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Study: E-Cigarettes Fail at Nicotine Delivery, No Better Than Unlit Cigarette
Jason Mick
February 10, 2010 11:42 AM
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Nurse Barbara Kilgalen, a participant in the Virginia Commonwealth University study, demonstrates e-cigarette use. The study indicates that electronic cigarettes epically fail at delivering nicotine to the body.
(Source: Paul Courson/CNN)
Despite popularity, the questions about e-cigarettes may not be all they are cracked up to be
Last year we wrote on the
health risks associated with electronic cigarettes
, commonly known as "e-cigarettes". The devices have been billed as "healthy living" products and as a tool to help smokers quit their addiction. Advocates say that since electronic cigarettes simply give smokers a vapor with nicotine and no burned chemicals, that they are relatively safe.
Those claims may be inaccurate, though. Last March, the Food and Drug Administration banned imports of the devices, which are largely manufactured in China. The FDA wants to investigate health concerns. Namely, the FDA found that chemical formulas for the smoky vapor often contained dangerous components; at least one
manufacturer used diethylene glycol as a key ingredient, a chemical commonly used in antifreeze and toxic to humans
Now a new study adds to the doubts about e-cigarettes, indicating that they are about as successful at delivering nicotine as puffing on an unlit cigarette. Dr. Thomas Eissenberg at the Virginia Commonwealth University led the study. The study involved 16 participants and extensively monitored nicotine levels in the body and heart rates when using both traditional and electronic cigarettes.
The study, the first study of e-cigarettes to be conducted by U.S. doctors, found that almost no nicotine was actually delivered by the devices and instead users were actually inhaling a nicotine-devoid toxic vapor of compounds like diethylene glycol or nitrosamines, a family of cancer-causing nitrogen compounds.
Describes Dr. Eissenberg, "They are as effective at nicotine delivery as puffing on an unlit cigarette. These e-cigs do not deliver nicotine. Ten puffs from either of these electronic cigarettes with a 16 mg nicotine cartridge delivered little to no nicotine."
The study was funded by the National Cancer Institute and will soon be published in the journal
Tobacco Control
, a product of the British Medical Journal Group.
Nicotine has some
beneficial health effects
, particularly for the mentally ill, so it is disappointing that e-cigarettes appear unable to deliver the compound.
Despite the mounting criticisms, many e-cigarette users stand by the product. Jimi Jackson, a former tobacco smoker in Richmond, Virginia, who sells electronic cigarettes,
, "I smoked 37 years, and when I found them, I was, like, 'Thank, you Jesus.'"
The FDA is currently being sued by a company called "Smoking Everywhere" that imports e-cigarettes from China. The company wants the FDA to lift the ban on e-cigarette imports. The company's court filings reveal just how popular the devices are -- the company sold 600,000 e-cigarettes in a year via the company's network of 120 distributors in the United States.
Why should the FDA lift its ban? According to Washington lawyer Kip Schwartz, representing "Smoking Everywhere", "We are on the verge of going out of business, which is why we are suing the FDA in U.S. District Court."
"I f***ing cannot play Halo 2 multiplayer. I cannot do it." -- Bungie Technical Lead Chris Butcher
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August 7, 2009, 12:45 PM
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Relax. That's the literal translation of the West Indies term, "Lymin", and the motto of St. Croix's Lymin Beach House. And relaxing is no problem here with 2 bedrooms, 2 baths, a large living area, a kitchen, a screened-in dining room/porch, and an on-site pool. Being atop a cliff, every angle shows off incredible lookout views of the ocean and property landscape. PLUS the porch and bedroom balconies open up to the west so the sunsets are exquisite. Take a set of stairs to the water, or visit the nearby Divi Carina Bay Resort and Casino in less than a 5-minute walk!
Shawna , 214-350-6220 x9102
St. Croix's Lymin' Beach House is a cheerful and relaxing waterfront cottage that sits on the edge of a cliff 30 feet above the Caribbean shoreline.
This 2 bedroom, 2 bath villa on the extreme East End of St. Croix offers a comfortable living area that opens up to the large screened porch (which doubles as your dining room).

subset: commoncrawl


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Thread Tools | Search this Thread |
17th July 2010, 01:59 PM | #1 |
diyAudio Member
Join Date: Aug 2007
audio nirvana super8 cabinets decision
Sorry to open another thread but noone seems to fit my specific needs
I have a pair of audio nirvana super8 and I would like to build a cabinet for them. I have read that plywood is best so I think I will go for it. Now I would like to ask which way should I go: 1. Fully enclosed cabinets (no hole) 2. Bass reflex designs (hole) 3. Folded horn design (like BIB cabinets for example) mids and tops are just fine and will probable be fine for me at any cabinets. but bass is the issue to my decision. I like very much low end bass 25-40Hz and probably more controlled, more tight (not like "woof-woof" bass). Like the low end bass that is coming out from these sub-woofers, although these have a separate amplifier... I would like to ask which type of cabinet should I go, and if there are any complete designs out there. Space is not a problem unless the speaker is more than 2.5 meters tall... Speaker specs attatched.
Great DIY site: http://www.neazoi.com Last edited by neazoi; 17th July 2010 at 02:03 PM. |
17th July 2010, 02:06 PM | #2 |
diyAudio Member
Join Date: Feb 2004
Location: near Hamburg Germany
a solution which fit your wishes, would be my double horns SAXOPHON and RDH20 look on my HP with plan, measurement and feedback
http://www.hm-moreart.de |
17th July 2010, 09:02 PM | #3 |
diyAudio Member
Join Date: Aug 2007
please send me a link
Great DIY site: http://www.neazoi.com |
17th July 2010, 10:47 PM | #5 |
diyAudio Member
I'd think Super8 would play well in a 12 inch driver Karlson cabinet but would be missing the lower octave.
YouTube - "Karlsonette" 1954 twelve inch Karlson speaker with FE206EN (Zoom H2) |
18th July 2010, 12:09 PM | #7 | |
diyAudio Member
Join Date: Mar 2005
Location: UK
Not an ideal candidate, but not impossible.
"'That'll do", comes the cry of the perfectionist down the ages.' James May -The Reassembler www.wodendesign.com Community sites www.frugal-horn.com http://frugal-phile.com/ |
19th July 2010, 07:02 AM | #8 |
diyAudio Member
Join Date: Aug 2007
I know, they cannot outerperform these super bass subwoofers, that have been designed specifically for the bass region. I am just tryying to raise the bass as far as I can at this 25-35Hz area so the low end sound will be warmer (to my ears).
Has anyone tried these BIB (bigger is better) folded horns or would you recommend them for my needs? Bigger Is Better 'BIB' Cabinet Dimensions - ZillaSpeak they say "Your BIBs are designed to balance out the sound of your full/wide range driver by enhancing bass frequencies." Tuning is made by appropriate stuffing of the cabinet with fiberglass They are much simpler to build but taller...
Great DIY site: http://www.neazoi.com Last edited by neazoi; 19th July 2010 at 07:16 AM. |
19th July 2010, 10:05 AM | #9 |
diyAudio Member
Join Date: Mar 2005
Location: UK
That's generally what vented boxes of various types are for.
Problem is, you might raise gain in the sub-bass region, but the price is a severe restriction of dynamic bandwidth & increased potential for AMD (doppler) right up through the range. Generally, you're better off not trying to force a driver to perform outside its optimal operating window; while you may be able to do it, you'll compromise everything else in the process. Tapped horns like the BIB can give excellent results, but typically, I wouldn't try running them too low with wide-range drivers. Sub-bass duties are best handled by units designed for the task.
"'That'll do", comes the cry of the perfectionist down the ages.' James May -The Reassembler www.wodendesign.com Community sites www.frugal-horn.com http://frugal-phile.com/ |
19th July 2010, 10:24 AM | #10 | |
diyAudio Member
Join Date: Aug 2007
For example you may listen to CDs like Maria Carey musicbox, good jazz recordings and other like good quality recordings, in low volume, but with so well balance between bass mids and highs that gives you the feeling of a very good balanced speaker system which is able to produce bass at the same volume that it produces mids and highs. Low frequency bass is more pleasant to my ear than higher. What I am trying to achieve is a bit more bass volume, to equal the high volume of mids and highs. As you have seen in another thread I am greatly considering BIBs... Sorry about my terminology of "big boon" etc, but I am not confident of how else can I describe the requirements in English language
Great DIY site: http://www.neazoi.com |
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Thread | Thread Starter | Forum | Replies | Last Post |
FS/FT Audio Nirvana Super 12 Cast Frame drivers in custom cabinets | vaughn | Swap Meet | 12 | 5th April 2010 01:51 PM |
Fostex or Audio Nirvana? | mikejennens | Multi-Way | 17 | 17th July 2008 02:12 AM |
ApexJr super8 fun | theNoid | Subwoofers | 14 | 1st December 2006 07:16 PM |
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Audio Nirvana - Where Is It? How Do We Get There? | Bas Horneman | Everything Else | 9 | 25th January 2006 02:05 AM |
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90+ | |
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66 Had a meal issue, manager fixed quickly, gave a free desert |
56 Kind of a chain brewpub feel, but still pretty nice. Beers ranged from bad to just okay. Cheap flight of 7 for $4.95. Didnt eat. Free parking in a lot. Okay for ticks, and thats about it. |
56 Was brought here by some co-workers as its one of their favorite local spots. A handful of year rounds on tap (I had the Big Red IPA) and a seasonal Maibock. The food menu is huge and varied. |
66 Fantastic Large ceiling bar, medium dark lighting, not too loud, a few TVs, sweet wait staff, average food at best, fabulous brewery ambiance through the glass. Personal homeboy tours on request. Atmosphere the best draw for me. Really like only 4 of the 7 or 8 micros I tried. Will go back a third time when in town again. |
68 Cant say too much for the ambiance: another over size steel building with a sports bar in it, or a TGI Fridays, but with brewing equipment. They did have a nice burger menu, one of which went pretty well with the beers the served. Of note is the fact that a "Curl" (a sampler tray shaped like a rams horn) cost $5 no matter how many beers they had on tap to sample. And I got 10 of em. The brewer was a pretty friendly guy, and he did seem pretty happy with his setup. He did have the choice to make some big beers besides the mandated company recipes. They do schedule tapping events for their special beers, but their corporate webpage is very skimpy on details. |
72 Neat little place. Bartender was super cool and the prices were pretty reasonable for chicago. Beer was ok. Nothing super special but all pretty drinkable. Probably wont be making any special trips but i would stop there again. |
