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You Could Make 700% Profits With These Two "Hidden Gems"
Every once in a while I like to give my readers a glimpse into other services that the team over at Money Morning have in their coffers.
And this service is particularly impressive.
It's called Fast Profits, and its sole purpose is to help you navigate the muddy market waters like a pro.
A handful of my colleagues regularly appear on Fast Profits to bring you specific, actionable trades and easy-to-follow instructions on how to turn this year's 1%, 5%, and 10% share price moves into 50%, 100%, or 200%-plus profits…
Sometimes in as little as five days.
For example, one of my colleagues, D.R. Barton, brought his viewers a 68% gain in just 10 trading days.
Better yet, this service is completely free.
And one of my colleagues is featuring this week with a brand new Fast Profits trade…
Find Even More Profit Opportunities Right Here
You may remember when I introduced Tim Melvin to you as one of my newest colleagues here at Money Morning.
Well, for the first time, he's appearing on Fast Profits to bring you two rare hidden "gems" in the market that can lead you to almost unheard-of returns.
Now, Tim is one of the best investors I've ever met.
When he told me his track record was nearly undefeated, I must admit, I was skeptical.
But taking a look at his trades, I have been convinced, after seeing that he at one point had 119 wins and 0 losses.
The vast majority of his current picks are in the green, and I'm of the firm opinion that he knows what he's talking about.
He uses mathematics and strategy to identify potential targets. And in this week's Fast Profits, he applies his strategy to the options market to give you two trade recommendations that could turn just a few hundred dollars into a huge payoff – eight times your money or better.
But this is far from the only thing Tim has been doing recently.
He recommends a new trade every Monday to his Heatseekers readers.
In fact, last week, he recommended an oil trade that I consider to be one of the best – and I've recommended it myself my Energy Advantage readers.
(I've recommended many other profitable energy trades in Energy Advantage. if you'd like to get access to them, just click here.)
For me, that solidifies his trading ability, and I don't want you to miss out on anything he has to offer you.
If you'd like to see his Fast Profits trade this week, just click here to get access.
I'll see you there.


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A glossary of credit terms
A good place to start learning more about your credit score is understanding some of the lingo!
Baffled by all the different credit terms? Here's a quick guide to what they mean:
Credit - In the context of personal finances, credit is when you have access to funds provided by another person or company, on the trust that you will repay those funds in the future. Personal loans, mortgages, credit cards are all types of credit.
But credit isn't only about borrowing money. Companies that offer you services, or goods, that you pay after receiving them are also giving you credit. These can include organisations such as phone or power companies, or even a tradesperson who invoices you after completing work for you.
Credit bureau - A credit bureau, also sometimes referred to as a credit reporter, is a company responsible for gathering all the details of your credit transactions into your credit file. This information is then used to determine your credit score. There are three credit bureaux in New Zealand: Centrix, Equifax and Illion.
Credit check - A credit check is when an individual or organisation contacts a credit bureau to find out your credit score, and to view your credit file. There are two types of credit check: a soft check which is not recorded on your credit file and a hard check which is recorded on your credit file, and may therefore impact your credit score. Some examples of when a soft check could be made would be for quoting purposes or by employers as part of background checks on potential employees. A hard check is made when you are asking for approval for a type of credit.
Credit file - This is the comprehensive summary of your credit history compiled by a credit bureaux. It is used to determine your credit score. Your file is used by lenders to assess your risk when you apply for credit. You can also request your own credit file. This is free and the request does not impact your credit score.
Credit grade - When your loan application is assessed by Harmoney we take the information in your credit report, along with the information in your application, and assign you a credit grade from A1 to F5 which determines your interest rate and loan amount.
Credit history - Your credit history is similar to your credit file. It encompasses all your credit transactions.
Creditor - A person or company to whom you owe money.
Credit rating - This is often used to mean the same thing as your credit score.
Credit report - A credit report is what a potential lender receives when they request a credit check. It usually contains your credit file as well as your credit score.
Credit reporter - See credit bureau, above. These are the organisations that are responsible for gathering all the details of your credit transactions into your credit file.
Credit score - This is a number assigned to you between 0 and 1000 which reflects all the transactions and information in your credit file.
Creditworthiness - This describes how suitable for credit lenders believe you to be. Your credit file and credit score are indicators of your creditworthiness.
Credit utilisation rate - This describes the total amount of credit you are using in relation to the total amount of credit you have available to you. It is usually referred to as a percentage. For example if you have a total credit limit of $10,000 but currently owe only $5000, your credit utilisation rate is 50%. Having a low credit utilisation rate can have a positive impact on your credit score. Below 30% is generally considered good.
Read more:
Nine things you should know about your credit score right now
You're more than just your credit score
Understand what impacts your credit score
What is comprehensive credit reporting?

subset: commoncrawl


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VACC is ACE
Sketch Group have recently had the great pleasure of working with VACC to create a video showcasing their VACC Committees.
VACC are champions of the automotive industry, and we're happy to champion them in this fun, engaging video that really captures their message and attitude.
Drive on!
Introducing Graphic Gear
I'm excited to announce that recently at Sketch Group we launched Graphic Gear, an online store selling markers, refill bottles, and accessories for illustrators, facilitators, and visual practitioners.
Wait, what? Let me explain ...
My first graphic recording gig, seven years ago, was in front of 3,000 people. I was on stage at a Microsoft conference on the Gold Coast, and nervous but quietly confident in my ability to listen, synthesise, and capture the content in real-time.
Unfortunately, the tools I'd chosen for the job were whatever markers I had lying around, purchased over the years and in various states of use. They bled through the paper, they dried up on me halfway through the gig, the colours were limited, and the fumes got a bit much after two hours of sketching.
Fast forward to the modern day, and I've become somewhat of a devotee of the Neuland brand of markers for every sketching job I tackle. Made in Germany, the reason I'm such a fan is:
After attending the International Forum of Visual Practitioners in Atlanta last year, I've realised that pretty much every professional graphic recorder and facilitator uses Neuland markers, for the same reasons. And every illustrator that I put one of these markers into becomes a fan of the brand and can't get enough of them. Neuland have created a great product.
The problem is that ordering them from Germany is slow and the shipping is expensive. So I decided to fix that. I signed up as the official Neuland reseller for Australia.
If you'd like to get your hands on the very same markers that the Sketch Group team use when we sketch events, now you can! Just visit graphicgear.com.au and make your mark today!
Fostering a Message that Matters
At Sketch Group, we feel extraordinarily lucky on a regular basis that we get to partner with clients doing work that matters. Not to suggest that the dozens of workshops we sketch, or the videos we animate, or the posters we create don't have an impact or aren't worthwhile. But sometimes a project comes along that humbles you, and you feel honoured to be a part of.
Sketching the Foster Carer Journey for the Department of Health & Human Services was one of those projects.
We worked with folks from DHHS and the Foster Carer's Association of Victoria to:
Because of the sensitive nature of the subject matter, we decided collectively that there was value in creating two versions of the poster—one that would be useful for recruiting, retaining, and raising awareness of foster carers, and another version that was more suitable for internal use. This internal version was more focussed on helping members of DHHS and agencies to identify opportunities where the overall system could be improved.
We were faced with the challenge of walking a fine line between wanting to shout from the rooftops about what amazing work foster carers do for our community, with painting a realistic picture that accurately portrays the fact that being a foster carer is hard. Some of the stories that came out on the day were heartbreaking, and the weight of responsibility to capture and visualise those emotions was enormous.
We were extremely proud of the final result, which was a truly collaborative effort from the department, agencies, carers, advocates, and several members of the Sketch Group team—Lucinda, Kerstin, and myself. One thing that I learned from the project is that there is much greater demand than there are available foster carers, so we hope the small part we played in creating this journey map goes some way to helping increase the number of Victorians who decide to volunteer to foster a child.
At Sketch Group, we often have conversations with people who've been asked to make a presentation, event or conference stand out. To do something different; to find new ways of engaging audience and keeping their focus and attention.
This is, generally, on top of all the other jobs they have already going on.
It's a big ask.
We can help.
We don't expect you to have all the answers alone.
We genuinely enjoy the process of discussing ideas for your presentation or event, and working out how we can help, collaborating to create something that suits your purposes and budget. We've been helping simplify the complex for clients big and small for years, with videos, visualisations, custom illustrations, training and live sketching.
Together, we can sketch it out.
You supply the occasion. We'll bring the colour.
Before I started the company that eventually became Sketch Group, I was working as a computer programmer. It paid well, but it wasn't fulfilling and felt a bit ... soulless. It also coincided with a period when I got sick a lot. Related? Perhaps.
A huge reason why we do what we do relates to the fact that drawing is good for you. The benefits of expressing yourself visually are extensive and well documented.
Art therapy uses different forms of visual expression to help improve physical, mental and emotional well-being by reducing anxiety, bringing in positive emotions and banishing negative ones. Drawing has also been shown to improve memory and recall in patients with Alzheimer's. And adult colouring-in books continue to fill airport bookstores due to the role they play in reducing stress, increasing mindfulness and helping the brain reach a meditative state.
And of course, it's fun.
Even if you think "I can't draw," who hasn't laughed over a game of Pictionary when no-one can guess what has been created in thirty seconds? Was it a toilet? A throne? A pineapple?
When we're young, we draw and paint and create all the time. Visual expression comes naturally to us—it's free-form, and it flows naturally, without the worry of judgement or getting things wrong.
In a world where we're being encouraged to be innovative, to fail fast, and to take risks, we need to go back to those times when we were more experimental. Pick up a pen and just draw.
Who knows where it could lead?
Are All Graphs Naff?
Let's be honest.
For a lot of us, graphs are a necessary evil.
They explain information in a way that makes sense, but they doesn't inspire much passion. They don't have personality.
At Sketch Group we put personality on the page. Or screen.
We make videos and illustrations that contextualise your information so that your graphs means something to your audience.
So for shareholder information that shows off what you actually do, or for reports that resonate, try something different.
Sketch it out.
Are you boring?
We don't want to get too personal, but at times it's good to ask yourself the question...are you boring?
Do you do the same-old, same-old?
