For a New Jersey resident, that property taxes are less than forgiving is less than revelatory. Boasting 600 school districts, and 566 municipalities, New Jersey has earned the dubious honor of having the highest property taxes per capita in the United States. The increasing burden of high property taxes is forcing residents to move out of state, and has drawn the ire of a state government trying to contemplate how to stem rising costs of living. Property taxes are not the only area for which New Jersey has achieved distinction, its sales tax also ranks among the highest in America. At a whopping 7.0 percent, the New Jersey sales tax is surpassed only by California, and remains tied with Indiana, Mississippi, Rhode Island; and Tennessee. According to a study conducted by the Tax Foundation which accounted for all taxes, including the property tax, New Jersey topped the list for local burden at 11.8%. For New York the burden was 11.7% and Connecticut followed at 11.1%. In comparison, the states with the lowest overall burden were Wyoming and South Dakota, at 7.0 and 7.9% respectively. Nearby Pennsylvania and Delaware were lower, scoring 10.2% and 9.5%, which clustered in average with the rest of the states.
The consequences of taxes, but particularly the property tax are rather stark. According to a 2009 Star Ledger Article, since 2000 rising costs of living have resulted in a state loss of 163,000 households, or $12.8 billion in gross income as residents flock to states with lower rates. In 2000 the average property tax for a home in Holmdel, Monmouth County, was $7,496. By 2007 that number had increased 52% to $11,049, an increase of some $4,000. Teaneck in Bergen County saw an increase in the average property tax from $3,233 in 1998 to $10,612 or 228% increase. In contrast, Atlantic County saw some of the lowest increases, the average property tax bill in Folsom Borough rose to only 3,167, from a low of 2,079 in 1998. Many believe the source of high property taxes is local school spending and employee pensions. In addition, in 1985 the New Jersey Supreme Court ruled in Abbot vs. Burke that adequate funding must be allocated to struggling urban schools. As a result, wealthier districts are left wanting in regards to available funds.
Yet to put it in perspective, property taxes account for 45 percent of all tax revenue raised in New Jersey. By contrast, the national average is 29 percent. In 2010 New Jersey spent approximately $13,385 per pupil on education, up 4.3% in cost from the previous year. This is less than the 5% rise to $12,720 in spending from 2007 to 2008, but the continuing increases illustrate that the problems posed by property taxes remain unchecked. In past several years many school budgets have also been increasing. From 2008 to 2009 the Freehold school district saw a 3% increase in the local school district, from $8,165,236 in 2008 to $8,373.022 in 2009. From 1998 to 2009 Bradley Beach saw a 33% increase from 3,728,017 to $4,952,368. In the same period the Woodbridge district saw increase of some 55% in the school budget, topping out at 151,027,561 in 2009. Despite the amount of spending on education for urban districts, the SAT score average for the state has remained static at 1009 for combined reading and math scores.
As a result, many districts have been classified as “In Need of Improvement” status, despite the high degree of state funding of education. Data for the 2009 “No Child Left Behind” report, compiled by the New Jersey Department of Education, revealed that the East Orange High School district in Essex County also did not meet mandate, achieving only a 75.5% student proficiency rating for language arts in the 2008-2009 school year. For mathematics students achieved a proficiency rating of only 31.1%, a 9% percentage decrease from the prior year, and well below the state standard of 74% for the district. By contrast, wealthier school districts such as Fair Haven and Rumson were classified as satisfactory, exceeding the district proficiency standard of 59% for English. Given that the majority of property taxes fund local schools; Fair Haven and Rumson have higher property tax averages, at $12,281 and $16,526 respectively. In contrast the Neptune Township school district, which boasts an average property tax of only $5,187, was classified as “In Need of Improvement”, falling 10% behind the state standard of 85% for language arts literacy and 8% for mathematics.
Sources of the problem
Many blame the property tax situation on towns insisting upon the tradition of self governance nicknamed “home rule”. With so many different municipalities the task of governing can pose immeasurable challenges. This practice entails that each town is responsible for providing separate police, fire departments and public work crews. Governing in this way becomes problematic given the myriad of independent municipalities New Jersey has. For example, Bergen County alone has over 70 municipalities. Not surprisingly, many residents have been frustrated by the resistance of local administrators toward efforts of consolidating services with nearby towns to reduce administrative costs. This idea has been proposed by state government as a remedy to check rising costs. Documented cases of municipal consolidation have shown promise. In 1999 five fire departments merged in Hudson County, coming from the areas of Weehawken, Guttenberg, North Bergen; West New York, and Union City. In the first year alone, this new department saved about $3 million through the elimination of two fire houses, several department chiefs, approximately 30 firefighters and six captains. As a result the average property tax bill in the five towns went down $400.
The Breaking Point
Beginning with the Corzine administration, the problems of property taxes began to attract inquiry at the state level. In Governor Corzine signed the state’s first ever property tax cap of 4%. The administration also began to put pressure on local towns to consolidate or else face a cutoff in state aid. Upon winning the 2009 New Jersey gubernatorial race Chris Christie promised to make property tax reform a centerpiece of his agenda as Governor. Governor Christie initially proposed a cap of 2.5%. All towns would be allowed to vote to exceed the cap, with a 60% margin for approval. After Senate President Steve Sweeney proposed a 2.9% cap, a compromise was reached and the cap was lowered to 2.0%, with many loopholes removed. However, the cap made exceptions, without voter approval, to debt payments, as well as pension and health insurance costs, increased school enrollments and states of emergency. The governor also proposed a 33 item legislative “tool kit” to serve as a guideline for municipalities working to stay under the cap. At the same time the cap was passed, the Governor porposed steep cuts in state aid to education, slashing spending by some $800 million. These cuts included municipal reductions, privatization in government functions and aid to public colleges. These proposals followed the Governors previous reduction of $425 million for the prior fiscal year.