66 Visited October 2010, the last stop of a long night.
Got in really late, as in after midnight, and it was still pretty full. Despite that the service was pretty good. Got a sampler and didnt eat anything. Beers at this location were a bit subpar after having been impressed by the Ram in Seattle a year earlier. Seems like a fun place to hang out but I dont think Id make a trip out from Chicago for this place. |
88 Nice atmosphere, good variety of beers. A big building too, with high ceilings. Very accepting. First visited in 2008. Some day I plan to return. |
64 A large brew pub with a chain feel to it. There were about 6 house beers on tap, with two being seasonal. The food was good, though nothing strayed too far from typical pub fare. Service was good. |
64 (Visited 05/2010): Ram Restaurant/Big Horn Brewing is located in Schaumburg right off I-90 on McConner Pkwy. They have a fairly large lot.
The inside is very spacious with high ceilings. The lounge/bar area is on the right and the restaurant seating area is on the left. There is a lot of brick along with red/brown colors and the place has a somewhat industrial feel. In the bar area the brewing equipment is visible, and there are large boards displaying the beers on tap.
As for the beers, this location has more or less the standard "spiral" group of beers from the Hefe, Big Red IPA, 71 Pale, etc as well as a seasonal (Maibock). All of the beers are more or less average and are available in a sampler for $4.
Service was decent on a weekday lunch. The bar server didnt seem overly knowledgeable about beer but was friendly.
The food at Ram is pretty good, no complaints about my sandwich.
Overall this is a decent stop along the highway but is pretty far down the list of Chicago-area beer spots. |
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Company Overview of Aescologic, AG
Company Overview
Aescologic AG operates as a distributor of medical supplies. The company is based in Wuppertal, Germany.
Unterkirchen 23
Wuppertal, 42349
Founded in 2000
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Direct Health Care Costs of Diabetic Patients in Spain
OBJECTIVE—The goal of this study was to estimate the health care resources spent by type 1 and type 2 diabetic patients in Spain during the year 2002.
RESEARCH DESIGN AND METHODS—This is a cost-of-illness study focusing on direct health care costs estimated from primary and secondary sources of information. A prevalence of diabetes ranging from 5 to 6% of the adult population was determined. Total cost is composed of six items: insulin and oral hypoglycemic agents, other drugs, disposable and consumable goods (glucose test strips, needles, and syringes), hospitalization, primary care visits, and visits to endocrinologists and dialysis.
RESULTS—The estimated direct cost of diabetes in 2002 ranges from €2.4 to 2.67 billion. Hospital costs were the most (€933 million), followed by noninsulin, nonhypoglycemic agent drugs (€777–932 million). Much lower are the costs of insulin and oral hypoglycemic agents (€311 million), primary care visits (€181–272 million), specialized visits (€127–145 million), and disposable elements (€70–81 million). Expenditures for all drugs and consumable goods ranged between €1.16 and 1.3 billion, representing 48–49% of total cost, which is 15% higher than hospital costs.
CONCLUSIONS—The direct health care costs of diabetic patients are high (6.3–7.4% of total National Health System expenditure). Their average annual cost is €1,290–1,476. For individuals without diabetes, the average annual cost is €865.
- CMBD, Conjunto Mínimo Básico de Datos
- DRG, diagnosis-related group
- SNS, Spain's National Health System
The goal of this study was to estimate the direct health care costs of patients with diabetes, including chronic complications. Diabetes is a high-incidence, chronic, globally occurring disease that increases morbidity and mortality, seriously diminishing quality of life. The World Health Organization estimated that in 1995, 135 million adults had the disease, and it forecasts that 300 million (a 120% increase) (1) will have it in the year 2025. Resources allocated to diabetes prevention and treatment are growing, but prevalence also grows steadily. Acute decompensations that are chronic complications, such as cardiovascular problems, renal disease, neuropathy, foot ulcer, and loss of vision, are frequently associated with diabetes. The risk of having these conditions is higher for diabetic patients compared with nondiabetic patients in the same age-group (2–4).
Chronic complications are the main cause of death among diabetic patients and account for the highest costs in hospitalization and drugs, and the costs of drugs for these complications are 2.5 times higher than those for the general population. Even after adjustment by age and exclusion of insulin and oral hypoglycemic agents, expenditures for other drugs are higher among diabetic patients (5,6). Given the relevance of diabetes complications (7–12), particularly chronic complications, cost-of-illness studies based only on acute complications result in underestimations. A key contribution of this study is to account not only for the direct costs of diabetes itself but also for the consumption of resources to prevent and treat complications.
In Spain the National Health System (SNS) is a public health care insurance system, with universal coverage of the population of 41 million. Administered by the 17 "autonomous communities" (states), it is coordinated by the national government and fully financed by the general tax fund. Hospitals and primary health care centers are publicly owned, with some contracting out to private hospitals. Medical doctors are paid by salary. Primary care doctors act as gatekeepers. There are private health insurance companies and private practices, particularly of specialists, with a complementary role, although some activities are totally private (i.e., dental care). The national health expenditure is 7.5% of gross domestic product: 71% public and 29% private.
In Spain, only three studies have measured the direct health care costs of diabetes. In the study by Hart et al. (13), total costs associated with diabetes in 1994 were ∼€544.8 million, with an average annual cost of €381 per diabetic patient. Hospitalizations represent the main portion of all costs (36%), followed by doctor and hospital outpatient visits (14.1%), antidiabetes drugs (13.2%), laboratory tests (10%), and dialysis (9.4%).
The CODE-2 study (14) analyzed 1,004 type 2 diabetic patients. The mean annual direct health care cost per patient was €1,304, indicating a total annual cost for Spain of €1.96 billion. The highest expenditures were drugs (42.4%), hospital care (32%), and ambulatory care (25.6%).
López Bastida et al. (15) considered the direct and indirect costs of diabetes in the Canary Islands. Their findings show that the direct health care costs were €24 million, or €470 per known diabetic patient per year (62% of the total cost of a diabetic patient). The indirect costs were €14.8 million (38% of the total). Because prevalence in this area is by far higher than the national average, it is a study that is difficult to extrapolate.
This study focuses on the prevalence of diabetes and is aimed at estimating total and per patient direct health care costs of diabetic patients cared for by the SNS in the year 2002. Because of lack of data, we do not consider private health care costs.
In accordance with the most recent epidemiological data for prevalence, we have selected an interval of 5–6% (16–29). The variety of sources, methodologies, and estimations made it difficult to select only one value; 5% is the figure from the 1997 Spanish National Health Survey (28) for adults (18 years and older) who reported that they had diabetes, had high blood glucose levels, or used antidiabetes drugs. In more recent studies, prevalence was near 6% or even higher (18,26,27,29). The interval selected is rather conservative, given that it is well established that a significant percentage of diabetes is not diagnosed (18,30), whereas prevalence of diabetes is increasing. Another assumption is that 90% of cases were considered type 2 diabetes and 10% type 1 diabetes (30).
The rate of prevalence determines the cost per patient. However, in our study, the total costs of some important items (e.g., hospitalizations, insulin, or oral hypoglycemic agents) were obtained from primary sources, with total coverage of the event under measurement (census technique, not survey). For this reason, these costs are not estimations but rather are recorded universal data and are not dependent on prevalence. Table 1 shows sources of information for resources considered.
Total expenditures on insulin and oral hypoglycemic agents were obtained directly from the databases of the General Directorate of Pharmacy of the Ministry of Health (31,32). These databases (ALHAQUEM and RHAZES) accurately compile comprehensive information on the consumption of medicines by all outpatients in the SNS. These data are obtained after processing all prescriptions for payment purposes to the pharmacies.
It is extremely important to consider the fact that diabetic patients are treated with additional medications to prevent or treat complications associated with diabetes. Age-adjusted consumption of hypolipidemic, antihypertensive, and platelet antiaggregating drugs is significantly higher in these patients than in the general population (6,14,33). Figures for noninsulin, nonoral hypoglycemic drugs come from the CODE-2 study (14), updated for the year 2002.
Expenditures on test strips were calculated using data from four available sources. INSALUD (the central government agency still providing health care to 14 million people before devolution to the states was completed in 2002) compiled the primary data. Studies by Olveira and Carral (33) and Clua and colleagues (34,35) were secondary sources of information.
The pattern of use and the costs of needles and syringes were drawn from studies by Costa and colleagues (36,37). We assumed that only type 1 diabetic patients use these items, which is a conservative hypothesis because a number of type 2 diabetic patients are treated with insulin.
