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Average hours caregivers spent doing additional chores around the home because of patient condition at study observation periods.
Customize your JAMA Network experience by selecting one or more topics from the list below.
Witt WP, Gibbs J, Wang J, et al. Impact of Inguinal Hernia Repair on Family and Other Informal Caregivers. Arch Surg. 2006;141(9):925–930. doi:https://doi.org/10.1001/archsurg.141.9.925
© 2019
Inguinal hernia significantly affects family and other informal caregivers, and hernia repair will significantly reduce caregiver burden.
We analyzed data from a Veterans Affairs Cooperative Study with mixed models to compare the level of burden among caregivers of inguinal hernia patients from preoperative measurement to measurement at 2 weeks and at 3 months postoperatively.
Most caregivers were wives (73%) and lived with the patients (88%). There were no differences in caregiver burden by type of treatment. The time caregivers spent assisting patients increased significantly over the 2 weeks following treatment (odds ratio, 4.34). In contrast, 3 months after treatment, caregivers reported spending less time on additional chores than before treatment (odds ratio, 0.12). Furthermore, caregivers' concerns about patients' abilities to perform normal household activities decreased by 2 weeks posttreatment (odds ratio, 0.52). Wives/girlfriends and caregivers of patients with complications were more likely to report these concerns.
Inguinal hernia and its repair significantly affect informal caregivers. Caregivers assumed the heaviest time and effort-related burden 2 weeks following hernia repair and expended additional effort if the patient experienced complications. Interventions should reflect when burden is greatest and target the subgroups of caregivers who most need support.
Inguinal hernia is a common condition, especially in men, appearing in all age groups with peak incidence in the newborn, young adult, and elderly populations.1 A National Health Survey on Hernia, conducted in 1960, determined that hernias occur at a rate of 15 per 1000 population.2 Surgical repair of inguinal hernias represents a large component of health care effort with approximately 700 000 herniorrhaphies performed each year in the United States.3
Hernias and hernia repair affect the quality of life of the patient4,5 and may have a substantial impact on informal caregivers, especially considering that many of these patients are discharged the same day as their surgery and much of their recovery is managed at home. However, no previous work has examined the impact of this condition and the type of surgical repair on caregivers. In this article, we use data from a Veterans Affairs (VA) Cooperative Study to examine the impact of hernia and hernia repair on caregiver burden across time from preoperative measurement to measurement at 2 weeks and at 3 months postoperatively.
Data are from a VA randomized hernia trial in which 1983 consenting men with inguinal hernias at 14 VA medical centers received either open mesh repair (Lichtenstein)6,7 or laparoscopic repair with mesh. The design, conduct, and primary results of the VA hernia trial are reported elsewhere.8,9
Informal caregivers were defined as unpaid persons (family members or close friends) who met the needs of, provided or arranged for care of, or provided support to the patients. Fifty-four percent of patients (n = 1065) identified the presence of an informal caregiver at baseline. The study sample for this article was 79% of identified caregivers (n = 837) who responded to the baseline questionnaire and to at least 1 of the follow-up questionnaires at 2 weeks and 3 months after the patient's course of treatment. The protocol and consent forms were approved by the Hines VA Cooperative Studies Program human rights committee and by each site's institutional review board.
Caregivers completed a self-administered questionnaire at baseline and at 2 weeks and 3 months after the patient's surgery. The baseline questionnaire was filled out by the caregiver either at the time of patient enrollment into the study (80% of our study sample) or shortly thereafter in a mailed survey. This instrument was developed for the VA hernia trial and was pretested in a sample of hernia patient informal caregivers.
In separate questions, caregivers were asked how concerned they had been in the last few days about the patient's ability to perform 4 types of activities: normal home, work, social, and recreational activities. Response alternatives included not at all, a little bit, moderately, quite a bit, or extremely concerned. A trichotomous variable was used in the analyses comparing caregivers with no concern with caregivers with "a little bit or moderately" or "quite a bit or extremely."
Caregivers were provided with a list of 10 common chores and asked how many hours they spent during the past week doing additional chores around the home because of the patient's condition. Hours were classified into 3 categories for the analysis: 0, 1 to 5, and more than 5 hours. Caregivers were asked how much effort it took to do these chores, and their responses were trichotomized for analysis: "no effort or a little bit," "moderate amount or quite a bit," and "a great deal."
Patients were assigned to either open or laparoscopic repair. The patient's hernia was categorized as primary or recurrent and as unilateral or bilateral. Complications were assessed intraoperatively and at specified intervals postoperatively. Patient health status was measured by the American Society of Anesthesiologists (ASA) presurgical classification system. Class 1 denotes healthy status; class 2, mild systemic disease; and class 3, severe systemic disease. In the statistical models, patients with mild and severe systemic diseases (ASA classes 2 and 3) were compared with patients in good health (ASA class 1).
The caregiver relationship to the patient was recorded as wife, girlfriend, other family member, friend, or other. For statistical modeling, these categories were collapsed to wife/girlfriend, family member, and other. Caregivers were also classified as residing with the patients or not.
The statistical analyses were performed based on the intention-to-treat principle. Univariate comparisons of treatment by caregiver burden across study periods were conducted using χ2 tests for trichotomous outcomes. Baseline category logit models with random effects were used to model the trichotomous outcomes over time. The outcome response of "no concern" or "no effort" was chosen as the baseline category for these models.
