is doing
- How performance is measured in the NHS
- Future challenges facing the NHS and how the system is changing in response to this
When would you like to start?
Most FutureLearn courses run multiple times. Every run of a course has a set start date but you can join it and work through it after it starts. Find out more
What will you achieve?
By the end of the course, you'll be able to...
Who is the course for?
This course is for anyone interested in the NHS in England and how it works. This includes NHS and social care staff in England (working in both clinical and non-clinical roles), students considering a career in the NHS, and patients and the public.
Who will you learn with?
Hong-Anh Nguyen
I'm a librarian at The King's Fund and alongside managing the library and public enquiry service, I also lead on our service that helps to keep people up to date on health policy in England.
Ian Ford
I create, commission and edit digital content for The King's Fund. I help to manage our online presence and find different ways to share our messages with others.
Lillie Wenzel
I'm a Fellow in the policy team at The King's Fund where I work on a range of projects. This has included work on commissioning and Integrated Care Systems.
Deborah Ward
I'm a senior analyst in the policy team at the King's Fund where I contribute to a range of research projects as well as providing regular analysis of data about the performance of the NHS.
Who developed the course?
Join this course
Start this course for free, upgrade for extra benefits, or buy Unlimited to access this course and hundreds of other short courses for a year.
Join free and you will get:
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for one year
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Get a taste of this course
Find out what this course is like by previewing some of the course steps before you join:
Do you know someone who'd love this course? Tell them about it...
You can use the hashtag #nhsexplained to talk about this course on social media.


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Things To Do In October 2017 at the Center for Puppetry Arts
September 29, 2017 14:31
The spooky season is here, and we're feeling festive. 🎃 We are so excited welcome back our annual Halloween show, The Ghastly Dreadfuls, and kick off this season's run with our first-ever Halloween party, The Ghastly Gathering. Of course, our regular Family Series offerings and workshops are also on the schedule, so October promises to be a blast for all ages. Check it out and plan to join us this fall!
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subset: commoncrawl


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Chelsea FC
**HD Thomas Pavillion Room Hire**Enquire today about hiring our own Chelsea FC Clubroomsfor your next event or Private Function!Sits a maximum of 100 people and approx.150 stand up
For all your Quality Sicilian Pastries and Cakes...mmm .....Yum!!(03) 9553 1928 Unit 4/ 74-80 Keys Rd, Moorabbin, VIC 3189
TD Plastering can help with all your plastering needs.For more than 23 years Bonbeach local Tony Ruberto has run TD Plastering. With 37 years of experience in the trade Tony has experience in all facets of the plastering trade. During this time the company has been providing top quality plastering services to clients throughout Melbourne and all over Australia As local run business, we know that reputation is everything. We offer good old fashioned service and the very best workmanship. TD Plastering provides a range of plastering services from new plaster work to renovations. We work all throughout the greater Melbourne area. 0412 581 691
At LifeStrong Physiotherapy Chelsea, we apply a holistic approach to your injury that is goal focused and aimed at providing long term results. Starting with a free initial assessment, we will guide your recovery, taking into consideration your individual lifestyle and preferences.
Irizar is a European manufacturer with 130 years of History with headquarters in North of Spain, region known as the Basque Country. Along this long history, Irizar became highly specialised in high luxury buses and coaches, proud of its brand recognition for safety and design.In 2018, the Irizar i8 Coach has being awarded as the best coach of Europe and Irizar has being awarded as the best bus and Coach manufacturer in the same year.In Australia, Irizar has a history of 13 years, with more that 800 units delivered and collaborating with transport operators. Our vehicles transport students, tourists, backpackers, mining workers, city commuters, government authorities, etc.


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Percussionist-athlete John Angeles spent his entire childhood in Fort Worth and studied music every step of the way, drumming in the Nolan Catholic High School marching band and majoring in music at Texas Christian University.
After college he joined a touring percussion group, and got hooked on the traveling lifestyle. Now he's with the touring production of Stomp, and every now and then he gets back to the Dallas area -- to steal his parents' pots and pans and cruise the local junkyards. He's here now for one such visit, a week-long run at the Bass Performance Hall in Fort Worth, presented by Casa Mañana. The show runs tonight through Sunday. After the jump, bang out a Q&A with Angeles.
Coming from your traditional music background, how was the adjustment to the, you know, unconventional kind of playing you do in Stomp?
I've been playing the drums for 18 years, so that was very important part of my life, as far as music goes. It's been a huge adjustment for me. I'd done a little bit of performing, but for most of the percussion stuff I've done before, I'm in the background. As the drummer, you're not the front man, you're the guy in back.
So now, some people think I'm a dancer and some think I'm just a drummer. The physicality of it takes a toll on the body. I was used to playing with drumsticks before, and now it's poles, trashcan lids, things I never developed the muscles to use. Over the last year and a half I've gotten stronger in ways I never would have imagined.
We use everything in the show, starting off with brooms, or matchboxes. We actually use our own bodies, stomping our feet, clapping our hands. Zippo lighters, water bottles, hammer handles. We actually use kitchen sinks -- everything that's not an actual percussion instrument.
?So where you are now, how much do you think you owe to the traditional music training?
The thing is, it very much is like a musical ensemble. I have to use all the formal training I went though in school, even marching with a marching band. It's the same stuff, listening to the people you're playing with -- but it's at a higher level, because the instruments we use aren't necessarily the most beautiful. There's a correct way to hit a water bottle, a correct way to hit a matchbox to produce the most efficient sound. You have to develop your own technique to get the sound you want.
For instance, on a water bottle, there's a seam. You don't want to hit it on the seam; you want to hit it on the end. It's a flick of the wrist, and you're basically pulling the sound out of the water bottle. It sounds crazy, but it works. With a flick of the wrist and one finger, you pull away as quick as you can and you get a fairly resonant sound.
So Stomp has been around for a while now [since 1991] -- is there anything new about the show this time?
It's actually the first time they've changed the show in 15 years. There's two new pieces in the show this time -- I'd say the whole show is 60 to 70 percent different from our last time through town. Two of the numbers are brand new. One is called "Donuts" -- it's tractor tires, the inner tubes of tractor tires. They're five and a half feet wide. The other one is "Paint Cans" -- that one was hard for me. It's actually kind of a juggling act.
Of course, our solos we always get to write ourselves -- I do a broom solo at the end of the first number. We feel more like a rock band or a jazz band sometimes -- we can actually communicate with each other onstage.
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As a drummer, you probably were always hitting things to make noise, but now that you're in Stomp do you look for potential instruments in any new places?
Totally. When you go to a new place, somebody'll say, "Hey there's a junkyard over here," and we'll find stuff there to play. I'll go through a kitchen and take a pot and pan if I like the sound of it. I try not to use my own stuff or things from my parents' place.
We're always trying to find new ideas for us. There's a lot of stuff out there that doesn't sound cool. There are trashcans that just sound horrible, a lot of the metal ones, actually. Most of our trash cans actually come from the U.K. The ones made here don't have a good tone. The best rubber trashcans for us are Rubbermaid.
Anything that can sound like a bass drum or a snare drum, we try to pick up. At a kitchen supply store in Dallas a while back, I bought a wok that sounds like a really deep cowbell. It really is that whole thing -- one man's trash is another man's treasure. --Patrick Michels


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Welcome back. Our theme for this series is "Business and The Survival of the Fittest". If you missed Ep. 1, be sure to check it out here.
We've arrived at Act Two of our show. Act two: "Blue Eyes vs. Brown, or: How Customers "See" Your Expertise".
In Act One, we talked about how it's the culmination of thousands of unique, individual experiences that make up who you are. These experiences are the DNA of your expertise--meaning that who you are makes you the expert.
Expertise = the DNA, or the terra firma on which your entire business is built.
In Act Two, we are going to expand the biology metaphor, if you will.
Big B, little b
Ring any bells from high school science class?
BB (big B) or bb (little b) refers to your genotype, DNA, or genetic makeup. It's the stuff you inherited from your parents, but can't see.
Brown eyes (BB) or blue eyes (bb) is how scientists refer to your phenotype, or how your genotype is physically expressed. And no, you won't be tested on this later. It's just the unique way we view expertise at 16 Hoops (link to checklist).
Let's put this all in plain language. If you have two parents with blue eyes, it's genetically impossible for you to have children with brown eyes. But, as my cousin Jenny proves, you can be born with blue eyes to two parents with brown eyes. Your blue eyes or brown eyes are how your DNA expresses itself.
(See--I told you that Mrs. Bresnick's words are burned into my memory!)
What on earth does all this have to do with your business? Still with us?
Expertise = DNA, or genotype.
Branding = Eye color, or phenotype.
Branding is how your expertise is expressed to your customers. It's how your expertise "looks."
Logos, marks, colors, feeling, design, style. Brown eyes, blue eyes, BB, bb.
The best businesses do the hard work to first uncover their own expertise, and then build a brand that expresses that expertise perfectly to their ideal customer.
Effective branding is like a pheromone to your perfect customer. They are drawn to it instinctively, like bears to honey.
Random branding is forgettable
Bad or random branding creates an echo chamber around your business. You might as well be talking to yourself.
Your potential customers are just going to pass you by or not see you at all.
Or worse, your potential customers won't be able to distinguish you and your pretty template logo from every other pretty template-logo photography business out there.
And so they hire the cheapest pretty template-logo photography business they can find--because, after all, what's the difference? They all look the same. If you're one ant in a seething pile, how can anyone be expected to notice you?
This is how the race to the bottom continues in our industry.
If you are tired of competing on price, do the very, very hard work to position yourself as an expert and express it TO YOUR PERFECT CLIENT through impactful branding.
The path to the profitable, easy-to-manage business of your dreams is to ignore everyone else and target your ideal client. You do this by first establishing expertise, then expressing it through compelling branding.
Coming up next week is Act Three: "You ARE good. You LOOK good. Now ACT good."