For outpatient visits to endocrinologists (including overhead costs and laboratory tests), we relied on the following information: 1) expertise from the department of analytical accountancy of the Hospital of Getafe, 2) secondary sources (15,39), and 3) data from INSALUD (38) on cost per visit in a section of endocrinology.
Another cost item is dialysis for diabetic patients. The prevalence of diabetic patients undergoing dialysis was obtained from a study by Amenabar et al. (40).
It should be noted that there is no information about visits to specialists other than endocrinologists (such as neurologists, cardiologists, and ophthalmologists). For this reason, we do not include these in our analysis.
Data for primary care are from secondary sources. In a study by López Bastida, Serrano Aguilar, and Duque González (15), the frequency of primary care visits was 11 per patient per year for patients receiving insulin and 9 for those receiving oral hypoglycemic agents or being treated by diet only. Clua and colleagues (34,35) found a frequency of 10 visits per patient per year in the area they analyzed. No primary data on costs per visit in primary care are available. We reviewed previous works published in Spain and found wide variations among different authors (13,41–45). Therefore, we drew on the mid-range values.
To calculate hospital costs, we relied on the Conjunto Mínimo Básico de Datos (CMBD) (set of minimum basic data) (46). The CMBD follows the recommendations of the European Minimum Basic Data Committee and compiles useful information, starting from clinical records and discharge reports from public and private hospitals using ICD-9-CM, in which diabetes has the main code 250. After the first classification, each patient is assigned to a diagnosis-related group (DRG) (Table 2). The CMBD recovers main and subsequent secondary diagnoses. This is very important because it improves the detection of diabetic patients hospitalized for causes other than acute diabetes complications. We selected all hospitalizations with diabetes as a diagnosis, whether primary or subsequent. When diabetic patients are hospitalized because of decompensation related to diabetes, they are included in either DRG 294 or DRG 295. If hospitalization was caused by a chronic complication, then we grouped the patients according to the primary disease, that is, diabetes. In this way, by grouping DRGs by disease, all chronic diabetes-related complications are taken into account.
From the aforementioned primary and secondary sources, we estimated the direct health care cost of diabetic patients in Spain. Other direct costs, such as special diets, educational programs, visits to specialist nurses, or emergency room services, were not considered. All figures were updated to the year 2002 by applying the annual inflation rate, unless otherwise specified.
According to data from the General Directorate of Pharmacy, the total cost of insulin and oral hypoglycemic agents (A10A and A10B subclasses) was €311.4 million (Table 3). A large part of the expenditures for type 2 diabetes is attributable to other drugs. In general, age-adjusted drug expenditures for type 1 diabetic patients are substantially higher than those for type 2 diabetic patients. Nonetheless, the average age of type 1 diabetic patients is younger, making it plausible that their average drug consumption could be similar even without age adjustment. We assumed that the average cost of noninsulin, nonoral hypoglycemic drugs is similar in type 1 and type 2 diabetic patients. Considering a 5% prevalence in the adult population (1,675,304 people), the cost of these drugs is €777.0 million. Assuming a 5.5% prevalence (1,842,835 people), the costs would be €854.7 million. Finally, if prevalence were 6% (2,010,365 people), the resulting cost would be €932.4 million.
INSALUD's expenditures for test strips reached €23.86 million in 2002. Extrapolating this figure for the whole population (36% of Spaniards were covered by INSALUD in 2000), the result is €66.82 million in 2000. Updated to 2002, the figure would be €70.89 million (hypothesis A). A previous study (33) estimated that 1.3% of the Spanish population, or 531,016 people, used test strips. The per capita annual cost in 1997 was estimated to be €103.6. Adjusting that figure to 2002 and assuming a constant percentage of users, the estimated cost for 2002 is €66.87 million (hypothesis B). If we suppose that the number of test strip users has increased to 1.5% of the population (615,593 people), then the estimated cost increases to €77.52 million (hypothesis C).
According to Costa and colleagues (36,37), the daily cost of needles and syringes ranged between €0.051 and 0.054. Applying our estimated prevalence, the total annual cost of needles and syringes for 2002 would range between €3.22 and 4.04 million.
To estimate the cost of visits to endocrinologists, our starting assumption was that between one-third and one-half of all visits to endocrinologists are because of diabetes (39). The subsequent visit–to–first visit ratio is four to one. The cost of each first visit (38) was €79.4 (updated to 2002), whereas the cost of each subsequent visit was €47.6. Total first visits range between 127,691 and 191,537 per year, and total annual number of subsequent visits range between 510,764 and 766,146. These figures would result in an estimated cost ranging from $34.46 to $51.69 million.
Amenabar et al. (40) reported the prevalence of dialysis in Spain and identified diabetes as the main cause of renal failure, responsible for 23% of patients undergoing dialysis in the year 2000. Therefore, the number of diabetic patients undergoing dialysis was 3,994, and 371 underwent peritoneal dialysis in that year. The total annual cost of dialysis for diabetic patients was €93 million in 2002, with €21,308 being the mean annual cost per treatment (47) (€19,500 in 1999, adjusted to 2002).
The frequency of primary care visits was conservatively (15,34,35) estimated to be nine per year. According to our prevalence rate, the number of primary care visits may fluctuate between 15 and 18 million annually. Because of the wide dispersion of costs estimated for primary care visits in Spain, we used an average of intermediate values found in recent literature. These values range between €12 (hypothesis A) and €15 (hypothesis B) per visit. Under these assumptions, the estimated cost ranges from €181.24 million (prevalence 5%, mean cost per visit €12) and €271.86 million (prevalence 6%, mean cost per visit €15), calculating in-between values for the other assumptions.
Finally, using the CMBD (46) we estimated hospital costs. We found 285,013 hospitalizations, a little more than 3 million stays, related to patients with "diabetes" in their diagnoses (main or secondary). Applying the mean tariff per DRG per case, the total cost of stays was €853.74 million in 1999 and €932.99 million in 2002 after adjustment for inflation.
Acute complications were 4.7% of total hospital costs for diabetic patients, chronic complications accounted for 37.4% (32.2% caused by macrovascular problems and 5.2% by microvascular), and hospitalizations apparently unrelated to diabetes accounted for the remaining 57.8%.
Aggregating the items just mentioned, we arrive at a direct yearly health care cost that fluctuates between €2.4 and 2.67 billion. If we compare this with total costs of the SNS, the costs for diabetes range from 6.3 to 7.4%. The annual average cost per diabetic patient is between €1,290 and 1,476, whereas, for nondiabetic individuals in the SNS, it is €860.
Regarding the distribution of these costs, hospitalization and drugs are the most important items. Hospital costs fluctuate, depending on the assumptions involved, between 35 and 39% of the total. Expenditures on insulin and oral hypoglycemic agents range from 12 to 13%, whereas the cost of other drugs is between 31 and 36%. The cost of primary care visits trail far behind, varying from 8 to 10% of the total. The cost of visits to the endocrinologist and dialysis are 5–6%, whereas the cost of test strips, needles, and syringes amount to 3–4% of the total.
It has been estimated that diabetic patients consume at least ∼5–6% of health care expenditures in developed countries and that a diabetic patient consumes more resources (physician services, drugs, and hospitalizations) than does a nondiabetic patient (11).
In this article, we quantify direct medical costs of diabetic patients for 2002 in Spain, capturing all available data in the National Health System. We found that they range between 6.3 and 7.4% of total public health expenditures. It means that the annual average cost of a person with diabetes is between €1,290 and 1,476 (excluding visits to specialists other than endocrinologists), whereas for individuals without diabetes the cost is €860.
Other attempts to determine the costs of diabetic patients in Spain had not included all relevant costs. It is important to highlight the fact that this is the first time to our knowledge that the CMBD and the General Directorate of Pharmacy databases have been used to estimate the cost of diabetic patients in Spain.
Several limitations of this study must be recognized. First, diabetes prevalence is probably higher than our figures because a significant number of cases go undiagnosed. This fact could change our average cost per patient but not total costs, obtained mainly from primary sources and official accounting records measuring resources spent independently of the number of patients treated. Only our estimations of "cost of other drugs" and "cost per visit in primary care" depend on the prevalence rate.
Second, our hospital cost figures are a conservative estimation of the real cost of diabetic patients. The reason for this is that the CMBD relies on a tariff for each DRG, but several studies show that for identical DRGs the average cost of diabetic patients is higher than the cost of nondiabetic patients (48–50). Therefore, hospital costs related to chronic complications and other hospitalizations of diabetic patients must actually be higher than our figures. The explanation is simple: diabetes makes treating any other disease more expensive because it extends hospital stays. This also makes diabetic patients more expensive than nondiabetic patients, independent of the episode that caused the hospitalization. Actually, the CMBD shows differences in the length of stay for diabetic and nondiabetic patients in the 590 identified DRGs, even after age is factored out. Other international studies reflect similar differences in the age-adjusted mean length of stay for identical DRGs among diabetic and nondiabetic patients (2,8,10,51).
We did not include costs for all possible health care items. Specifically, the number of visits to specialists other than endocrinologists is unknown. For the number and cost of visits in primary care, we had to rely on secondary sources. The fact is that for ambulatory care (primary or specialized), at present, there are no general, homogeneous, high-quality data (whereas data for drugs and hospitalizations are solid).
It also should be underlined that the present work does not consider non–health care direct costs, indirect costs (productivity loss), or informal care costs faced by patients and society as a whole. Estimations of indirect costs are not often performed, and findings diverge, ranging anywhere from 30 to 55% of total costs (4,7,11,52–55). Similarly, intangible costs connected to diabetes were not included. In chronic diseases, these costs are often significant, but quantifying them is very complex.