Sectors facing cutbacks
Skeptics wonder whether property taxes will not continue a steady increase due to the recent proposals by the state. These views are concomitant with concerns that more demands will be made on municipal governments with lesser resources. According to Ben Dworkin, an adjunct professor and director of the Rebovich Institute of New Jersey Politics at Rider University, the cutbacks in state funding are going to present significant challenges for local government. According to Dworkin, “Even if the Governor’s entire tool kit is passed, there will be immediate cutbacks in both services and personnel that will be necessary. The tool kit involves important, but long term savings” Municipal governments are likely to see considerable layoffs with cutbacks of this ilk being apportioned. An analysis of data for the Fair Haven budget in Monmouth County shows that most of municipal spending is dedicated to salary, police, and Department of Public Works. For police alone, salaries and wages made up more than $1,308,212. Salaries for public works, such as street and road maintenance made up more than $735,000. According to Dworkin, “Nobody wants to layoff a public employee, but that’s where the money is.”
Past Efforts at Reform
Regardless of whether the current ideas for property tax reform are successful, they are the most significant proposals made to date. Prior to the events of the past several years, the last significant efforts for property tax reform took place in the 1970s during the administration of Governor Cahill. In Robinson v. Cahill the Supreme Court ruled that overreliance on the property tax was inequitable, and therefore an alternative source of revenue needed to be developed. These efforts resulted in the passage of the state’s first income tax during the administration of Governor Byrne. In order to attract positive voter sentiment for the proposal, the proposal contained a provision that dedicated income tax revenues towards property tax relief. Property taxes continued to be an issue and the state implemented a series of relief programs, including the Homestead Rebate, the Veterans Senior Citizens and Disabled Citizens Property Tax Deductions, NJ-Saver, and Senior Freeze. In the 1990s legislators began to focus on the impact unfunded state mandates have on property taxes. Such programs inquired local municipal governments to exact revenue to fund programs and services imposed by the state. Upon voter approval of the amendment proposed by then Senate President Donald DiFranchesco, and Assembly Speaker Chuck Haytaian the legislature passed a bill that repealed pre-existing mandates. At the time it was thought that savings from the repeal could total up to $25 million. Though the amendment was effective, New Jersey continued to be burdened by property taxes.
Study database on Tax Foundation website http://www.taxfoundation.org/publications/show/22320.html
Fleisher, Lisa, “Gov. Chris Christie pushes for property tax cap in N.J. Constitution”NJ.com 17 May 2010 Web Dec 9 2010
Property Tax Information can be viewed on Division of Local Government Services Web Site <http://www.nj.gov/dca/lgs/taxes/taxmenu.shtml>
Statehouse Bureau Staff “Chris Christie plans to cut school aid by $800 million”NJ.com (2010 15 March) Retrived December 11 2010
Melli, Juan “Corzine Signs Property Tax Legislation” NJ.com 2007 April 3 Web December 13 2010 from Blue Jersey.com. <http://www.bluejersey.com/showDiary.do?diaryId=4430>
“N.J. school report card: Spending per pupil increases”, 2010 February 9 Web December 15 2010 from Nj.com <http://www.nj.com/news/index.ssf/2010/02/nj_school_report_card_annual.html>
New Jersey League of Municipality Property Tax Information http://www.njslom.org/property-tax-history/index.html
2009 No Child Left Behind Report <http://education.state.nj.us/rc/nclb09/nclb.html>
By Paul Kaspereen
LAWRENCEVILLE, N.J.– Since the fall of the year 2006 a startling occurrence in the world of beekeeping has been brought to light: the disappearance of honeybees that are kept in captivity. This phenomenon, known as Colony Collapse Disorder, (CCD for short) has had far-reaching effects on the world of beekeeping, agriculture and the American economy in general. The disorder has been researched extensively since it was first identified in 2006 but no single cause for the emergence of the disorder has been named.
It is not uncommon for beekeepers to have bad years for their hives. Poor weather, the presence of mites or viruses, pesticides and other factors such as stress can all contribute to significant losses to the numbers of bees in a year. CCD differs from these dangers to colony health in a few ways. The primary difference is that in the case of CCD no adult worker bees are found in the hive, not even the dead bodies. In cases of CCD it appears that the worker bees, which make up the vast majority of honeybees in a colony, vanish with little or no trace.
Since CCD was first identified in 2006, the overall losses to colonies managed by beekeepers have increased drastically from years before the disorder was identified. The USDA has been monitoring the losses through surveys since 2007. In that time the number of average colony loss has hovered around 30 percent every year. Of the percentage of lost colonies, close to 30 percent of the colonies lost were reported by beekeepers to show signs of CCD.
The chart above focuses solely on the figures released by the USDA. Other surveys have been released that report slightly different figures and different breakdowns of the numbers. A survey released by Lupine Logic Ltd. with financial backing by the U.S. Army Center for Environmental Health Research asked beekeepers to describe the degree of their losses. 42 percent of those who responded said that their losses were “severe”.
Another study released by the Journal of Apicultural Research in 2009 found an interesting correlation between the presence of CCD and the size of the beekeeping operations. The study grouped the beekeeping operations into divisions based on the number of colonies managed. The table below describes their findings:
These findings indicate that larger beekeeping operations tend to display the symptoms of CCD more often than smaller operations. No reasons for the correlation were discussed in the study.
For beekeepers, the threat of colony loss is a very frightening scenario. Linda Osborne is a beekeeper at Foxhill Honey in Lafayette, N.J. who relies on the honey and wax produced by honeybees to sell in various products. New Jersey has been spared the brunt of the CCD epidemic, but concern about the disorder becoming more prevalent is still being kept in mind by beekeepers there.
“We have not experienced Colony Collapse Disorder from what I’ve seen,” said Osborne. “I’ve heard from beekeepers in Pennsylvania who have discovered empty hives though, and it makes me worried about what could happen here.”
New Jersey has seen less bee losses than most states in general with 15 percent of colonies lost in 2008. Compared to states like West Virginia where 52 percent of colonies were reported lost that year or Michigan where 56 percent were lost, New Jersey has been faring far better.
“We’re thankful that our bees have been relatively healthy,” said Osborne. “Hopefully New Jersey can maintain its healthy bee population.”
Aside from the prospect of losing bee-related products, CCD’s biggest threat is to the agricultural industry in the United States.
“I’m not sure if people realize how much of a role these bees play in getting produce on the table for us to eat,” said Osborne. “These losses could really hurt the production of important crops.”