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His job is a very big deal to him, especially in these tough economic times. This fear causes men to (re)focus on their career/job. As they put their attention to it, other things suffer from a lack of attention — family, relationship, etc. He's probably not doing it on purpose, but it leads to women asking why he doesn't care or put effort in any more.
The rub: She doesn't want to tell him that she feels he's dropping back, because then his renewed effort isn't "genuine" (read: he didn't think of it himself, so it isn't him wanting to).
How she can help: Acknowledge the issues and the stress that accompanies them. She might remind him that you are both in this together. If life throws a curveball, she'll be there — with him and for him. At the same time, gently remind him that he needs balance. Jobs and money might come-and-go ... but she is there and that is where his effort needs to be also.


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It may not quite be in the Olympics yet but that has not stopped golf well and truly playing its part in this extraordinary sporting year. From Rory McIlroy proving beyond doubt he is the world's best, to the return of Tiger Woods to somewhere near his best, along with the most incredible Ryder Cup in the event's history, it has been a season to savour. And while the list of memorable moments could have been a longer, here is our top ten of 2012's golfing highs and lows.
Out of the Woods
After two-and-a-half years without a tour victory – a 923-day drought in which he endured both a cataclysmic sex scandal and serious injury problems – Tiger Woods finally won again at the Arnold Palmer Invitational in March. The 14-time major champion had said his winless run ended at the Chevron World Challenge four months previously but topping an invited 18-man field in your own tournament and lifting a trophy with a Tiger on it isn't the real thing. However, seeing off a full field by five shots at Bay Hill was, kick-starting a year which began with Woods outside the world's top 50 and ended with him at No.3. He won three events in total, and finished tied for third at The Open. Many still doubt him, even more find him a hard man to like, but make no mistake, Tiger's back.
Shot of the Year
Bubba Watson is known for many things. Crying a lot, that's one. Another is having a ludicrous pink driver with which he can launch the ball into neighbouring states.
But slightly more surprising is how his extraordinary, unique swing can produce shots of which lesser golfers can only dream. And he decided to play one at the time of the most intense pressure, when the small matter of his first major was at stake. Deep in the trees at the first play-off hole of the Masters, the 34-year-old took a wedge to clip his ball off a bed of pine needles, move it a staggering 40 yards left to right in the air and plop it gently onto the green ten feet from the hole. A simple par followed to see off a shell-shocked Louis Oosthuizen. And then, of course, the American's tears flowed.
Webb's Olympic moment
Heading into Sunday at the US Open, Webb Simpson was four shots off the lead. But a final-round 68 was enough to leave the American at the head of the field. His one-shot win at San Francisco's Olympic Club continued a remarkable streak of different major winners – Simpson was the 15th in a row.
Not so great Scott
No matter how good they are, no matter how much it seems to be their destiny, many of the best golfers ever to play the game don't win a major. Colin Montgomerie didn't. Sergio Garcia and Lee Westwood are running out of time. And after a meltdown of quite epic proportions at Royal Lytham and St Anne's in July, it is hard to see how Adam Scott will ever recover to claim a long overdue first big one. With four holes to go on the final day, he led by four. After four closing bogeys, he had lost by one to Ernie Els. In one sense it's a story that should be about how the 42-year-old South African claimed his fourth major, ten years after his last one. Instead, it will always really be about one of the biggest collapses ever seen.
Roger, Roger
It took unheralded Englishman Roger Chapman 19 seasons – and 472 tournaments – before he claimed his only European Tour victory. But after just three years in the old boys' ranks, he completed a remarkable double of winning the Senior PGA and Senior US Open in the same year – a feat only achieved by the slightly more well-known Jack Nicklaus, Gary Player and Hale Irwin. And it earned him just shy of £600,000.
Hear him Ror
The critics said he had taken his eye off the ball, claiming he spent too much time travelling the world with girlfriend Caroline Wozniacki, his body language was all wrong, he gave up too easily. It appears they were wrong. At Kiawah Island in August, Rory McIlroy put on an exemplary display, destroying the field to win the US PGA by eight shots, equalling the record margin of victory in the event held by Jack Nicklaus. But he wasn't quite done there. He then won the FedEx Cup, helped regain the Ryder Cup, topped the US money list and then did the same on the European version. Critics answered, world No.1 spot secured, two majors in the bag, many more to come. Quite simply, the Northern Irishman's has left his rivals feeling exactly as they did when facing Tiger Woods in his prime – when McIlroy plays his best, he wins.
Sergio's smiling again
Four years without a win is a long drought for any player. For someone as sublimely talented as Sergio Garcia, it's ridiculous. But after all manner of turmoil for the Spaniard, including off-course splits and on-course swing yips, he finally returned to the winner's circle at the Wyndham Championship.
Ryder Cup part I – the new Seve
The trophy may have gone to the European team but, for many, the Ryder Cup was won by one man. The heroics of Ian Poulter in Saturday's afternoon fourballs proved the turning point of the whole match. Late in the day, the visitors were 10-4 down overall and staring at another defeat in Poulter's match – two down with six to play paired with Rory McIlroy against Jason Dufner and Zach Johnson. But the Englishman wasn't finished. With five birdies in his last five holes, he single-handedly grabbed a vital point for Europe who ended the day 10-6 behind but suddenly with all the momentum. They carried this into the final day singles. Poulter won again – obviously – and the Americans crumbled.
Ryder Cup part II – He Kaym, he conquered
While Poulter became the embodiment of Seve Ballesteros, the ultimate Ryder Cup legend, to drag Europe to the brink of possibly the greatest win in the event's history, it needed a young German with a very cool head to clinch it. Standing over a six-footer on the 18th needed to close out his match with Steve Stricker, Martin Kaymer admitted he thought back to the putt missed by his countryman Bernhard Langer at Kiawah Island in 1991 to lose the cup on the final green. But Kaymer, who had sought Langer's advice two days before as he struggled to find his form, made no such mistake. 'It was such a fine line between being the hero and the biggest idiot,' admitted the man who was very much the former. The miracle at Medinah was complete.
Belly flop
What better way to end the year than with a nice spot of controversy. Despite howls of protest from many pros, both old and young, the game's governing bodies decided they had had enough of long putters. Sort of. Players can still use them but they can't anchor the putter to their bodies. So, a belly putter becomes, simply, a putter. It seemed the bigwigs did not mind the oldies using them to cure the shakes but when pros started winning majors with them and even juniors went for the long option – 14-year-old Chinese prodigy Guan Tianlang opting for a belly version – then change was needed. Not yet, of course. It takes a while to reprint all those ever thickening rules of golf books. The ban arrives in 2016.


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West Philly Rising!November 18, 2015 | by Brooke Willmes
West Philly has been on the rise for the last several years but this year, the numbers are even more staggering! It's clear that Philadelphia has two downtown and both seem to be booming. The vacancy rate in University City is only 2%.
Here is a look at the article and numbers from the latest University City report.A�
Data gathered from phillymag.com
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Chesapeake Children's Book Festival, an event to celebrate children, community, and literacy was held June 17 at the Talbot County Free Library in Easton.
The day offered music, crafts and make-a-book, book sales, and games, prizes and art exhibits. The festival brought together over 30 children's book authors and illustrators for this second annual event. Visitors had the opportunity to meet some of their favorite authors, listen to readings, and purchase signed books at a discount, courtesy of Eventful Giving, a component fund of the Mid-Shore Community Foundation, and the numerous sponsors which include For All Seasons.
For All Seasons, Executive Director, Beth Anne Langrell met several authors throughout the day, receiving over 25 autographed books that will be available for the children to enjoy in the waiting rooms of For All Seasons.
Founding Chair, Marie U′Ren relates "the sponsors enabled the Festival to purchase more than 800 books that were autographed by the authors and then given away to the 354 children in attendance who signed up for the Library's Summer Reading program or sold as a discount to Festival attendees."
After the festival, copies of the 104 signed books not sold during the event were given to libraries or area nonprofits including For All Seasons, Talbot Mentors, the YMCA in Easton & St Michaels, Neighborhood Service Center, Critchlow Atkins Children's Center, the Multicultural Center, Tilghman Island Youth Associations, St. Luke's in St. Michaels, and Toys for Tots.


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A projected 100 jobs will be created over three years with the arrival of Coastal Cloud, a new technology-based company slated to open in Flagler County. The first of those positions will be filled quickly: The company plans to open its doors within the month.
Coastal Cloud anticipates hiring 15 employees in its first year, 35 in its second and 50 in the third. It will eventually build a facility in Flagler County, but will lease initially so the business can open quicker.
Coastal Cloud's goal is to bring cloud-based solutions to businesses both nationally and internationally, and will start by building on the client base the IT consulting service Graphene already has, said Sara Hale, a managing partner of Coastal Cloud. Coastal Cloud will use online services and self-developed tools, to generate custom reports for clients, allowing them to track customers and successes.
It also will let companies use software through cloud computing, which will lower their operating costs. Rather than purchase expensive software for each employee, businesses using Coastal Cloud can provide employees a portal to log in and use such software through a cloud service.
"Using software this way is much more affordable for small and medium businesses because they don't have to buy the software," said Tim Hale, the other managing partner for Coastal Cloud. "They pay based on number of people using it."
Tim Hale told Flagler County's Economic Opportunity Advisory Council Wednesday that even though Coastal Cloud is new, it can be ambitious in its plans to expand because it will be supported by Graphene, which is already well established. One of the initial challenges to starting the company will be funding payroll, but if necessary, those costs will be shouldered using revenue from Graphene.
The partners also have access to a line of credit they can use if necessary, Sara Hale said. The company has been approved to receive Florida's Qualified Target Industry incentive, which rewards businesses based on the number of new jobs they create.
The Economic Opportunity Advisory Board decided at its Wednesday meeting to recommend that the Flagler County Board of County Commissioners give Coastal Cloud a similar incentive package for creating jobs.
The package would be performance-based, and would pay Coastal Cloud $500 for every job created. The money would be paid at the end of the year in which employees were hired, and will never exceed more than $50,000 over seven years, said Helga Van Eckert, executive director of Flagler County's Department of Economic Opportunity.
The County Commission should decide whether to approve the incentive package at its Feb. 18 meeting.
Coastal Cloud is planning to move more into the public sector by providing services for governmental bodies, Tim Hale said. Its other two targeted industries, at least for now, are telecommunications and real estate, both of which Graphene and the Hales have experience with.
"I'm a big believer that you've got to have industry focus and differentiated knowledge, so that's where we'll start first," Tim Hale said. "We'll further specialize as we go. The public sector is new to us, but we think it will give us continued growth."
Now that it's been approved, Coastal Cloud will aggressively work on securing its first employees. The company is launching its website at CoastalCloud.us today, which will include an application center.
"Coastal Cloud will have a tremendous impact on our economy," Van Eckert said. "Not only will it bring more jobs and the construction of a large facility, but it will help diversify our economy and could attract more businesses."