The relative weight of different items is similar to the findings of other studies (4,8,9,11), with hospital costs being the main item. However, many articles omit data on drugs other than insulin and oral hypoglycemic agents. Polypharmacy is a frequent phenomenon among diabetic patients and becomes widespread with age and the evolution of the disease over time. Almost every diabetic patient requires not only hypoglycemic treatment but also treatment for comorbidities and cardiovascular risk factors linked to diabetes. In fact, if we add up the aggregate costs of insulin, oral hypoglycemic agents, and other drugs, plus the costs of consumable goods, their total value would surpass hospital costs (49 vs. 35% for 6% prevalence). This is our more striking finding. (It should be noted, however, that the relative weight of each item should be considered rather cautiously, given the aforementioned information and data problems.) This finding is a reflection of the fact that almost all diabetic patients will undergo treatment for cardiovascular risks, macrovascular complications, and other complications, with the number of drugs increasing with age and disease progression that will account for a high proportion of overall costs. Therefore, quality management of diabetes and chronic complications should be imperative.
Resources should not be allocated according to the costs of diseases (56) but rather where interventions benefit the most. As this study has shown, cost-of-illness studies help to illustrate the real dimension of health problems and are suitable to reveal the economic burden of a given disease, quantifying health care and other resources spent that could be allocated to alternative goals (57).
This study has been funded by a grant from Novo Nordisk.
We thank I. Urrutia, F. Gómez, J.L. Clua, J. López Bastida, A. Rivero, J. García Rey, J. Gervás, L. Cabello, J. Damián, B. Crespo, and three anonymous referees.
J.O. and F.L. have received consulting fees, honoraria, and grant/research support from Novo Nordisk. S.M. has received honoraria from Novo Nordisk.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
- Accepted August 2, 2004.
- Received January 21, 2004.


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spanishstoat is already a PRO member, don't waste your vote
OK so this is something I have been contemplating for a while now but didn't
quite know how I was going to execute it and decided to do it MOTM style.
Make A Member PRO Rules
No Cheerleaders Allowed
Poll nominees can't vote for themselves, but HAVE to vote.
Everyone can nominate one non pro member (dark blue name) with a reason as to why they deserve it
The top 3-5 nominees will be placed into a poll
You guys then pick the winner who will be made a PRO Member
Previous Winners
Encorporeus, Congrats mate!
(I choose him as the first member to kick things off, but you guys choose from now on)
Now Lets See Some Nominations People
View Poll Results: Which Member Deserves Being A PRO Member
- Voters
- 23. You may not vote on this poll
Results 1 to 20 of 34
GDT RIP May Make A Member PRO
This is a discussion on GDT RIP May Make A Member PRO within the Site & Member Thrown Competitions forum, part of the PS3Trophies.com Headquarters; spanishstoat is already a PRO member, don't waste your vote OK so this is something I have been contemplating for ...
05-15-2013 #1
- Join Date
- Sep 2011
- Location
- Queensland, Australia
- Posts
- 3,395
- Reputation
- 351
Total Awards: 19GDT RIP May Make A Member PRO
Last edited by great_daze_tazer; 05-21-2013 at 08:40 PM.
05-15-2013 #2
- Join Date
- Sep 2011
- Location
- Queensland, Australia
- Posts
- 3,395
- Reputation
- 351
Total Awards: 19I nominate Hall_Of_Game because every time we have talked he is always polite and I feel he could make an impact on the site
05-15-2013 #3
I'll second Hall of Game's nomination. In the conversations I've had with him and the posts of his that I've read, he seems to be a stand up guy that would add to this site. Another person who fits the same criteria is spanishstoat, he's a fun guy to chat with too. Both of them are plenty active around here, which is a big plus due to our declining activity amongst members lately.
I'll put spanishstoat's name in the mix.
05-15-2013 #4
- Join Date
- Sep 2011
- Location
- Posts
- 4,628
- Reputation
- 661
Total Awards: 43Stoat isn't PRO already? I would throw in another tally for him…Stoat is friendly and contributes to the threads and now makes sig's and avy's for people. Also he is almost always found in the CB chatting away with someone
05-15-2013 #5
i'd like to nominate xEl_Cidx because of his forum activity (1000+ posts) and he's been active member for a while so you wouldn't be wasting the upgrade on someone who isn't going to stick around.
05-15-2013 #6
05-15-2013 #7
I would like to nominate Herr-Ninja for the prize, he is always fun to chat with in the CB .
05-15-2013 #8
Throwin' in a vote for spanishtoast. He's written some nice guides, started doing GFX for members of the site, and also a lil' chatter box in the CB.
05-15-2013 #9
05-15-2013 #10
Hey, I won!
Anyway I'll vote for xEL_Cidx as he's an active forumer who's been contributing a lot recently on the forum games and trophy checklist sections of the forums and is funny when you get to know him.
05-15-2013 #11
- Join Date
- Sep 2011
- Location
- Dark Fantasy
- Posts
- 3,724
- Reputation
- 158
Total Awards: 18My vote goes to spanishstoat. He's an awesome guy to talk to, always active, has made some top-notch guides for the site and recently has just started making sigs and avys for other members and I praise him for that.
Last edited by Qurb; 05-15-2013 at 11:41 AM.
05-15-2013 #12
- Join Date
- Sep 2011
- Location
- One dimension short of being in a 3D game.
- Posts
- 2,432
- Reputation
- 161
Total Awards: 11xEl_Cidx for me, consistent in forum appearances and doesn't push up his post count with filler.
Also, congrats to Encorp, well deserved.
05-15-2013 #13
Shit there are a few I'd vote for but gonna have to go with my mate Hall Of Game. He ticks all the boxes, he's active, friendly, welcomes the new members and yeah he's just a top bloke. People like him encourage new members to become active.
05-15-2013 #14
Aw guys Thanks a lot.
As much as I'm here so far, I'm still new, haven't contributed to any guides, and I'm not exactly experienced with the PS3 at all. Thanks though for considering me.
I have to say it's tough to vote. It looks like ST has got some good support so far, so I'll throw my vote to Cid. We like to play forums games a lot.
But don't forget ST.... he made my sigy
Almost forgot, THANKS GDT FOR ANOTHER GREAT COMP!
05-15-2013 #15
Have go throw my vote for stoat. This kid has been a great member and has contributed a hell of a lot with guides. Helps out with boosting whenever possible and is a great person to talk to in the CB.
05-15-2013 #16
- Join Date
- Jan 2012
- Location
- Morphogenetic Field
- Posts
- 2,151
- Reputation
- 281
Total Awards: 21The Stoat. He's always looking for ways to contribute to the site.
05-15-2013 #17
- Join Date
- Feb 2013
- Location
- Cape Girardeau, Missouri
- Posts
- 64
- Reputation
- 1
Total Awards: 3I'd also like to nominate Spanishstoat he has been very helpful and fun to chat with and also there to lend a helping hand
05-15-2013 #18
I suppose I will go with Herr-Ninja. Decent dude most times, plays a lot of games with the members and is always in the cb,
05-15-2013 #19
05-15-2013 #20
- Join Date
- Sep 2011
- Location
- City Of Angels
- Posts
- 2,100
- Reputation
- 114
Total Awards: 10I'd like to nominate The Toat, He's been active and he made some cool looking sigs for people too
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Remodeling's "Hidden" Charges Exposed – Tiles
January 27, 2011
As consumers, we are always fearful that we will be taken for a ride. Remodeling is one of those places where, inevitably, the dollar amount charged is not what you expected and then there are the little things that carry a big price tag.
After repeat requests about "how much does a remodel cost," we created this educational series highlighting places where expenditures rise. Sometimes these expenditures can be avoided, sometimes not; however, the more prepared you are when it is time to remodel your home, the more confident you will be in your relationship with your contractor and your design decisions.
As a material, tile comes with a price tag starting at $1.25 on up to hundreds of dollars per square foot. This is pretty obvious when you have the material in hand. What is not so obvious is the labor cost involved for the tile you are looking at. Our first thought is that the cost to install tile is a flat rate no matter what tile we choose. This is a mistake.
Floor and Wall Patterns
If you want to have your tile installed in a pattern, the floor on a diagonal for example, your investment goes up. When tile is installed 90-degrees to the room, tile edges will line up with the wall; when the pattern is put on a diagonal, every tile that meets the wall will need to be cut. This requires more material and more time for the installer to make these cuts. As such, you will be looking at paying more.
The more intricate the pattern, the more time the installer will need to take during the install and the more expensive the project.
Odd Shaped Tile
The same thing applies to any tile that is not rectangular in shape. Where floor meet the wall, every tile will need to be cut.
Mosaics are typically 1×1 tiles and come on a 12×12 mesh sheet. These can be relatively easy to install. But… here it comes. If you are looking at a tile that is a hexagon you will want to be sure that the tile line carries "points." Points are pre-cut portions of the tile. Remember, when you get to the wall you will need 1/2 of a 1″ piece of tile to fill the void. Paying for your tile expert to cut 1″ pieces of tile is going to add up in a hurry. If the tile doesn't come with points and you really love it but don't want pay your tile setter for the additional tile, you may opt to have the 1/2″ void grouted in. Once the baseboard is installed it will be hardly noticeable.
