In elf ears and wizard hats, 'Hobbit' fans rejoice

WELLINGTON, New Zealand (AP) — Wearing elf ears and wizard hats, sitting atop their dad's shoulders or peering from balconies, tens of thousands of New Zealanders watched their favorite "Hobbit" actors walk the red carpet Wednesday at the film trilogy's hometown premiere.

An Air New Zealand plane freshly painted with "Hobbit" characters flew low over Wellington's Embassy Theatre, eliciting roars of approval from the crowd.

Sam Rashidmardani, 12, said he came to see Gollum actor Andy Serkis walk the red carpet — and he wasn't disappointed.

"It was amazing," Rashidmardani said of the evening, adding his Gollum impression: "My precious."

British actor Martin Freeman, who brings comedic timing to the lead role of Bilbo Baggins, said he thought director Peter Jackson had done a fantastic job on "The Hobbit: An Unexpected Journey."

"He's done it again," Freeman said in an interview on the red carpet. "If it's possible, it's probably even better than 'The Lord of the Rings.' I think he's surpassed it."

While it is unusual for a city so far from Hollywood to host the premiere of a hoped-for blockbuster, Jackson's filming of his lauded 'LOTR' trilogy and now "The Hobbit" in New Zealand has helped create a film industry here. The film will open in theaters around the world next month.

One of the talking points of the film is the choice by Jackson to shoot it using 48 frames per second instead of the traditional 24 in hopes of improving the picture quality.

Some say the images come out too clear and look so realistic that they take away from the magic of the film medium. Jackson likens it to advancing from vinyl records to CDs.

"I really think 48 frames is pretty terrific and I'm looking forward to seeing the reaction," Jackson said on the red carpet. "It's been talked about for so long, but finally the film is being released and people can decide for themselves."

Jackson said it was strange working on the project so intimately for two years and then having it suddenly taken away as the world got to see the movie.

"It spins your head a little bit," he said.

Aidan Turner, who plays the dwarf Kili in the movie, said his character is reckless and thinks he's charming.

"I don't get to play real people it seems, I only get to play supernatural ones," he said. "So playing a dwarf didn't seem that weird, actually.

Perhaps the most well-known celebrities to walk the carpet were Cate Blanchett and Elijah Wood, who reprise their roles in the LOTR in the "Hobbit."

"Mostly I came here to see everyone. I like them all," said fan Aysu Shahin, 16, adding that Wood was her favorite. She said she wanted to see the movie "as soon as possible. I'm excited for it."

At a news conference earlier in the day, Jackson said many younger people are happy to watch movies on their iPads.

"We just have to make the cinema-going experience more magical and more spectacular to get people coming back to the movies again," he said.

Jackson said only about 1,000 of the 25,000 theaters that will show the film worldwide are equipped to show 48 frames, so most people will see it in the more traditional format. The movie has also been shot in 3D.

A handful of animal rights protesters held signs at the premiere.

The protest by the group People for the Ethical Treatment of Animals comes after several animal wranglers said three horses and up to two dozen other animals had died during the making of the movies because they were housed at an unsafe farm.

Jackson's spokesman earlier acknowledged two horses had died preventable deaths at the farms but said the production company worked quickly to improve stables and other facilities and that claims of mistreatment were unfounded.

"No mistreatment, no abuse. Absolutely none," Jackson said at the news conference.

Read More..

The New Old Age Blog: Doctor's Orders? Another Test

It is no longer news that Americans, and older Americans in particular, get more routine screening tests than they need, more than are useful. Prostate tests for men over 75, annual Pap smears for women over 65 and colonoscopies for anyone over 75 — all are overused, large-scale studies have shown.

Now it appears that many older patients are also subjected to too-frequent use of the other kind of testing, diagnostic tests.

The difference, in brief: Screening tests are performed on people who are asymptomatic, who aren’t complaining of a health problem, as a way to detect incipient disease. We have heard for years that it is best to “catch it early” — “it” frequently being cancer — and though that turns out to be only sometimes true, we and our doctors often ignore medical guidelines and ongoing campaigns to limit and target screening tests.