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You are looking at 1 - 10 of 2,716 items for
Sri Harsha Tella, Anuhya Kommalapati, Apar Kishor Ganti and Alissa S. Marr
Background: The advent of targeted therapies and immunomodulatory agents has revolutionized the management of advanced cutaneous malignant melanoma (MMel) by prolonging overall survival. This study evaluated the therapeutic and survival disparities among patients with advanced MMel based on hospital volume using the National Cancer Database (NCDB). Methods: A retrospective analysis using regression models and Kaplan-Meier estimates was performed from the data obtained from the NCDB on patients with MMel diagnosed in 2004 through 2015. Results: A total of 40,676 patients with MMel were treated at 1,260 facilities. Multivariable analysis showed that facility volume was an independent predictor of overall survival (P<.0001). Compared with patients treated at high-volume facilities (tertile 3 [T3]), those with stage III disease (n=27,528) treated at intermediate- and low-volume facilities (T2 and T1, respectively) had a significantly higher risk of death (T2 hazard ratio [HR], 1.15; 95% CI, 1.09–1.20; T1 HR, 1.23; 95% CI, 1.17–1.29). Compared with patients treated at T3 facilities, those with stage IV disease (n=13,148) treated at lower-tertile facilities had a significantly higher risk of death (T2 HR, 1.16; 95% CI, 1.10–1.21; T1 HR, 1.29; 95% CI, 1.23–1.36). Further, patients with stage IV disease treated at T3 facilities (vs T1 facilities) were more likely to receive chemotherapy (38% vs 28%) and immunotherapy (23% vs 10%) (P<.0001). Conclusions: Patients with advanced-stage MMel treated at high-volume facilities had significantly improved survival and were more likely to receive chemotherapy and immunotherapy.
Henry Soo-Min Park
Nicholas G. Zaorsky, Ying Zhang, Vonn Walter, Leila T. Tchelebi, Vernon M. Chinchilli and Niraj J. Gusani
Background: This retrospective cohort study sought to characterize the accrual of patients with cancer into clinical trials at the time of diagnosis and analyze the impact of accrual on survival. Methods: The National Cancer Database (NCDB) was queried for patients enrolled in clinical trials at their initial course of treatment for 46 cancers from 2004 through 2015. Descriptive statistics were used to characterize the accrual of patients with cancer in clinical trials at diagnosis, and Kaplan-Meier graphical displays, log-rank tests, odds ratios, and stratified Cox proportional hazards models were used to analyze the impact of accrual on overall survival (OS). Strata were defined using 10 variables. Model-based adjusted survival curves of 2 groups were reverse-generated based on a Weibull distribution. Results: Of 12,097,681 patients in the NCDB, 11,576 (0.1%) were enrolled in trials. Patients in clinical trials typically had metastatic disease (30.9% vs 16.4%; P<.0001), were white (88.0% vs 84.8%; P<.0001), had private/managed care insurance (56.4% vs 41.8%; P<.0001), had fewer comorbidities (Charlson-Deyo score 0: 81.9% vs 75.7%; P<.0001, and Charlson-Deyo scores 1–3: 18.1% vs 24.3%; P<.0001) compared with those not in trials. At a median follow-up of 64 months, enrollment in a clinical trial was associated with improved OS in univariate and stratified analyses, with a median survival of 60.0 versus 52.5 months (hazard ratio, 0.876; 95% CI, 0.845–0.907; P<.0001). Stratified analysis with matched baseline characteristics between patients enrolled and not enrolled in a clinical trial showed superior OS at 5 years (95.0% vs 90.2%; P<.0001). Conclusions: Enrollment in clinical trials at first line of therapy in the United States is exceedingly low and favors young, healthy, white patients with metastatic disease and private insurance who are treated at academic medical centers. Patients with cancer treated in clinical trials live longer than those not treated in trials.
Carolina Villanueva, Jenny Chang, Scott M. Bartell, Argyrios Ziogas, Robert Bristow and Verónica M. Vieira
Background: More than 14,000 women in the United States die of ovarian cancer (OC) every year. Disparities in survival have been observed by race and socioeconomic status (SES), and vary spatially even after adjusting for treatment received. This study aimed to determine the impact of geographic location on receiving treatment adherent to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for OC, independent of other predictors. Patients and Methods: Women diagnosed with all stages of epithelial OC (1996–2014) were identified through the California Cancer Registry. Generalized additive models, smoothing for residential location, were used to calculate adjusted odds ratios (ORs) and 95% CIs for receiving nonadherent care throughout California. We assessed the impact of distance traveled for care, distance to closest high-quality hospital, race/ethnicity, and SES on receipt of quality care, adjusting for demographic and cancer characteristics and stratifying by disease stage. Results: Of 29,844 patients with OC, 11,419 (38.3%) received guideline-adherent care. ORs for nonadherent care were lower in northern California and higher in Kern and Los Angeles counties. Magnitudes of associations with location varied by stage (OR range, 0.45–2.19). Living farther from a high-quality hospital increased the odds of receiving nonadherent care (OR, 1.18; 95% CI, 1.07–1.29), but travel >32 km to receive care was associated with decreased odds (OR, 0.76; 95% CI, 0.70–0.84). American Indian/other women were more likely to travel greater distances to receive care. Women in the highest SES quintile, those with Medicare insurance, and women of non-Hispanic black race were less likely to travel far. Patients who were Asian/Pacific Islander lived the closest to a high-quality hospital. Conclusions: Among California women diagnosed with OC, living closer to a high-quality center was associated with receiving adherent care. Non-Hispanic black women were less likely to receive adherent care, and women with lower SES lived farthest from high-quality hospitals. Geographic location in California is an independent predictor of adherence to NCCN Guidelines for OC.
Suzanne M. Mahon
Families with hereditary risk for developing malignancy benefit from organized, coordinated care by a genetics professional. This report presents a case illustrating the potential errors that can occur when genetic care is fragmented and not coordinated, including ordering too much or not enough genetic testing, failing to communicate with the family who is at potential genetic risk, failing to communicate what the results of testing mean, and failing to recommend appropriate care, which may lead to psychosocial distress and late-detected cancers. This case highlights the complexities of genetic care and why management by a genetics professional results in more fiscally responsible care, appropriate genetic testing, and comprehensive care for all family members at risk.
Nadeem R. Abu-Rustum, Catheryn M. Yashar, Sarah Bean, Kristin Bradley, Susana M. Campos, Hye Sook Chon, Christina Chu, David Cohn, Marta Ann Crispens, Shari Damast, Oliver Dorigo, Patricia J. Eifel, Christine M. Fisher, Peter Frederick, David K. Gaffney, Ernest Han, Warner K. Huh, John R. Lurain III, Andrea Mariani, David Mutch, Christa Nagel, Larissa Nekhlyudov, Amanda Nickles Fader, Steven W. Remmenga, R. Kevin Reynolds, Rachel Sisodia, Todd Tillmanns, Stefanie Ueda, Emily Wyse, Nicole R. McMillian and Jillian Scavone
Gestational trophoblastic neoplasia (GTN), a subset of gestational trophoblastic disease (GTD), occurs when tumors develop in the cells that would normally form the placenta during pregnancy. The NCCN Guidelines for Gestational Trophoblastic Neoplasia provides treatment recommendations for various types of GTD including hydatidiform mole, persistent post-molar GTN, low-risk GTN, high-risk GTN, and intermediate trophoblastic tumor.
Margaret Tempero
Puyao C. Li, Zilu Zhang, Angel M. Cronin and Rinaa S. Punglia
Background: Women with a history of ductal carcinoma in situ (DCIS) are at increased risk for developing a second breast cancer (SBC). A prior meta-analysis of randomized studies of radiotherapy (RT) for DCIS has shown a trend toward increased breast cancer–specific mortality after SBC, but it did not have the power needed to detect a significant difference, due to a limited number of recurrences. This study sought to evaluate the impact of RT for DCIS on mortality after SBC in a larger cohort. Patients and Methods: Using the SEER database, 3,407 patients were identified who received breast-conserving therapy with or without RT for primary DCIS in 2000 through 2013 and subsequently developed a stage I–III invasive SBC within the same time period. Fine-Gray competing risk models were used to study the association between receipt of RT and mortality after SBC. Results: Prior RT was found to be associated with higher rates of breast cancer–specific mortality (hazard ratio [HR], 1.70; 95% CI, 1.18–2.45; P=.005), even after controlling for cancer stage. Interaction analysis suggested that this risk trended higher in patients with ipsilateral versus contralateral SBC (HR, 2.07 vs 1.26; P=.16). Furthermore, compared with patients who developed contralateral SBC, those with ipsilateral SBC were younger (P<.001) and more often lacked estrogen receptor expression (P<.001). Conclusions: Patients who previously received RT for DCIS had higher mortality after developing an invasive SBC than those who did not receive RT. This finding may have implications for initial treatment decisions in the management of DCIS.
NCCN Guidelines Insights: Kidney Cancer, Version 2.2020
Featured Updates to the NCCN Guidelines
Robert J. Motzer, Eric Jonasch, M. Dror Michaelson, Lakshminarayanan Nandagopal, John L. Gore, Saby George, Ajjai Alva, Naomi Haas, Michael R. Harrison, Elizabeth R. Plimack, Jeffrey Sosman, Neeraj Agarwal, Sam Bhayani, Toni K. Choueiri, Brian A. Costello, Ithaar H. Derweesh, Thomas H. Gallagher, Steven L. Hancock, Christos Kyriakopoulos, Chad LaGrange, Elaine T. Lam, Clayton Lau, Bryan Lewis, Brandon Manley, Brittany McCreery, Andrew McDonald, Amir Mortazavi, Phillip M. Pierorazio, Lee Ponsky, Bruce G. Redman, Bradley Somer, Geoffrey Wile, Mary A. Dwyer, CGC, Lydia J. Hammond and Griselda Zuccarino-Catania
The NCCN Guidelines for Kidney Cancer provide multidisciplinary recommendations for the clinical management of patients with clear cell and non–clear cell renal cell carcinoma, and are intended to assist with clinical decision-making. These NCCN Guidelines Insights summarize the NCCN Kidney Cancer Panel discussions for the 2020 update to the guidelines regarding initial management and first-line systemic therapy options for patients with advanced clear cell renal cell carcinoma.