Tell the same story. The same way. Again and again.
(and wonder why no-one is listening).
We all fall into the trap of doing things the way they have always been done.
It's easy. It's known.
But in a world seeking disruption and difference, perhaps it's time to try something new.
We're offering to help banish the boredom.
Not with everything, but with presentations, productions and messages.
We're offering to make them sparkle, make them unique.
Make them yours.
A custom illustration that pops your powerpoint.
More than a graph, to show your profit and loss.
An annual report that moves and shakes things up.
Be different.
Be smart.
Be Sketchy.
Time to Rhyme
We've had an absolutely amazing time over the past year working with the fabulous team at VELCRO® Brand. We've created brand awareness spots, explored their unique history and recently we've finished a ten-video campaign about how best to use their products in a whole range of situations.
We showcased how you could use VELCRO® Brand Fasteners in a whole heap of various situations.
It was super fun to be able to use motion graphics and a bit of rhyme to create this campaign. Yes, we sketch but we animate as well. And we love it!!
Check out some more of the spots here.
A Big Week for The Big Issue
The Big Issue are celebrating International #VendorWeek.
It's a time to celebrate the fabulous people you buy your Big Issue from.
The Street Vendors
We've seen first hand how hard everyone on The Big Issue works together. In the past year we've made a poster and a video showing what an empowering model of working it is.
So happy International #VendorWeek
Oh, and why not buy yourself the latest copy of The Big Issue from your local vendor?
Update: I finally got around to uploading Dan Rubin's closing keynote. Follow the links at the bottom of the page to browse all four keynotes from the conference on Google Poly.
As many readers will know, one of my roles here at Sketch Group is as a graphic recorder. I'm one of a team of illustrators whose job it is to take visual notes at events—conferences, workshops, panel discussions, and so on. It's stimulating, rewarding, creative work, and we're regularly humbled by just how fundamentally this work can change the dynamic of an event.
Attendees are fascinated by watching a large canvas come to life, and event organisers love having something different to engage delegates at their event—not to mention the value of having a large, colourful, visual summary of the content to photograph and share after the event is over.
Usually our canvas is a large sheet of paper, positioned to the side of the main stage, so that attendees can watch it come to life throughout the event. Graphic recorders are required to listen, synthesise, and capture the content that they hear.
Last week, the organisers of Web Directions Summit 2017 engaged me to graphically record the keynote sessions at their conference. However, this time I wasn't drawing on paper—in fact, I didn't even have a canvas to draw on, and there were no markers in my tool belt.
On this occasion, I was drawing in 3D space, using an HTC Vive virtual reality headset. In what I believe might just be a world-first (I don't know of anyone else using the tool in this way before, so I'm claiming it!) I sketched the presentations in virtual space, in real-time, using a tool called Google Tilt Brush.
The idea
The idea of taking VR Sketchnotes (that's what I'm calling them, unless a better name comes along; sculpt-noting, anyone?) came to me earlier this year, when I attended the International Forum of Visual Practitioners conference, in Decatur, Georgia. I was attending as a delegate (the only one in attendance from Australia) and saw a demonstration in the Exhibitor's Hall of a 3D mind map that had been created by the wonderful folks at Lizard Brain Solutions. I was curious to learn more about how it had been created, and exchanged a series of emails with the team after returning to Australia. When I learned that the mind map had in fact not been created on the fly (it comprised a series of text nodes that had been imported from Adobe Illustrator, and then positioned afterwards) I realised there was potential to explore how sketching in VR in a real-time environment could add a new element to the experience of attending an event, much like graphic recording does already.
When I saw the amazing promotional video for Tilt Brush, the dots were connected; I was determined to ensure that the device I purchased would be one that ran this app. A week later, with a sizeable hole in my pocket, I'd purchased my headset and set it up at home. My foray into the world of VR had begun.
The challenges
As you can imagine, there were more than a few hurdles to overcome in order to sketch a conference presentation in 3D. Here are a few that come to mind:
The result
Due to my travel commitments at the moment, I haven't had a chance to process all of the sketches from the conference properly yet. However, I have uploaded some stills, videos, and 3D sketches that you can browse on your computer, your phone, or with your own VR headset, if you have one.
I'll update this post and fill in the blanks next week after I've had a chance to process all of the files from the sketches. In the meantime, though here are a few samples for you to explore.
The VRdict ...
VR Sketchnoting is a new and innovative way to visualise content in real-time. Capturing content in virtual space has the potential to add to an attendee's experience of an event in new and unique ways. In addition to the increased engagement of watching a VR sketchnote be created in the moment, having 3D digital sketches of content can empower attendees to explore and reflect on the content after an event in a number of ways, via a range of digital channels. This digital collateral can also be repurposed as promotional content by event organisers and speakers after the event.
Creating a VR sketchnote at an event comes with its challenges; there are some logistics involved that require one to be organised, and the concept may be met with resistance by some folks, who may consider it too different or new. However, the upsides that I've listed above suggest that this is an area worthy of further exploration, even if it's not yet clear exactly what role it will play and what form it will take. Meanwhile, the goal posts continue to move as technology evolves. We'll keep you updated as we continue to explore this emerging field.
Browse all four of the Web Directions Summit 2017 sketches on Google Poly:
Matt is Chief Doodler at Sketch Group. He likes swimming, LEGO, and chocolate lemon curd cake—but then, who doesn't?
March 2020


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From behind the scenes to leading the parade, Riihilouma honored as grand marshal
August 9, 2018
Dale Riihiluoma has been the announcer of the Ma and Pa Kettle parade each year for all 33 years of its existence. However, he will not be announcing for this year's parade. He will be leading the parade as grand marshal.
"This is the first year that I won't be announcing the parade," he commented in a recent interview. "It will be different for me.
"That announcing job brought other jobs. I've announced at the steak fry for the Barnum fire department and at the steak fry at the Star Club. I've received wonderful comments about my announcing. Some people think that I must be on the radio."
Riihiluoma has observed the changes in Ma and Pa Kettle Days over the years.
"The two co-ops used to have a free breakfast for their patrons," he said. "They served 1,200 to 1, 500 people. But the steak fry has stayed pretty stable. They have served 450-500 steaks each year for many years."
Riihiluoma grew up in Kettle River, the son of Nick and Signe Riihiluoma.
He had three older sisters. One is still living at Big Lake, Minnesota. The other two have passed on, he explained.
"My sister and her husband and my niece are planning on coming," he said.
Riihiluoma graduated from Moose Lake High School in 1972. He and Diane Klejeski married in 1974. They couple has two daughters. One daughter is married and lives in Lindstrom and the other daughter is single and lives in Rochester, he said. They have no grandchildren.
Riihiluoma worked at Mercy Hospital, starting when he was still in high school.
"I was an orderly under a program that they had with the hospital," he explained. "I worked there for eight years."
The couple moved away in 1985 and didn't return to the area until 2005. Again, Riihiluoma found himself working at the hospital after the family moved back to the area and, most recently, worked at Essentia-St. Mary's hospital until this spring. He is currently enjoying the summer until the next job opportunity comes along.
As a resident of Barnum, Riihiluoma has served on the Barnum City Council for many years and also serves as vice president of the Spring Fever Days board.
Riihiluoma serves as president with the Knights of Columbus, an organization of the three Catholic parishes of Holy Angels in Moose Lake, St. Isidore's in Sturgeon Lake and St. Mary's in Willow River.
Riihiluoma is appreciative of his family for supporting his volunteer work.
"I couldn't have done it without their support," he said.
Riihiluoma is looking forward to this year's celebration.
"It is humbling to actually have been named grand marshal," he said. "I have announced all of the grand marshals and Ma and Pa Kettles over the years. They were all great people. I am looking forward to being here again this year, talking with people and taking part in the activities."


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After being gone for 9 days - Meron was ITCHING for some family time.
She petitioned hard all day long and finally got us all at Uncle Buck's for some evening bowling!
Everybody was pretty excited...
Even if mommy appeared to fall asleep while helping Z-Dogg!
Meron was pretty stoked to be here...
and she showed us that it didn't matter how ya got that ball down the lane...
while mommy showed off some of her yesteryear bowling league skills!
But let's be honest... we all know that BEARDED BOYS BOWL BETTER.
I mean seriously... look at that leg extension. And be jealous.
Zechie found the hand-cooler-air-blowing-thingie to be of great amusement as he used it to style his hair in between turns...
while Meron was almost eaten by a shark.
Overall - we had a BLAST!
Thanks Meron for pushing for some much needed family time!
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Sunday, July 27, 2014
How We Roll
Written by Tymm at 10:59 PM
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Reviews of Magazines
Buddhism is a new Quarterly, edited by Bhikkhu Ananda Maitriya, and published by the International Buddhist Society. As its title implies, it is devoted to the propagation of the Buddhistic tenets. It is a voluminous magazine of 175 pages, beautifully printed on excellent paper. It is richly and profusely illustrated, and all the articles are of a high literary standard. Among its contributors are C. A. F. Rhys Davids, M.A., Dr. Jarl Eugen Neumann, and Sir Edwin Arnold, K.C.I.E. The latter contributes an original poem entitled "The Golden Temple," which is a rare poetical gem. "The Faith of the Future," an article in three parts, by the Editor, is a masterly piece of composition, and is rich in profound reasoning and persuasive eloquence. "Animism or Agnosticism?" by Moung Po Me, is another article lucidly explaining the fundamental teaching of Buddhism. "The Women of Burma," by M. M. Hla Oung, describes, in language glowing with enthusiasm and admiration, the beautiful life lived by the Burmese women, and the advanced social liberty which they enjoy. Dr. Giueseppe De Lorenzo contributes a most original article on "Buddhist Ideas in Shakespeare," in which he introduces copious quotations from our immortal dramatist. There are other article and poems of deep interest and superior literary excellence. Nowhere in the journal is there to be found any manifestation of bitterness. Its tone is subdued, peaceful, and bears upon it the impress of Love and Goodwill. The piece which we have this month reprinted from its pages will convey to our readers some idea of its spirit. Those of our readers who send for the Journal will be richly repaid. It can be obtained of the International Buddhist Society, Rangoon, Burma.