Some caregivers were missing responses from both of the posttreatment interviews. A baseline comparison between these caregivers to those with at least 1 posttreatment interview revealed significant differences by patient and caregiver sociodemographic characteristics. Excluding the caregivers with no follow-up response from analyses could introduce bias because missing data could be due to patient treatment status and caregiver burden. To adjust for potential selection bias, a logistic regression model was used to model the probability of missing caregiver data at both posttreatment interviews10-12 for all the identified caregivers (n = 1086); the predicted probability was taken as the propensity score with higher propensity scores indicating a higher probability of missing data. The dependent variable in this model was "complete caregiver data posttreatment" (complete data with baseline information and at least 1 posttreatment interview) vs missing data either at baseline or both posttreatment interviews. Covariates included in the model were variables thought to be associated with the likelihood of missing data: caregiver relationship and residence, caregiver concern about 4 types of normal activities, hours and effort spent doing additional chores, and baseline stratification variables. A 0.1-unit increment in propensity score was used in calculating the odds ratios of the outcomes.
Potential explanatory variables considered in all models were treatment, time, treatment × time interaction, propensity scores of missing data/interviews, hernia type (primary/recurrent), hernia side (unilateral/bilateral), presence of complications (any complication/none), ASA class (class 1, 2, or 3), caregiver relationship (wife or girlfriend/family/other), and residence (lives with patient/does not live with patient). The time variable was considered a covariate in all of the models to determine changes in caregiver outcomes over the study period. Time was put in the model using 2 dummy variables to represent 3 levels: baseline, 2 weeks, and 3 months. The 2-way interaction term of treatment and time was examined to see whether treatment effect changed across time.
Because 6% of patients did not receive the assigned treatment, full models were also run with an "as treated" rather than the intent-to-treat variable. The as-treated variable was not significant in any of the models.
All statistical tests were 2-sided; the statistical significance level was set at P = .05. All analyses were conducted using PROC NLMIXED from SAS version 8.0 (SAS Institute Inc, Cary, NC).
The first set of analyses describes the relationship of the caregiver to the patient and whether or not they resided together. The caregiver was most often the patient's wife (73%), and 88% of caregivers reported that they lived with the patients (Table 1).
Analyses of differences in caregiver burden by treatment across the study period revealed that the average number of hours spent by caregivers doing additional chores because of patient condition did not vary by the type of hernia repair at any point during the study period (Table 2). Across the study period, there were no significant differences by treatment group in caregiver concern about the patients' ability to perform normal work, social, or recreational activities. Caregivers' concerns about the patients' activities around the home were no different by treatment group at baseline and 2 weeks posttreatment. Three months after treatment, caregivers of patients who had the open repair were more likely to be a little bit or moderately concerned about the patients' abilities to perform activities around the home as compared with caregivers of patients who received laparoscopic surgery (33.3% vs 24.3%, respectively, P<.05). Caregivers of both laparoscopic and open repair patients increased their time assisting the patients during the 2 weeks after the operation, but this time decreased sharply from 2 weeks to 3 months after the operation (Figure).
Four separate models were estimated to examine caregiver concerns about the patient's ability to perform activities around the home, at work, in social settings, and during recreation (Table 3). Results from these models show that caregiver concerns were not related to patient treatment status, time × treatment interaction, hernia type or side, or caregiver living situation for any of the activities. Greater propensity for missing caregiver data from 1 of the posttreatment interviews was significantly associated with nearly all of the outcomes of interest with the exception of concern about the patient's ability to perform normal activities around the home. Caregivers' concern about the patients' abilities to perform all activities significantly decreased across the study period. For example, concerns among caregivers about patients' abilities to perform normal household activities were lower 2 weeks following treatment than before treatment (odds ratio, 0.52; comparing quite a bit or extreme to not at all). Moreover, we found that these concerns were further alleviated 3 months following treatment (odds ratio, 0.04; quite a bit or extreme vs not at all) compared with baseline.
Wives and girlfriends were significantly more likely than other types of caregivers to report concern about a patient's ability to engage in work, social, or recreational activities. Family members were about 3 times more likely to be "extremely concerned" about a patient's ability to engage in recreational activities when compared with other types of caregivers. Caregivers of patients who experienced complications were more likely to express concern about all types of patient activities than caregivers of patients without complications. Patient ASA class at baseline was a strong predictor of caregiver concern about home and social activities. For example, caregivers of patients with severe systemic disease were 2.7 times as likely to report being moderately concerned and 1.7 times as likely to report being extremely concerned about home activities compared with caregivers of healthy patients. A similar pattern was observed for social activities. Although not as strong a predictor, ASA class was also related to increased caregiver concern about recreational activities.
Two separate models were estimated to determine the key factors related to increased caregiver time and effort in performing additional chores (Table 4). Findings from these models show that caregiver effort was not related to patient treatment status, time × treatment interaction, hernia type or side, or ASA classification. Greater propensity for missing caregiver data from 1 of the posttreatment interviews was significantly associated with increased caregiver effort with the exception of caregivers who reported 1 to 5 hours spent in performing additional chores as compared with caregivers who reported no hours.