text: Loren Merritt <lorenm at u.washington.edu> writes: > On Mon, 25 May 2009, M?ns Rullg?rd wrote: >> Reimar D?ffinger <Reimar.Doeffinger at gmx.de> writes: >> >>> currently there is this code in cavs.c: >>> DECLARE_ALIGNED_8(uint8_t, bs[8]); >>> The reason for it is that kind of code: >>>> *((uint64_t *)bs) = 0x0202020202020202ULL; >>>> if( *((uint64_t *)bs) ) { >>> >>> I thought of "solving" this via a union, but is this code really this >>> speed critical that we need such a mess? >>> Can't we just use memset for the writes and e.g. AV_RN64 for the read? > > Are you complaining about the aliasing, or trying to simplify the code? > >> Such huge literals are fairly inefficient anyway on most CPUs. > > As opposed to what? memset() or repeated stores of a smaller value. > The compiler should emit the same code for memset as for > *(uint64_t*), I thought we'd already established that compilers suck. > and gcc on x86 does. Impressive. What about other targets? -- M?ns Rullg?rd mans at mansr.com


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Sump pump reminder
It's time again to remind everyone that sump pumps must be discharged outside. They cannot be pumped into the sanitary sewer. This practice violates Ordinance #137. Please make sure your sump is being discharged outside.
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Thursday, June 1, 2017
Alice in Wonderland Tote Bag, Mug & Pillow Giveaway
83 comments:
- SolangeJune 1, 2017 at 12:38 AM
For me, it has always been Gone with the Wind by Margaret Mitchell. I have grown up loving the bravery and tenacity of Scarlett O'Hara.ReplyDelete
I love Tristan & Iseult.ReplyDelete
This comment has been removed by the author.ReplyDelete
Pride and Prejudice and The Brother's Grim. Not sure why I like them so much.ReplyDelete
My favourite classic is Heidi, I loved to read it as a child.ReplyDelete
One of my favorites (and hardest to read at the same time) is Watership Down. There's a few others but that one really stood out to meReplyDelete
The Snow Queen by Hans Christian Andersen and The Happy Prince by Oscar WildeReplyDelete
Probably Little WomenReplyDelete
The Man Without Qualities by Robert MusilReplyDelete
Wind in the willows, I love ToadReplyDelete
The Count of Monte Cristo - the perfect revenge story!ReplyDelete
The Little Prince - it is just so beautiful. I also love all of Jane Austen's works.ReplyDelete
It is so very hard to say just one.. but any book by Thomas Hardy would be my favorite... Tess or Jude the ObscureReplyDelete
Pride and Prejudice, timeless masterpiece, loved it!ReplyDeleteReplies
It's my favourite tooDelete
I love Grimm's fairytales as they are so full of magic and wisdom - not always child appropriate as stories can be quite brutal, then again in the beginning they were meant for adults anyway.ReplyDelete
My favorite classic is definitely Dracula because I love anything spooky.ReplyDelete
Little Mermaid, but not the Disney story, the Hans Cristian Andersen version, a true sacrifice for love.ReplyDelete
Pride & Prejudice. It's just so romantic and timeless.ReplyDelete
A lovely giveaway. My favourite classic is Anne of Green Gables.ReplyDelete
Romeo and Juliet!ReplyDelete
Romeo & julietReplyDelete
Romeo & julietReplyDelete
The Little Prince because I love yours storiesReplyDelete
Oliver Twist by Charles Dickens, I read it whilst at school and loved it. I found it a riveting story and I'm sure that I still would should I have the chance to read it again.ReplyDelete
Wuthering Heights. Loved the ruggedness of the book and always wanted my own Heathcliffe. :)ReplyDelete
Romeo & Juliet - I've read that one so many timesReplyDelete
My favorite classic would probably be Gone with the Wind. I completely fell in love with it and read Scarlet soon after.ReplyDelete
My favourite classic is Lady Mcbeth.ReplyDelete
My favorite is Gone With the Wind.ReplyDelete
Alice in Wonderland and solving the mad hatters riddle. Because one is nevaR backwards and one is for words #whyisaravenlikeawritingdeskReplyDelete
I don't know what my favorite classic is, either the Little Prince or the Lion the Witch and the Wardrobe.ReplyDelete
- BookLadyJune 3, 2017 at 1:58 AM
I enjoy historical romance and my favorite classics are Gone With the Wind and Pride & Prejudice.ReplyDelete
My favourite classic is Wuthering Heights. I read it as a child (it was there on a book shelf, so I assumed that I could?), so thought it was a children's book until my brother started studying it for English A-level!ReplyDelete
Definitely Romeo & JulietReplyDelete
The Secret Garden. I love that they've found their own secret and magical place!ReplyDelete
The Secret Garden I just love the story of redemption.ReplyDelete
- Mel DanielsJune 3, 2017 at 11:21 PM
A Christmas Carol, the perfect Christmas story full of ghosts, mystery, joy and redemption :)ReplyDelete
My favourite classic is The Secret Garden, as my mum gave me a copy that belonged to her and it was one of the first "mature" books I readReplyDelete
My favorite classic is The Wizard of Oz by Frank L. Baum :) It's a tale that will always be embraced, no matter what the current year is.ReplyDelete
I love Anne of Green Gables because it is the first "long" book I read as a little girl.ReplyDelete
Mine have to be Alice in Wonderland. I just love that rabbitReplyDelete
The Hitchhikers Guide to the GalaxyReplyDelete
The Hitchhikers Guide to the GalaxyReplyDelete
My favorite classic is The Chronicles of Narnia by C.S. Lewis. I will pick this book up on occasion and re-read it again.ReplyDelete
I love the Great Gatsby for its plot :)ReplyDelete
My favorite classic is Alice in Wonderland. I watched the disney movie when I was really young and feel in love with the colors and the strangeness of the story. I finally read the book when i wad older and I just love the story even more. Then there is Of Mice and Men by John Steinbeck and Great Expectations by Charles Dickens. I can't say why exactly they're my favorite. They both were the first and only classics I read when I was younger and the stories just stuck with me.ReplyDelete
Around the world in 80 days from Jules Verne. Love the unusual adventure of Mr Figg and his servant Passepartout experience.ReplyDelete
também gostava desteReplyDelete
My favourite has to be Pickwick Papers by Charles Dickens. Just loved the humour in this classicReplyDelete
The Secret Garden has always been my favorite. I'm trying to create my own little version of a garden to read my days away in. :)ReplyDelete
A Christmas Carol, by Charles Dickens. i like happy endings.ReplyDelete
I love Wuthering Heights. It was one of the first classics I ever read and I just fell in love with it.ReplyDelete
The Goose Girl, because she's like Cinderella from rags to riches. Her story inspired me a lot.ReplyDelete
My favorite classic is Cinderella because it has always been my favorite since I was a little girl! Love it!ReplyDelete
Little Women....about family and strong women!ReplyDelete
i love quo vadis because it's the first one i've readReplyDelete
A little Princess by Frances Hodgson Burnett. Sara is so inspirational!ReplyDelete
Ha! I'm not sure I have one. Maybe Savages by Shirley Conran.ReplyDelete
Pride and Prejudice - just a perfect classicReplyDelete
Little Women! I was my favourite book as a child!ReplyDelete
My favorite classic is the Secret GardenReplyDelete
Alice in Wonderland, because it's so weirdReplyDelete
The War of the Worlds by H.G. Wells - the ultimate portrayal of humanity at warReplyDelete
Alice in Wonderland. It has great life lessons!ReplyDelete
- Christine O.June 17, 2017 at 4:24 PM
Alice in Wonderland. Best fantasy book for me!ReplyDelete
I love David Copperfield because I first read it at school and have loved it every since.ReplyDelete
Alice in Wonderland!!! =) =)ReplyDelete
I love this, my favourite Classic is Alice In WonderlandReplyDelete
Mary Poppins. I love the way how she treats the kids and that she solves everything with magic.ReplyDelete
Little women. Having read all my books my mother wouldn't buy me anymore as I was reading too quickly. So decided to introduce me to the books she read when she was young. Little women was the first and I really enjoyed it.ReplyDelete
I like Heidi but do like but Alice in Wonderland as wellReplyDelete
I love Vanity Fair as I think Becky Sharp is an amazing character!ReplyDelete
Little Women. It's a favorite of my mom's too.ReplyDelete
Alice in Wonderland is my favorite classic.ReplyDelete
This is almost an unfair question…there are literally thousands of books to choose from. Literature is as diverse as music: so many different genres, so many different styles.ReplyDelete
But, since I don't like it when people use that reasoning to get out of answering the question in a concrete manner, I shall give my current favorite, one that I've enjoyed for a long time, since I was a child. This choice is subject to change, however. My favorites list revises itself continuously.
I'd have to go with To Kill a Mockingbird, if you'll allow that particular suggestion (you didn't specify which era of classic you wanted). It was published in 1960, making it over fifty years old. I love this book because it's so powerful. Harper Lee doesn't waste much time on embellishments or flourishes; she simply tells the story in the harsh light of reality, without prettying it up. The central themes remain applicable to this day and the story of Atticus Finch and his children is timeless.
The first book I can remember loving was Little Women.ReplyDelete
The Princess Bride <3ReplyDelete
- Chiara S.June 21, 2017 at 9:36 PM
The Hobbit! It's an easy and fun read with lots of character.ReplyDelete
Nineteen Eighty-Four, not only my favourite classic but favourite book of all time :)ReplyDelete
My favorite is Cinderella. I read it a lot as a little girl. I just love the fantasy in it.ReplyDelete
- AnonymousJune 22, 2017 at 2:36 PM
Sense and Sensibility I love the the embarrassing moments and the ruthless caricatures of the very rich in wealth but decidedly lacking in wit and humour.ReplyDelete