Formerly this leaf, containing reviews of books, etc., has not been paged as part of the Journal, but from this time forward it will be included as part of the Journal, and will appear in the bound volumes.
K2_MORE_IN_THIS_ISSUE« Reviews of Books |
K2_LATEST_FROM_CUSTOM James Allen
James Allen
James Allen was a little-known philosophical writer and poet. He is best recognized for his book, As a Man Thinketh. Allen wrote about complex subjects such as faith, destiny, love, patience, and religion but had the unique ability of explaining these subjects clearly and in a way that is easy to understand. He often wrote about cause and effect, sowing and reaping, as well as overcoming sadness, sorrow, and grief. For more information on the life of James Allen, click here.


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The Commonfolk Collective make scented candles and bath/body products with a wellness twist. Their range aims to promote everyday mindfulness in your home through inspirational words, photography from emerging artists and blissful scents.
Packaged in recycled materials, their soy wax candle promotes a natural, sustainable way of life, even down to the glass jar – it's reusable! Plus, all the scents of the range are inspired by nature, in keeping with the brands boho style.
Showing all 16 results


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1980s Victor Costa Fitted Lace Dress w Dotted Tulle Overskirt$175 USD was $$425 USD
1980s Victor Costa Fitted Lace Dress w Dotted Tulle Overskirt
$175 USD was $425 USD
This is a seriously sexy, dramatic strapless dress that was made to hug and create curves whether a girl has then or not. It is all fitted and shaped to give you that Barbie Doll body with the bust and hips exaggerated in just the right way. The actual dress is a strapless little number that is cut above the knee and has a black cotton lace set over a nude base. Between the lace and the inner nude fabric is a layer of the same dotted tulle that makes up that dramatic skirting. This gives the lace an very interesting texture and depth. The sweetheart neckline tops the fitted silhouette of the dress. Circling the hip is a curving overlay of dotted tulle over two other tulle layers. These curve around and down and give the dress the suggestion of a full fifties skirt. Totally '80s and fabulous. Excellent condition
The dress is fully lined in a nude silky rayon and closes with a back metal and nylon zipper.
Bust: 17" flat across from side seam to side seam
Waist: 14" flat across from side seam to side seam
Hips: 19.5" flat across from side seam to side seam
Length: 32" from top of bodice to hem of dress, 36" to longest point of tulle overlay
Modern Sizing Equivalent: SML-MED
Item# DD2773
This garment has been professionally cleaned, pressed and is odor free. Thoroughly checked over before shipping, it will be ready to wear upon arrival.


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"A concerned Marlon questions Bob about Donna's whereabouts; Ross is desperate for an update on George and makes a confession to Finn so he will pay the victim a visit; Megan catches Jai off guard with a business proposition; James moves into The Woolpack; and homeless Robbie realises Brook Cottage is free and swipes the keys." (TV Times synopsis)
A worried Ross is desperate to get an update on George. Megan berates Leyla for mouthing off about Jai's financial problems. Victoria tells Chas that she's received a call from Robert and he's getting married in Mexico but she can't afford to go. James asks Victoria to make a cake for Finn's birthday. An increasingly concerned Marlon questions Bob about Donna's whereabouts. Robbie realises Brook Cottage is free and swipes the keys from Home Farm. Kerry is chuffed when she and Dan go to set a date for their wedding. Ross begs Finn to go to the hospital to find out about a guy who has been in a fight, lying that he is asking on behalf of a mate. Jai is frustrated that Megan is doing the dirty work for him and warns her to stop taking over at the factory. Finn is reluctant to go to the hospital and Ross is forced to admit that it was him who beat the guy up. Pete is adamant that it's Ross's problem but Finn can see Ross's desperation so relents. James moves into The Woolpack and Chas is bemused by all of his belongings. Finn and Pete find themselves at the hospital and overhear Beatrice talking about George on the phone saying that nobody's sure if George will make it through the night and he could be paralysed if he does. Pete finds an article in the newspaper and deduces that Ross was responsible for robbing the jewellers. He's forced to lie to the nurse that he and Finn know George, but Beatrice tells the nurse she's never seen them before. They quickly leave the hospital. Bernice seems fed up when Andy opts for a night with Adam watching football instead of with her. Jai apologises to Megan for his outburst earlier but is caught off guard when Megan tells him she wants to buy into the business. Finn and Pete confront Ross with what they've learned at the hospital. Finn tells him he doesn't want anything to do with it anymore. Kerry excitedly shares that she and Dan have sent a date at the registry office in The Woolpack. Nicola winds her up and inspires Kerry into changing her mind and opting for a lavish church wedding instead. Pete tells Ross that if anything comes back on him and Finn for visiting the hospital, he won't hesitate dropping him in it with the police.
Regular castEdit
- Kerry Wyatt - Laura Norton
- Bernice Blackstock - Samantha Giles
- Ross Barton - Michael Parr
- Andy Sugden - Kelvin Fletcher
- Adam Barton - Adam Thomas
- Marlon Dingle - Mark Charnock
- Laurel Thomas - Charlotte Bellamy
- Leyla Harding - Roxy Shahidi
- Megan Macey - Gaynor Faye
- Jai Sharma - Christopher Bisson
- Chas Dingle - Lucy Pargeter
- James Barton - Bill Ward
- Victoria Sugden - Isabel Hodgins
- Bob Hope - Tony Audenshaw
- Jimmy King - Nick Miles
- Nicola King - Nicola Wheeler
- Robbie Lawson - Jamie Shelton
- Dan Spencer - Liam Fox
- Finn Barton - Joe Gill
- Pete Barton - Anthony Quinlan
Guest castEdit
- Main Street
- The Woolpack - Public bar, Hallway, Kitchen, Backroom
- Beauty & Bernice - Front garden
- Mill Cottage - Living room, Kitchen
- Dale View - Front garden, Hallway/stairs, Living room/kitchen
- Café Main Street - Public café, Kitchen
- Brook Cottage - Kitchen, Back garden
- Hotten Road
- Butler's Farm - Yard, Cowshed
- Sharma & Sharma - Office, Corridor
- Home Farm - Office, Stairs
- Hotten General - Corridor
|June 2014 episodes
| • Mon 2nd • Tue 3rd • Thu 5th (1 2) • Fri 6th • Mon 9th • Tue 10th • Wed 11th • Fri 13th (1 2) • Mon 16th
• Tue 17th • Fri 20th • Thu 26th (1 2) • Fri 27th (1 2)


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Something for the heavy dark of winter.
You all know the card game, "War", I suppose. Split the deck, simultaneously flip two cards, winner takes them both and puts them on the bottom of their half of the deck. Whoever ends up with all the cards wins. In the event of a tie, you do a "diddle"; deal two more face down and the third one is up – winner take all.
While waiting for a banjo to get tuned up (but that's another story), my niece and I added a bunch of special functions to all the cards, and came up with quite an exciting, fast-paced game, that gave players some choices and actually came to a conclusion pretty quickly.
Ace – Hero or Champion – if tied, diddle 3 face down
King – if he wins, allows you to peek at the next two cards and choose which to play after you see the opponent's move.
Queen – seduces (beats) the King
Jack – seduces (beats) the Queen
10 – Soldiers – expected on average to win, lose 1 random penalty card if you lose
9 – Miltia – expected to lose on average, claim 1 random bonus card if you win
8 – Crazy/Holy Man – automatically triggers a diddle
7 – Saboteur – beats any card (including an 8) of the same suit
6 – Assasin – "kills" choice of face card (royalty, JQK), it is replaced from owner's hand (royal succession)
5 – Skirmisher – optionally, you may choose to replace this card with one from your own hand
4 – Entrenchment or Seige – both players add another card to the battle.
3 – Scout – calls for help. Optionally, you may add another card to the battle.
2 – Spy – beats Ace.
Note that it gets messy when you have multiple cards battling. General rule, add up the value of the cards ranging 2 to 13. Any card that "beats" another card present is upgraded to the value of it's target plus 1. So a Jack facing a Queen becomes 13 instead of 11, and so forth. Anybody flipping an eight causes the whole thing to be replaced by a diddle.
Try it – hope you enjoy it. Make up new rules, especially for the jokers and weird "advertisement" cards in your deck. Mix two decks. And remember, part of the game is recognizing and claiming any advantages your cards may have. Your opponent is under no obligation to point out their own defeat!
As usual, remember us if you figure out a way to make big money off this!


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Another Year of Life
Another birthday, another year of life gone by.
Birthdays always leave me feeling introspective but this one especially so. Now it's not so much what to do in my next year of life so much as what do I want to accomplish before I turn 30.
I feel like I didn't accomplish as much as I wanted between 28 and 29, so I definitely don't want a repeat year in that sense. What I do want… Well, I'm not sure about that, either.
I am indecisive as fuck.
Ah, well. We'll see what happens.


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Watch on Netflix
Unblock Your Netflix
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In this gangland epic based on real-life events, black gangs in 1930s New York City battle the Italian mob for control of the Harlem numbers racket.
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In this tutorial, we learn how to build a greenhouse to grow flowers or vegetables. A greenhouse means the growing season doesn't have to end. You should plan the greenhouse out on paper before you begin, and allow space for walkways, location, and more. Make sure you can afford one and know that it will cost more for you to keep the climate in this preferable to grow plants. You can put a number of different glasses on the greenhouse, so pick which one you can afford and prefer the most. Plastics are the most recent design for greenhouses, because they save on energy costs. A smaller greenhouse is cheaper to maintain and build, so it may be a better idea when it comes to costs for a greenhouse. Whatever you choose, enjoy your greenhouse and your flowers or vegetables!
Start your career in Graphic Design with the WonderHowTo's Beginners's Guide to Photoshop Course


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Qualifications required:
- University Law Degree - an LPC and/or LLM shall be considered an additional advantage;
- Member of the Cyprus Bar Association;
- One or two year(s) minimum experience in corporate law, financing transactions, M&A work and corporate administration;
- Good drafting skills and pleasant personality;
- Ability/experience to handle transactions with supervision by his/her team leader.