Diagnostic tests, on the other hand, are meant to help doctors evaluate some symptom or problem. “You’re trying to figure out what’s wrong,” explained Gilbert Welch, a veteran researcher at the Dartmouth Institute for Health Policy and Clinical Practice.

For these tests, medical groups and task forces offer many fewer guidelines on who should get them and how often — there is not much evidence to go on — but there is general agreement that they are not intended for routine surveillance.

But a study using a random 5 percent sample of Medicare beneficiaries — nearly 750,000 of them — suggests that often, that is what’s happening.

“It begins to look like some of these tests are being routinely repeated, and it’s worrisome,” said Dr. Welch, lead author of the study just published in The Archives of Internal Medicine. “Some physicians are just doing them every year.”

He is talking about tests like echocardiography, or a sonogram of the heart. More than a quarter of the sample (28.5 percent) underwent this test between 2004 and 2006, and more than half of those patients (55 percent) had a repeat echocardiogram within three years, most commonly within a year of the first.

Other common tests were frequently repeated as well. Of patients who underwent an imaging stress test, using a treadmill or stationery bike (or receiving a drug) to make the heart work harder, nearly 44 percent had a repeat test within three years. So did about half of those undergoing pulmonary function tests and chest tomography, a CAT scan of the chest.

Cytoscopy (a procedure in which a viewing tube is inserted into the bladder) was repeated for about 41 percent of the patients, and endoscopy (a swallowed tube enters the esophagus and stomach) for more than a third.

Is this too much testing? Without evidence of how much it harms or helps patients, it is hard to say — but the researchers were startled by the extent of repetition. “It’s inconceivable that it’s all important,” Dr. Welch said. “Unfortunately, it looks like it’s important for doctors.”

The evidence for that? The study revealed big geographic differences in diagnostic testing. Looking at the country’s 50 largest metropolitan areas, it found that nearly half the sample’s patients in Miami had an echocardiogram between 2004 and 2006, and two thirds of them had another echocardiogram within three years — the highest rate in the nation.

In fact, for the six tests the study included, five were performed and repeated most often in Florida cities: Miami, Jacksonville and Orlando. “They’re heavily populated by physicians and they have a long history of being at the top of the list” of areas that do a lot of medical procedures and hospitalizations, Dr. Welch said.

But in Portland, Ore., where “the physician culture is very different,” only 17.5 percent of patients had an echocardiogram. The places most prone to testing were also the places with high rates of repeat testing. Portland, San Francisco and Sacramento had the lowest rates.

We often don’t think of tests as having a downside, but they do. “This is the way whole cascades can start that are hard to stop,” Dr. Welch said. “The more we subject ourselves, the more likely some abnormality shows up that may require more testing, some of which has unwanted consequences.”

Properly used, of course, diagnostic tests can provide crucial information for sick people. “But used without a good indication, they can stir up a hornet’s nest,” he said. And of course they cost Medicare a bundle.

An accompanying commentary, sounding distinctly exasperated, pointed out that efforts to restrain overtesting and overtreatment have continued for decades. The commentary called it “discouraging to contemplate fresh evidence by Welch et al of our failure to curb waste of health care resources.”

It is hard for laypeople to know when tests make sense, but clearly we need to keep track of those we and our family members have. That way, if the cardiologist suggests another echocardiogram, we can at least ask a few pointed questions:

“My father just had one six months ago. Is it necessary to have another so soon? What information do you hope to gain that you didn’t have last time? Will the results change the way we manage his condition?”

Questions are always a good idea. Especially in Florida.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

Facebook Gift Store Urges Users to Shop While They Share

SAN FRANCISCO — Facebook is already privy to its users’ e-mail addresses, wedding pictures and political beliefs. Now the company is nudging them to share a bit more: credit card numbers and offline addresses.

James Best Jr./The New York Times

Facebook Gifts is a service that prompts users to buy things for friends on the social network.

Sharing Even More

What do you think about Facebook’s plan to have users buy gifts for their friends through the site using their credit cards?

A screenshot of Facebook Gifts.

The nudge comes from a new Facebook service called Gifts. It allows Facebook users — only in the United States for now — to buy presents for their friends on the social network. On offer are items as varied as spices from Dean & DeLuca, pajamas from BabyGap and subscriptions to Hulu Plus, the video service. This week Facebook added iTunes gift cards.