When the time and effort caregivers spent in performing additional chores were analyzed, we found that caregivers were significantly more likely to spend additional hours at 2 weeks following surgery as compared with baseline (odds ratios, 2.90 and 4.26 for 1 to 5 hours or more than 5 hours on additional chores, respectively). However, 3 months after surgery, the odds that caregivers would spend 1 to 5 or more than 5 hours on additional chores rather than 0 hours significantly decreased (odds ratio, 0.25 and 0.12 of the estimated odds at baseline, respectively). Family members were 4.34 times more likely to spend more than 5 hours on additional chores rather than 0 compared with other caregivers; however, the amount of time wives/girlfriends spent on chores did not significantly differ from other caregivers. Caregivers living with the patient were more likely to spend additional hours with chores as compared with caregivers living outside of the home.
Two weeks following the hernia repair, the odds of caregivers reporting a moderate and great deal of effort increased 2-fold as compared with the odds of effort at baseline. However, at 3 months postoperation, caregiver effort had substantially decreased compared with baseline. Family members were more likely to report that either a moderate or a great deal of effort was required doing additional chores compared with other caregivers. There was no difference between wives/girlfriends and nonfamily caregivers in the amount of effort reported. Caregivers living with the patient were 2.9 times more likely to spend a great deal of effort on additional chores compared with their nonresidence counterparts. Caregivers of patients who experienced complications were 2.2 and 1.6 times more likely to report a moderate and a great deal of effort in performing additional chores, respectively.
To the best of our knowledge, this is the first study to document informal caregiver burden associated with caring for patients with inguinal hernia before and following hernia repair. Our study contributes 3 important new findings in understanding the extent to which this condition and its treatment affects caregivers' concerns, time, and effort after the patient returns home.
First, our study found that both caregiver concern about patient activities and the time and effort spent helping the patient diminished over the study period and did not differ by type of operation. However, the pattern of change for these 2 aspects of caregiver burden was different. Multivariate analysis indicated that concern about patient activities declined from baseline to 2 weeks after surgery and then declined more sharply from baseline to 3 months. On the other hand, caregiver time and effort in helping the patient with additional chores increased during the 2-week postoperative recovery period before decreasing significantly by 3 months. Although caregiver effort understandably increases during the recovery period, concern may already be lessened because the caregiver anticipates that the patient's performance will improve after recovery from surgery.
Second, we found that wives/girlfriends were more likely to be concerned about most activities even after taking time and other factors into account. Moreover, family members and other caregivers living with the patient reported more hours and effort in completing additional chores. These findings indicate that initial days or weeks after surgery may be a critical point at which caregivers need support in providing home-based care and that family caregivers in particular may need to be targeted for interventions because they have a greater burden.
Third, caregivers of patients with operative complications were significantly more likely to be concerned about the patients' abilities to participate in certain activities and reported having to expend more effort in completing household chores. In better preparing caregivers of high-risk patients, the health care team may want to consider providing comprehensive information about the possible patient recovery trajectories and the potential impact patient outcomes can have on caregiver burden.13 A recent qualitative study found that caregivers of recently hospitalized patients wanted to be more informed and involved in the discharge planning process.14 Such an approach may alleviate postoperative concerns among these caregivers and improve the patient recovery process. A predischarge informational intervention for male spouses of coronary artery bypass graft patients showed that patients whose spouses received the intervention were less likely to experience problems requiring additional health care compared with patients whose spouses received standard discharge information.15
The literature supports the involvement of clinical staff in supporting patients and caregivers with postoperative home-based care. Such interventions can prepare patients for recovery at home,16 reduce anxiety among patients and partners,17 and improve the family's quality of life.18
Another strength of this study is our effective use of a propensity score to adjust for missing data. Certain individual and environmental factors in the data collection process often increase the chance of missing data. The respondent's poor health status19,20 or mental health21 and sociodemographic characteristics such as poverty22 can all lead to missing data. These results support the use of the propensity scores in the regression models, and exclusion of these caregiver-patient dyads from the analyses could have biased results by introducing error due to incomplete coverage of the target population.
This study has several limitations. We were not able to examine caregiver coping strategies over the study period. There may have been critical adaptive responses among caregivers, thus influencing their level of concern about the hernia patient. In addition, we did not have information about the level or quality of caregiver-patient communication and the potential impact this could have on caregiver burden. A recent cross-sectional cohort study of caregivers of patients with a serious illness found that poor communication between patients and informal caregivers was associated with greater caregiver burden.23
A paucity of research exists on caregiver burden in the context of short-term care and recovery, and this study adds to the dearth of this literature in broadening our understanding of the caregiving experience following patient surgery and into recovery, specifically for the case of hernia. Inguinal hernia and its repair significantly affect the informal caregiver, and our findings suggest that health care providers may want to target interventions for the immediate postoperative recovery period with a particular focus on spousal caregivers of patients with complications and poorer preoperative health status.
Future studies should consider the impact of caregiver burden on the hernia patient recovery process. Other studies have suggested that caregiver physical and emotional support can have a salutary effect on patient recovery from surgery.24,25
Correspondence: Leigh Neumayer, MD, Veterans Affairs Medical Center, VAMC-112, 500 Foothill Dr, Salt Lake City, UT 84148 (email@example.com).
Accepted for Publication: July 19, 2005.
Funding/Support: This research was supported by the Cooperative Studies Program of the Department of Veterans Affairs Office of Research and Development.