Large Format Tile
Large format tile is anything over 12″x12″. Large format tile is quickly gaining in popularity, and for good reason. Why look at grout lines when you could be looking at a pretty tile?
However, the gaps between tiles is where installers find room for adjustment. Perhaps the room isn't perfectly square (most rooms aren't perfectly square) or the wall/floor isn't perfectly flat (most walls/floors aren't perfectly flat), adjustments made in small increments are undetectable to the eye and, at the same time, hides the imperfections of the room's construction. (The reason why old homes feature mosaic floors is more than just a design statement.)
Now, compare the installation of a 12×24 versus a 12×12. Instead of making an adjustment every foot you are making an adjustment every 2 feet, this doubles the adjustment. What may have been 1/16″ adjustment is now 1/8″ – and it is no longer undetectable. However, if the adjustment isn't made, your room will look out of square.
Every contractor wants repeat business and they aren't keen on a shoddy looking room. The resolution is to start with as near perfect room as you can. This means more shimming, more skimming and possibly even a coat of self leveling floor compound. This prep work is time-consuming.
If you are installing large format tile on the walls you can expect an added layer of cost. The larger the tile, the heavier it is. When working with small tiles, an entire wall can be set at once. As the tiles get heavier, the more they want to slide down the wall. Bottom rows of tiles need to set and cure before you can add height. Your installer may only be able to set a few rows of tile (or just one row of tile it is very large tile) per day.
You may be trying to pinch your pennies during this economy. In the past, there was a vast price gap between porcelain tile and ceramic. Today, the difference in price is negligable. For durability and longevity, invest in the porcelain. And then, keep your tile rectangular and 12×12 or under in size. Nothing feels worse than to buy a tile on clearance thinking you're getting a deal, just to find out it will cost you double in labor… and when it comes to tile, the labor is usually the more expensive portion of the project.
As a side note, if you are looking for something truely unique but want to keep life simple for your tile setter, there are companies that will precut extensive tile patterns. Your contractor can provide to this kind of company your tile and your pattern. If you have a unique shaped tub of shower base, you contractor can give them a scribe or pattern of the shapes and they can cut your tiles to fit. This will not only be a cleaner look, but may also be less expensive than having your contractor cut each piece on the jobsite.
Written by staff designer Stephanie Bullwinkel, CBD for Imperial Kitchens and Baths, Inc.
Remodeling's "Hidden" Charges Exposed – Demolition
January 18, 2011
As consumers, we are always fearful that we will be taken for a ride. Remodeling is one of those places where, inevitably, the dollar amount charged is not what you expected and then there are the little things that carry a big price tag.
After repeat requests about "how much does a remodel cost," we created this educational series highlighting places where expenditures rise. Sometimes these expenditures can be avoided, sometimes not; however, the more prepared you are when it is time to remodel your home, the more confident you will be in your relationship with your contractor and your design decisions.
On average, newer homes are easier and less expensive to demo. The plumbing and electric is generally up to code and building materials are in good condition. So I will be addressing the cost of doing work in a pre-1978 home.
US EPA RRP Lead Laws
Right from the start, your contractor should be EPA Lead RRP certified. When permits are pulled for your project, your local government will require it. Homes that we're built prior to 1978 have a higher chance of being painted with lead-based paint. If your contractor is disrupting painted surfaces, they will need to partition off the area with plastic and vacuum the area with a HEPA rated vacuum. This should lower the risk of contaminating the rest of the home with lead paint dust.
You can expect a fee of a few hundred dollars for the material and labor for this service. The exact amount will be determined by the size of the area to be shielded in plastic. Once the area has been taped-off, stay out. If you do not like the way the plastic has been hung, talk to your contractor – do not remove the plastic on your own. Not only could this make you responsible for any damage the contractor's adhesive may cause your ceiling, walls or floor – but the contractor will probably charge you a second fee for having to reinstallation the plastic.
Glass Tile
Vitrolite: The bathrooms of older homes often have this beautiful glass tile in large format. It can be just in the shower/bath area, or all around the room. The biggest problem with this tile is that it is heavy and it is not tempered. Carefully removing this kind of tile is time-consuming and therefore costly. Many of our clients opt to save money by doing their own demo; however, removal of this kind of tile is not a DIY project.
(As a word of caution, if you currently have this kind of tile in your home and it is loose or falling off the walls, but you are not ready to renovate just yet; remove the few tiles in question carefully, or have a professional do it for you. If you have another bathroom in the home, use it exclusively until you can have the room updated.)
Disruption of a "Seemingly Fine" Room
During demo is when problems with a room rise to the surface. Walls are opened and mold is exposed, floors and soffits hide iron drain pipes where the top halves are rusted away. If the room has never seen a renovation, or it has been several decades since the last remodel, be prepared for surprises. It would be wise to budget for unseen expenditures, as your contractor will not know what these costs will be until they are uncovered. Once you know what you can afford for your remodel, take 90% of it and give that number to your contractor or designer and save the remaining 10% as your cushion to pay for the unseen.
Can you save money on a demolition? Yes! But it will probably require you to take responsibility for the labor of removing and disposing of product and building materials.
Written by Imperial Kitchens and Baths, Inc. staff designer Stephanie Bullwinkel, CBD.
Remodeling's "Hidden" Charges Exposed – Change Orders
January 4, 2011
As consumers, we are always fearful that we will be taken for a ride. Remodeling is one of those places where, inevitably, the dollar amount charged is not what you expected and then there are the little things that carry a big price tag.
Change Orders
Many builders and remodelers charge a fee for change orders. This fee can be a flat price or a percentage. Regardless of whether you are adding to a project or deducting from a project, this fee will probably hold. Be sure to ask your contractor about this fee and scan your paperwork for it prior to signing anything; they need to be upfront about it in order to charge for it.
Once a project is sold, the office will start to process the finalized paperwork. This process includes the obvious of ordering materials and scheduling trades. The not-so-obvious part is the distribution of information. Your salesperson/designer is your contact, but that person disseminates information to a team of people who distributes that information to their team of people.
Here's an example to illustrate this: The salesperson gives a copy of the contract and all supporting documentation to the comptroller (to enter all information into the company's system), to the accountant (to figure out payment schedules to the various vendors), to the scheduling department, to the supervisor and to the material handler. The comptroller pulls permits and other licenses, bonds, etc.; the scheduling department organizes all the various trades according to availability of labor and the availability of product; the supervisor looks over the plans and creates a work order for each trade and the material handler calls all the vendors necessary to get the products in-house when needed.
When a change order comes from a client, everyone needs to be alerted to the change. Even something as small as changing the finish on a faucet can cause turmoil. Time, effort and due diligence is required of all staff members and the risk of an error is raised substantially.
These are all factors that are considered when a contractor accepts a client's change order. Without involving a fee for this disruption in the process, a contractor could easily go broke. And, of course, this is just for the service end of a change order. By removing product from a project, you can also expect a restocking fee (25% is standard) for the unexpected shipping, handling and additional paperwork on the part of the warehouse. Beware, custom and special ordered product is usually non-refundable.
Of course, things happen on job sites. A wall is opened and surprise! These kind of things are par for the course and you should not be charged an additional premium for a change order.
It can be said that change order fees discourage clients from changing their minds. From a contractor's stand point, that's not a bad thing. If you desire the smoothest project for the least amount of money, stay committed to the agreed to project.
Written by staff designer Stephanie Bullwinkel, CBD for Imperial Kitchens and Baths, Inc.
Defining Style
November 16, 2010
What is the "current design trend?"
This year, article after article (in both retail and to-the-trade magazines) designers are contradicting themselves before they even get to penning the final paragraph. As you read, experts are saying black and white combos are so now. However, neutrals and earth tones are hotter than they've ever been. Bold colors like hot pink and chartuese are timely. But dark green is selling with clients.
Basically, anything goes… and it's a blessing and a curse.
How fun it is to say that you can have almost anything you want and it is current with today's style trends. But what about tomorrow?
It's enough to drive a designer insane, let alone a homeowner trying to update their house to sell (or live in for that matter). With the economy strapped for cash, we want to spend our dollars on design that will last.
While the design industry seems to be saying "Anything goes! Just spend money;" consumers keep asking, "What design direction should I go in that is the best choice for longevity and resale value?"
So, adding our voice to all the other experts writing about home design, here is our take on how to focus yourself on a design for your home.
- Keep the architecture of your home in mind. If you have a home with a predisposed historical design, then follow it (ie. owners of bungalows should look to 1920's designs and materials for inspiration).
- Then be daring, go to the extreme. High contrast or minimal contrast. Stay way from the middle ground or the "safe zone." While, it does not need to shout, a home should make a clear statement.
- Finally, look for balance. Some women need to take off a piece of jewelry before they leave the house while others need to put a piece on – designing a room is no different.
If you're still finding yourself dazed and confused, even with a designer in tow as you visit the Merchandise Mart week after week, take heart. You can never go wrong with buying design that you like… after all, you live there. And if anyone asks you to define your home's style, tell them it's "eclectic" – after all, it's all the rage.
Written by staff designer Stephanie Bullwinkel, CBD for Imperial Kitchens and Baths, Inc.
Show Me Your Work
August 18, 2010
I love to look at the work of other designers. I have subscriptions to atleast 10 magazines showcasing either design trends for the general public or ideas and knowledge for industry professionals. Those fleeting moments when I'm waiting for applications to load on my computer, I'm surfing the internet studying the competition.
While our company is located in the midwest, I look at sites for designers and remodelers all over the world. The ideas that can accumulate in one's brain is amazing! And while a popular design trend in Miami will probably never fly with my Chicago client, a solution to a design challenge can sometimes rise to the top.