Indeed, honeybees have been a major part of the modern agricultural industry. It has been estimated that in the past 50 years, there has been a 300 percent increase in the number of crops that require outside pollination. Honeybees make up the vast majority of the pollinators used in this way. Beekeepers rely on being able to provide farmers with healthy populations of honeybees to pollinate their crops.
“I wouldn’t be surprised if there were some shortages in food production,” said Osborne. “These bees are really the backbone for a lot of the agricultural industry.”
Since the emergence of CCD, beekeepers have had to increase the prices at which they rent out their pollinators to farmers. This premium cost is necessary for the beekeepers to keep their own business sustainable, but it has a serious economic impact in the operation of farms.
“I have heard about beekeepers really increasing their prices,” said Osborne. “There’s really no way around that unfortunately.”
One particular area that is being hit hard by the honeybee shortage is the almond industry. Around 80 percent of all almonds in the world are grown in California and honeybees are responsible for the pollination of the almond trees there. Every spring beekeepers from across the country bring their hives out to California to rent them out to almond farmers for pollination.
The threat of CCD has made the pollination of almond crops a more difficult and expensive process. There have been reports of beekeepers making the trip to California in the spring of this year only to discover that many of their colonies had mysteriously vanished by the time they arrived. With the price of hive rental increasing already, less bees to work with makes it even harder for almond farmers to insure the growth of their crop. The potential for a world almond shortage is a distinct possibility because of the loss of bees.
Of main concern for beekeepers and farmers alike is to find out a way to stop CCD. The problem with such an endeavor is that the reasons for the emergence of CCD have not been determined. Despite intense research over the past four years the whole colony collapse phenomenon is still largely an open-ended mystery for the scientific community.
Research into the causes of CCD has been unable to identify a single cause for the disappearance of worker bees. Scientists believe a combination of factors contributes to the disappearance. Exactly what factors and how they interact with each other is still the subject of research for those in the industry as well as the U.S. government.
There are many threats to captive bee hives that have existed for some time. There are mites such as varroa mites that feed on the hemolymph (insect blood) of bees. Tracheal mites attack the respiratory system of honey bees and can devastate hives. Then there’s the more recent Israeli acute paralysis virus (IAPV) which emerged in 2004 in Israel and has since found its way over to the United States. This virus has been linked to many cases of CCD but has not been identified as the definitive cause for the disorder.
Beyond the natural threats to honeybees there is also the possibility that man-made pesticides used to keep out invaders such as the varroa mite could be contributing to the rise of CCD. Some researchers believe that these pesticides weaken the larvae (developing bees) in a colony and may cause other unforeseen issues among adult bees.
One pesticide produced by Bayer Crop Science Company to protect crops that bees sometimes pollinate has been linked by some beekeepers as a potential cause of CCD. In August The National Resources Defense Council sued the EPA for withholding information about the risks that the pesticide poses to honeybees. Though there has been no research that has confirmed the pesticide as a leading cause of CCD, many beekeepers have implicated it as a potential hazard for the bees.
Research into CCD is not all dead-ends, however. A recent study conducted by the U.S. Army along with researchers out of the University of Montana found a connection between two bee antagonists that could prove to be invaluable in the understanding of CCD. The researchers discovered the presence of the DNA-based invertebrate iridescent virus (IIV) and the fungus Nosema cerenae in all of the hives that they studied that had suffered from CCD. This is the first time a direct relationship between two bee ailments has been found in colonies suffering from CCD. The next step, according to the researchers, is to infect a colony with the virus and fungus and see whether it causes a colony collapse. If the correlation proves to be true then researchers could be another step closer to solving the mystery of Colony Collapse Disorder and could then begin finding ways to fight back.
In the meantime, those involved in the beekeeping and agricultural industry are looking for any help that they can get in the fight against Colony Collapse Disorder. The North American Pollinator Protection Campaign is an effort that seeks to protect pollinators including honey bees by creating funding for research and spreading awareness. In addition, the campaign provides an opportunity for the public to volunteer in conservation efforts that protect pollinators. With support from the public and the government, the fight against CCD could help to protect the well-being of not only the bees, but also our own health and economy.
The little busy bee. (2010). VA Living, 8(3), 96-101.
Mendleson, R. (2010). Buzz kill. Canadian Business Magazine, 13(83), 24-7.
Watanabe, M. (2008). Colony Collapse Disorder: Many Suspects, No Smoking Gun. BioScience, 58(5), 384-8. doi: 10.1641/B580503
Bjerga, Alan. “Honeybee-Colony Losses Widened Last Winter, USDA Says.” Bloomberg Businessweek 29 Apr. 2010: n. pag. Web. <http://www.businessweek.com/news/2010-04-29/honeybee-colony-losses-widened-last-winter-usda-says-update3-.html>.
Flottum, K. (2010, July 5). The grove gamble: will there be enough bees to pollinate this spring? read more: http://www.thedailygreen.com/environmental-news/blogs/bees/2011-almond-crop-0705#ixzz18fzywtlj. Retrieved from http://www.thedailygreen.com/environmental-news/blogs/bees/2011-almond-crop-0705
Jacobson, Rowan. “The Importance of Bees to Our Food Supply.” Eating Well Apr. 2009: n. pag. Web. <http://www.eatingwell.com/food_news_origins/green_sustainable/the_importance_of_bees_to_our_food_supply>.
Johnson, Kirk. Scientists and Soldiers Solve a Bee Mystery.” New York Times [Denver]06 Oct. 2010: A1. Print.
2007 Beekeeper Survey http://beealert.blackfoot.net/~beealert/UpdatedSurveyResultsJune19_2007.pdf
2008 Beekeeper Survey
2009 Beekeeper Survey
LAWRENCEVILLE, N.J. – There is a national trend in women empowerment over the passed decade that exists within business ownership, with a 20 percent growth in female-owned businesses between 2002 and 2007.
What makes this growth so significant? Between 2002 and 2007, there has been an 18 percent increase in businesses across the nation. In that time, the amount of women-owned businesses has gone up 20.1 percent and men-owned businesses only 5.5 percent.
While women are dominating men in the percent change of owned businesses from year-to-year, men still hold the title for owning the most businesses nationwide.