Job Responsibilities:
The successful candidate will be responsible at a junior level with supervision from our senior staff for advising and/or assisting clients with cross-border transactions, including structuring, drafting / reviewing / negotiation of legal documents, M&A transactions, and the provision of corporate services to clients.
Please apply in writing by April 15th 2018 enclosing a detailed CV to:
All applications shall be kept strictly confidential


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BACKGROUND: We studied patients treated with radical cystectomy for locally advanced bladder cancer to compare the results of both preoperative positron emission tomography/computed tomography (PET/CT) and conventional CT with the findings of postoperative histopathological evaluation of lymph nodes.
METHODS: Patients who had bladder cancer and were candidates for cystectomy underwent preoperative PET/CT using 18-fluorodeoxyglucose (FDG) and conventional CT. The results regarding lymph node involvement were independently evaluated by two experienced radiologists and were subsequently compared with histopathology results, the latter of which were reassessed by an experienced uropathologist (HO).
RESULTS: There were 54 evaluable patients (mean age 68 years, 47 [85 %] males and 7 [15 %] females) with pT and pN status as follows: < pT2-14 (26 %), pT2-10 (18 %), and > pT2-30 (56 %); pN0 37 (69 %) and pN+ 17 (31 %). PET/CT showed positive lymph nodes in 12 patients (22 %), and 7 of those cases were confirmed by histopathology; the corresponding results for conventional CT were 11 (20 %) and 7 patients (13 %), respectively. PET/CT had 41 % sensitivity, 86 % specificity, 58 % PPV, and 76 % NPV, whereas the corresponding figures for conventional CT were 41 %, 89 %, 64 %, and 77 %. Additional analyses of the right and left side of the body or in specified anatomical regions gave similar results.
CONCLUSIONS: In this study, PET/CT and conventional CT had similar low sensitivity in detecting and localizing regional lymph node metastasis in bladder cancer.
OBJECTIVES: To investigate the possibility of detecting sentinel lymph nodes (SNs) in patients with urinary bladder cancer (BCa) intra-operatively and whether the histopathological status of the identified SNs reflected that of the lymphatic field.
PATIENTS AND METHODS: We studied 103 patients with BCa pathological stage T1-T4 who were treated with cystectomy and pelvic lymph node (LN) dissection during 2005-2011 at the Department of Urology, Linköping University Hospital. Radioactive tracer Nanocoll 70 MBq and blue dye were injected into the bladder wall around the primary tumour before surgery. SNs were detected ex vivo during the operation with a handheld Geiger probe (Gamma Detection System; Neoprobe Corp., Dublin, OH, USA). All LNs were formalin-fixed, sectioned three times, mounted on slides and stained with haematoxylin and eosin. An experienced uropathologist evaluated the slides.
RESULTS: The mean age of the patients was 69 years, and 80 (77%) were male. Pathological staging was T1-12 (12%), T2-20 (19%), T3-48 (47%) and T4-23 (22%). A mean (range) number of 31 (7-68) nodes per patient were examined, totalling 3 253 nodes. LN metastases were found in 41 patients (40%). SNs were detected in 83 of the 103 patients (80%). Sensitivity and specificity for detecting metastatic disease by SN biopsy (SNB) varied between LN stations, with average values of 67% and 90%, respectively. LN metastatic density (LNMD) had a significant prognostic impact; a value of ≥8% was significantly related to shorter survival. Lymphovascular invasion (LVI) occurred in 65% of patients (n = 67) and was significantly associated with shorter cancer-specific survival (P < 0.001).
CONCLUSION: We conclude that SNB is not a reliable technique for peri-operative localization of LN metastases during cystectomy for BCa; however, LNMD has a significant prognostic value in BCa and may be useful in the clinical context and in BCa oncological and surgical research. LVI was also found to be a prognostic factor.
Background: Bacillus Calmette-Guerin (BCG) instillation is regarded as the most effective bladder-sparing treatment for patients with high-grade T1 tumours and carcinoma in situ (CIS). The major problem with this therapy is the side-effects, making maintenance therapy difficult, even impossible, in a proportion of patients. Thus, alternative schedules and drugs have been proposed. Objective: To compare BCG to the combination of epirubicin and interferon-alpha 2b as adjuvant therapy of T1 tumours. Design, setting, and participants: This is a Nordic multicenter, prospective, randomised trial in patients with primary T1 G2-G3 bladder cancer. Initial transurethral resection (TUR) was followed by a second-look resection. Patients were randomised to receive either regimen, given as induction for 6 wk followed by maintenance therapy for 2 yr. Measurements: The drugs were compared with respect to time to recurrence and progression. Also, side-effects were documented. Results and limitations: A total of 250 patients were randomised. At the primary end point, 62% were disease free in the combination arm as opposed to 73% in the BCG arm (p = 0.065). At 24 mo, there was a significant difference in favour of the BCG-treated patients (p = 0.012) regarding recurrence, although there was no difference regarding progression. The subgroup analysis showed that the superiority of BCG was mainly in those with concomitant CIS. In a multivariate analysis of association with recurrence/progression status, significant variables for outcome were type of drug, tumour size, multiplicity, status at second-look resection, and grade. A corresponding analysis was performed separately in the two treatment arms. Tumour size was the only significant variable for BCG-treated patients, while multiplicity, status at second-look resection, and grade were significant for patients treated with the combination. Conclusions: For prophylaxis of recurrence, BCG was more effective than the combination. There were no differences regarding progression and adverse events between the two treatments.
OBJECTIVE: To report the 10-year follow-up of a study randomizing between instillations of bacillus Calmette-Guérin (BCG) and mitomycin-C (MMC) for treating high-risk and not muscle-invasive urinary bladder cancer to assess progression, the need for more aggressive treatment and survival (cancer-specific and overall), as many of the published studies comparing different treatments for disease that is not muscle-invasive have a short follow-up. PATIENTS AND METHODS: Between 1987 and 1992, 261 patients were included, they had frequently recurring Ta/T1G1-G2, T1G3 or primary Tis-dysplasia. The patients were randomized to treatment with either 40 mg of MMC or 120 mg of BCG (Danish strain 1331) given weekly for 6 weeks, then monthly up to a year and finally every third month for a further year. The 250 evaluable patients were followed using hospital files and national registers on causes of death. RESULTS: The median follow-up for survivors was 123 months. The disease progressed in 58 (23%) of the patients, 34 in the MMC group and 24 in the BCG group (P = 0.26). Of the 140 patients who died, 68 were in the BCG and 72 in the MMC group (log-rank P = 0.98), most (95, 68%) died from other causes. CONCLUSION: Based on the follow-up of the present patients it cannot be concluded that the drugs originally administered, MMC or BCG, differed in their effect on progression, need for subsequent treatment or survival. © 2007 The Authors.
OBJECTIVES To assess the value of bladder mapping and prostatic urethra biopsies for detection of urothelial carcinoma in situ (CIS). CIS of the urinary bladder is a flat high-grade lesion of the mucosa associated with a significant risk of progression to muscle-invasive disease. CIS is difficult to identify on cystoscopy, and definite diagnosis requires histopathology. Traditionally, if CIS is suspected, multiple cold-cup biopsies are taken from the bladder mucosa, and resection biopsies are obtained from the prostatic urethra in males. This approach is often called bladder mapping (BMAP). The accuracy of BMAP as a diagnostic tool is not known. PATIENTS AND METHODS Male patients with bladder cancer scheduled for cystectomy underwent cold-cup bladder biopsies (sidewalls, posterior wall, dome, trigone), and resection biopsies were taken from the prostatic urethra. After cystectomy, the surgical specimen was investigated in a standardised manner and subsequently compared with the BMAP biopsies for the presence of CIS. RESULTS The histopathology reports of 162 patients were analysed. CIS was detected in 46% of the cystoprostatectomy specimens, and multiple (greater than= 2) CIS lesions were found in 30%. BMAP (cold-cup bladder biopsies + resection biopsies from the prostatic urethra) provided sensitivity of 51% for any CIS, and 55% for multiple CIS lesions. The cold-cup biopsies for CIS in the bladder mucosa showed sensitivity and specificity of 46% and 89%, respectively. CONCLUSION Traditional cold-cup biopsies are unreliable for detecting CIS in bladder mucosa and negative findings must be interpreted with caution.
Purpose: In a multicenter, prospectively randomized study we evaluated the 5-year outcomes of bacillus Calmette-Guerin alone compared to a combination of epirubicin and interferon-alpha 2b in the treatment of patients with T1 bladder cancer. Materials and Methods: Transurethral resection was followed by a second resection and bladder mapping. Stratification was for grade and carcinoma in situ. Followup entailed regular cystoscopy and cytology during the first 5 years. The end points assessed in this analysis were recurrence-free survival, time to treatment failure and progression, cancer specific survival and prognostic factors. Results: The study recruited 250 eligible patients. The 5-year recurrence-free survival rate was 38% in the combination arm and 59% in the bacillus Calmette-Guerin arm (p = 0.001). The corresponding rates for the other end points were not significantly different, as free of progression 78% and 77%, treatment failure 75% and 75%, and cancer specific survival 90% and 92%, respectively. The type of treatment, tumor size and tumor status at second resection were independent variables associated with recurrence. Concomitant carcinoma in situ was not predictive of failure of bacillus Calmette-Guerin therapy. An independent factor for treatment failure was remaining T1 stage at second resection. Conclusions: Bacillus Calmette-Guerin was more effective than the tested combination therapy. The currently recommended management with second resection and 3-week maintenance bacillus Calmette-Guerin entails a low risk of cancer specific death. More aggressive treatment in patients with infiltrative tumors at second resection might improve these results. In particular, concomitant carcinoma in situ was not a predictive factor for poor outcome after bacillus Calmette-Guerin therapy.