The gift service is part of an aggressive moneymaking push aimed at pleasing Facebook’s investors after the company’s dismal stock market debut. Facebook has stepped up mobile advertising and is starting to customize the marketing messages it shows to users based on their Web browsing outside Facebook.

Those efforts seem to have brought some relief to Wall Street. Analysts issued more bullish projections for the company in recent days, and the stock was up 49 percent from its lowest point, closing Tuesday at $26.15, although that is still well below the initial offering price of $38. The share price has been buoyed in part by the fact that a wave of insider lockup periods expired without a flood of shares hitting the market.

To power the Gifts service, Facebook rented a warehouse in South Dakota and created its own software to track inventory and shipping. It will not say how much it earns from each purchase made through Gifts, though merchants that have a similar arrangement with Amazon.com give it a roughly 15 percent cut of sales.

If it catches on, the service would give Facebook a toehold in the more than $200 billion e-commerce market. Much more important, it would let the company accumulate a new stream of valuable personal data and use it to refine targeted advertisements, its bread and butter. The company said it did not now use data collected through Gifts for advertising purposes, but could not rule it out in the future.

“The hard part for Facebook was aggregating a billion users. Now it’s more about how to monetize those users without scaring them away,” said Colin Sebastian, an analyst with Robert W. Baird.

He added: “Gifts should also contribute more to Facebook’s treasure trove of user data, which has the benefit of a virtuous cycle, driving more personalization of the site, leading to better and more targeted ads, which improves overall monetization.”

Facebook already collects credit card information from users who play social games on its site. But they are a limited constituency, and a wider audience may be persuaded to buy a gift when Facebook reminds them that a friend is expecting a baby or a cousin is approaching her 40th birthday.

The Gifts service, which grew out of Facebook’s acquisition of a mobile application called Karma, was introduced in September and expanded earlier this month on the eve of the holiday shopping season.

Magnolia Bakery, based in New York, was among Facebook’s early partners for Gifts. Its vice president for public relations, Sara Gramling, said the company had sold roughly 200 packages of treats since then. She counted it as a marketing success. The bakery, which gained fame thanks to “Sex and the City,” had only recently begun shipping its goods. “It was a great opportunity to expand our network,” she said.

Magnolia Bakery isn’t exactly catering to the masses. A half-dozen cupcakes cost $35, plus about $12 for shipping. Facebook, Ms. Gramling said, takes care of the billing. The bakery is eyeing Facebook’s global reach, too, as it opens outlets internationally, especially in the Middle East.

One of the appeals of Facebook Gifts is the ease of making a purchase. Facebook users are nudged to buy a gift (a gift-box icon pops up) for Facebook friends on their birthdays. They are offered a vast menu to choose from: beer glasses, cake pops, quilts, marshmallows, magazine subscriptions and donations to charity. They are asked to choose a greeting card. Then they are asked for credit card details. Facebook says it stores that credit card information, unless users remove it after making a purchase.

Facebook has declined to say how many users have bought gifts, only that among those who have, the average purchase is $25.

David Streitfeld contributed reporting.

Read More..

Politics in Play Over Safety Net in Deficit Talks

Carolyn Kaster/Associated Press

President Obama and Speaker John A. Boehner of Ohio at the White House this month.

WASHINGTON — President Obama’s re-election and Democratic gains in Congress were supposed to make it easier for the party to strike a deal with Republicans to resolve the year-end fiscal crisis by providing new leverage. But they could also make it harder as empowered Democrats, including some elected on liberal platforms, resist significant changes in entitlement programs like Social Security and Medicare.

As Congress returned Monday, the debate over those programs, which many Democrats see as the core of the party’s identity, was shaping up as the Democratic version of the higher-profile struggle among Republicans over taxes.

In failed deficit reduction talks last year, Mr. Obama signaled a willingness to consider substantial changes in the social safety net, including a gradual increase in the eligibility age for Medicare and limits in the growth rate of future Social Security benefits. An urgent question hanging over the new round of deficit talks is which of those changes Mr. Obama and Congressional Democrats would accept today.

While a potential change in calculating Social Security increases was part of the talks with Speaker John A. Boehner last year, the White House press secretary, Jay Carney, made clear on Monday that the administration was not considering changes to the retirement program as part of the deficit talks.