According to a December 2010 press release from the U.S. Census Bureau’s Survey of Business Owners, in 2007 women-owned businesses still “lag” behind businesses owned by men, who account for 51.3 percent of all businesses. But that’s not by much.
Throughout history, women have been fighting for certain rights and equality among many different aspects of life. Many of the movements were through waves of feminism. While those movements of women empowerment have been historically documented, the numbers over time have shown that more and more women are beginning to own more newly owned businesses than men, which is very empowering within its own data.
The New Jersey Association of Women Business Owners (NJAWBO) state president Willa Edgerton-Chisler believes there are a few factors that are driving the increase of women-owned businesses.
“Number one, you have nesters,” said Edgerton-Chisler. “They are women who were homemakers, and their children have gone to school, but they decided to turn something they are passionate about into a business.”
While “nesters” are a big contribution to the increase in women-owned businesses, corporate setting is a large contributor, but probably in an unexpected way.
“Women in the corporate setting trying to balance corporate life and caretaker of the family found that some companies don’t embrace that type of philosophy that give them a liberty to work from home,” Edgerton-Chisler said.
Her third reason for the jump in women-owned businesses was on a more personal note, yet true among many women in many cases during the current recession and the layoff trend in corporate America.
Instead of going back in that setting, some women have decided, like myself, to create their own businesses, said Edgerton-Chisler.
Statistics on women-owned business are calculated every four-to-five years on the U.S. Census Bureau’s Survey of Business Owners, the number of firms owned by women increase by roughly a million every cluster of years, since 1897.
In 1987, 4.1 million businesses accounted for all kinds of firms that were owned by women. In 2007, 10 years later, women nearly doubled that ownership by accounting for 7.8 million businesses nationwide.
While there has been a total of 4.1 million new businesses nationwide between 2002 and 2007, women-owned businesses account for 1.3 million of the new businesses, and men account for 726,600, and the rest make up an unmarked variable.
It is fairly accurate to deduce from the numbers that women have dominated men in their new ownership in that specific time period.
In addition, women also compute to a greater percent change of ownership across all states, as compared to the men-owned businesses, which also shows that women are beginning to be in higher positions.
Men trail the women when it comes to ownership in Georgia. In the 2002-2007 period, women have a percent change of 44 percent, doubling the men’s change of 20.4 percent.
Women also dominate in percent change across the board in business ownership in other popular states, such as California, New York, New Jersey and Nevada, among many more.
While it is significant that women have own more new businesses between 2002 and 2007, the historical data provided by the Census Bureau’s Survey of Business Owners do not break it down by men-owned business stats before 2007.
A possible contender to the rise in women-owned businesses is the amount of women enrolled in college compared to men.
“I do know women are enrolling in college or going back to school, so can you correlate the two together? Sure,” said Edgerton-Chisler. “When you talk about women and their abilities to do whatever it takes, the opportunities are endless, so if they need to go back to school, they go back to school.”
According to the Population Reference Bureau, the proportion of women enrolled in college has exceeded the enrollment rate for men, and account for 54 percent of the 10.8 million enrolled students population.
According to the Business Exchange through a 2007 study by the Forte Foundation, female enrollment at 25 of the top U.S. full-time MBA programs is roughly 31 percent. Many business schools leaders who would like to see that number increase are implementing new programs and strategies aimed at women.
“The next generation has a good advantage of creating businesses because technology has made it so easy,” said Edgerton-Chisler. “You can start a business in pretty much any industry, and because of technology, the ability to create a business is unlike it has ever been before, so it makes it very simple to go out and try it.”
LAWRENCEVILLE, NJ – Phyllis Smith went into Cooper Hospital with migraines, a swollen liver, and stomach pains among other symptoms. She was there for a month from July to August 2010 and another two weeks at the end of August. During her stay, she went through many tests as the doctors tried to determine what was wrong.
Nicole Smith, her daughter, 22, arrived one morning to visit her mother and after visiting with her for two hours noticed that the urinary catheter bag and tube were full. These should be changed regularly as it is a health risk. The most common problem from an unchanged bag and a full tube is a urinary tract infection.
Smith, concerned for her mother’s health, particularly as she is studying to be a nurse, went to the nurse’s station to inform them that the bag needed changing and her mother needed more medicine. She explained that the tube was backed up completely and had been that way for some time. The nurses told her they would be there soon and she returned to her mother’s room.
Nicole returned to the desk several times reminding them that her mother needed to be seen. Someone finally arrived to change the bag and give her mother medicine nearly three hours after Nicole had brought it to their attention.
“I understand that nurses have a lot of work to do and patients to look after but something like that, which needs to be changed or it will create even more problems for someone who is sick, they need to take care of that. They still did not know what was wrong with my mom at that point. I didn’t want her to have any more problems. Especially since I told them, the nurses should have been there to change that almost immediately,” Nicole said.
A 1999 report, which was the last comprehensive study on medical negligence done in the United States done by the Institute of Medicine, found that at least 44,000 deaths and as many as 98,000 could be attributed to medical mistakes. A more recent study done by Dr. Christopher P. Landrigan focused on 10 North Carolina hospitals and it shows that there has been no improvement over six years.
“It is unlikely that other regions of the country have fared better,” Dr. Landrigan, an assistant professor at Harvard Medical School, said. The hospitals in North Carolina were selected because they have worked harder with programs to reduce mistakes and improve patient care. If these hospitals have not had any improvement, then other hospitals in the nation probably have not improved either.
The Cooper Hospital website declares they have a “commitment to Patient Family- Centered Care, we want to make sure your experience is as pleasant as possible. Your needs — medical, of course, but also emotional and spiritual — are our primary concern.”
This is a hospital that prides itself on giving care of all kinds to its patients. The doctors and staff “welcome [the family and friends] involvement” in the healing process, which brings the relatives into a role in the hospital as well. However, this situation that the Smith’s experienced contradicts everything the hospital policy states.
In non-federal short- stay hospitals there are 1,143.9 discharges per 10,000 in a population with an average hospital stay of 4.8 days, according to the Centers for Disease Control and Prevention. With this number of people being released from a hospital, many perhaps experienced similar problems in care that Phyllis did.