Designers and remodelers should always be learning from each other. But as I have been surfing often lately, I have been coming across a disturbing trend more and more… Photo galleries that are not necessarily reflective of a company's portfolio of work.
The most natural thing when shopping for a designer or contractor is to investigate their website. You see a link called "Photos" and wow! Amazing photographs of amazing rooms. The first question you need to ask… is this a "portfolio of work?" Or is it a "photo gallery?" The later being a collection of photos freely downloaded from the internet that has no relationship to the work performed by this company or individual.
Sad as it may seem, while not blatantly saying 'this is my work' when it is not – posting photos on a website gives the impression that this is the product of this particular company, especially when the source of the photo is not acknowledged. With unemployment so high, many people are trying their hand at flying solo and an impressive website is a good start to finding clients. The old adage of "fake it until your make it" comes in here.
There is nothing wrong with using a first time designer or remodeler on your project – as long as you know, up front, that you are a guinea pig and your investment reflects the inconveniences that you will inevitably encounter.
If you find a website where the photos are professionally shot and there are no acknowledgements attached to the pictures, ask them in an email or phone call if the photos of are their work. If the answer is that it is not their work but they can replicate that look, ask to see a portfolio of their actual work. Don't be afraid to even ask for references for those photos. Trust is earned, not given – and in this business, you are dealing with one of your biggest investments, your home. Never assume anything.
Written for Imperial Kitchens and Baths, Inc. by staff designer Stephanie Bullwinkel, CBD.
Renovate Right
March 24, 2010
On April 22, 2010 the US EPA's law on "Renovation, Repair and Painting" (RRP) will go into effect. This new law will affect you, if:
- You live in a home that was built prior to 1978.
- Your children (age 6 or younger) attend a facility that was built prior to 1978.
Why 1978? Lead-based paint was used in more than 38 million homes and buildings until it was banned for residential use in 1978. Once ingested, lead, like other heavy elements, has a way of hanging around in our bodies – this can cause biological disturbances. In large doses, it can lead to toxicity – affecting our brains and nervous systems. Children, in their developing stages, are the most susceptible to lead toxicity.
Lead in paint that is adhered to an object does not propose a danger – it does not out-gas or radiate. If you live in a home that contains lead paint, you do not necessarily need to have a costly abatement team remove all paint from your home. Disrupting lead paint is where the EPA's concern is.
Lead gets into our bodies via nose and mouth. Paint chips and dust particles are the biggest culprits to ingesting lead paint. If you are renovating an older building, paint disruption is due to occur.
The EPA is requiring by federal law that all contractors who work in buildings built before 1978 and disrupt more than 6 square feet of interior paint or 20 square feet of exterior paint to be Certified. This includes, but is not limited to:
- Renovators
- Remodelers
- Plumbers
- Painters
- Electricians
- Window and Door Contractors
- General Contractors
- Landlords and Property Managers
- Some Building Engineers
Your contractor should provide for you, before the renovation begins, a copy of the EPA's Renovate Right pamphlet. You will also need to sign documentation for your contractor's files saying that you received the pamphlet. This documentation also outlines options available if you would like to opt out of the RRP procedures.
Certified professionals have been through training in how to properly handle spaces where lead paint may be present. Containment of lead paint chips and dust are a primary concern. These procedures are time-consuming and require additional job materials. You can expect your renovator to line item this procedure for your home project (this small cost may vary depending on the space, project and your geographical location). The added time and cost to your contract is worth the sense of mind in knowing that your health and wellbeing is being protected. The federal government is currently experiencing a backlog as US contractors rush to get their certification. If your contractor cannot produce a RRP Certification, ask to see proof of their RRP training.
Property owners who opt to DIY are excluded from this new law. However, it highly recommended that homeowners take steps to keep themselves safe with these best practices.
- Tape off with plastic the area you are working in.
- Limit leaving the work area to go to other areas of the home.
- Do not eat in the work area.
- Keep children and animal out of the area until it has been throughly cleaned.
- If you have them, use power tools that are connected to a vacuum system.
- Do not sand lead-based paint. If you must sand an area, wear a face mask. When done, mist the area with a spray bottle of water to bring the dust out of the air.
- When cleaning up the area, mist down all drop cloths. Fold drop clothes edges in first to keep dust and particles from escaping.
- Clean the area with a HEPA vacuum. Remove the vacuum bag from the vacuum outside of the building and tape shut.
- Promptly remove clothing and wash before walking through your home or coming in contact with other family members.
If you are not planning a major renovation, but you have paint flaking in your home, a fresh coat of paint will keep more paint from coming off. And of course… teach your children to NEVER EAT PAINT FLAKES OR CHEW ON PAINTED SURFACES (this includes furniture and window sills).
If you have further questions about this new law, you can add your comment below or visit www.epa.gov/lead/index.html.
Written by Stephanie Bullwinkel, CBD for Imperial Kitchens and Baths, Inc. Imperial Kitchens and Baths, Inc. is proud to have completed their RRP required training. As of March 18, 2010, Imperial is in compliance with the US EPA's RRP rule and IDPH. Pending official notice from the EPA, the company will be a RRP Lead Certified Renovator in the Chicago area.
Architecturally Correct Kitchen Expansion
March 9, 2010
An addition should not feel like someone took part of another home and just stuck it on. But too often, that is exactly what happens. Inside and outside the home – roof lines, walls, floors, ceilings – everything should line up and make sense. But contractors who rush often ignore subtile details.
We all are familiar with the saying "God is in the details." Regardless of whether you are religious or not, I think we all can agree that it is the details that make the difference.
We recently completed work on a Berwyn Bungalow where the client is a stained glass artisan. The details of this project were not to be overlooked.
Larry Rych designed the space to open up to the dining room and also incorporate the back porch. The new space had to made sense with the rest of the home. The cabinetry, tile and counter have an understated elegance with simple craftsman style. Crown molding around the ceiling elevates the stature of the room. Our client then added his personal touch, and the focal point of the room, with his own custom stained glass.
While traditionally, a home of this vintage would not have the kitchen open to the rest of the home (nor would it have a kitchen of such magnitude), the new kitchen feels appropriate because many design elements of the period were recreated and the new construction was seamlessly integrated with the old.
When you are shopping for a remodeling contractor, ask to see their portfolio; if you can visit a site, all the better. At first glance, you should see any glaring issues, then look closer. These details will make the difference, not in just how you feel about your home when the project is complete but also its resale value if you ever decide to move.
Designing By The Numbers
January 27, 2010
Sometimes we find ourselves in spaces that just don't feel right. Though we can't put our finger on it, we feel uncomfortable – sometimes to the point that we don't linger, but rather leave the area as soon as we can. If that space happens to be in our home, it's common to not use that room. Or if it is in our office, we'll end up wandering during the day or taking our work to the conference room or other space.
Issues with temperature, lighting, use of color, etc. can all be pinpointed to an extent. The most illusive cause of unknown discomfort, and probably the most common, is that the design of the room disregards the mathematical laws of nature… I speak of the Fibonacci numbers.
Leonardo Pisano Fibonacci (AKA: Leonardo of Pisa) lived from 1170 to 1250 and many think him one of the greatest mathematical geniuses. One of the best modern sources of information about Fibonacci is by A. F. Horadam, "Eight hundred years young," The Australian Mathematics Teacher 31 (1975) pgs 123-134.
Recognizing that arithmetic with Hindu-Arabic numerals is simpler and more efficient than with Roman numerals, Fibonacci traveled throughout the Mediterranean world to study under the leading Arab mathematicians of the time. Leonardo returned from his travels around 1200. In 1202, at age 32, he published what he had learned in Liber Abaci (Book of Abacus or Book of Calculation), and thereby introduced Hindu-Arabic numerals to Europe. (Wikipedia)
Also in the Liber Abaci is one of his other great contributions to the world, what we refer to as the Fibonacci numbers. While he did not discover this number pattern (the formula was being used in India as early as the 6th century), Fibonacci did introduce this sequence to the western world.
In the Fibonacci sequence of numbers, each number is the sum of the previous two numbers, starting with 0 and 1. As such the sequence begins 0, 1, 1, 2, 3, 5, 8, 13, 21, 34, 55, 89, 144, 233, 377, and goes on. The ratio that begins to emerge is referred to as the "Golden Ratio" (approximately 1.6180339887498948…). This ratio has history that goes back to the ancient Greeks and Romans.
This ratio is seen in all things of nature… shells, trees, our bodies. Artists of the Renaissance period used the formula within their paintings. Early last century, physicists found that the formula applied to crystal formation. Some financial experts currently use the ratio to forecast stock expectations.
Architects and designers use the Fibonacci Number system to create spaces of harmonious proportions. Famous Swiss Architect Le Corbusier used the system almost exclusively in designing buildings, furniture and spaces.
The portions provided by the Fibonacci Numbers and Golden Ratio give us a sense of balance when designing rooms. Whether we are looking to remodel or decorate, by incorporating these proportions into our "bag" of design theories, we can calculate appropriate room dimensions, fireplace placement, couch height, etc., which will feel appropriate to the other relationships in a room, including human scale.
Furniture can always be moved or replace to remedy an awkward space. But if you happen to occupy a building that is structurally awkward, reaching a solution may be more difficult. Remodeling, sometimes, is the only option – however, not before exploring creative cosmetic changes. Windows that are out of proportion can be fixed with custom sized molding or curtains. Ceilings can be brought down, if above 8′ AFF (above fixed floor). Bookshelves can bring walls in. If you have an awkward space and need suggestions, or if you have examples of disproportional spaces you have salvaged – please share them with us.