Purpose Neoadjuvant chemotherapy before cystectomy is recommended. To our knowledge the subset of patients likely to benefit has not been identified. We validate emmprin and survivin as markers of chemotherapy response. Materials and Methods Tumor specimens were obtained before therapy from a total of 250 patients with T1-T4 bladder cancer enrolled in 2 randomized trials comparing neoadjuvant chemotherapy before cystectomy with a surgery only arm. Protein expression was determined by immunohistochemistry. Results Expression was categorized according to predefined cutoffs reported in the literature. Data were analyzed with the Kaplan-Meier method and Cox models. Patients in the chemotherapy cohort with negative emmprin expression had significantly higher down staging overall survival than those with positive expression (71% vs 38%, p <0.001). The values for cancer specific survival were 76% and 56%, respectively (p <0.027). In the cystectomy only cohort emmprin expression was not associated with overall survival (46% vs 35%, p = 0.23) or cancer specific survival (55% vs 51%, p = 0.64). Emmprin negative patients had an absolute risk reduction of 25% in overall survival (95% CI 11-40) and a number needed to treat of 4 (95% CI 2.5-9.3). Survivin expression was not useful as a biomarker in this study. Limitations were the retrospective design and heterogeneity coupled with the time difference between the trials. Conclusions Patients with emmprin negative tumors have a better response to neoadjuvant chemotherapy before cystectomy than those with positive expression. © 2015 American Urological Association Education and Research, Inc.
Objective. To investigate the type of urinary diversion performed after cystectomy in patients with muscle-invasive bladder cancer in Sweden, using data from a population-based national register. Material and methods. Since 1997, the Swedish Bladder Cancer Register has included more than 90% of all patients with newly diagnosed bladder cancer. The different types of urinary diversion performed in 1997-2003 were analysed, comparing non-continent diversion (ileal conduit) with continent reconstruction (bladder substitution or continent cutaneous diversion). Results. During the study period, 3463 patients were registered with clinical T2-T4 non-metastatic bladder cancer. Cystectomy was performed in 1141 patients with ileal conduit in 732 (64%) and continent reconstruction in 409 (36%). Ileal conduit was used more frequently in females than males (p = 0.019), in patients older than 75 years (p andlt; 0.00001), and in those with less favourable TNM classification. Continent reconstruction was done more often at university hospitals than at county hospitals (p andlt; 0.00001), but rarely in the northern and western healthcare regions compared with other regions (p andlt; 0.00001). Nationwide, the proportion of registered continent reconstructions decreased, although the absolute number was relatively stable (50-60 per year). Conclusions. Continent reconstruction after cystectomy for muscle-invasive bladder cancer is performed more often in some healthcare regions and in patients at university hospitals than in county hospitals, indicating a substantial provider influence on the choice of urinary diversion. Over time, the proportion of these procedures has decreased, while the absolute number has remained low and stable; therefore, concentration in high-volume hospitals specialized in bladder cancer and continent reconstruction seems appropriate.
Objective. To analyse the management of muscle-invasive bladder cancer in a population-based national register, and specifically to investigate the role of curative therapy (i.e. cystectomy or radiotherapy) in relation to patient, tumour and hospital characteristics. Material and methods. The Swedish Bladder Cancer Register covers more than 90% of all patients in the country who have been diagnosed with such disease since 1997. Results from 1997-2003 were analysed regarding curative-intent treatment given within 3-6 months of diagnosis of muscle-invasive bladder cancer. Results. In total, 3463 patients with clinical T2-T4 bladder cancer were included in the analysis. Of those patients, 1426 (41%) received curative-intent treatment in the form of radiotherapy (285, 20%) or cystectomy (1141, 80%). Male gender, age 76 years, favourable TNM category and registration at a high-volume hospital were associated with such treatment. Curative-intent treatment was given to significantly more patients registered at high-volume hospitals (1003/2227, 45%) than at low-volume hospitals (423/1235, 34%) (2=37.7, p0.00001). Cystectomy was performed more often in those registered at high-volume than at low-volume hospitals (826/2227, 37%, and 316/1235, 26%, respectively, 2=47.3, p0.00001). Conclusions. Lower rates of curative-intent treatment were found in patients registered at low-volume than at high-volume facilities, and the same was seen when comparing females with males, and patients aged 76-80 years with younger patients. Since many of these bladder cancer patients were registered at and eventually treated at hospitals handling fewer than 10 such cases annually, it seems desirable to concentrate treatment of this disease at more specialized centres.
Objective. The aim of this study was to use the Swedish National Registry of Urinary Bladder Cancer (SNRUBC) to investigate changes in patient and tumour characteristics, management and survival in bladder cancer cases over a period of 15 years. Materials and methods. All patients with newly detected bladder cancer reported to the SNRUBC during 1997-2011 were included in the study. The cohort was divided into three groups, each representing 5 years of the 15 year study period. Results. The study included 31,266 patients (74% men, 26% women) with a mean age of 72 years. Mean age was 71.7 years in the first subperiod (1997-2001) and 72.5 years in the last subperiod (2007-2011). Clinical T categorization changed from the first to the last subperiod: Ta from 45% to 48%, T1 from 21.6% to 22.4%, and T2-T4 from 27% to 25%. Also from the first to the last subperiod, intravesical treatment after transurethral resection for T1G2 and T1G3 tumours increased from 15% to 40% and from 30% to 50%, respectively, and cystectomy for T2-T4 tumours increased from 30% to 40%. No differences between the analysed subperiods were found regarding relative survival in patients with T1 or T2-T4 tumours, or in the whole cohort. Conclusions. This investigation based on a national bladder cancer registry showed that the age of the patients at diagnosis increased, and the proportion of muscle-invasive tumours decreased. The treatment of all tumour stages became more aggressive but relative survival showed no statistically significant change over time.
Purpose: Polidocanol sclerotherapy for hydrocele or spermatocele combines high efficiency with low morbidity, but the optimal dose is not known. We compared the efficacy and morbidity of 2 or 4 ml polidocanol sclerotherapy for hydrocele or spermatocele. less thanbrgreater than less thanbrgreater thanMaterials and Methods: From 1993 to 2005 a double-blind randomized clinical trial was conducted using 2 or 4 ml polidocanol (30 mg/ml) for sclerotherapy of hydrocele/spermatocele in 224 evaluable patients at 3 university hospitals. Fluid was evacuated and 2 or 4 ml polidocanol was administered by a nurse, with the amount injected concealed from others present. At 3-month followup morbidity was ascertained using a questionnaire completed by the patients. Fluid recurrence was determined clinically and generally re-treated. less thanbrgreater than less thanbrgreater thanResults: After the first treatment, cure was observed in 59% and 47% in the 4 and the 2 ml group, respectively (p = 0.04). More patients in the 4 ml group had complications (31% vs 18%, p = 0.04). Complications were mostly of low or moderate intensity and seldom required medication. After 1 to 4 treatments 200 of 224 patients (89%) were cured and another 10 (5%) had small amounts of residual fluid, with no difference between the groups. Of the patients with hydroceles/spermatoceles larger than 175 ml, 58% and 34% were cured after the first treatment in the 4 and 2 ml groups, respectively (p = 0.012), with no differences in complications between the groups. less thanbrgreater than less thanbrgreater thanConclusions: Polidocanol sclerotherapy was effective for the treatment of hydrocele or spermatocele in our patients, with 94% satisfactory results after 1 to 4 treatments. A dose of 4 ml was superior to 2 ml, particularly for larger hydroceles/spermatoceles.
Objective. To study residual tumours at second-look resection in patients resected 4-8 weeks earlier for T1 tumours of the urinary bladder. Material and methods. All patients randomized in the ongoing Nordic T1G2-G3 Bladder Sparing Study with monitored data available were included in the study. Data on residual tumours at second-look resection were compared to basic patient and tumour characteristics. Results. There were 72 patients (56%) without and 57 with residual exophytic tumours. In the former group, 20 patients (28%) had carcinoma in situ, compared to 19 (33%) in the latter group. Potentially dangerous tumours (either carcinoma in situ, T1 or Ta grade 3) were observed in 55 patients (43%). Multiple tumours at primary resection were more prone to residual tumour at second-look resection than single tumours. No other tumour or patient characteristics could predict the occurrence of a residual tumour. Conclusions. Residual tumours are frequently observed at second-look resection 4-8 weeks after primary resection of T1 tumours. The majority of residual tumours detected at this stage are potentially dangerous, therefore, early second-look resection followed by intravesical instillation therapy is mandatory in patients with T1 tumours of the urinary bladder. © 2005 Taylor & Francis.
Objective. This study evaluated risk factors for local tumour recurrence, defined as recurrence at the same location in the bladder within 18 months after primary resection in patients with newly diagnosed pTa or pT1 bladder cancer. Patients and methods. The study included 472 patients with newly diagnosed pTa/T1 bladder cancer between 1992 and 2001. The patients were followed prospectively in accordance with a control programme and possible risk factors for tumour recurrence were registered. Results. Local tumour recurrence was observed in 164 (35%) patients, another 117 (25%) patients had recurrence at other locations in the bladder (non-local recurrence) and 191 (40%) had no recurrence at all. Tumour size and multiple tumours were significantly associated with a higher risk for developing local recurrence as opposed to non-local recurrence. Tumour category was of borderline statistical significance. Gender and tumour grade were not found to be risk factors for developing local recurrence. Conclusion. Tumour size and multiplicity are risk factors for development of recurrence at the same location in the bladder as the primary tumour. Local tumour recurrence may be a result of non-radical primary transurethral resection. One may consider recommending standard re-resection within 6-8 weeks in patients with tumours >3 cm or those with multiple primary tumours. © 2008 Informa UK Ltd. (Informa Healthcare, Taylor & Francis AS).
OBJECTIVE To evaluate the effect of the bladder wash cytology finding at the primary diagnosis of Stage Ta-T1 urinary bladder cancer on recurrence and progression. less thanbrgreater than less thanbrgreater thanMETHODS The clinical and pathologic characteristics of all patients with primary Stage Ta-T1 urinary bladder cancer were prospectively registered. The data were divided according to the bladder wash cytology results at diagnosis. Multivariate analyses were performed to determine the influence of bladder wash cytology on recurrence and progression. less thanbrgreater than less thanbrgreater thanRESULTS The analysis included 768 evaluable patients with a mean follow-up of 60 months. Recurrence was observed in 478 patients (62%) and progression in 71 (9%). High-grade malignant bladder wash cytology was predictive for recurrence and progression (P andlt; .001 and P = .036, respectively). Other factors affecting recurrence were missing bladder wash cytology data, tumors size 16-30 mm and andgt;30 mm, Stage T1 tumor category, and multiplicity (P = .008, P = .006, P andlt; .001, P = .002, and P andlt; .001, respectively). Progression was also associated with T1 tumor category, local recurrence, and primary concomitant carcinoma in situ (P andlt; .001, P andlt; .001, and P = .024, respectively). less thanbrgreater than less thanbrgreater thanCONCLUSION High-grade malignant bladder wash cytology at the primary diagnosis was predictive for recurrence and progression. This could be taken into account in designing future follow-up schedules.