Phyllis was a nurse in the Cooper Hospital Emergency Room for six years before moving to the Labor and Delivery Center at Virtua Hospital in Voorhees, where she worked for five years. During her time as a nurse, Phyllis witnessed this kind of negligence from fellow nurses.
“The nurses would use the phones for personal calls and they would be sleeping during the night shift instead of helping their patients. I would go to my superiors but it never seemed to result in any change. Most often, I would check on those nurses’ patients myself,” Phyllis said.
There is a problem here with the ethics and sense of responsibility that the nurses have. “There needs to be more consequences for nurses who are caught not working. I am appalled and embarrassed as a nurse that this treatment is occurring in a hospital,” Phyllis said.
This negligence in the hospital system from nurses and other staff members, could lead to other hospital acquired infections. In Phyllis’ case she avoided any major complications. However, many others like her have picked up other infections.
Hospital acquired infections get the credit for killing 48,000 patients. They are also responsible for 2.3 million days for patients spent in hospitals in addition to the days spent for the reason they entered the hospital to begin with. This amount of time has the price tag of $8.1 billion.
Medicare recently stated, as reported by the Canadian Medical Association Journal, that they would no longer pay for eight preventable hospital mistakes. The includes infections from the use of urinary catheters, which was a potential problem Phyllis faced, or other problems like retrieving tools left in a patient after surgery. Insurance will not cover these costs.
These costs will now have to be covered by the hospital; regulations prevent the hospital from charging the patient. Many patients are going to need to have these costs covered by the hospitals.
The Department of Health and Human Services completed a study in 2008. It found that 1 in 7 of Medicare recipients experienced an “adverse event” during a hospital stay. An adverse event is the technical term used in official reports about medical care causing harm on a patient.
These adverse events are related to medication, patient care, surgery or other procedures, and infection, according to the study. These categories represent all the issues that have resulted from improper care. The most problems result from medication, which includes excessive bleeding, severe hypotension, and respiratory complications, among others.
This could serve as an even greater incentive for hospitals to enforce increased care for their patients and stricter punishments for those doctors or nurses who make the mistakes. Hospitals are not going to want to cover these bills.
This does not include the amount of court cases that result from improper care. According to the Bureau of Justice Statistics, in 2001, the most recent data available, in the 75 largest counties in the country, the total costs awarded to plaintiffs were $448,219,000. These costs were for medical malpractice.
Hospitals would face hefty bills for care to correct these adverse events or in payouts as a result of court cases. If hospitals lose money this way, that means there will be less money for paying employees and equipment, which could make it difficult for hospitals to help people.
Phyllis believes the best course of action to remove the prevalence of adverse events in hospitals is to remove the “incompetent nurses.” Nurses are expected to care for the patients all the time as doctors cannot always be with them.
However, as Nicole witnessed when her mother was sick, some nurses do not react when patients need attention. There are some excellent nurses caring for patients, but there are also nurses who sleep or talk on the phone as Phyllis saw firsthand during her time as a nurse.
The problem could be relative to the amount of people who are utilizing hospitals on a daily basis. There may not be enough nurses to deal with the patients or visit each patient often enough. In this case, hospitals need to alter the requirements for how many nurses should be staffed at a time so they may perform their tasks.
Hospitals are going to have to generate change in policy to prevent medical negligence. Many hospitals will no doubt be interested in making changes to prevent unnecessary loss of money through corrective surgeries and court cases.
After the study completed in 1999 by the Institute of Medicine, the hospitals responded with assurances of change. However, as recent studies show, hospitals have not done enough to fix this problem. Hopefully, hospitals will continue efforts to improve their staffs and prevent more adverse events from occurring.
Patients should be vigilant when in a hospital as well. In some cases, the patients will be entirely in the care of doctors and nurses and will need to trust that they do the right thing. However, in other cases, like Phyllis’, having an attentive family or being aware of your own needs and insisting nurses help could make the difference between getting an infection or not.
LAWRENCEVILLE, N.J. — For Ann Delamater, 57, weight was never an issue. As an adolescent and young adult, she was extremely active, constantly moving and constantly equipped with energy. Because of this, her diet that was high in carbohydrates, refined sugars and almost entirely void of nutritional value.
“I never had moments when I questioned the food choices I was making,” she said, “I ran track and played soccer so I was able to eat whatever I wanted. Throughout at least two decades of my life I did whatever I pleased. The idea of obesity was something that I hadn’t ever given a second thought to.”
A yearly survey done by the Center for Disease Control and Prevention reports that in the past 20 years, obesity rates in the United States has increased quickly and dramatically and is continuing to do so. In 1990, the population for every state in the country had an obesity percentage of less than 15%.
Now, Colorado is the only state in the country to have an obesity population under 20%. On the other end of the spectrum, nine states (Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee, and West Virginia) now have a prevalence of obesity equal to or greater than 30%.
According to the CDC, the National Health Interview Survey for 2009 showed that 33% of adults 18 years of age and older engage in no leisure-time physical activity. “I was getting winded after walking up two flights of stairs in my school. I might as well have just had a sign that read, ‘This isn’t normal’ waved in front of my face,” Delamater said.
Like countless other Americans, Delamater’s on-the-go lifestyle settled down when she began working a desk job and adapting to life in the “real world.” Between 2007 and 2009, 12 states reported an increase in physical inactivity. With the cutting down of her activity levels, the nutritionally lacking choices were slowly taking a toll on Delamater. When she reached her 50th birthday, the 5’5 teacher weighed 190 pounds. It was then that she realized her health was potentially in danger.
Obesity is defined as a body mass index (BMI) of 30 or greater and is extremely detrimental to one’s health. BMI is an estimate of one’s body fat and acts as a gauge toward concluded a person’s risk for diseases that can occur with more body fat. A normal BMI range should fall somewhere between 18.5 and 24.9. Delamater’s body mass index was 31.6.
“I always felt ‘off’ and for a while I knew that it was because of the amount of weight I had put on. I believe that my pride played a factor in that. No one ever wants to admit that they’ve let themselves become obese,” Delamater said.
Delamater is only one of millions affected by this growing problem that is causing much concern for the well being and future of the United States.