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And Now The Independent-All Say NO To Zionist Hooliganism
It doesn't take a genius to notice that British media shows a real fatigue of Zionist's violence in our midst. This Manchester concert cancellation saga has brought a lot of attention to the vile tactics Jewish militant organizations are employing in our midst. For the first time, I detect a clear mainstream acceptance and support of my views and thoughts. If British Jews are concerned with antisemitism, and they should be, they better find a way to restrain their extremist Zionist elements.
Sign a petition in support of the Gilad Atzmon & The OHE: https://www.change.org

subset: commoncrawl


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Windows- and Mac-compatible. Fully HD-capable screen. Recyclable aluminum-and-glass construction. EPEAT Gold certified and Energy Star 5.0 precertified. Minimal cables. 4GB of DDR3 RAM comes standard. No crapware. iLife '09 included. More memory, storage and graphics power for the same $2,199 price.
No media card slots. Mighty Mouse is slippery and annoying. Vista 64-bit installation is complicated. No Blu-ray option. No eSATA. No numeric keypad and cursor control on the standard keyboard. Only 90 days of phone tech support.
Bottom Line
The Apple iMac 24-inch (GeForce GT 130), the company's new top-of-the-line iMac, is a moderate refresh. The new Nvidia motherboard chipset and discrete graphics give it a leg up on the previous high-end model, and CTO (configure to order) options give it the flexibility to serve all but the most specialized content creators.
The Apple iMac comes in four base models: a $1,119 20-inchsystem plus three 24-inch models culminating in the $2,199 (direct) top-of-the-line 24-inch iMac (Nvidia GeForce GT 130) reviewed here. I've already given the midpriced ($1,499) 24-inch iMac (Nvidia GeForce 9400M) an Editors' Choice, both for being an object of lust and for offering good bang for the buck in the all-in-one desktop space. Unfortunately, the high-end iMac won't be joining it, but it's still a terrific system that will serve graphic artists and other content creators well.
Similar Products
The $2,199 iMac (GT 130) has the same exact exterior and beautiful 24-inch widescreen monitor as its $1,499 brother, so if you're buying the iMac strictly for its looks, get the cheaper one. That said, the $2,199 model comes with a 3.06-GHz Core 2 Duo E8435 processor (the same as the previous 3.06GHz Penryn model, but faster than the 2.66-GHz CPU found in the new, cheaper iMac 24-inch), a larger 1TB hard drive (640GB for the $1,499 model), and most important, the Nvidia GeForce GT 130 discrete graphics card (up from the integrated GeForce 9400M in the cheaper model).
Likewise, the new iMac improves upon the last 3.06-GHz iMac, which had 2GB of DDR2 memory, a 500GB hard drive, and GeForce 8800GS graphics. The new 1TB drive is a boon to digital media collectors. Sure, you could hook up an external drive to boost storage, but to do so would spoil the clean lines of the iMac. iMacs aren't known for their expandability, so the drive that ships with the system is likely to be it for the life of the system. The extra 2GB of memory helps content creators in both the Mac OS and in Windows, as well as helping overall performance. The new GeForce GT 130 graphics is a significant improvement over the GeForce 8800 GS graphics in the previous 24-inch iMac. Both have midlevel graphics cards, but the GT 130 gives the iMac a bunch of extra 3D oomph. For even more 3D performance, you can option in the ATI Radeon HD 4850, but CTO (configure to order) options like graphics and extra memory (up to 8GB) will increase your waiting time for delivery (four to six weeks extra at press time), not to mention the final price tag.
The 24-inch iMac (GT 130) has many of the same positives and negatives that the iMac (Nvidia GeForce 9400M) has: Positives include no crapware, the new iLife '09 suite, the large screen, and recyclability. Negatives include the lack of digital media card readers, a slippery and temperamental Apple Mighty Mouse, only 90 days of phone tech support, a shorter standard keyboard, a quirky 64-bit Vista installation, and lack of Blu-ray and eSATA. (On the Windows setup, Boot Camp works only with 32-bit Windows Vista or XP, but you can install 64-bit Vista manually using the 64-bit drivers on the iMac's installer CD. Once Vista is installed, you can switch between it and the Mac OS by holding down the Option key during start-up.)
The iMac (GT 130) finished the Photoshop CS4 test in a quick 1 minute 35 seconds in Windows Vista, and 1:57 in Mac OS X. Both are very good scores and are even competitive with quad-core-powered systems like the Cybernet iOne GX-31 (1:57) and the HP Pavilion Elite m9550f (1:33). When you compare the Photoshop score with that of the older 3.06-GHz iMac (2:16), you really see the improvement that the extra 2GB of memory gives you. The memory is also faster: 1,066-MHz DDR3 SDRAM, up from 800-MHz DD2 in the previous version. The iMac (GT 130) finished the Windows Media Encoder (WME) test in 56 seconds. I consider any WME time of less than 1 minute a very good score. The quad-core iOne and Pavilion Elite outpace the iMac a smidge at 44 and 43 seconds, respectively. PCMark Vantage scores (which measure the system's ability to handle day-to-day tasks) improved from 4,448 in the old iMac to 4,917 in the new.
The new iMac is good enough, at least for casual players, to play both Crysis (48 fps) and World in Conflict (50 fps) at the lower 1,280-by-1,024 resolution. Hard-core gamers will want a Crysis score of 60 fps or more, as they'll start complaining that they're noticing missed frames in the 45-to-60-fps range. World in Conflict frame rates will seem steady for most gamers, since RTS (real-time strategy) games are playable at a frame rate as low as 30 fps. The iMac's 3D scores far outpaced the iOne, which can't run DX10 3D games at all, and the m9550f posted scores similar to the iMac's. The "old" iMac had a playable WiC score (45 fps), but Crysis was mostly too jerky to play at 36 fps (you could play it, but it won't be as much fun). Therefore, the new graphics are worth it for 3D gaming, and the additional faster memory helps for everything else.