Introduction: To evaluate the impact of experience in transurethral resection of bladder tumor (TUR-BT) on recurrence and progression in primary Ta/T1 urinary bladder cancer.
Methods: Clinical and pathological characteristics of patients with primary Ta/T1 urinary bladder cancer were recorded prospectively from 1992 to 2007 inclusive. Data on surgeons' experience were categorized as follows: (a) experience by training status (residents or specialists); (b) number of TUR-BTs performed by each surgeon during the registration period, with cut-off levels at > 100, > 150, > 200, > median, and > third quartile of surgical volume; (c) lifetime high-volume surgeons (> 100 TUR-BTs). Hazard ratios (HRs) were estimated using Cox regression with 95% confidence intervals (CIs) in both univariate and multivariate analysis.
Results: The analysis included 768 evaluable patients with a median follow-up of 60 months. Recurrence was observed in 478 patients (62%) and progression in 71 (9%). Surgery was performed by residents in 100 cases and specialists in 668, with recurrence in 75 (75%) and 403 (60%) patients, and progression in 9 (9%) and 62 (9%), respectively. Surgery performed by residents was statistically associated with recurrence (HR = 0.69, 95% CI = 0.54-0.89) but not progression (HR = 0.72, 95% CI = 0.35-1.48). Surgical volume (b and c) was not found to have a significant impact on recurrence or progression in any of the analyses at the chosen cut-offs.
Conclusions: Surgical experience (specialist/resident) was a predictive factor for recurrence after TUR-BT for Ta/T1 bladder cancer. However, surgeon volume was not associated with recurrence at the chosen cut-off levels. Training programs, checklist
Objective. This study aimed to evaluate the impact of tumour size on recurrence and progression in a population-based series of non-muscle-invasive bladder cancers. Material and methods. Clinical and pathological characteristics of patients with primary Ta/bladder cancer were registered. The patients tumours were categorized by size into five size groups (1-10, 11-20, 21-30, 31-40 and andgt;40 mm) or three size groups (1-15, 16-30 and andgt;30 mm). Results. The analysis included 768 evaluable patients with a mean follow-up of 60 months. Recurrence was observed in 478 patients (62%) and progression in 71 (9%). Tumour size was associated with recurrence for tumours sized 21-30, 31-40 and andgt;40 mm (p = 0.03, p andlt; 0.001, p andlt; 0.001, respectively) in the five size group and for tumours sized 16-30 and andgt;30 mm (p = 0.003 and p andlt; 0.001) in the three size group. Other factors affecting recurrence were T1 tumour category, multiplicity and surgery performed by residents (p andlt; 0.001, p andlt; 0.001, p = 0.002, respectively). Considering progression, there was no significant association with tumour size, and T1 category and local recurrence were the only significant risk factors (both p andlt; 0.001). Conclusion. Tumour size andlt;= 15 mm is associated with a lower risk of recurrence but not progression. Dividing tumour size into three size groups gives additional information compared with two size groups with cut-off at 30 mm.
Objective. This study investigated the presence of residual tumour in the marginal resection (MR) after a complete transurethral resection (TURB) of Ta/T1 transitional urinary bladder cancer. The association between positive MR and recurrence was analysed. Material and methods. After macroscopically complete TURB, a marginal resection of 7 mm (corresponding to the diameter of the resection loop) was removed around the entire resection area. Univariate and multivariate Cox regression analyses were performed to assess the influence of residual disease on recurrence. Results. In all, 94 patients with a median follow-up time of 36 months were included, and residual tumour in the MR was present in 24 (26%). The recurrence rates for all cases, for those with a tumour-positive and a tumour-free MR were 60 (64%), 20 (83%) and 40 (57%), respectively. Local recurrence was found in 14 (58%) of the patients with tumour presence in the MR compared to 13 (19%) of those with a tumour-free margin. A positive MR was significantly associated with overall recurrence (p andlt; 0.001) and local recurrence (p = 0.001). Conclusion. Incomplete transurethral resection of bladder cancer is common, as demonstrated in 26% patients with positive MR. The presence of tumour in the MR may be a risk factor for recurrence, and particularly local recurrence.
Objective: The aim of this study was to evaluate tumour growth located around the ureteric orifice (LUO) at primary diagnosis of Ta/T1 urinary bladder cancer in relation to effects on recurrence and progression. Materials and methods: Clinical and pathological characteristics of patients diagnosed with primary Ta/T1 urinary bladder cancer from 1992 to 2007 were recorded prospectively. Location of the primary tumour and growth around the ureteric orifice (within 1 cm) were recorded and correlated with recurrence and progression during further follow-up. Hazard ratios (HRs) were estimated using Cox regression with 95% confidence intervals (CIs) in both univariate and multivariate analysis. Results: The study included 768 evaluable patients with a median follow-up of 60 months. Recurrence was observed in 478 patients (62%) and progression in 71 (9%). Growth of a primary tumour adjacent to the ureteric orifice was associated with recurrence (HR = 1.28, 95% CI = 1.07-1.54) but not progression (HR = 1.04, 95% CI = 0.65-1.67). The most common location of the first recurrence was the posterior bladder wall (29%). Other locations in the bladder did not predict recurrence or progression. Additional factors affecting recurrence were tumour size greater than 15mm, T1 tumour category, multiplicity, malignant or missing/not representative bladder wash cytology and surgery performed by residents. Conclusions: A primary tumour located around the ureteric orifice was predictive of recurrence, which could be taken into account in future follow-up schedules.
Objective. Cystectomy combined with pelvic lymph-node dissection and urinary diversion entails high morbidity and mortality. Improvements are needed, and a first step is to collect information on the current situation. In 2011, this group took the initiative to start a population-based database in Sweden (population 9.5 million in 2011) with prospective registration of patients and complications until 90 days after cystectomy. This article reports findings from the first year of registration. Material and methods. Participation was voluntary, and data were reported by local urologists or research nurses. Perioperative parameters and early complications classified according to the modified Clavien system were registered, and selected variables of possible importance for complications were analysed by univariate and multivariate logistic regression. Results. During 2011, 285 (65%) of 435 cystectomies performed in Sweden were registered in the database, the majority reported by the seven academic centres. Median blood loss was 1000 ml, operating time 318 min, and length of hospital stay 15 days. Any complications were registered for 103 patients (36%). Clavien grades 1-2 and 3-5 were noted in 19% and 15%, respectively. Thirty-seven patients (13%) were reoperated on at least once. In logistic regression analysis elevated risk of complications was significantly associated with operating time exceeding 318 min in both univariate and multivariate analysis, and with age 76-89 years only in multivariate analysis. Conclusions. It was feasible to start a national population-based registry of radical cystectomies for bladder cancer. The evaluation of the first year shows an increased risk of complications in patients with longer operating time and higher age. The results agree with some previously published series but should be interpreted with caution considering the relatively low coverage, which is expected to be higher in the future.
Objectives. To prospectively evaluate the incidence of transitional cell carcinoma (TCC) in the prostatic urethra and prostate in the cystoprostatectomy specimen, investigate characteristics of bladder tumours in relation to the risk of involvement of the prostatic urethra and prostate and examine the sensitivity of preoperative loop biopsies from the prostatic urethra. Material and methods. Preoperatively, patients were investigated with cold cup biopsies from the bladder and transurethral loop biopsies from the bladder neck to the verumontanum. The prostate and bladder neck were submitted to sagittal whole-mount pathological analysis. Results. The incidence of TCC in the prostatic urethra and prostate in the cystoprostatectomy specimen was 29% (50/175 patients). Age, previous bacillus Calmette-Guérin treatment, carcinoma in situ (Cis) in the cold cup mapping biopsies and tumour grade were not associated with the risk of TCC in the prostatic urethra/prostate. Cis, multifocal Cis (≥2 locations) and tumour location in the trigone were significantly more common in cystectomy specimens with TCC in the prostatic urethra and prostate: 21/50 (42%) vs 32/125 (26%), p=0.045, 20/50 (40%) vs 27/125 (22%), p=0.023, and 20/50 (40%) vs 26/125 (21%), p=0.01, respectively. Preoperative resectional biopsies from the prostatic urethra in the 154 patients analysed identified 31/47 (66%) of patients with TCC in the prostatic urethra/prostate, with a specificity of 89%. The detection of stromal-invasive and non-stromal involvement was similar: 66% and 65%, respectively. Conclusions. The incidence of TCC in the prostatic urethra and prostate was 29% (50/175) in the cystoprostatectomy specimen. Preoperative biopsies from the prostatic urethra identified 66% of patients with such tumour growth. Our findings suggest that preoperative cold cup mapping biopsies of the bladder for detection of Cis add little extra information with regard to the risk of TCC in the prostatic urethra and prostate.
Objective. The aim of this study was to investigate recurrence and progression of non-muscle-invasive bladder cancer (NMIBC) in a large population-based setting. Materials and methods. Patients with bladder cancer (stage Ta, T1 or carcinoma in situ) diagnosed in 2004-2007 (n = 5839) in Sweden were investigated 5 years after diagnosis using a questionnaire. Differences in time to recurrence and progression were analysed in relation to age, gender, tumour stage and grade, intravesical treatment, healthcare region, and hospital volume of NMIBC patients (stratified in three equally large groups). Results. Local bladder recurrence and progression occurred in 50 and 9% of the patients, respectively. The rate of local recurrence was 56% in the southern healthcare region compared to 37% in the northern region. A multivariate Cox proportional hazards model, adjusting for age, gender, tumour stage and grade, intravesical treatment, healthcare region and hospital volume, showed that recurrence was associated with TaG2 and T1 disease, no intravesical treatment and treatment in the southern healthcare region, but indicated a lower risk of recurrence in the northern healthcare region. Adjusting for the same factors in a multivariate analysis suggested that increased relative risk of progression correlated with older age, higher tumour stage and grade, and diagnosis in the Uppsala/Orebro healthcare region, whereas such risk was decreased by intravesical treatment (relative risk 0.72, 95% confidence interval 0.55-0.93, p = 0.012). Conclusions. The incidence of NMIBC recurrence and progression was found to be high in Sweden, and important disparities in outcome related to care patterns appear to exist between different healthcare regions.