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If you've started your new year with the resolve to improve your content marketing strategy with video then, congrats, you're already headed in the right direction! But if you have yet to get started or perhaps need a bit more convincing, we've got three of this year's top reasons for why 2016 needs to be the year of video for your business:
1. The Internet Loves Video: Video is the magic solution to optimizing your site, your social posts, and your paid social advertising. Which means now, more than ever, is the time to use video if you want to reach your customers online and on social media. For proof, we'll let the stats speak for themselves:
– Sites with video on their homepage are 53 times more likely to get first page Google search rankings.
– Facebook's video algorithm favors native video over YouTube or other linked video—especially if it's related to a trending topic.
– Users digest video content 60,000 times faster than text. Plus, they hang around on sites with video for a full two minutes longer than those without. Goodbye drop-off!
2. Video Is Eating the World: People love video. There's just no getting around it. By 2017, video will account for 69% of all consumer internet traffic. And given Facebook's new video algorithm for native video, it's no wonder that, to quote Sheryl Sandberg:
"In just one year, the number of video posts per person on Facebook increased 75 percent globally and 94 percent in the U.S. Today, over 50 percent of people in the U.S. who come to Facebook daily watch at least one video per day, and globally, over 65 percent of Facebook video views occur on mobile."
And that will likely keep on growing.
3. It's the Best Bang for Your Buck: Given that consumers are more likely to engage with, digest, share, and/or make a purchase upon watching a video, it's easy to see why 52% marketers around the world see video as the most effective type of content to spend your marketing dollars on.
Not sure where to start capturing the necessary footage you need to make 2016 the year of video? Check out this blog post here for tips on starting to generate that content without having to change your business's routine. Then, download the VidMob app here to connect with talented video editors just waiting to transform that footage into powerful, effective marketing content.
Stats and quotes sourced from the following articles:
| Mist Media | WPEKA | Entrepreneur | OutBrain | My Customer | HubSpot | Virtuets | Adweek |


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Back in March, I chose Seasonal Scape for the theme on my Google Personalized Homepage. All spring, I wondered when Google would update the scenery so that it would show a spring theme instead of a winter scene with a snowman. Since it is almost summer, and I was still seeing a snowman, I went to see what was going on. In the theme settings the Seasonal Scape theme preview showed a spring scene. I switched it to that so now I have a theme that matches the weather (well, not that the winter scene matched the snowlessness of the San Francisco Bay Area).
Since the theme changes as the time of day changes, I thought that it was clever enough to change with the season, without manual intervention. Otherwise, what's the point of calling it a Seasonal theme? It might as well be called Winter Scape so then I would know I needed to get another theme when the season changed.
Update: After a day of using this, I've witnessed several different scenes: a frog and lady bug having donuts and coffee, kung fu fighting, playing badminton , having a lunch picnic, playing cricket, fighting with water balloons and Super Soaker, roasting marshmallows at a campfire.


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In the midst of Autumn this year I made the most of the beautiful colours with this gorgeous family. They have just made their way over to the East Coast of Oz and what a better way to welcome them to the Hills District than a trip to Fagan Park to admire all the gorgeous leaves.
If you have been thinking about booking in a family session, do it!! don't wait! I love winter sessions and would love to chat with you now about crafting the perfect session for your family.


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Christmas is a little bit like an all you can eat buffet. Everything looks so good and before you know it you said yes to far more things than your actual body can handle. Or you time can handle. Or your budget can handle. You get the gist...
The surprising blessing of having five kids in five years is that it constantly forces clarity. When you start knowing you are at capacity it brings sharp focus to what you can take on and actually handle. Which is, of course, almost nothing most of the time.
So we find ourselves with a full house and full hands at the fullest holiday of the year. So how do we do Christmas without going crazy? Well, here are a few yes's and a few no's.
Yes to Advent.
I've talked in length about how this practice saved Christmas for me. I was just a little bit of green fur away from actually being the Grinch. So as a family, we focus on this season as a place of spiritual expectation. Waiting. Hoping.
It sets the tone for a slower more special season. We do a daily practice that involves our head, heart, and hands. We read scripture, sing carols, light candles.
Actually, how about I tell you more about how we practically celebrate Advent as a family later this week?
No to Gifts.
I figured I'd better go ahead and get this one out of the way because it's the shocker. We don't do teacher, coach, extended family gifts. But also? We don't actually do gifts for our kids. (I'll just give you a minute to let that sink in.)
For one, it just doesn't fit our values. But really, the numbers just don't work out either. If each of our children gets only one gift from three sets of grandparents (and "just one" has never happened) we have fifteen new things for our kids to play with. No kid on earth can process 15 things in one month, much less far more than that.
We do fill their stockings with things that are both useful and delightful, but since we just don't have a culture of gifts being the endgame at Christmas, it just really isn't a big deal.
Yes to Gifts.
Wait? What? You just said...
Well, last year my sister-in-law had all the kids draw each others names to make a gift for the one person they drew. Without any prompting or conversation my kids decided to do that again this year. The rules? You must homemake (not buy) a gift for the person you drew, the gift must be about them and not yourself.
Listening to them talk and scheme and pull me aside to bounce ideas is one of my favorite things about the month. There is something beautiful about watching them put so much though and work into giving something to someone else.
No to Big Events.
It seems like there is some sort of parade, party, light show situation every day of the week in December. I'm not going to lie, they are so tempting for me. In our experience though, they end up being super stressful, a major letdown, or even if they live up to their billing, completely distracting from what we are trying to focus on in this season.
Saying no to things that aren't personal helps us have more time to say yes to things that are. We can help make costumes for the church Christmas show, we can go ahead and have our friends over for a gift exchange, movie night complete with pajamas, popcorn, and Elf? Absolutely.
Yes to Christmas everyday.
We do something Christmas-y everyday in December. Nothing big or over-the-top, most of it is stuff we do to practice advent. Maybe a mug of warm cinnamon milk and a christmas book, baking, tying a couple of sticks together to make a cross to hang on the tree. Once Russ is home in the evening we will pour our cider in to go cups and drive around and look at Christmas lights.
Super simple. Super special. It helps stretch the holiday out a little both so we don't get overwhelmed and go into meltdown mode and so we can savor it for a little longer.
No to traveling.
So we do travel during December, but only during the first half, and never when Russ is off of work. (Read: The weekends.) Those days when we can all be together and at home are off limits. We are happy to go visit relatives and friends other times of the year, in fact, I, personally, love to be on the go. But we decided when we had five kids that trying to hit all the hot spots in one week's time left us exhausted and frustrated.
So tell me, do you have a plan to stay sane during the holidays? How to you keep the crazy out of Christmas?


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@ Riverside Stadium, Carinya St, QBN!
We invite the whole club, past and present to attend and join us in our celebrations.
11am - Women's PL 1st v Canberra FC
1pm - U10's small sided match exhibition
3:10pm - Men's PL 1st v Canberra Olympic
There will be presentations of our NPL squads in between the matches, VIP's, food and drinks served and many more!


text:
Government policy is a major factor that can either hinder or accelerate cryptocurrency adoption. Because of Australia's crypto-friendly stance, holders of digital currencies can now enjoy crypto-related services not available in other countries.
Many within the crypto community have been longing for the day that cryptocurrencies can be used to pay for virtually anything. That dream may be moving closer to reality, at least for Australians, who will soon be able to pay their bills using cryptocurrencies.
Cointree Partners With Gobbill
Australian crypto holders will soon be able to benefit from the convenience of paying their bills directly with cryptocurrencies, thanks to a partnership between Cointree and Gobbill. In a Twitter post, the Melbourne-based digital currency exchange announced its partnership with the Australian financial service firm, Gobbill, enabling customers of both companies to enjoy the service.
On Aug 20, Cointree tweeted:
"Excited to finally announce our partnership with @gobbill , this partnership will enable automated bill payments with cryptocurrency!"
Pay Bills Using Any Cryptocurrency Accepted by Cointree
According to a post on Cointree's website, the partnership will allow users to pay bills using digital currency from their Cointree wallet. The crypto exchange projects that by the time this bill payment feature goes live, users will be able to use more than 50 types of tokens to pay their bills, as Cointree is planning to include more coins into its platform.
Users don't have to worry whether the Australian utility or service provider accepts crypto payments or not. Payment specialist Gobbill will act as the go-between and will receive the crypto funds from the payee and make the payment on their behalf.
The service targets households and small businesses, giving them a safer and more convenient way to pay their bills using any cryptocurrency.
Shendon Ewans, CEO and co-founder of Gobbill, believes that the service is bound to be a hit, saying:
"Digital currencies are becoming mainstream, and our view at Gobbill is to support customer choice and convenience. We anticipate a surge in the number of customers who would like to pay their bills in crypto in the coming years."
Australia has long been known as a crypto-friendly country with well-defined guidelines for crypto and blockchain-related businesses. Brisbane airport merchants are a great example of this, with various cryptocurrencies accepted within the airport. This friendly stance gives businesses the confidence to offer crypto-related services to Australians.