“We should address the drivers of the deficit, and Social Security is not currently a driver of the deficit,” Mr. Carney said.

Republicans insist that changes in the major entitlement programs be on the table in exchange for their willingness to accept increases in tax revenue. But Democrats have given no indication that they are willing to consider policy changes or savings of the magnitude demanded by Republicans. The underlying dispute highlights a reason the politics of the deficit are so thorny: even as many voters say they want Washington to reduce the budget deficit, they oppose many of the benefit cuts and tax increases that could help achieve that goal.

As the negotiations enter a crucial phase, influential outside advocacy groups like AARP and the National Committee to Preserve Social Security and Medicare are weighing in, alerting their members to possible changes in the popular programs.

In the current negotiations with Congress over deficits and the debt, Mr. Obama said he would take a serious look at how to “reform our entitlements” because “health care costs continue to be the biggest driver of our deficits.” Unless Mr. Obama and Congress reach some agreement, tax increases and budget reductions will take effect automatically on Jan. 1.

Mr. Obama’s room for maneuvering is limited by several political factors. In the presidential campaign, for example, he attacked cost-cutting proposals by his Republican opponents and won support from millions of voters by promising to defend Medicare.

Moreover, since the Supreme Court upheld the new health care law in June, Mr. Obama has become skittish about cutbacks in Medicaid, the federal-state program for low-income people. The court said the expansion of Medicaid was an option for states but not a requirement. Cutting federal Medicaid payments to states could reduce the federal budget deficit, but could also cripple Mr. Obama’s efforts to persuade governors to expand the program, the foundation of his health care overhaul.

Even if Mr. Obama and Republican leaders in Congress could agree on savings in Medicare and Medicaid, the president would face resistance from some liberal members of his party who oppose cuts in the two giant health care entitlement programs. Medicare and Medicaid insure one-third of all Americans, account for more than one-fifth of the federal budget and are expected to grow much faster than the economy in the coming decade.

Two staunch liberals, Senators Tom Harkin of Iowa and John D. Rockefeller IV of West Virginia, said in a letter to Mr. Obama that he should “reject changes to Medicare, Medicaid and Social Security that would cut benefits, shift costs to states, alter the structure of these critical programs, or force vulnerable populations to bear the burden of deficit reduction.”

More than 40 House members, led by the Congressional Progressive Caucus, declare in a resolution that any deal on taxes and spending “should not cut Medicare, Medicaid or Social Security benefits.”

Republicans say the revenue to be gained from Mr. Obama’s tax proposals would be dwarfed by the growing costs of the benefit programs.

“You can’t raise taxes enough to solve the problem,” said the Senate Republican leader, Mitch McConnell of Kentucky. “Additional revenue should be tied to the only thing that will save the country in the long run, and that is reforming entitlements.”

Mr. Boehner said the newest entitlement — insurance subsidies for more than 20 million people under the health care law — should be “on the table” in negotiations. White House officials said the law should be given a chance to work before its budget is cut.

Read More..

Berry's ex says he was threatened before fight

LOS ANGELES (AP) — Halle Berry's ex-boyfriend claims the actress's fiance threatened to kill him during a Thanksgiving confrontation that left him with a broken rib, bruised face and under arrest.

Gabriel Aubry's claims are included in court filings that led a judge Monday to grant a restraining order against actor Olivier Martinez, who is engaged to the Oscar-winning actress.

Aubry, 37, was arrested on suspicion of misdemeanor battery after his confrontation with Martinez on Thursday, but he states in the civil court filings that he was not the aggressor and that he was threatened and attacked without provocation. Martinez told police that Aubry had attacked first, the filings state.

A representative for Martinez could not be immediately reached for comment.

Aubry's filing claims Martinez threatened him the day before the fight at an event at his daughter's school that he and the actors attended. Aubry, a model, has a 4-year-old daughter with Berry and the former couple have been engaged in a lengthy custody battle.

The proceedings have been confidential, but Aubry states a major aspect of the case was Berry's wish to move to Paris and take her daughter with her. The request was denied Nov. 9, Berry's court filings state, and Aubry shares joint custody of the young girl.