The United States was found to be the country with the highest obesity problem in the world with 30 percent of the population. Mexico was the next highest country on the list but at 24 percent, still six percent lower than American, according to a study done by the Organisation for Economic Co-operation and Development.
Katherine Younger, a registered dietician, believes that the problem of obesity in the country is made clear by the statistics and the matter needs to be taken seriously. “I think one of the biggest problems with America’s obesity epidemic is simply that no one understands why it is important to eat healthy,” she said, “They may know what is considered to be ‘good food’ and ‘bad food’ but nothing can be learned if it isn’t put into action.”
In 2007, the Journal of the American Medical Association showed that obesity is associated with over 112,000 excess deaths due to cardiovascular disease. Obesity is also related to over 20 different types of chronic diseases which include coronary heart disease, breathing problems, gall stones, hypertension and stroke, type 2 diabetes, and certain types of cancer.
For Mississippi, the state with the number one highest obesity rate for the fifth year in a row, has been enveloped in a vicious cycle. Due to the difficult expenses and problematic economic struggles, the state also has the highest rate in the country for premature death, according to an extensive report compiled by the Mississippi Department of Education’s Office of Healthy Schools.
The growing obesity in the country and the declining economy has become parallel with one another. Six of the states with the highest poverty rates are also states with the highest obesity rates. The growing number of people in the population that are unemployed, uninsured and underinsured proves to be an extremely influential factor.
Delamater had struggles with the prices associated with healthy living but was able to cut corners in order to still benefit from it. “Buying in bulk helped out a lot. I would buy fruits in vegetables from a local market so there would always be an alternative for snacks,” she said, “I had to really start getting creative with what I cooked. All the organic foods were just too expensive.”
Between 1985 and 2000, the cost of fresh fruits and vegetables rose nearly 40 percent, while the cost of soft drinks, sweets, fats, and oils decreased in the United States. Eating adequate amounts of nutrients and buying “healthy” foods has steadily increased. In an article from the New York Times, Dr. Adam Drewnowski, director of the center for public health nutrition at the University of Washington, said that because more calorie dense foods are usually cheaper, lower-income households will be more inclined to make these purchases.
“If you have three dollars to feed yourself, your choices gravitate toward foods which give you the most calories per dollar,’’ said Dr. Drewnowski, “Not only are the empty calories cheaper, but the healthy foods are becoming more and more expensive. Vegetables and fruits are rapidly becoming luxury goods.”
Younger agrees with the pricing problem, “We are eating foods void of these micronutrients but then our bodies will always want to eat more because they are craving those nutrients that they aren’t receiving. Eating a salad over fast food is the ideal but it’s just not that easy for some people.”
The obesity problem is raising concern not just for adults but for children as well, who are being affected on an even greater scale. A report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) entitled F as in Fat: How Obesity threatens America’s Future, showed that since 1970, the percentage of obesity among children ages 12-19 has tripled. Americans surveyed for the report stated that they believe childhood obesity to be an issue that needs to be more fervently addressed.
“I’m fortunate my children didn’t go through the same thing that I did,” said Delamater, who has two adult children, “We are a much more health conscious family now and my children are now teaching their children better than I did. It’s a complete 180; the days of boxed macaroni and cheese are long gone.”
The overwhelming numbers have proved to be an incentive to educate the country as a whole about the benefits of positive eating habits and exercise. Collective efforts have been put into effect by President Barack Obama and first lady Michelle Obama, said the official White House website. In May 2010, President Obama created the White House Task Force on Childhood Obesity, which includes the goal of reducing childhood obesity rates from 17% to five percent by 2030.
Alongside this effort, Michelle Obama established the Let’s Move! Campaign which hopes to combat childhood obesity by empowering parents and caregivers, providing healthy food in schools, improving access to healthy, affordable foods and increasing physical activity.
It appears that Americans are beginning to realize that education is a main component to halting the obesity epidemic, for adults and children alike. Younger, who dispenses nutritional advice on a daily basis, is adamant about effective methods for informing the country.
“I’m a huge believer that education is the path to freedom – it gives people the option of making their own educated decisions. I think our country needs to embark on a huge nutrition education effort,” she said.
Delamater, since her initial decision to regain her health, has lost 65 pounds and has kept the weight off for 5 years now. “My entire lifestyle had to change and I had to really dedicate myself to what I wanted. I think that’s what the rest of the country needs to do,” she said, “It doesn’t matter about how much money you make or who you are, if you want to regain control of your life, that’s the only thing you really need.”
By AMANDA SANDLIN
LAWRENCEVILLE, N.J. — It set in about two weeks after they eliminated his title as a Movie Gallery field technician — the melancholy. Although he didn’t go to a mental health facility to get diagnosed, Robert Bannan, 35, of Tamaqua, Pa., admits he was undoubtedly depressed.
Bannan’s story is one of many, with countless testimonies and studies backing up the correlation of mental illness and unemployment. Given the United States’ poor fiscal state, sources say that the poor economic outlook could exacerbate depression for the unemployed.
The National Suicide Prevention Lifeline reports that people who lost jobs since the onset of the recession in late 2008 are 13 percent more likely to report considering self-inflicted pain. This same population is also four times as expected to demonstrate signs of mental illness, commonly in the form of depression.
“I did, in fact, experience depression from being unemployed,” Bannan says. “I didn’t have a purpose anymore, going day-by-day just drifting. Not only was I not working, but I didn’t have much interaction with other people because I wasn’t in the office anymore.”
Bannan recalls his feelings of what he believed to be depression: loneliness, insignificance, boredom and laziness.
According to the National Institutes of Health, common symptoms of depression include sadness, loss of interest in activities, weight variation, difficulty sleeping, loss of energy and feelings of worthlessness.
“I’m glad I found a job before too long because I can definitely see how jobless people would turn to substances like drugs or alcohol for a source of stimulation,” Bannan explains. “Instead, I just slept all the time and gained a ton of weight until I realized that I was in a serious state of depression.”
With national unemployment hovering at 9.3% in November, according to the U.S. Bureau of Labor Statistics, the job outlook is meek for those let off. This factor could drive the unemployed into even greater depression, according to Dr. Barbara Korzun, Psy.D, of RSM Psychology Center in Princeton, New Jersey.