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….but no pictures of the bedroom yet. I still need to hang the curtains and do a few other odds and ends then I will unveil it. LOL!
But here are a few recent pictures:
This is my Uncle Tom, who (whom?) I just met yesterday for the first time. He is a believer! It was so precious to meet him!
Yesterday was Julianne's last day at co-op. This is the view from the church's parking lot where the co-op is held. Isn't it beautiful??


text:
Portal 2 - the Computer Game
Created | Updated Jan 23, 2014
Portal 2 is a computer game. It is the sequel to the game Portal, but you don't need to have played the first game to appreciate the second one. Portal and Portal 2 do not involve running around shooting aliens, nor do they feature magical encounters. Instead there are a series of logical puzzles in which you must escape from a chamber by crossing pits, operating switches, disabling dangerous laser beams and so on. Probably the game it is closest to is the classic Lemmings from the 1990s. The original Portal game was quite short, but Portal 2 is a full computer game that will keep you busy for days or weeks. Portal 2 was released in 2011 and is available on Xbox 360, Playstation 3, Windows and Macintosh. It is produced by Valve Corporation1.
Portal 2 is fun. It is a non-violent game which does not require a huge amount of physical dexterity to play. There are a few of the puzzles that require some careful timing, but most can be thought about, planned and then carefully set up, so if you are not the fastest on the keyboard, you can still get a lot from this game.
Portal 2 is funny. Not only is the commentary provided by the on-screen characters amusing, but there are many hilarious touches, such as the cute 'turret' robots, the muttering blocks made from discarded robots and the space-obsessed robot at the end of the game.
The Main Characters
Chell - you are playing the part of the character Chell, who is trapped in the industrial complex of Aperture Laboratories and is trying to escape. Although you don't normally see yourself, you occasionally catch glimpses of yourself in the distance. You are a young woman with medium-coloured skin and dark hair tied back in a ponytail. You are wearing a white T-shirt and orange trousers. You do not speak at any point during the game.
GLaDOS - a computer with a female voice, GLaDOS initially controls the whole of Aperture Laboratories. In a former story (the game Portal), you defeated and disabled GLaDOS (she describes it as 'murdered') so she is out to get her revenge on you. This involves trapping you in a series of puzzles ('tests'). You must use your ingenuity to escape from the test chamber, but there is always another, more difficult test to be completed. GLaDOS reckons she has enough tests lined up to keep you going for the rest of your life, and as you progress she taunts you, promising you freedom at the end of the next test, then admitting that she lied. In the game, GLaDOS is voiced by American voice actor and soprano, Ellen McLain.
Wheatley - a small, stupid robot about the size and shape of a football, with an eye-like camera lens on one side. Wheatley is initially disturbed at your treatment and tries to help you escape. He is totally unsure of himself, and constantly changes his mind, stumbles in his speech or repeats himself. Wheatley is voiced by British comedian Stephen Merchant.
Cave Johnson - voiced by American actor JK Simmons, the character of Cave Johnson is never actually encountered in the game, but recordings of his voice are played at various times. He was the CEO of Aperture Laboratories. His gung-ho attitude in the 1950s recordings gradually turns more bitter as his company gets into difficulties and he himself starts to suffer from the ill-effects of the careless testing of dangerous substances in his lab. You don't have to pay attention to Cave Johnson at all - you can finish the game without listening to a word he says - but it provides a convincing and amusing background story, explaining the existence and original purpose of the whole Aperture Laboratories complex.
What You'll Meet Along the Way
Test Chambers. These are giant rooms. Each test chamber has a door by which you came in, which shuts and cannot then be opened, and a separate exit. The exits are always clearly marked. It is rarely easy to get to the exit - there are often apparently insurmountable obstacles in the way. Even when you get there, the door may be locked, and the only way to unlock it is by operating a switch in some other part of the room. The presence of the entrance and exit doors divides the game up into different 'levels', but in some parts of the game the chambers have no clear boundaries as the whole complex is falling apart and walls may be missing.
A portal is a gateway or 'wormhole' that joins two places together. Stepping into one end of the portal, you immediately come out of the other end. The two ends of the portal appear as a blue and an orange ellipse. These can be fired onto any suitable surface by the portal gun which you acquire early in the game and keep with you throughout. (Surfaces must be smooth, flat and painted white.)
In the early stages of the game, the use of the portal is quite simple. You fire a blue portal end onto a nearby wall, fire an orange portal end onto a distant wall and step through the portal, avoiding all the pits and hazards in between.
You can do much more, though. Objects can fall or be thrown through a portal. Momentum is preserved, so that if you are moving fast as you enter, you emerge moving fast as well. If both portal ends are in vertical walls the effect is obvious, but more unusual effects are produced when one end of the portal is on a horizontal surface. Falling into a portal end on the floor, you can emerge from the other end which you have positioned on a wall, and your vertical speed is converted to horizontal speed, which can be useful for jumping across a pit. Positioning a portal in the floor and with the other end directly above it in the ceiling, you can fall downwards indefinitely, accelerating to great speeds. Laser beams, light bridges and transport tubes can also travel through portals.
Pits, which may be full of water or bottomless, make it difficult to reach some parts of the chamber. In the early stages of the game there are very few ways to kill your character - falling into water is one of the few. (As the game progresses you will encounter more and more). If your character does die, you just start the level again.
Switches control some features such as the exit door, and certain ramps and lifts. Switches are large and obvious. They are clearly marked, with a dotted line linking them to the item they control, so it's usually obvious what they do. You can operate a switch by standing on it, but normally its effect is undone as soon as you step off the switch, so you need to find something you can leave permanently sitting on the switch. There are blocks known as weighted storage cubes in some places which can be picked up and placed on a switch.
Powerful lasers shine out of the walls in some places. Don't stand in the way of a laser as it will burn you and you will die. You can divert the path of a laser by sending it through a portal, and there are special lens blocks which can also divert them. Lasers have a few uses, one being that there are special laser-operated switches.
Turrets are cute little robots. They talk to you in pathetically cute voices, but if you get into their line of sight, they attack with machine guns and you die. Turrets are stupid, though; you can creep up behind them and knock them over, rendering them powerless.
Light bridges are long sheets of light you can walk across.
Launchers are spring-loaded devices which hurl you through the air.
Blue Gel can be spattered over surfaces to make them bouncy.
Red Gel appears in the later levels - applying red gel to a surface makes you accelerate as you move across it.
White Gel is the rarest type of gel. Although there are many smooth, flat surfaces in the game which might be useful for placing a portal, you can't use them as they are not painted white. White gel turns out to be the white paint that allows a surface to accept a portal.
Transport Tubes are tubes of light that support you in the air and move you along. They're very useful for crossing large pits, but you can't control the speed or direction you move.
The Story
The action of the game has a natural story behind it which is revealed by what you see around you, by comments from GLaDOS and Wheatley, and by recordings of the voice of Cave Johnson, a character from the past who created Aperture Laboratories. We won't give too much away here, as part of the fun is finding out what is going on. There are three main sections to the game:
Escaping from GLaDOS
In the first section, you are forced to solve a series of increasingly difficult tests, but Wheatley appears and opens a separate route into the hidden corridors of the complex. You and he devise a plan to defeat GLaDOS, replacing her evil personality in the central computer with Wheatley's benign one.
Finding your way back to the Control Room
Wheatley is driven mad by power. He throws you and GLaDOS (now housed in a tiny computer powered by a potato battery) into a rubbish chute. You must use your ingenuity and the portal gun to work your way through the mainly deserted and dilapidated industrial complex, which is much bigger than you originally thought. GLaDOS devises a plan to defeat Wheatley by exposing him to a logical paradox, but he is too stupid to be affected by it.
Escaping from Wheatley
Now in control of the system, Wheatley gets pleasure from watching you solving more 'tests'. The first of these is trivial but they rapidly become very difficult puzzles. Then he decides he has had enough and tries to kill you. At this point, you must avoid potential death traps and make your way to a final showdown with Wheatley in the control room.
Two-Player Game
Portal 2 also includes a two-player version, where you and a friend control two robots: a tall, thin one and a short, round one known as P-body and Atlas and reminiscent of Laurel and Hardy or Sullivan and Mike Wazowski. Each robot is equipped with a portal gun. There are plenty of opportunities to see the two robots being crushed or destroyed by lasers as you fail to line everything up just right for the solution of the problem.
The two players can be both on the same computer/console device, or can be in different locations connected via the Internet2. The screen is split in two with the left side showing the view of one player and the right the view of the other player. Most puzzles require the co-operation of the two players - for example, one player may have to fire the other across a barrier, then the second player open a portal for the first player to step through. Some doors can only be opened by two switches being pressed simultaneously. And the switches may be on the ceiling! You get the idea.
If the two players are sitting side by side, there's no great difficulty in co-ordinating these moves, but if the other player is remote, there are a number of controls which allow your robot to make gestures to the other player, to mark a spot on the screen where you want the other player's robot to stand or to countdown - 3, 2, 1, Go. This last one is important in puzzles where two switches have to be operated simultaneously.
With two portal guns, it is possible to open up two portals simultaneously. One gun fires yellow and red portal ends while the other fires light and dark blue ones. The technique of positioning a portal end directly over the other end of the same portal and accelerating through an endless fall, while requiring great dexterity in the single-player game, is pretty easy to manage in the two-player version. One player can fall endlessly while the other player can fire the portal end to release them from the loop and hurtle them across the chamber.
The two-player game appears to be much simpler than the single-player game. There is a very simple back story, and there are only about 30 levels. You still get to hear GLaDOS's voice insulting both robots at every available opportunity.
Because the two-player game is very much just puzzle-solving, it is important that you play it with someone who has not played it before - otherwise, they will end up solving all the puzzles and you'll just tag along, and won't get very much from the experience.
All in all, Portal 2 is one of the most enjoyable games of recent times. It suits a player who doesn't want to shoot anybody, likes using their brain and enjoys a good laugh.