Aubry claims Martinez told him, "You cost us $3 million," while he was punched and kicked him in the driveway of Berry's home. Aubry had gone to the home to allow his daughter to spend Thanksgiving with her mother, the filings state. Aubry claims Martinez threatened to kill him if Aubry didn't move to Paris.

Berry was not in the driveway during the confrontation and neither was their daughter, the documents state.

Photos of Aubry's face with cuts and a black eye were included in his court filing.

A judge set a hearing for Dec. 17 to consider whether a three-year restraining order should be granted. Aubry has a Dec. 13 court date for the possible battery case, which has not yet been filed by prosecutors.

___

Anthony McCartney can be reached at http://twitter.com/mccartneyAP .

Read More..

Clearing the Fog Around Personality Disorders

For years they have lived as orphans and outliers, a colony of misfit characters on their own island: the bizarre one and the needy one, the untrusting and the crooked, the grandiose and the cowardly.

Their customs and rituals are as captivating as any tribe’s, and at least as mystifying. Every mental anthropologist who has visited their world seems to walk away with a different story, a new model to explain those strange behaviors.

This weekend the Board of Trustees of the American Psychiatric Association will vote on whether to adopt a new diagnostic system for some of the most serious, and striking, syndromes in medicine: personality disorders.

Personality disorders occupy a troublesome niche in psychiatry. The 10 recognized syndromes are fairly well represented on the self-help shelves of bookstores and include such well-known types as narcissistic personality disorder, avoidant personality disorder, as well as dependent and histrionic personalities.

But when full-blown, the disorders are difficult to characterize and treat, and doctors seldom do careful evaluations, missing or downplaying behavior patterns that underlie problems like depression and anxiety in millions of people.

The new proposal — part of the psychiatric association’s effort of many years to update its influential diagnostic manual — is intended to clarify these diagnoses and better integrate them into clinical practice, to extend and improve treatment. But the effort has run into so much opposition that it will probably be relegated to the back of the manual, if it’s allowed in at all.

Dr. David J. Kupfer, a professor of psychiatry at the University of Pittsburgh and chairman of the task force updating the manual, would not speculate on which way the vote might go: “All I can say is that personality disorders were one of the first things we tackled, but that doesn’t make it the easiest.”

The entire exercise has forced psychiatrists to confront one of the field’s most elementary, yet still unresolved, questions: What, exactly, is a personality problem?

Habits of Thought

It wasn’t supposed to be this difficult.

Personality problems aren’t exactly new or hidden. They play out in Greek mythology, from Narcissus to the sadistic Ares. They percolate through biblical stories of madmen, compulsives and charismatics. They are writ large across the 20th century, with its rogues’ gallery of vainglorious, murderous dictators.

Yet it turns out that producing precise, lasting definitions of extreme behavior patterns is exhausting work. It took more than a decade of observing patients before the German psychiatrist Emil Kraepelin could draw a clear line between psychotic disorders, like schizophrenia, and mood problems, like depression or bipolar disorder.

Likewise, Freud spent years formulating his theories on the origins of neurotic syndromes. And Freudian analysts were largely the ones who, in the early decades of the last century, described people with the sort of “confounded identities” that are now considered personality disorders.

Their problems were not periodic symptoms, like moodiness or panic attacks, but issues rooted in longstanding habits of thought and feeling — in who they were.

“These therapists saw people coming into treatment who looked well put-together on the surface but on the couch became very disorganized, very impaired,” said Mark F. Lenzenweger, a professor of psychology at the State University of New York at Binghamton. “They had problems that were neither psychotic nor neurotic. They represented something else altogether.”

Several prototypes soon began to emerge. “A pedantic sense of order is typical of the compulsive character,” wrote the Freudian analyst Wilhelm Reich in his 1933 book, “Character Analysis,” a groundbreaking text. “In both big and small things, he lives his life according to a preconceived, irrevocable pattern.”

Others coalesced too, most recognizable as extreme forms of everyday types: the narcissist, with his fragile, grandiose self-approval; the dependent, with her smothering clinginess; the histrionic, always in the thick of some drama, desperate to be the center of attention.