“There has to be a direct relationship,” Korzun says. “This is especially true if you’re older and losing physical capability, or if there’s a greater need for something that’s not in your field of work.”
Korzun explains that while depressed, a person has a more correct grip on reality. Because of this, the unemployed and depressed begin to realize the true significance of the recessed economy.
“You actually see the world in a more accurate way when you’re depressed,” Korzun says. “Sometimes it is exaggerated, but you see a stark reality. Where as when you’re not depressed you see a little bit more rose-colored reality.”
Bannan serves as a poster-child for Korzun’s theory. At the time, separated from his wife and being responsible for two separate mortgages, he was left paying $1850 per month. Bannan says that his unemployment benefits gave him just $454 per month, so he had “to dip into savings.”
In order to feel productive, he took on the second home independently to do renovations. He hoped to increase the value of the property and make a profit. Unfortunately, Bannan says, he began to realize that things wouldn’t work out that way.
“That was my thinking until they said the housing market wasn’t going to just bounce back,” he says. “Anything above $200,000 lost 40% of the value. So even though I stayed productive, I gradually became more pessimistic than optimistic.”
A study from the American Public Health Association reported the impact of stress on 300 men both while employed and after being fired. The results showed that post-job loss, the participants experienced increased feelings of isolation and depression, among other negative emotions.
While the harmful effects of job loss are apparent, other studies show that certain populations carrying low unemployment rates boast healthier mindsets overall. Some argue that this may illustrate that those employed tend to be happier and less apt to depression.
According to the United Health Foundation, North Dakota ranked first for lowest annual unemployment rate in 2010, clocking in at 4.3%. Likewise, South Dakota’s unemployment rate was one of the lowest in the past year — only 4.8% unemployed. That was the third-lowest unemployment rate in the country. Both North and South Dakota’s population averaged only 2.4 out of the past 30 days taken off because of poor mental health reasons. This was the lowest number out of all States.
Kentucky ranked highest, having taken the most mental health days within a month’s time. According to the United Health Foundation, Kentucky residents took on average of 4.6 days in the past 30 days — the most of all the States. Kentucky also fell in the top 10 states for unemployment, with approximately 10.5% of the state jobless this past year.
Alabama falls just behind Kentucky in poor mental health days, the average being 4.2 days taken off from work in the past 30 days for poor mental health. Interestingly enough, Alabama also fell into the higher half of States with unemployment with an annual rate of 10.1%.
Mental Health America, formerly known as the Mental Health Association, found South Dakota to be the healthiest state in regards to depression. Just over 7 percent of adults in South Dakota had a major depressive episode in the past year, and about 11 percent experienced “serious psychological distress.” Among youth in South Dakota, only 7.4 percent encountered a major depressive episode within the past year.
In the study “Ranking America’s Health” by Mental Health America, the institute found that several different aspects affect depression status among people. First, the availability and access to mental health facilities — on average, a higher number of psychologists, psychiatrists and social workers per capita yield to lower suicide rates.
The institute considers suicide to be the most negative outcome of depression. Pennsylvania ranks 18th in the country for suicide rates, with an age-adjusted average of about 11 percent. Bannan, a Pennsylvania resident, admits to having toyed with the thought multiple times throughout his duration of unemployment.
“There were a few times within the past year that I seriously considered if I wanted to go on or not,” Bannan says. “It’s just that, when you’re not contributing to society, I at least, feel no point to life.”
MHA also found that inability to access treatment affect the overall suicide rate and depression status of a state. When a state reported more citizens being able to afford and access healthcare, the suicide rate echoed lower numbers. The state also generally retained a better depression status as a whole.
Socioeconomic characteristics also affect states’ depression status and suicide rates, MHA reports. States with more educated populations experienced lower suicide rates and superior depression status.
An article from the Los Angeles Times suggests that loss of employment is linked to depressive symptoms, alcohol abuse and long-term mental and emotional harm. Part of this may be because of a loss of income, but it suggests that instead it is the result of loss of connection and purpose through losing work.
Dan Ariely, behavioral scientist and author of “The Upside of Irrationality,” says in the article: “We become very dedicated to things it would be hard to be dedicated to if we were perfectly rational. It turns out you can give people lots of meaning in lots of ways, even small ones.”
In a study conducted by Christopher Hsee of the University of Chicago, a question was raised: Do people genuinely enjoy busy work, or prefer to do nothing at all?
Subjects were asked to travel to one of two boxes — one that was nearby, or one that rested farther away. All were informed they would receive a chocolate reward upon reaching either box, but some were told that the farther box contained a different type of treat. Most of the subjects that walked to the farther box were the group told that it contained a different type of chocolate — but those that trekked the longer distance reported happier results.
The LA Times suggests that this study confirms that people seek to stay busy because more effort produces positive emotions — hard work makes people feel good.
“Busy people are happier, even if they are forced to be busy,” Hsee said to the Times. “We believe that people may well be happier when building bridges to nowhere than being idle, especially if they are given a justification for building the bridges.”
Korzun believes that depression stems from issues the affected person experienced as a child. A rocky past can leave you at greater risk for depression, and being unemployed can spark those weaknesses, she says.
“If there was a distortion that got laid down when someone was younger, then a point of stress like losing a job could trigger depression,” Korzun says. “Even if everything that stayed in the background until now.”
If a person had an issue with control as a child that continued with them to adulthood, then the loss of a job could spark depression upon losing control of job status. Likewise, low self-esteem issues undoubtedly carry into unemployment-sparked depression, she says.
“Anything can trigger this depression,” Korzun says. “It really depends on how they’re wired. It can absolutely be a lack of control, I feel like that’s the case for most people that have been unemployed. Either way, there just has to be a direct relationship between unemployment and depression.”
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By Megan O’Connell
The latest headlines in every gossip magazine always seem to be about what celebrity couple is calling it quits, but with nearly half of married American couples doing the same thing every day; this news has lost its shock value. It’s no longer, who is going to divorce? It’s when are they going to divorce?
The traditional American family structure consisted of husband wife and two children. The husband made the family income, the wife may have made some income too, but mainly took care of household chores and raised the children; and they all lived under the same roof. Over time the traditional structure has changed due to many factors including divorce. Now the average American family is living under separate roofs, sharing custody or maybe one parent is completely out of the picture.