Written for Imperial Kitchens and Baths, Inc. by designer Stephanie Bullwinkel, CBD.
Kitchen Safety is a Must for Every Home
January 11, 2010
As kitchen designers, we look to create rooms that are not only beautiful and functional, but also safe. As a workspace, the kitchen is one of the most dangerous – sharp objects, slippery floors and open flames are just some of the things we encounter daily. But keeping ourselves safe is ultimately the responsibility of the occupant.
If you are a parent, you are probably super diligent about hazards in the kitchen – knives, poisons, glass jars, etc are kept out of reach or behind latching doors. But there are other things that we all should do to minimize our risk when in the kitchen.
- Remove floor rugs. We recommend that floor rugs not be used in the kitchen. They can become loose and get caught up in our feet causing us to trip or slip. If you feel you must have floor rugs in you kitchen, then make sure the underside has a non-skid lining.
- When cooking, don't wear loose clothing that could catch fire.
- Make sure you have adequate ventilation for the size of your range. If you cook with oil frequently, have your vents checked every few years. Oil can build up inside the vents, creating an area prime for a fire within your walls.
Practicing fire safety is a number one priority. Every kitchen should have a fire extinguisher within reach. Check the extinguisher twice a year to be sure it is fully charged; we recommend checking your extinguisher when you check the batteries in your fire alarm. Your extinguisher should be rated for both electrical and grease fires.
If you find yourself with a kitchen fire and you can't get to the fire extinguisher, keep yourself safe. DO NOT POUR WATER ON A KITCHEN FIRE. As someone who has experienced two kitchen fires (one a toaster malfunction, the other over heated oil in a pot), I know how important it is to be prepared so you can calmly assess the situation and not lose your home or your life.
An electrical fire:
- Unplug the appliance and move it away from flammables, if you can.
- Smother the fire with a heavy element like salt or baking soda.
- Smother the fire with a heavy cloth or metal pot lid.
A PSA was recently emailed to me regarding how to handle a grease fire with a damp (not dripping) dish towel. You can find this video posted to our Facebook page. It is good to note several things, before you watch. Do this only if you can't quickly access a lid large enough to cover the pot. Do not attempt this with a shallow pan where the towel will submerge into the oil. In the case of an oil fire, do not try to smother the fire with particulate matter (salt, sugar, flour, etc) – this will cause an explosion.
Here's to a safe and happy cooking experience in the new year!
Written by Imperial Kitchens and Baths designer, Stephanie Bullwinkel CBD.


text:
This study is provided by Child Care & Early Education Research Connections.
National Household Education Survey, 2005 (ICPSR 4599)
Principal Investigator(s): United States Department of Education. National Center for Education Statistics
The National Household Education Survey (NHES) reports on the condition of education in the United States by collecting data at the household level rather than using a traditional, school-based data collection system. The surveys attempt to address many current issues in education, such as preprimary education, school safety and discipline, adult education, and activities related to citizenship.
This survey included three topical survey components.
The Early Childhood Program Participation Survey addressed the nonparental care and program participation of preschool children, that is, children from birth through age six and not yet enrolled in kindergarten or higher grades. The survey collected information on all of the child's current, regular care arrangements, such as care by a relative or by someone not related to the child, in a private home as well as at a day care center or preschool, including Head Start. Information was collected about the number of hours per week or per month that the child received nonparental care, as well as parental perceptions of the factors associated with choosing such care. Other information was collected on topics such as educational activities at home, emerging literacy and numeracy, the child's characteristics (including health and disability status), and parent/guardian and household characteristics. Interviews were completed with parents of 7,209 preschool children.
The After-School Programs and Activities Survey focused on children enrolled in kindergarten through eighth grade who were aged 15 years or younger. Parents reported on the after-school arrangements in which their children participated, including care by relatives or nonrelatives in a private home, after-school programs in schools or centers, activities that might provide adult supervision in the after-school hours, and children's self-care. Other information includes reasons for choosing parental care, the child's characteristics (including health and disability status), and parent/guardian and household characteristics. Interviews were conducted with the parents of 11,684 students.
The Adult Education Survey measured participation in the following types of formal educational activities: English as a Second Language (ESL), basic skills and General Education Development (GED) preparation courses, college or university degree or certificate programs, vocational or technical diploma programs, apprenticeship programs, courses or training for work-related reasons, and personal-interest classes or courses. In addition, information was collected on participation in informal learning activities for personal interest. The survey also gathered information on employer support for educational activities. Detailed information about educational attainment, employment, and household characteristics was also collected from both participants and nonparticipants. Adults aged 16 and older who were not enrolled in twelfth grade or below, who were noninstitutionalized, and who were not serving on active military duty were eligible for this survey. Interviews were completed with 8,904 respondents, 4,732 of whom had participated in formal educational activities in the past year and 4,172 of whom had not.
Access Notes
The public-use data files in this collection are available for access by the general public. Access does not require affiliation with an ICPSR member institution.
WARNING: This study is over 150MB in size and may take several minutes to download on a typical internet connection.
Study Description
U.S. Dept. of Education, National Center for Education Statistics. NATIONAL HOUSEHOLD EDUCATION SURVEY, 2005. ICPSR04599-v1. Washington, DC: U.S. Dept. of Education, Institute of Education Sciences [producer], 2006. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2007-03-13. http://doi.org/10.3886/ICPSR04599.v1
Persistent URL: http://doi.org/10.3886/ICPSR04599.v1
Export Citation:
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Scope of Study
Subject Terms: adult education, after school programs, basic skills, caregivers, child care, child development, early childhood education, educational programs, English as a Second Language, families, Head Start, home environment, home schooling, households, parental attitudes, preschool children, school age children
Geographic Coverage: United States
- 2005
- 2005-01--2005-04
Early Childhood Program Participation: Parents of infants, toddlers, or preschoolers.
After-School Programs and Activities: Parents of children in kindergarten through eighth grade.
Adult Education: Adult respondents.
Universe: National sample of household members in the United States.
Sample: National sample of households.
Weight: Since no data intended for analysis were collected at the household level only, household-level weights were calculated solely for use as a basis for computing person-level weights for the analysis of the extended interview data.
Weights for Early Childhood Program Participation (ECPP) and After-School Programs and Activities (ASPA) Data
The same methodology was used for creating person-level weights for the ECPP data as for the ASPA data. The first step in developing the person weights for the ECPP and ASPA surveys was to account for the probability of sampling the child's domain in the given household. The second adjustment accounted for the probability of sampling the child from among all eligible children in the given domain. The application of these two adjustments to the household weight created a person-level base weight for the ECPP and the ASPA interviews.
The next step involved adjusting the person-level base weight for nonresponse to the ECPP or ASPA interviews. Nonresponse adjustment cells were created using age/grade combinations: children aged 0, children aged 1, children aged 2, unenrolled children aged 3 through 6, preschoolers, kindergartners, and children enrolled in each single grade for first grade through eighth grade. Enrolled children with no grade equivalent were included in the cell containing the modal grade for their age, that is, they were assigned to the grade in which most children their age are enrolled. For each cell, the ratio of the weighted number of eligible sampled children to the weighted number of responding children was then computed. This ratio was multiplied by the person-level base weight to create the nonresponse-adjusted, person-level ECPP and ASPA interview weight.
The final stage of weighting for the ECPP and ASPA data was a raking adjustment. The raking procedure is carried out in a sequence of adjustments. First, the weights are adjusted to sum to the totals on one marginal distribution (or dimension) and then the adjusted weights are further adjusted to sum to the totals on the second marginal distribution, and so on. One sequence of adjustments to the marginal distributions is known as a cycle or iteration. The procedure is repeated until convergence of weighted totals is achieved.
Weights for Adult Education (AE) Data
Four adjustments were made to the household-level weight to compute the person-level weight for the AE data. The first adjustment accounted for the probability of sampling adults in the household. The second adjustment was used to account for the probability of selecting the adult from among all adults in the household in the sampled educational attainment by participation domain (e.g., adult education participants with less than a high school diploma). The application of these two adjustments to the household weight created a person-level base weight for the AE data.
The third adjustment for the AE interview person-level weights was the nonresponse adjustment. The nonresponse-adjusted weight was adjusted in the final step to national totals using a raking procedure. The control totals for raking the AE weights were obtained from the March 2004 Current Population Survey (CPS). The four dimensions for the raking cells were (1) a cross of the adult's race/ethnicity (Black/non-Hispanic alone/Hispanic/other) and household income ($10,000 or less/$10,001-$25,000/$25,001 or more), (2) a cross of age (16-29 years/30-49 years/50 years or more) and sex, (3) a cross of Census region (Northeast/Midwest/South/West) and urbanicity (urban/rural), and (4) a cross of home tenure (rent/own or other) and highest educational attainment (less than high school diploma/high school diploma or equivalent/some college). These raking dimensions were used because they include important analysis variables (e.g., educational attainment) and characteristics that have been shown to be associated with telephone coverage (e.g., race/ethnicity).
Mode of Data Collection: computer-assisted telephone interview (CATI)
Response Rates: The overall unit response rates for the Screener, the ECPP Survey, the ASPA Survey, and the AE Survey are 66.9 percent, 56.4 percent, 56.3 percent, and 47.6 percent, respectively.