The iMac (GT 130) earns our PCMag.com GreenTech Approved rating, thanks to a combination of green certifications, company policies, and energy usage. Like the other new iMacs and Mac minis, the iMac (GT 130) has EPEAT Gold certification, meets Energy Star 5.0 criteria, and the system itself is made of easily recyclable materials. Apple accepts your old computer and monitor for recycling if you buy a new Mac, and systems collected in North America are recycled locally. Last but not least, the iMac (GT 130) uses only a few Watts more power than its brother, the iMac (Nvidia GeForce 9400M). The iMac (GT 130) uses 98W of power while idling (vs. 95W for the iMac (9400M)), and 120W while under load (vs. 118W for the iMac (9400M)). Considering the extra graphics power in the iMac (GT 130), it's a decent tradeoff. This also makes the iMac (GT 130) more energy efficient than the Sony VAIO VGC-LV190Y which idles at 132W and uses 160W under load.
Like the $1,499, 24-inch iMac (Nvidia GeForce 9400M), the $2,199 iMac (Nvidia GeForce GT 130) gives the casual user a whole lot more screen real estate and day-to-day performance than the 19-inch Cybernet iOne-GX31 touch-screen all-in-one. The iOne is $2,358 and more business-oriented, so unless you really need the touch screen, the iMac is a better home PC. The $2,900 Sony VGC-LV190Y is our current high-end all-in-one Editors' Choice, and it still deserves that honor for the included HDMI-in, TV tuner, and Blu-ray drive. It is, however, burdened by crapwarenot a lot, but some. The LV190Y is the ultimate all-in-one entertainment PC, though the iMac may be better suited to the home or business user who doesn't need all those media features but really needs a fast Mac. Stepping up means going to the Mac Pro, and that behemotha standard desktop rather than an all-in-oneis really meant for those deified content creators with titles like Media Guru or Senior Art Director. The iMac (Nvidia GeForce GT 130) is a high-end system for people who spend their whole workday in Photoshop (or Final Cut Express, or Logic Express, for video and music editing, respectively), or any of the other prosumer and professional content creation applications for both Windows and Macs.
So, is springing for the Apple iMac (Nvidia GeForce GT 130) worth it? That depends. If you're a home user who just wants a dock for your iPhone and a great overall all-in-one desktop, get the $1,499 iMac with integrated GeForce 9400M graphics (our midpriced all-in-one Editors' Choice). If you absolutely need a home entertainment center, go with our high-end all-in-one Editors' Choice, the Sony VAIO VGC-LV190Y. However, if you're the type who needs the power to finish Photoshop or video projects but you don't feel as if you need or can afford a Mac Pro, get this pricier 24-inch iMac.
Check out the Apple iMac's (Nvidia GeForce GT 130) performance test results.
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Hi folks,
There is an interview with Nick Cave published in German press and I still have not found out why, but I always find the German interviews hilarious and once again I present you a once English now German interview translated back to English in the middle of the night due to insomnia. How much reality makes it through will not be known probably, so take it or leave it 😉
This one was published in Die Welt. Frédéric Schwilden sat down with Nick Cave in Berlin.
Photos are by the incredible Chris John Dewitt whose photographs of more than three decades Berlin are wonderful and fascinating to younger folks who have a thing for it – like me. I choose some of my favourites. They are from the year I was born, 1985 when Berlin according to Nick was an artistic wonderland. The last one is a place that according to the photographer still looked basically like that in 2008. Some junkyard's never get old it seems.
Links to original authors and photographers below.
The great musician and poet Nick Cave recommends steroids if you have trouble with your voice but thinks that Oskar Roehler uses the wrong syringes. An interview about racism and stew.
Nick Cave is in Berlin for a concert. During the 80s he lived here. Recently he wrote a poem about a tour of North America he did last year. It is called "The Sick Bag Song" and is published as a book. He wrote it on airplane sickbags.
Frédéric: Did you have a pleasant journey?
Nick: Yes one can say so. I even slept which is very interesting. Usually I do not sleep well. Today I indeed slept 6 hours.
Frédéric: At dinner I recently sat next to a very successful lawyer. She said that after a 14-hour workday a glass of red wine and a Xanax do it for her. What is your formula?
Nick: I tried everything and experimented for a long time. Now I consciously try to avoid things like that but I am not always successful with that of course.
Frédéric: Nick Cave, I initially wanted to start this interview with the following sentence: I have to thank you, to your song "Jubilee Street" I maybe had the best sex in my life.
Nick: I am very happy to hear that. Astonishing that you made it through the song. It is longer than three minutes.
Frédéric: You just wrote a poem. It is called "The Sick Bag Song" and you wrote it on airplane sickbags. Aren't these bags incredibly beautiful? They look so classy, like they have fallen from time and they are so well designed aren't they?
Nick: They are just perfect. Plus there are many interesting things written on them.
Frédéric: For example: "Please ask your flight attendant for the proper disposal of a used needle". You never asked the stewart didn't you?
Nick: No. Never.