Objective. To evaluate outcome after radical cystectomy for primary bladder cancer in a large population-based material. Material and methods. Between 1997 and 2002 all patients treated with radical cystectomy within 3 months after diagnosis of primary bladder cancer without distant metastasis were retrieved through the Swedish Bladder Cancer Registry. A follow-up questionnaire was distributed to all units where the primary registration of patients was performed. Follow-up data on recurrence date were retrieved from the patient charts and causes of death were obtained from the Swedish Cause of Death Registry until 2003. Results. During the study period radical cystectomy was performed in 39 units in Sweden, of which only five units were considered high-volume hospitals performing 10 or more procedures annually. Mean blood loss was 2300 ml (median 2000 ml) and the 90-day mortality rate was 5.7%. Blood loss was higher in high-volume units than in hospitals with lower hospital volumes, but the 90-day mortality rates were similar. During a median follow-up of 3.5 years, 24% of the patients were submitted to a reoperation. Reoperation rates were significantly higher in patients who received a continent urinary diversion (29%) compared with an ileal conduit (22%, p andlt; 0.015). Conclusions. Radical cystectomy was associated with a reoperation rate of 24% in Sweden during the study period. The reoperation rates were higher in patients receiving a continent cutaneous diversion or bladder substitution. Blood loss was higher in high-volume units; otherwise, surgical volume did not affect mortality rates, cancer-specific survival or reoperation rates.
Objective. The HER2 receptor is involved in pathways essential for cell proliferation, and is an important predictive and prognostic factor in breast cancer. HER2 probably plays a critical role in many types of cancer, including urothelial carcinoma of the bladder (UCB). Stage T1 UCB exhibits heterogeneous clinical behaviour, and the frequency of HER2 expression in such disease has not been thoroughly examined. The aim of this study was to use an immunohistochemical technique to evaluate the frequency of HER2 expression in a defined population-based cohort of patients registered as having primary stage T1 UCB. Material and methods. The initial study population comprised 285 patients registered as having primary stage T1 UCB. The original histological specimens were re-evaluated with regard to T stage and World Health Organization grade. Hospital records provided information on tumour size, multiplicity, possible presence of histologically proven recurrence and progression. The patients were followed for at least 5 years or until death. In tumours still considered stage T1 after re-evaluation, HER2 was investigated by immunohistochemistry of paraffin-embedded material and scored according to the guidelines used in breast cancer. Results. After histopathological re-evaluation, 201 patients were still T1 UCB and could be investigated regarding HER2 expression. HER2 overexpression was observed in 25 of those patients (12.4%). HER2 status was not significantly associated with recurrence or progression. Conclusions. HER2 was overexpressed in 12.4% of the present cohort of patients with primary stage T1 UCB. There was no significant association between tumour HER2 status and prognosis.
Background and Objective. The cell cycle is regulated by proteins at different checkpoints, and dysregulation of this cycle plays a role in carcinogenesis. Matrix metalloproteinases (MMPs) are enzymes that degrade collagen and promote tumour infiltration. The aim of this study was to evaluate the expression of various cell cycle regulators and MMPs, and to correlate such expression with progression and recurrence in patients with stage T1 urothelial carcinoma of the bladder (UCB).
Patients and Methods. This population-based cohort study comprised 201 well-characterized patients with primary stage T1 urothelial carcinoma of the bladder. Immunohistochemistry was performed on formalin-fixed material to quantify expression of cell cycle regulators and two MMPs.
Results. Normal expression of p53 and abnormal expression of MMP9 were associated with greater risk of tumour recurrence. Also, normal p16 expression was related to a lower risk of tumour progression. MMP2, p21, cyclin D1, and pRb showed no significant results that could estimate progression or recurrence.
Conclusions. Normal p16 expression is associated with a lower risk of tumour progression, but immunohistochemistry on cell cycle regulators and MMPs has little value in predicting the prognosis in stage T1 UCB.
Objective. Stage T1 urothelial carcinoma of the bladder (UCB) exhibits heterogeneous clinical behaviour, and the treatment is controversial. The aim of this study was to evaluate prognostic factors for UCB in a defined, population-based cohort comprising patients with a first time diagnosis of primary stage T1 UCB.
Material and methods. The study population initially consisted of 285 patients with primary stage T1 UCB reported to the regional Bladder Cancer Registry in the Southeast Healthcare Region of Sweden from 1992 to 2001. The histological specimens were re-evaluated concerning stage, substaging of T1, World Health Organization (WHO) grade, lymphovascular invasion (LVI), tumour volume and total resected volume. Hospital records provided data on tumour size and multiplicity, occurrence of possible relapse and/or progression, death from UCB and whether treatment was given.
Results. After re-evaluation, the study population comprised 211 patients. The median follow-up time was 60 months. LVI was a prognostic factor for UCB progression and recurrence. Tumour size larger than 30 mm and multiplicity increased the risk of recurrence. T1 substaging, tumour volume and total resected volume were not associated with recurrence or tumour progression.
Conclusions. LVI is significantly correlated with progression and recurrence in patients with primary stage T1 UCB. Therefore, the presence of LVI should be evaluated in every new case of T1 UCB.
Background: Urinary bladder carcinoma stage T1 is an unpredictable disease that in some cases has a good prognosis with only local or no recurrence, but in others can appear as a more aggressive tumor with progression to more advanced stages. The aim here was to investigate stage T1 tumors regarding MDM2 promoter SNP309 polymorphism, mutations in the p53 gene, and expression of p53 and p16 measured by immunohistochemistry, and subsequently relate these changes to tumor recurrence and progression. We examined a cohort of patients with primary stage T1 urothelial carcinoma of the bladder and their tumors.
Methods: After re-evaluation of the original slides and exclusions, the study population comprised 141 patients, all with primary stage T1 urothelial carcinoma of the bladder. The hospital records were screened for clinical parameters and information concerning presence of histologically proven recurrence and progression. The paraffin-embedded tumor material was evaluated by immunohistochemistry. Any mutations found in the p53 gene were studied by single-strand conformation analysis and Sanger sequencing. The MDM2 SNP309 polymorphism was investigated by pyrosequencing. Multivariate analyses concerning association with prognosis were performed, and Kaplan-Meier analysis was conducted for a combination of changes and time to progression.
Results: Of the 141 patients, 82 had at least one MDM2 SNP309 G allele, and 53 had a mutation in the p53 gene, but neither of those anomalies was associated with a worse prognosis. A mutation in the p53 gene was associated with immunohistochemically visualized p53 protein expression at a cut-off value of 50%. In the group with p53 mutation Kaplan-Meier analysis showed higher rate of progression and shorter time to progression in patients with immunohistochemically abnormal p16 expression compared to them with normal p16 expression (p = 0.038).
Conclusions: MDM2 SNP309 promoter polymorphism and mutations in p53 were not associated with worse prognosis in this cohort of patients with primary stage T1 urinary bladder carcinoma. However, patients with abnormal p16 expression and a mutated p53 gene had a higher rate of and a shorter time to progression, and p53 gene mutation was associated with an abnormal immunohistochemistry for p53 at a cut-off of 50%.
Objective. The aim of this study was to analyse the rate of use of bacillus Calmette-Guerin (BCG) at a population-based level, and the overall mortality and bladder cancer mortality due to stage T1 bladder cancer in a national, population-based register. Materials and methods. In total, 3758 patients with primary stage T1 bladder cancer, registered in the Swedish Bladder Cancer Register between 1997 and 2006, were included. Age, gender, tumour grade and primary treatment in the first 3-6 months were registered. High-volume hospitals registered 10 or more T1 tumours per year. Date and cause of death were obtained from the National Board of Health and Welfare Cause of Death Register. Results. BCG was given to 896 patients (24%). The use of BCG increased from 18% between 1997 and 2000, to 24% between 2001 and 2003, and to 31% between 2004 and 2006. BCG was given more often to patients with G3 tumours, patients younger than 75 years and patients attending high-volume hospitals. BCG treatment, grade 2 tumours and patient age younger than 75 years were associated with lower mortality due to bladder cancer. Hospital volume, gender and year of diagnosis were not related to bladder cancer mortality. However, selection factors might have affected the results since comorbidity, number of tumours and tumour size were unknown. Conclusions. Intravesical BCG is underused at a population-based level in stage T1 bladder cancer in Sweden, particularly in patients 75 years or older, and in those treated at low-volume hospitals. BCG should be offered more frequently to patients with stage T1 bladder cancer in Sweden.
Objective. This study evaluated the impact of hospital volume on local recurrence and distant metastasis in a population-based series of radical cystectomy patients in Sweden. Material and methods. All patients who underwent cystectomy for bladder cancer in 1997-2002 in Sweden and were reported to the National Bladder Cancer Registry were included. A high-volume hospital (HVH) was defined as one with greater than= 10 cystectomies/year and a low-volume hospital (LVH) as one with less than10 cystectomies/year. Information on preoperative tumour, node, metastasis (TNM) classification, operative procedure, postoperative course and follow-up was obtained from medical records. Results. Of the 1126 patients, 827 (74%) were males. The mean age was 66 years and median follow-up 47 months. Of the 610 (54%) HVH patients, 68 (11%) were pT0, 123 (20%) less thanpT2, 177 (29%) pT2, 242 (40%) greater thanpT2 and 69 (11%) were microscopic non-radical. Corresponding figures for the 516 (46%) LVH patients were 35 (7%), 68 (13%), 191 (37%), 222 (43%) and 96 (19%). Local recurrence was observed in 245 patients (22%): 113 (19%) at HVHs and 132 (26%) at LVHs. Distant metastasis was found in 363 (32%): 203 (33%) at HVHs and 160 (31%) at LVHs. Perioperative chemotherapy was given to 193 (17%). Multivariate Cox proportional hazards analysis showed that local recurrence was associated with LVHs and non-organ-confined disease, whereas distant metastasis was correlated with non-organ-confined disease and lymph-node metastases. Conclusions. In this retrospective analysis, local tumour recurrence after cystectomy was common, particularly in patients with non-organ-confined disease. Furthermore, local recurrence was more frequent at LVHs than HVHs, and overall survival was better at HVHs. These findings suggest that concentrating cystectomies in HVHs may improve outcomes such as local recurrence and overall survival.