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Sojo's Gossip Sandwich
Written by SoJo on May 25, 2009
Ben Stiller has revealed he has been working on a script for a Zoolander sequel. It would be set 10 years in the future from the first and Zoolander is dealing with no longer being apart of the model world. Instead, he will engross himself in running a modelling school and raising his now 10 year old son.
After 4 seasons, NBC has cancelled My Name Is Earl (Instant bad Karma I reckon). The show has owned 5 Emmys during its run, including Outstanding Supporting Actress for Jaime Pressley along with Outstanding Writing and Directing for a Comedy Series. BUUUT The studio, 20th TV, is talking to Fox and ABC about potentially picking up the series. Fingers crossed!
2002's Survivor: Africa winner, Ethan Zohn, has been diagnosed with stage-two Hodgkin's disease and has started chemotherapy treatments this week for the rare form of cancer.
The legendary filmmaker, Steven Spielberg, is working on an officially-sanctioned biopic of Martin Luther King Jr. Although one of King's sons, Dexter King, has given DreamWorks and co-producer Spielberg his blessing, saying the film could "be the definitive film" about his dad, Bernice King and Martin Luther King III don't agree with their brother.
Wino was admitted to hospital in St Lucia for the 3rd time in 3 months! She recently did a performance where she threw stuff at the crowd, spat her chewing gum at a fan and stopped mid-song to say "I'm just kinda bored".
Jennifer Love Hewitt is working on a country album. Queue shudder.
Rumour train- Orlando Bloom & spunky model GF Amanda Kerr could be engaged. Unconfirmed at this stage.
Lady gaga learnt piano by ear at 4!!
Ghostbusters 3! It's happening! Dan Aykroyd confirms that he Bill Murray, Ernie Hudson, Harold Ramis, and even Sigourney Weaver are on board for the third movie. As for the film's plot, it'll deal with the aging, original Ghostbusters getting ready to retire and pass on the responsibilities of protecting NYC over to a new crew, with maybe a female or two this time helping to capture the ghosts.
Spray tan 'ho bags Peter Andre & Jordan have reported split. Real or publicity stunt?
Pregnancy rumours for Jessica & Ashley Simpson.
MOFO of the WEEK:
Keeping it local: Westpac. Charge every one else through the roof why don'tchya then "accidentally" deposit $10 Mill into someone's account. Niiiice. Good luck finding them!


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Katherine S. Panageas, DrPH; Deborah Schrag, MD, MPH; Elyn Riedel, MA; Peter B. Bach, MD, MAPP; Colin B. Begg, PhD
Acknowledgments: The authors thank 2 anonymous reviewers for help with the article. They also thank the groups responsible for the creation and dissemination of the linked database, including the Applied Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute; the Office of Strategic Planning and the Office of Informational Services, Centers for Medicare & Medicaid Services; Information Management Services; and the Surveillance, Epidemiology, and End Results tumor registries.
Grant Support: In part by grants from the National Cancer Institute (CA83950 [Dr. Schrag], CA90226 [Dr. Bach], and CA08748 [Dr. Begg]).
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Colin B. Begg, PhD, Memorial Sloan-Kettering Cancer Center, 307 East 63rd Street (3rd Floor), New York, NY 10021; e-mail, email@example.com.
Current Author Addresses: Drs. Panageas, Schrag, Bach, and Begg and Ms. Riedel: Memorial Sloan-Kettering Cancer Center, 307 East 63rd Street (3rd Floor), New York, NY 10021.
Author Contributions: Conception and design: K.S. Panageas, D. Schrag, E. Riedel, C.B. Begg.
Analysis and interpretation of the data: K.S. Panageas, D. Schrag, E. Riedel, C.B. Begg.
Drafting of the article: K.S. Panageas, D. Schrag, C.B. Begg.
Critical revision of the article for important intellectual content: K.S. Panageas, D. Schrag, P.B. Bach, C.B. Begg.
Final approval of the article: K.S. Panageas, P.B. Bach, C.B. Begg.
Provision of study materials or patients: D. Schrag, C.B. Begg.
Statistical expertise: K.S. Panageas, E. Riedel, C.B. Begg.
Obtaining of funding: C.B. Begg.
Administrative, technical, or logistic support: C.B. Begg.
Collection and assembly of data: D. Schrag, C.B. Begg.
A large body of literature documents associations between the volume of cases a hospital or surgeon treats and clinical outcomes. Most of these studies have used conventional statistical methods that do not recognize the fact that hospitals or surgeons with similar volumes may have very different outcomes because of systematic differences in processes of care, a phenomenon that exaggerates the true statistical significance of the effect of volume on outcome.
To describe methods to assess the degree of this clustering of outcomes and to explore the impact of available statistical techniques that correct for clustering.
Reanalysis of 3 previously published volumeoutcome studies.
Medicare beneficiaries 65 years of age or older undergoing surgery for colon, prostate, or rectal cancer in the population defined by the Surveillance, Epidemiology, and End Results cancer registries during 1992 to 1996.
3 data sets were analyzed to assess the impact of surgeon volume on outcomes: 1) 24166 colectomies performed by 2682 surgeons, 2) 10737 prostatectomies performed by 999 surgeons, and 3) 2603 rectal resections performed by 1141 surgeons.
Volumeoutcome trends were analyzed by a conventional method (logistic regression) and corrected for clustering. Two widely used statistical methods for analyzing clustered data, a random-effects model and generalized estimating equations, were used and compared, and the degree of clustering was presented graphically.
Substantial clustering was observed in the analyses involving morbidity end points. The 2 statistical techniques produced noticeably different results in some analyses.
The presence of clustering represents variations in outcomes among providers with similar volumes. Thus, in volumeoutcome studies, the degree of clustering of outcomes should be characterized because it may provide insight into variations in quality of care.
Panageas KS, Schrag D, Riedel E, et al. The Effect of Clustering of Outcomes on the Association of Procedure Volume and Surgical Outcomes. Ann Intern Med. 2003;139:658–665. doi: https://doi.org/10.7326/0003-4819-139-8-200310210-00009
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© 2019
Published: Ann Intern Med. 2003;139(8):658-665.
Colorectal Cancer, Gastroenterology/Hepatology, Gastrointestinal Cancer, Healthcare Delivery and Policy, Hematology/Oncology.
Copyright © 2019 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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Tag Archives: tortoise
Falconry Of Kenya, Malindi – What A Thrill!
Posted on February 27, 2019 by Habiba Bien
Hey Peaches, welcome back to my blog. Today, we are going to the Falconry of Kenya in Malindi. The Falconry of Kenya is a private sanctuary in Malindi for birds and reptiles. Serves as a tourist center to promote awareness and … Continue reading →
Posted in adventure, lifestyle, Travel, Uncategorized | Tagged adventure, Aldabratortoise, birdsanctuary, breeding, bushbaby, crocodile, eagle, falcon, feeding, flying, friends, fun, hawk, hawkfeeding, holiday, Kenya, lifestyle, love, Malindi, nature, owlconservation, owls, snake, snakeconservation, Thefalconryokenya, tortoise, Travel, vacation, wildlife | 4 Comments


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Dc Bonavoglia signed up on Team Relief 2016-11-16 14:09:28 -0800
Team Relief
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If you would like to be a part of Team Relief, fill out the form at the bottom of this page.
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A few things to keep in mind:
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"Chop Shop", the one and only original Rock 'n' Roll Hair Shop, unmistakably brings back clients upon walking into the nostalgia of the popular 50's theme. The salon is known for it's innovative and progressive hair styling, and reached mainstream success being featured on Slice Network in rotation since 2008 "the Chop Shop Show".
Located throughout British Columbia with it's corporate store in New Westminster, this reputable business is known for quality hair service with a fun and retro edge. We invite one and all to come to the Chop Shop for a Tune Up, Paint Job, Pin Stripping or the Classic Cut & Chop - let our acclaimed stylists wow you!
Call us at 778 -39 STYLE (397-8953)
Interested in becoming part of our great team,
Contact Us today to find out how you can have the opportunity.
The Chop Shop came to life in the spring of 2005 to service high quality cuts and colors in a creative vibrant environment. The shop was developed to identify with the timeless style and spirit of Rock 'n' Roll.
The first Chop Shop opened on Granville Street in the heart of Downtown Vancouver's Entertainment District, the Shop grew quickly in popularity and the demand rose for more locations, thus franchises grew.
In a short time the visionary approach to a successful business model grew to over 5 lower mainland locations.
"We're thrilled to receive such a positive reaction to the salon and are excited to share the fun and restore the much loved nostalgic Rock 'n' Roll with the rest of the world!" says Co-founder, Daniel Hudon.
The Chop Shop TV show has resulted in critical acclaim among its viewers and loyal fans. The show has garnered the shop a permanent position in the ever-popular world of reality TV. Through this intimate yet public view of our salon business, Chop Shop, the brand has been given a huge advantage with it's instant media recognition. The opportunity associated with our franchise is having a salon that is established in reality TV as a household name of hair salons. What a marketing tool!
The Chop Shop was brought forth to identify and benefit from the timeless style and spirit of Rock 'n' Roll and Hot Rod cultures.
All stores are equipped with an actual Hot Rod front desk and all stylists work from their mechanic toolbox stations. In our 1950's garage environment you can kick back relax and imagine being back in that timeless era. The color scheme is simple with primary reds, yellows, orange and black and the classic garage brick walls are adorned with nostalgic graphics, that appeal to both young and old. Like garages our shops are scalable and can be as small as a 3 bay stations or 13 depending on the area and plans of the individual owners.
The Chop shop term that refers to a haircut.
The Chop Shop term that refers to a partial and all over colour. Partial refers to either grey coverage or colour blending into the existing colour. All over colour refers to a root to end colour.
The Chop Shop term for half head Highlights and full head highlights. A Highlight is when individually targeted stands of hair are sectioned out and coloured or toned to the client's specific wants or the stylist's recommendations.
A specialized technique influenced by the art of tattooing in which the stylist carves designs into the shaved hair of the client ie, flames, swirls,checkers, etc.
The Chop shop term for any styling services i.e., Up do's, shampoo and blow dry's, roller sets and straightening.
The Chop shop term for any frill trim and neck cleanup services between trims.
The Chop Shop accepts and recognizes that without you there would be no Us! And to show our appreciation here's what we are wanting to offerFree Tune Up
A free haircut with any chemical service on your first visit. Please check with the stores for their latest offerings. *
"Bring your children with you and save". When the mom or dad gets the hair cut, one of your kids cut is free. *
Various pre purchase amounts can be made available.*
Refer 5 Friends to the same location and redeem a complimentary haircut. *
Let us at Chopshop keep you looking your best even in between cuts !*
Inquire about specials on services for your birthday. *
150 - 1169 Pacific Street
Coquitlam, BC
Phone: +1604 475 6909
Email: firstname.lastname@example.com
519 Abbott Street
Vancouver, BC
Phone: +1604 249 2467
Email: email@example.com
506 Herridge Lane
Nelson, BC, V1L 6G2
Phone: +1 250-352-0060
Email: firstname.lastname@example.com
Be The Next...
Email : email@example.com
Benefits of Ownership
Become part of an industry as old as time, recession proof in all geographic locations. Chop Shop's look and feel is both timeless and appealing to a unisex clientele of all ages, the design has lifted all ethnic and demographic barriers as the 50's happened and was respected as a boom and growth era.
Chop Shop's unmistakable brand has an advantage and appeal, the retro style has an endless amount of creative marketing possibilities. We have an in house marketing team, accompanied with strategic partnerships with renowned international Design & marketing consultants (FSHDesign). We will help create an effective and suitable campaign for each franchisee and their respective district.
Chop Shop has developed an extensive proprietary training and support program manual for the use of each franchisee. The manual explains all the technical aspects of operating a successful shop.
Chop Shop provides all franchisees with a full week of comprehensive hands on training at our New Westminster corporate store, followed by an additional one- week on-site, troubleshooting program. We also provide a 3day technical education course for all shop employees, by our mobile team of professional stylists.