Frédéric: "The Sick Bag Song" is a poem about life on tour. How do you prepare?
Nick: Before we go on tour? We rehearse a little. Of course not too much. But we do not pray or have a circlejerk, that is not our kind of thing.
Frédéric: You sleep in the Sheraton, in the Ritz, in the Grand Hyatt. How do you know that a hotel is good?
Nick: I don' t really care for hotelrooms. They are just functional rooms that are there. I also don't care about the bar or the bar food.
Frédéric: A huge problem when you travel long distance is jetlag. You write that steroids help with that. Can you recommend that without hesitation?
Nick: Right, I wrote that. But the steriods really help me more with my flu. I am a singer and when you don't have a voice in the morning, steroids are genius. The only problem is that they have the tendency to cause some psychological problems. They lift you up totally. But they are really magic when it comes to the voice. If you can't sing at all, you can do it like Maria Callas once you're on steroids.
Frédéric: Your poem describes a tour of North America. Do you feel welcomed there? I have a hard time doing so.
Nick: I feel very welcomed. Is it because you are German? Do you feel like an Arab? Look, that is your mustache. Shave it off and America will be happy to welcome you.
Frédéric: It is also that kind of expressionistic police work.
Nick: You have the advantage of being white. If you are black, it is completely different. There are so many Afro-Americans in prison compared to white people.
Frédéric: Is the American police racist?
Nick: Are you fucking kidding me? Of course. The police has a terrible problem. The cops do not look like polite policemen but like army guys, like Sci-Fi soldiers with Sci-Fi equipment. On top of that their perception is disturbed. They think: If two black people shoot each other, it's their own business. A black business. Nevertheless America is one of the best places you can visit.
Frédéric: Let's rather talk about art again. You have created a list of things that stop us most from being creative. The biggest obstacle is procrastination, the tendency to put something off for as long as possible. Do you do that?
Nick: No, absolutely not. I just heard about it. I personally just have a thought and then realise it. That is how I work. It is not about motivation it is just about realisation. Maybe my work would be even better when there would be a moment between thought and realisation.
Frédéric: One of the possibilities of procrastination, you write, is a terrorist attack. When I saw the Twin Towers crash as a child I wished for a war in Europe cause of a terrorist attack because I thought then I would never have to go to school again. Is that reprehensible?
Nick: No, not at all. It is an astoundingly good idea indeed. In the end you always find a good excuse for not doing things.
Frédéric: Oskar Roehler just made a movie about the 80s in Berlin. Blixa Bargeld and you are in it as well.
Nick: Personally I was amazed by Blixa's actor. Fucking hell, that is really Blixa. But the Nick Cave guy, he had a completely different body type. Look, that was more a big guy. Big bones. On top of that the drug scenes were not correct. When film people try to show drugs, they always do it wrong basically. It just is not like that. Look, that guy just opens a casket with a syringe. And this syringe is just too fucking big. You put something like that into horses.
Frédéric: Lets talk about Berlin. What do you think of Berlin today?
Nick: I have no idea about Berlin how it is now. The only Berlin I know is the Berlin of the 80s. That Berlin had a society within the society. An artist society. We were unhappy and felt alienated and we flew from something. And we found refuge in Berlin, this city gave us an artistic unity. I have never experienced that kind of creative bond again. But what happens in Berlin today – I have no idea. What really comes up to me when thinking about Berlin are these sticky dumplings with red cabbage and stewed meat, that is genius.
Photographs: http://chrisjohndewitt.tumblr.com
Original Interview: http://www.welt.de/kultur/pop/article141176444/Kotztueten-sind-einfach-perfekt-zum-Dichten.html
Translation: Anna


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Heriot-Watt is one of the world's leading universities with strong links to business and industry. We are a truly international university with five global campuses, partners in over 100 countries and over 29,000 students worldwide.
Virtual Open Days
Looking to find out more about postgraduate opportunities with us? Why not join our Virtual Open Day? We hold live chats throughout the autumn and winter months where you can personally talk to student advisers, admissions staff and academics. Academics will represent various university programmes and they will be on hand to answer any questions about courses you may have.
It is also the chance to talk to current postgraduate students from across our main subjects. They will be available online to give you their first hand experiences of studying here. You can ask them direct questions about their studies, without even leaving your own house.


text: Bophuthatswana Police Camo (1980's – 1990's) November 8, 2015Color Data, Custom and Tailored Items, Later Cold War (1969 - 1989), South Africa Sample 1: "Fantasy item". Slangvel made from fabric like below. Sample 2: Raw fabric, swatch is color balanced. Material (cotton/poly? blend poplin) matches that of most South African produced uniforms. Pattern Tile: No horizontal repeat.


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THE SUBTLE BODY by Megan Campisi
59E59 Theaters / Shanghai Dramatic Arts Center
Produced by Gold No Trade
February 2015
In 1702 an eccentric English doctor travels to China to unravel the inner workings of the human pulse through Chinese medicine. But it's his wife who makes a momentous discovery when she falls in love with their translator and discovers that there is more than one way to fill the human heart.
Cate McCrea (scenic), Isabel Coler (costumes), Mary Ellen Stebbins (lighting), Eric Sluyter (sound).
Above: Stephanie Thompson, Michael Zlabinger, Ya Han Chang, and John Wu. Photo: Eric Carter.
Above: Stephanie Thompson and Ya Han Chang. Photo: Eric Carter.