AbstractObjective: The aim of this investigation was to describe tumour characteristics, treatments and survival in patients with urinary bladder cancer (UBC) in a national population-based cohort, with special reference to gender-related differences. Material and methods: All primary UBC patients with urothelial pathology reported to the Swedish National Registry of Urinary Bladder Cancer (SNRUBC) from 1997 to 2011 were included in the study. Groups were compared regarding tumour, node, metastasis classification, primary treatment and survival. Results: In total, 30,310 patients (74.9% male, 25.1% female) with UBC were analysed. A larger proportion of women than men had stage T2?T4 (p?<?0.001), and women also had more G1 tumours (p?<?0.001). However, compared to women, a larger proportion of men with carcinoma in situ or T1G3 received intravesical treatment with bacillus Calmette?Guérin or intravesical chemotherapy, and a larger proportion of men with stage T2?T4 underwent radical cystectomy (38% men vs 33% women, p?<?0.0001). The cancer-specific survival at 5 years was 77% for men and 72% for women (p?<?0.001), and the relative survival at 5 years was 72% for men and 69% for women (p?<?0.001). Conclusions: In this population-based cohort comprising virtually all patients diagnosed with UBC in Sweden between 1997 and 2011, female gender was associated with inferior cancer-specific and relative survival. Although women had a higher rate of aggressive tumours, a smaller proportion of women than men received optimal treatment.


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Do you want to clean your home effectively & affordably with nontoxic & eco-friendly DIY products?Click to sign up now!
Learn about our online course
Conscious Cleaning 101: A Green Cleaning workshop minus the Greenwashing B.S.!
This class is for you if…
You want video tutorials to learn how to effectively clean your home with tried & tested DIY products and tricks that are affordable and safe.
You want a convenient cleaning program: cleaning gear checklists, a product guide, your list of DIY cleaning cabinet essentials, printable labels, your cleaning schedule, a handy e-workbook for easy reference, and more.
You want options for off-the-grid zero waste cleaning that include thrifting, reusing, repurposing, crafting, and foraging for cleaning agents.
You want to learn about the dangerous substances hiding in your cleaning products and how to detect greenwashing.
We tested over 100 tricks and recipe combinations so you wouldn't have to waste your time with trial and error.
Cleaning your home without the risk of getting cancer should not be a privilege reserved for the wealthy.
We've only chosen the absolute safest ingredients for your DIY products and share important safety guidelines.
The ingredients have a small ecological impact, and we always call ourselves out on where they fall short.
Everything is at your disposal to easily make your cleaning cabinet essentials and stick to a cleaning schedule.
Why we created this class…
I had always felt like there wasn't much that could be done to escape toxic cleaners without paying a good amount of money on the safe "green" products. That is until I learned that you could clean with vinegar. How in the world had I never been taught this most basic skill? Ever since then, I've been trying new ingredients, testing new recipes, learning how to detect greenwashing, and discovering more and more about how to clean safely, effectively and affordably.
I even began teaching about the new cleaning skills I was acquiring, and that's when dear Cristina came along. We put our heads together to create this master class with the very best tried and tested recipes and tricks that actually work! To do so, we may have overcommitted ourselves. We stained our clothes, our carpets, left dirty areas unattended for a bit too long, just to test over 100 tricks and recipe combinations! We took one for the team so that you wouldn't have to waste your time with trial and error.
We want to make it easy, convenient and affordable for you to clean your home safely. To help you on your journey to nontoxic living, we have gathered the most valuable information about green cleaning in our online class: Conscious Cleaning 101.
Imagine if…
…you could easily & affordably stock up on your DIY cleaning products for an entire year and wouldn't have to worry about being short on supplies.
…you had full support to achieve your goals through video tutorials, an e-workbook, checklists, guidelines, a helpful online community, and guidance on taking action in your local community.
Conscious Cleaning 101: A Green Cleaning Workshop minus the Greenwashing B.S.!
Module 1: Goal-Setting
We want you to be successful on your journey to nontoxic living! This module helps you determine what your specific goals are in taking this class.
Module 2: Toxic Chemicals in Everyday Products
We cover safety testing for chemicals on the US market, how risk factors for chemicals are determined, and look at US vs. EU regulations.
Module 3: Health Risks
Exposure to toxic chemicals in cleaning products carries the risk of certain acute and chronic health problems.
Module 4: Navigating Labels
In the US, cleaning products are not required to disclose their ingredients on labels, and workers often aren't aware of the exposure hazards.
Module 5: Safe Ingredients: Common
We review 15+ cleaning ingredients that are cheap and widely available: how they're made, their properties, limitations, etc.
Module 6: Safe Ingredients: Potentially Uncommon
We review the properties and limitations of 4 ingredients that are popular in Europe, and worth learning about.
Module 7: Questionable ingredients
Some products that are often touted as safe green products didn't make the cut. We explain why.
Module 8: Safety Precautions
There are common sense safety rules to follow as well as precautions you may not have considered when it comes to cleaning.
Module 9: Cleaning Gear Essentials
Determine what gear you need while minimizing your environmental impact by reusing and repurposing.
Module 10: Intro to Recipes & Tricks
This section introduces your list of cleaning cabinet essentials, provides printable labels for your products and reminds you which ingredients not to mix.
Module 11: Cleaning your Kitchen
You'll make kitchen cleaner and dishwashing or dishwasher soap. You'll receive your cleaning schedule and learn cleaning hacks & more recipes.
Module 12: Cleaning in the Laundry Room
You'll make a hamper ball, a pre-treat stain remover, laundry powder, whitener, fabric softener, laundry perfume, dryer sheets, and much more.
Module 13: Cleaning your Bathroom
Projects include a shower spray, a mildew-fighting mix, scouring paste, toilet cleaner and fizzies, and learning about candles and essential oils.
Module 14: Cleaning your Living Areas
You'll prepare multi-purpose cleaner, window cleaner, air fresheners (tea tree oil spray, vaporizer mix, pot-pourri), wood polish, and more.
Module 15: Thanks & Bloopers
An invitation to take action locally, info on staying involved in nontoxic living, as well as a Best Of gag reel.
BONUS: Zero Waste Cleaning Tips
We discuss package-free options for cleaning ingredients and which packaging options are most and least eco-friendly.
BONUS: Houseplants that clean the air
Indoor air pollution is often worse than outdoors. These houseplants sequester up to 90% of pollutants from the air within 24 hours.
BONUS: 10 Ways to Clean with Soap Nuts
Learn about the many ways to use soap nuts to clean your home, your laundry, and even your skin and hair.
BONUS: Cleaning with Essential Oils
Meet Jenny from Aromatics International who discusses the many benefits of cleaning with essential oils.
BONUS: Building Community around Nontoxic Living
Meet Kristi from Savvy Women's Alliance who explains how joining or starting a local chapter can help you on your journey to nontoxic living.
Lifetime access to the video tutorials
for all 20 modules (2 hours)
A 250+ page PDF workbook
that contains Modules 1-15, beautifully designed by Cristina, with a gorgeous cover by the talented Eco with Em.
Review questions
to help you assimilate the class information
Access to an exclusive student forum
You will have access to a supportive online community hosted on Facebook to submit your questions and share your successes or difficulties. It's a wonderful opportunity to get feedback and motivate one another.
Access to workshop updates
As we add content to our workshop over time, you will have access to all updated information.
Support from Savvy Women's Alliance
Savvy Women's Alliance will support you in joining or starting a local chapter to promote nontoxic living in your community.
15% off your purchase of essential oils from Aromatics International*
* valid until end of 2019
20% off your purchase of soap nuts from NaturOli*
*valid until end of 2019
Frequently Asked Questions
What do you mean by "conscious cleaning"? Is your class truly "green"?
- we encourage you to be as resourceful as possible by reusing and repurposing to minimize waste
- the ingredients we list do not pollute our waterways (and some can be composted after use)
- the products we list are not toxic to your health, to the environment, and are not deadly dangerous
- the products we list are produced responsibly as compared to other products on the market
Our class is all about green cleaning minus the greenwashing. If you are tired of false advertising and misleading claims on cleaning products, we are right there with you! So let's call ourselves out on where we fall short.
Other than going foraging for English ivy to make homemade soap, making your own kombucha vinegar, using coffee grounds, or collecting ash from a firepit, NO product is going to have a carbon neutral footprint. Almost every ingredient we use in our class will need to be produced, shipped, and discarded. Additionally, some of these otherwise "eco-friendly" products might come in single-use packaging or wrapped in plastic. Not all the ingredients on our list are going to be completely "green".
The current world we live in makes it difficult, if not impossible to make perfect choices. So, green perfection is not our goal. Our goal is to minimize our environmental impact by making way better choices for the planet. We will encourage you to always be resourceful, support companies who are getting things right whenever possible (i.e. sustainable production, package-free), and to become more conscious in the decisions you make to clean your home.
I want information on Zero Waste cleaning, will I find that here?
What is greenwashing?
Is this class the right fit for me?
Do you offer refunds?
How long do I have access to this workshop for?
What format is the class delivered in?
How much should I budget for materials?
Throughout the class, we encourage you to reuse items whenever possible. This includes going thrifting for cleaning gear, repurposing old shirts, socks, and toothbrushes, reusing old spray or pump bottles (when it's safe to do so), or even crafting sponges out of old stockings. There are many ways to clean on a small budget and minimize waste in the process.