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Now for the fabulous deals!
1. BaxCatandCo - store-wide coupon BaxCat30 for 30% off!
5. K5Art - store-wide coupon Pet20 for 20% off
6. TheWickedShop - store-wide coupon WICKEDSALE for 15% off
Happy Shopping!
Julie and Cylene
| Catnip toy American flag cat...
| Scrabble Tile Pendant - Cool...
| Flip Flop Diva - Bright, Mul...
| Leash Bag and Placemat Set -...
| Animal Print, Dog, 5x7, Cust...
| Dog Placemat - Custom MTO - ...
| Catnip toy cat heart toy - r...
| Scrabble Tile Pendant Neckla...
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| Ship Ahoy Pooch - Red, White...
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Love the doggy dress.
I have two dogs and a cat. One of my dogs is a model for my doggie clothes, the other hasn't learned to sit still yet...lol
My lovely baby is a 85lbs Rottweiler - who loves to snuggle!!
We have 4, 2 dogs and 2 cats. All are rescues except for our German Shorthaired Pointer. One of the kitties is a polydactyl with 7 toes on her front paws and 5 toes on her back paws...her front paws look like baseball mitts!ReplyDelete
Don't own a pet, but I paint pet portraits! :) Love the ship ahoy dress.ReplyDelete
We have a rescue pup that is awesome!! I wish he got along with other dogs b/c I would love to rescue more!ReplyDelete
Thanks for the feature! Lovely Gift Guide!
oh my, we have too many! I have a 185 lb St. Bernard who thinks she is the size of her head :), then a yellow lab/st. bernard and she is only 100lbs.. We then have 3 cats, 2 lizards, and several fish! Crazy houshold!


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$30.00 – $100.00
This is considered our strongest and most effective cream yet. The organic menthol crystals combined with medicated emu oil delivers the medication deep and straight where you need it for almost instant pain relief with only a small dime size amount. Due to the icy effect this cream produces it is not suggested for use on sensitive skin, rashes, and open wounds. This cream is also very effective for migraines.
|1 lbs
|1 x 1 x 1 in
I was given this cream as a gift and waited about a month to use it. Well never again, I suffer from arthritis in my elbows, wrist and neck due to a accident. I've done injection, nerve ablations and lots of different pain killers. Everything had one nasty side affect after another. I didn't notice much difference at first. then after the 3-4 days I noticed I could move and use my arms with a little less pain. I just started my second week using the cream so hoping for even better results as we go.
thank you
This stuff is wonderful…I have used it for low back pain, sore neck and shoulders, migraine by rubbing up the back of my neck and into my scalp, knee pain, sore hands, etc. Much more effective than other menthol but non MJ based creams, and way less burn for those of us with sensitive skin – less noticeable smell, too. I'm hooked, and strongly recommend!
I have fibromyalgia and it makes my legs quite painful especially at night and I can't sleep. This creme makes the pain almost disappear and relaxes me to easily fall asleep. The men in my family use it on their shoulders and backs after a long day of physical work. We love this product!!
I broke my shoulder four years ago, and every once in a while it still hurts really badly. It injures easily, it responds poorly to damp weather, all of it. My coworker suggested I try Permafrost. It's AMAZING. Absolutely removes all pain, makes my shoulder nice and supple and it feels great! Thank you so much for freeing me from a really dreary routine of vicodin and ibuprofen.
Bought it and brought it home, no expecting much – my legs and feet feel like they used to before I was disabled! Gave it to my neighbor with menstrual cramps – gone – two more friends and they're amazed as well. It's not just me – this stuff really works and it works VERY WELL!
I originally bought some KC to have on hand for burns, and I actually treated a fire spinning friend's arm burn very impressively. But in early 2012, I came down with shingles, five days before diagnosed, so the pain and the rash were pretty strong. Shingles hives, even when healed, leave pock marks and scars. Knowing this, and having been impressed with how KC helped with burns, I treated the affected area about 4-6 times. When I returned to my doctor about ten days after the first KC treatment, I was able to show him that there were only very light pink spots where the rash was, and the area looked healthy and healing. By the next visit, there was absolutely No sign that anything had ever happened. NOTHING. Absolute normal. I truly believe that there is nothing KC can't make better! Every home should have a jar of this stuff for burns, scrapes, rashes, everything!
I have had 3 spine surgeries over last couple of years and I use the Permafrost for the last couple of years for pain at night. It helps me get to sleep giving me 2-3 hours of pain relief which helps me fall asleep. I use to write for a cannabis magazine and have personally used and written a review of the 5 most popular Topicals available at the time to patients. Permafrost is my go to and IMHO is the best is the class.
This stuff is amazing I love it! No other medicated creams compare it is the one and only.
These reviews are no lie. This is some powerful, almost instant, pain reliever. I use it for my sciatic pain. I get super annoying pain in either my left or right lower back/upper buttocks area that is really hard to relieve. I can rub a small amount of the Organic Permafrost and, this is no joke, the pain is gone within 90 seconds. Best topical pain reliever ever!
Thank you so much!! i have de quervain's tenosynovitis in my left hand and the pain at times could send me through the roof if i used it wrong. Products like Aleve, Bengay, Icy hot, advil, etc. didn't do anything for me and all the doctors have told me to do is use a brace and get injections for the pain. It took me a while to really open up to using anything cannabis based, but i am so glad that i did. This has given me back the use of my hand and relaxes me enough me to sleep at night. That in itself is huge. I recommend this for everyone who needs pain relief. I will be a repeat customer. Can't wait to try your other products.
I mentioned minor neck pain at the store and the sales person grabbed this cream and had me try it. It was INSTANT relief!
So much relief that I felt other pains on my body that I ignored for the past 20 years.
I came home and told my wife about it (she suffers from chronic neck pain), and she exclaims, "you must go back and bring me this magical lotion!!!"
It is the only thing that helps with her pain.
Thank you for such a wonderful product!!!
wife had broken back using 60 meg of morphine aday after operation put it on ONE NIGHT next morning ask her if she need a pill yet, she said it feel less pain. Has not taken morphine for 6 weeks.
Using for my 6+ years neck and shoulder pain.Gives me relief for about 4-5 hrs and makes falling asleep easier.
I have stenosis of my lower back an just had both hips replaced. A friend brought this cream to me to get me off of the pain killers .well it has great effects of talking through pain away an easing your body into relaxing an resting. I will recommend this product to anyone with chronic pain.
I've had a host of surgeries. More specifically, two on one of my knees. The permafrost absolutely helps when my knee is inflamed. Pain is reduced entirely. Wonderful product. Thank you for what you do.
I have arthritis in most of my joints and degenerative disc disease in my spine. Kush Cream relives my pain so that I can get a decent nights sleep. I have been using this for almost a year. I don't plan on stopping.
Works for my low back
Helps my low back pain after exercise as well
as lavender aroma very soothing
Great for low back pain after exercise
If you have a headache, you just dip the tip of your index finger, spread it onto your other index finger and rub your temples. Your headache will disappear. I have chronic migraines and this works miracles for them. I also have scoliosis and being heavy chested makes it a lot worse, so I also use it for my back. It helps tremendously. I couldn't bend down without either wanting to cry or almost falling over from the pain. With this stuff, I can function normally. My back doesn't ache or anything and it lasts for hours. You do not have to smoke or ingest the stuff and it works fast. It does not smell like marijuana. It does not get you high. It simply helps alleviate pain.
I've used this for years and I absolutely love it and highly recommend it! I use it on my back that I broke at T 4&5 years ago. I also use it after I run on sore knees and feet! Works like a charm. I've had friends use it for arthritis and after one day tell me how much better they feel! This product is totally worth it!
This cream was a life saver! I use it for my neck pain, shoulder pain, Mortons Neuroma, and eczema! Effective on everything!
The thing is, I haven't had success with other treatments on my foot (the Mortons Neuroma and eczema) and within a couple days, I've seen a huge improvement with both conditions! It's insane.
Thank you, thank you, thank you. I can't wait to try more products.
My sister in law gave me some of this cream that she had left over and it is hands down the BEST cream on the market. I work on a lobster boat and suffer from neck and back pain so bad that at times I can't walk after a long days haul. Sense I got this cream my wife rubs it on my neck and lower back first thing in the morning and I have no issues throughout the day I'm able to make a whole day on the ocean and still be the man I want to be. Thank you for the relief of the pain.
Not as effective as directly applying CBD Glycerin tinctures BUT, DO NOT turn your nose up at this stuff. It works extremely well compared to many of the topicals and salves I've tried and it's not unreasonably priced.
Appreciate you guys making a product that is high quality and works well! I'll agree it's probably the BEST cream on the market.
I received this as a race giveaway for one of the Thanksgiving Quadzuki races (I want to say Widdle Waddle) and my husband uses it for his back pain and absolutely loves it. It really does just take a dime's worth so I didn't need to order more until today. I recommend it all the time. Glad to support such a great product.
I love this cream. Best product on the market for arthritis relief. I won't leave home without it
This is my second order. I cannot express what this product does for me. I used it for relief before my knee replacement and it has been the only product to help after the surgery. I have tried perscription cream and others. Nothing works as well as this!