Above: Michael Zlabinger and Ya Han Chang. Photo: Eric Carter.


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10 markets in 10 days: day 8 - Bowl of Cream Soup Base
Over the next 10 days I will be sharing some of the items I flip on a daily basis on the Guild Wars 2 Trading Post, all of these items are part of my personal flipping portfolio which works to bring in hundreds of gold every month, for hardly any effort at all.
This roux-thickened soup base is the key ingredient to a variety of other soup recipes in Guild Wars 2, many aspiring chef's use these recipes to level up their profession and get frustrated when they see the list of ingredients required to craft this gem! (Salt&Pepper, Roux & Poultry Stock)
Instead, they opt to buy the bowl of Cream Soup Base directly from the Trading Post, bypassing all the headaches involved in gathering the necessary prerequisites.
The soup currently brings in roughly 20c each, and if I am lucky I am able to buy and sell anywhere between 20 to 100 soup bases every 24 hours. Paired with other components such as Tomato Sauce, Stock's & seasoning these item's can bring in 1-2 gold every day!
As always, use the TP Calculator and gw2tp graphs to ensure that the item will be profitable before investing!
You should also check out the awesome Gold Wars 2 website, a premium Trading Post tool with a wealth of customisation & item tracking options!


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London, Feb 20:
Are exit polls results done in the run up to elections always accurate? No, says new research that points out two major lacunae in the whole exercise.
"Excluding the population who only have a mobile phone from pre-election telephone polls leads to significant biases in assessing voter intention," said Sara Pasadas del Amo, in her PhD thesis written at the NUP/UPNA-Public University of Navarre, Spain.
The work has its starting point in the study provided by the regional Andalusian elections of 2012 in which the predictions of all the pre-election polls were wrong.
"These polls predicted a distance of the PP (conservative) ahead of the PSOE (socialist) that ranged between 9 and 15 points and which in the end was reduced to little more than one point," she said.
As Sara Pasadas pointed out, the reasons behind this lack of accuracy can be grouped into two categories. Firstly, factors relating to the behaviour of the people interviewed and the electors, some of whom state one thing in the polls and do something different on the polling day.
And secondly, the factors relating to the technical and methodological design of the polls.
In the case of phone interviews, a significant chunk of the population has no chance of being part of the samples, either because they do not have a phone at home or because their numbers do not appear in the telephone number data that many of these surveys use as the sampling frame.
"To this segment of the population that cannot be located by phone, which in itself is high, one would have to add the population that refuses to participate in polls of this type, and who, if they agree to respond, refrain from the questions about voting intention," the researcher wrote. IANS


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"Why aren't you married yet?"
Getting annoyed with friends/colleagues/relatives asking you the same old question every year, especially when you just want to enjoy the great champagne and canapes? Learn some great comebacks – they come in various styles to suit your personality.
Technorati Tags : dating, romance, love, relationship, being+single
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Nis America to Live Steam February Event
Nis America just sent out an email regarding the February 17th press event. No longer will the press be the only people to see the event happen live. For the first time ever, Nis America will be live streaming the event via Twitch!
The email went on to indicate that we will also get the release date for Disgaea 5 Complete in the US. They have previously hinted at a 3DS game announcement. Just Pause will be there with live coverage of the event and hands-on impressions and video of Disgaea 5 Complete and the Switch.
This year's press event is shaping up to be a doozy with special guests SUDA51 and Kazutaka Kodaka, five new games to announce and maybe even release dates for our first game on Switch and a game featuring an adorable black and white bear…!
Gamers at home hoping to keep up with all our announcements can tune in at http://twitch.tv/nisamerica for a live stream of our presentation on February 17 at 7pm PST (10pm EST).


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On-time delivery date is 100% guaranteed if press-ready files are received by cut-off time.
Vinyl banners steal the show every time they're on display. They lure people towards your store or your tradeshow booth. They can be used to detail what products or services you offer. You can include contact information that customers can easily take pictures of, for future reference if interested.
Our banners come in different sizes for you custom fit it in nicely where they're supposed to go up. You also have your choice of material: 13 oz. scrim vinyl, 9 oz. mesh vinyl, and 15 oz. vinyl.
The treatment options let you indicate whether you want your banners to have hem with grommets, hem without grommets, pole pockets, or have no hanging treatment added.
To those who are unfamiliar, grommets are metal reinforced holes that allows you to hang up your banners typically by tying each end with a cord. Pole pockets are long pockets that are added to each end of banners so you could insert a pole right through more conveniently.
You can order quantities of 1 to 25 per order.
Next step:


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I have taken about a million instagram photos since the last time I shared (not that long ago). So today's post is a huge photo dump of the last few weeks of life. I absolutely love the ease of taking photos throughout the day with my phone, otherwise, most of these moments would not have been captured. It will never take the place of real quality photography, but for daily moments, its the best thing ever. By the way, have you seen how Instagram made your profile page look? Pretty cool! Here is mine.
All good days start with the music behind them right? A few tunes I enjoyed this week.
Having these kids at my house. Precious full of life girls these are.
These moments that happened during Katelyn's visit. So many more, but these were some of my favorites. Especially capturing both girls dancing in the living room. And watching James interact with them. Priceless.
Our photoshoots. We only got a few behind the scenes of day two since James was there to help us.