Original ICPSR Release: 2007-03-13
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text:
American Boy: Pushing SixtyBy Anthony Buccino |
Working class verse about life and growing up in New Jersey in the 1950s, 1960s and 1970s, and growing older in the 1980s, 1990s and the oughts. From the center of the Baby Boom, this working class verse begins under a wooden class room desk as an air raid siren sounds, and captures the summer spell and its simplicity in drinking water from a garden hose. Verse I RUMOURS OF WAR COWBOY OF OCTOBER WATER FROM A GARDEN HOSE MILKWEED CAROMS TELEVISION ENDING SATURDAY TV COWBOY BUTCH BOYS IN THE WOODS HOT LUNCH BUG JUICE AMERICAN BOY NAMES MONEY IN NEWSPAPERS NEEDLE LEGLESS SOMETIMES I SWEAR IN ITALIAN FACCIA BRUTE DEAR OLD MAN GAMES WE PLAYED THAT FIRST KISS BAD BOYS KILLER JOE OLD MAN II SILENT TALK TRAVELS THE CAFETERIA ALL THE BEST FOODS FORGOTTEN DREAMS SILENT SOUNDS SURPRISE NO TIME FOR OOPS CLASS EVERYTHING HURTS CURSE OF THE BUTTONS VANISHING WORDS SANDWICHED TALKING ABOUT THE WEATHER YOU WANT TO KNOW OLD YOUNGER MAN'S CLOTHES SHOELACES CRAYONS FIFTY-TWO MIRROR RUBBER TIRES JOB ROCK QUIET ONE LAST LAUGH BIRTHDAY POEM III PINKY IN MY ROOM CONFETTI TOWN PUB LAST DOG DEAR ROY DO OVER IV WHAT'S WRONG PUSHING SIXTY WHAT'S IT LIKE TO BE WHAT I DON'T UNDERSTAND MARCIA ONE TRUE LOVE Acknowledgements Some poems in this collection may also appear in other collections of Buccino's work and in the following literary journals. BIRTHDAY POEM published in Medusa's Kitchen EVERYTHING HURTS, ALL THE BEST FOODS and WHAT'S IT LIKE TO BE published in Rattlesnake Review (Poetry With Fangs) HOT LUNCH, AMERICAN BOY and DO NOT THINK published in Poem Factory OLD MAN published in Raving Dove YOUNGER MAN'S CLOTHES published in The Edison Literary Review SILENT TALK published in Journal of New Jersey Poets TOWN PUB published in LIPS AMERICAN BOY: Pushing Sixty by Anthony Buccino Copyright © 2009 By Anthony Buccino, all rights reserved. Published by: Cherry Blossom Press, PO Box 110252, Nutley, NJ 07110 From readers "I just received ... your American Boy: Pushing Sixty. I read every single poem, and during some, it was hard not to feel sad enough to cry. I think I like this best of your books and I know I will read it a few more times to savor all of them again." "I read your book through and through twice. Absolutely enjoyed it. Your words flow so freely." |
ANTHONY'S WORLD Anthony Buccino HomeAnthony Buccino books on Amazon Tweet this pageFollow Anthony on Twitter @AnthonyBuccinoGet updates on Facebook AuthorABuccino ''New Jersey's 'Garrison Keillor' '' ** ** "... or something to that effect" Buccino's Work Has Appeared
Paterson Literary Review |
New Jersey author Anthony Buccino's stories of the 1960s, transit
coverage and other writings earned
four Society
of Professional Journalists Excellence in Journalism awards. The Pushcart Prize-nominated writer has been called ' "New Jersey's
'Garrison Keillor" or something to that effect.'
Copyright © 1995-2016 By Anthony Buccino.
rights reserved.
Permissions & other snail mail: Buccino Books 6 Pompton Avenue, Cedar Grove, N.J. Certified sports chiropractor |


text:
Commercial property > Landlord and tenant > Lease renewal
Lease renewal
Lease renewal
The Landlord and Tenant Act 1954 is the primary legislation governing lease renewals in England and Wales. Landlords must be aware of their rights and obligations under the Act to ensure they maintain and improve investment values.
The Act details how a landlord can terminate a lease with a Section 25 notice, and how a tenant can request a new tenancy with a Section 26 notice. It also covers how landlords can oppose renewals and how new rents should be determined.
There are a small number of important exemptions to the act that landlords should be aware of, and some significant case law that clarifies key issues.
This section is maintained by Chris Hill of Fieldfisher LLP.
Related RICS professional guidance
- Glossary
- Cases
- Document templates
- Features
- Legislation
- Market surveys
- Research
- RICS standards and guidance
- Preliminary issues
- Protection under the 1954 Act
- Landlord terminating - Section 25 notice
- Tenant's actions
- Landlord opposing renewal
- Terms of a new lease
- Court application and other dispute resolution options
- Rent
- Negotiation
- Excluding the Act
- Further information on lease renewal
Relevant case law
- Lease or licence?
- Carrying on of a business?
- Continuity of occupation
- Ground (a) – failure to repair
- Ground (b) – persistent failure to pay rent
- Ground (c) – other breaches or some other reason
- Ground (d) – alternative accommodation
- Ground (f) – redevelopment
- Ground (g) – own occupation
- Compensation
- Length of new term
- Other terms of the tenancy
- Alienation
- Rent review provisions
- Surrender and attempts to exclude the Act


text:
Interview: Charlie Musselwhite
The American blues-harp master looks ahead to June 7's Lucerna Music Bar show
America's best blues harp player roars into town Tuesday night with a hot band and his latest release, The Well. It represents a milestone for Charlie Musselwhite, even after 40 years in the music business: This is the first CD for which he wrote or co-wrote all the songs, and is nakedly autobiographical, dealing with intensely personal subjects like his alcohol addiction, time in jail and the 2005 murder of his mother, Ruth Maxine.
Musselwhite doesn't just play the blues -- he's lived them. Born in small-town Mississippi and raised in Memphis, he eked out a living for years doing hard, blue-collar work -- digging ditches, driving trucks, even running moonshine -- before finding a home in the blues clubs on the south side of Chicago. He sat in with icons like Muddy Waters, Big Joe Williams and Howlin' Wolf, and recorded with Big Walter Horton.
In 1967, Musselwhite's first release -- Stand Back! Here Comes Charley Musselwhite's South Side Band -- coincided with the rise of the American counterculture, which embraced the new style of electric blues. In the four decades since, Musselwhite has built a diverse fan base that ranges from aging hippies to bikers to hardcore blues fans. A lot of musicians are fans, too: Mavis Staples sings on his new CD, and last summer Musselwhite toured with Cyndi Lauper.
The Well is a powerful personal work. What prompted you to dig so deep into your own life?
It wasn't really a plan, that's just how it turned out after my producer, Chris Goldsmith, asked me to write all the tunes for the album. And when I write, I write what I know about. I draw from my life experiences.
The cut Sad and Beautiful World is about your mother's murder. Was it difficult for you to revisit that?
Sure. Dealing with the death of one's mother is not easy, and murder is just about unbearable to contemplate. But I didn't want to write a sad dirge. You can actually tap your foot to Sad and Beautiful World. Having Mavis Staples join me on the song meant a lot to me -- she's a close and dear friend, and has so much depth and substance. But I wrote the song for my mom, and I know she wouldn't want me to be sad. That's why it has a beat, and is not a weary blues.
There are dozens of good blues guitar players, but you can count on one hand the number of great harp players. What drew you to the instrument?
I've played harmonica as far back as I can remember. Seems like there was always a harp around the house. As a child, I'd make up little kid's tunes, just making noise to entertain myself. When I was about 13, I had lots of blues records and had been listening to blues on the radio and following the street singers in Memphis, and it just occurred to me to start making up my own blues. Since I had a harmonica, and was familiar with how to get something out of it, I liked to go out in the woods by myself and make up my own blues.
Was it intimidating trying to break into the blues scene in Chicago?
I arrived in Chicago from Memphis in 1962, when I was 18 years old. I didn't know a soul. I discovered the blues scene there by seeing signs in the windows of bars advertising the likes of Muddy Waters or Elmore James. At night I would go to those clubs and hang out. It was never a problem for me, I fit right in. I already knew how to drink, and being from the South just made me one of the guys from down home.
What will you be playing in Prague?
Some tunes from The Well, some older tunes and some that I've never recorded. We have so much fun playing them that the audience can't help but have fun, too.
This will be your Prague debut. Any reason you've never been here before?
I don't know why, maybe it was just a matter of hooking up with the right booking agent. But we're all very much looking forward to coming to Prague. I'm very excited to see and visit your beautiful city.
Video on YouTube
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text:
Friday, January 14, 2011
New Things
9 comments:
I have ripped out quilting stitches in more than one quilt (shouldn't really be bragging about that, should I...), and spritzed it with water after requilting the top to remove the holes. Any stubborn ones have been rubbed with a wet q-tip. Washing will remove all those holes at once, except when you have used fusibles.
ReplyDeleteI know that story got me too.
I think it depends on which stitches you want to get rid of. Machine stitches leave holes, needle cuts the threads? I think that problem could be hand quilted over. I find when I hand quilt the fabric holes are easier to remove. I can rub over them with a finger and the threads come together.
Either way, with a good wash, I think the fabric threads would shrink and minimize the holes.
Don't keep it in the closet. This is one of my favorites.I think your blog is super cute!
The Tucson shootings are close to my heart and in my state :( Thanks for sharing this article, I didn't know that they said she was a quilter, that makes me smile and she really looks like a sweetie :) Just think of the quilts that will remind her loved ones of her :)