Divorce is no longer a stigma because it is considered to be part of the modern family dynamics. Over the past 40 years there has been a significant increase in divorces and short lasting cohabitation relationships. This leads people to question the sanctity of marriage. A couple’s vows aren’t “till death do us part”, but rather “till we feel we should split.” In fact, only 5 percent of married couples reach their 50th anniversaries and only 35 percent reach their 25th anniversary according to the Census Bureau in 2002.
Even though divorce has become a significant part of our society, the divorce rate is on a steady decline. The divorce rate in 2005 was 3.6 percent per every thousand people– that was the lowest it has been since 1970. The highest divorce rate was at 5.3 percent in 1981 as stated by the Census Bureau.
“It’s pretty much believed that half of all couples get divorced,” said Maria Imbalzamo, attorney at Stark and Stark specializing in divorce. “Some people might be embarrassed, but most Americans aren’t surprised by the divorce rate.”
Looking back at divorce statistics, it isn’t hard to see when divorce started to turn into a national trend. The 1970’s in America was considered a ‘divorce revolution’. This was due mostly to state law changes that opened up the grounds for divorce. Although this was not the only reason for the rise in divorce it seemed to play a significant part.
Between 1960 and 1980 the U.S divorce rate nearly doubled. The no-fault law makes it so the wife or husband does not have to prove fault against their spouse. Prior to the law either party had to prove a “fault” confirming that their spouse had done something to break up the marriage. The grounds for divorce had to be established by proving things like adultery, felony or abandonment. Now either party can file a divorce based on “irreconcilable differences” which can account for a number of reasons.
In 1953, Oklahoma was the first to pass a law allowing couples to file for divorce without fault while it took 17 years for the rest of the country to follow in its footsteps. California was next to pass the no-fault law and it quickly spread to other states. New York is currently the only state that has not adopted any no-fault laws.
Not only did the change in laws add to this revolution, there were also many social trends in America that ushered in the divorce revolution.
“Women became more economically independent,” said Dr. Prakash Sharma a sociology professor at Rider University. “They were entering in the workforce and becoming equal with the men they worked with.”
Women were attending college, having children later in life, and not being the standard house wife that needed to depend on their husband’s income to live.
Dr. Sharma, who teaches a family course, also believes that in other underdeveloped countries such as India there is a lower divorce rate because women are not equal in the workforce. Therefore there is a greater need to depend on their husbands for financial reasons. Just because the divorce rate is lower may not mean they are happier couples. These women may need to stay married as a means to live.
Unlike couples in countries with greater restrictions, Americans are given the freedom to end a marriage and still be financially stable as a single person. People are marrying just as fast as they are getting divorced, and it’s not uncommon to be married and divorced more than once and maybe more than twice.
The age of the couple when they were married also plays a part in the divorce statistic. Younger couples aged 20-25 are more likely to get divorced at just under 40 percent according to the Center for Disease Control’s (CDC) Monthly Vital Statistics Report.
“You really have to know yourself to get married and that’s really young to know who you are as a person,” said Kathleen Bonfield a graduate student interning at Rider University’s Counseling Center. “Who you are at 20 and 25 is going to look differently from who you are at 30.”
Even though younger couples have the higher risk there has been a new trend in divorcing couples that has been seen in the past five to seven years known as “gray divorce”. This term refers to older couples who get divorced after decades of marriage.
“The children have moved out of home and the couple is left with one another for the first time in a while,” said Bonfield who has done extensive research on divorce. “They now feel like they don’t know each other anymore.”
The slow decline in divorce rate since the 80’s is no reason to celebrate because Americans couples are still facing the same unresolved issues. Some experts believe the decline in divorce rate may be because many American couples are living together without ever getting married.
The problems a married couple faces aren’t due to the fact that they have a marriage license and a ring. When unmarried couples who cohabitate split, it can feel the same for them as a divorce.
“I recently represented a lesbian couple who never got married, but [the divorce] was messier than any divorce I had dealt with,” said Imbalzano. “It is the same for every couple. They had the same issues that any married couple had.”
According to Imbalzano’s New Jersey Law Blog, the growing rate of cohabitating couples has caused growing issues in the court about adjusting alimony. In some divorce cases the agreement is to cease alimony once the spouse receiving the alimony remarries or cohabitates. It is difficult however, to prove if the couple is just living together or if they are in a relationship.
Dr. Sharma believes that cohabitation is also beneficial for couples considering marriage. He suggests that although it was not socially accepted in the 60’s more couples turn to this to find out how compatible they are.
The reason why more couples are living together and not getting married could be because of the hard economic times the country is facing. Living together is sometimes a cheaper way of life for couples not ready to make the commitment.
“In a bad economy people stay together until things get better,” said Imbalzano. “There is no way to tell if the divorce rate will go up in the future when the economy is better.”
The bad economy may be keeping some divorces on the back burner, but it is also fueling more problems for other divorced and divorcing couples because of the rise in unemployment rate. Many study results have shown that losing a job increases the likelihood of divorce. Even after a divorce, losing a job can send a couple back to court to make adjustments.
“I have been busier than ever in a bad economy,” said Imbalzano. “More people are losing jobs so they are filling motions to change the circumstances of their alimony because of their decreased income.”
From Imbalzano’s experience with clients, money issues are often the root of the problem that leads to other issues such as infidelity.
“Cheating is really the outcome of the real problem, whether it is financial or something else,” said Imbalzamo. “When couples aren’t on the same page as to how to spend their money it can lead to other issues.”
Imbalzano feels the bad economy is forcing couples to stay married for the time being. She suggested many couples may not have the means to sell their house right now and when they can they will be able to go their separate ways. Dr. Sharam suggests that aside from financial issues, when money is tight it can also cause couples to become unhappier in their relationships.
“In better economic times couples do more leisurely things and spend more quality time together because they can afford it,” said Dr. Sharma.
The declining divorce rate does not reflect the increase of happiness in the relationship, but rather the change in economy. For now there may be a decline in divorce, but further down the road when the economy is better the country may see divorce back on the rise.
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