Endless hours editing, editing, editing. the work on this upcoming lookbook has been non stop and I'm about to pass out it seems, but I know it will be so worth it and I absolutely can't wait to release it on the 13th. And then actually clean my house, ha.
So much good food has been consumed. (along with lots of not so good food this week. Ive been so bad and have been eating chips and dip for lunch, seriously).
Rearranged the house a bit after company. Bundled tons of sage.
And yes of course, feet shots. Because that's what I do.
The past two weekends in a row we helped my brother move. I got to spend time with my family, spend the night with my nanna, play with my nephew Aiden, go out for a girls night out with my women. Good stuff.
I managed to snag several shots of my boy. Without begging. That's the best part.
I got to wear beanies, test out James new tshirts coming soon to his shop, wore my hair straight alot and fell in love it, then got a hair cut which was a very bad idea. Oh, and I ate a massive carrot.
Took countless pics of my kitty Bella laying all over the house. It's so cute how many different places I find her. She is the ultimate lounger, let me tell you.
When I could, I squeezed in reading and a bit of IChing. I'm taking my time through the last part of Women Who Run With Wolves. Enjoying every word.
Even just taking time out to post this blog feels lavish. Time to get back to work on the collective. I forget each time how much is involved towards the end. I could use a team of 10 working around the clock for real. Katelyn has been a saving grace for how much she has helped me out with this project! I'm not sure if I'll be back at all until monday, but I have a fun giveaway for you... and then tuesday is the big release!!!
If your name is Danielle Covington or Kristal of Swabbycat, PLEASE email me at violet_bella (at) hotmail (dot) com by Sunday to claim your winning. Otherwise I will be drawing a new winner for the blowfish shoes giveaway and the love, life and babies giveaway. Thank you so very much.


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MALACCA - The state expects 15 million domestic and foreign tourist arrivals this year, 1.5 million more than last year.
Chief Minister Datuk Seri Idris Haron said he was confident that the target could be achieved with Tourism Malaysia's Visit Malaysia 2014 programmes planned for this year.
"We are upbeat about meeting the goal, based on the 13.5 million arrivals in 2013, in spite of the earlier estimated arrivals of 13 million," he said after presenting hampers and ang pow to the elderly, single mothers and the less fortunate in conjunction with Chinese New Year at the International Trade Centre here yesterday.
A total of 165 recipients received ang pow of RM100 (S$38.70) each, hampers, packets of rice and oranges.
Idris said the government would ensure that hotels and homestay lodges in the state get 20,000 rooms ready over the next three years to meet the growing demands of the tourism sector.
"Currently, hotels and homestays can only provide 7,500 rooms to domestic and foreign tourists," he said.
He said with the support of the Federal Government and the increasing number of investors in the industry, Malacca was poised to maintain its attractiveness as a global tourist centre and become one of the main destinations during VMY 2014.


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From celebrities to the street style set, the white shirt is a grade-A wardrobe staple…
Holly Willoughby wearing a white shirt – get the look with our blouson sleeve shirt, £39, and red skirt, £45.
As the old saying goes, sometimes the simple things in life are the best. It's an adage that lends itself rather nicely to fashion too. From a lived-in leather biker jacket to wear everywhere (and with everything) jeans or a trusty LBD, often it's the pared-back, enduring pieces in our wardrobes that bring us the most joy. Ultimately, simple doesn't have to equal uninspiring, and if there's one piece that proves this, it's the classic white shirt.
Holly Willoughby and Katie Piper styling their white shirts with striped skirts.
A cornerstone of male wardrobes, the white shirt entered the female fashion arena somewhat scandalously in 1793, when French queen Marie Antoinette wore one for a portrait, breaking royal protocol. In the forties and fifties, white shirts were regularly worn by Hollywood stars Lauren Baccall, Ava Gardner, Katharine Hepburn and Audrey Hepburn. An iconic piece worn by icons on and off stage or screen – Patti Smith, Marlene Dietrich, Julia Roberts in Pretty Woman – it remains a go-to for celebrities and street style stars alike.
Clemente Poesy and a street styler wearing white shirts with denim and tailoring.
There are currently countless stylish women making the case for the white shirt. Holly Willoughby likes to wear hers tucked into a pencil or full skirt – likewise Katie Piper, while French actress Clemence Poesy wears hers insouciantly undone with denim. The ultimate work-to-weekend piece, a white shirt is also perfectly at home with sharp tailoring and a sleek handbag.
Actress and street style star Olivia Culpo and Rosie Fortescue get creative with their white shirts.
It is the street style set, however, who prove that the white shirt can be anything but basic. Constantly coming up with creative ways to elevate theirs, this season is all about layering it under a spring dress or creating shape with an on-trend corset belt. For a look that doesn't require quite as much effort but will still make a statement, try our balloon sleeve white shirt – just add our red lace skirt for a street style worthy outfit.
Inspired? Scroll down to find your new favourite white shirt…


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Today you have the chance to win a diamond
ring plaster by ATYPYK, which is just as adorable than the Brangelina-bling-bling.
To win, just leave a comment below. On Sunday, April 22 I will draw the lucky (randomly chosen) winners . Good luck!!!
The winners are: Swen, Jenny, Dave, Rebecca, Sarah, Doreen, Sandra and Tom & Julia who commented on Facebook.
Have fun with the bling bling plaster and a big Merci to generous Atypyk boys. The winners will be contacted per e-mail.