In the late 1970s, Ted Millon, scientific director of the Institute for Advanced Studies in Personology and Psychopathology, pulled together the bulk of the work on personality disorders, most of it descriptive, and turned it into a set of 10 standardized types for the American Psychiatric Association’s third diagnostic manual. Published in 1980, it is a best seller among mental health workers worldwide.

These diagnostic criteria held up well for years and led to improved treatments for some people, like those with borderline personality disorder. Borderline is characterized by an extreme neediness and urges to harm oneself, often including thoughts of suicide. Many who seek help for depression also turn out to have borderline patterns, making their mood problems resistant to the usual therapies, like antidepressant drugs.

Today there are several approaches that can relieve borderline symptoms and one that, in numerous studies, has reduced hospitalizations and helped aid recovery: dialectical behavior therapy.

This progress notwithstanding, many in the field began to argue that the diagnostic catalog needed a rewrite. For one thing, some of the categories overlapped, and troubled people often got two or more personality diagnoses. “Personality Disorder-Not Otherwise Specified,” a catchall label meaning little more than “this person has problems” became the most common of the diagnoses.

It’s a murky area, and in recent years many therapists didn’t have the time or training to evaluate personality on top of everything else. The assessment interviews can last hours, and treatments for most of the disorders involve longer-term, specialized talk therapy.

Psychiatry was failing the sort of patients that no other field could possibly help, many experts said.

“The diagnoses simply weren’t being used very much, and there was a real need to make the whole system much more accessible,” Dr. Lenzenweger said.

Resisting Simplification 

It was easier said than done.

The most central, memorable, and knowable element of any person — personality — still defies any consensus.

A team of experts appointed by the psychiatric association has worked for more than five years to find some unifying system of diagnosis for personality problems.

The panel proposed a system based in part on a failure to “develop a coherent sense of self or identity.” Not good enough, some psychiatric theorists said.

Later, the experts tied elements of the disorders to distortions in basic traits.

Read More..

Rebels Claim They Seized Air Bases and a Dam in Syria

BEIRUT, Lebanon — Fresh from declaring that they seized an important military airport and an air defense base just outside Damascus, Syrian rebels on Monday said they overran a hydroelectric dam in the north of the country, adding to a monthlong string of tactical successes — capturing bases, disrupting supply routes and seizing weaponry — that demonstrate their ability to erode the government’s dominance in the face of withering aerial attacks.

The New York Times

Marj al-Sultan is one of the main bases for Mi-8 copters.

The battlefield advances coincided with fresh claims of bloody events on the ground with rebels saying a government airstrike on Sunday killed several schoolchildren in a playground. On Monday, moreover, the conflict was reported once again to have spilled beyond Syria’s border, drawing in Turkish antiaircraft gunners who were said by the insurgents to have opened fire on a government warplane that appeared to have entered Turkish airspace as it attacked rebel positions in the Syrian town of Atma, just across the 550-mile Turkish-Syrian border.

According to two anti-government Syrian opposition groups — the Syrian Observatory for Human rights and the Local Coordinating Committees — and a fighter on the ground, who gave his name only as Saado, the Turkish fire deterred an attack on an area that includes a rebel headquarters and a camp for internally displaced Syrians. But there was no confirmation of the episode from Turkey.

Syria and Turkey have exchanged mortar fire on numerous occasions in recent months and Turkey, a NATO member, has requested that the alliance provide it with Patriot antimissile batteries, a possible step toward creating a de facto no fly zone in northern Syria to protect rebels from Syrian government air attacks.

But Reuters reported Monday that Turkey planned to use the Patriot missiles only to defend Turkish territory, not to establish a no fly-zone, citing a statement from the Turkish military. Turkey has come under criticism from Russia and others for the Patriot proposal.

“The deployment of the air and missile defense system is only to counter an air or missile threat originating in Syria and is a measure entirely aimed at defense,” the statement was quoted as saying. “That it will be used to form a no-fly zone or for an offensive operation is out of the question.”

On Monday, amateur video, which could not be verified, showed what was purported to be rebel soldiers ransacking boxes of captured weapons — including hand grenades and rocket-propelled grenades at the Tishreen Dam near the town of Menbej. “Here are your spoils Bashar,” a voice can be heard saying, referring to President Bashar al-Assad. “Here are your weapons, Bashar. God is great,” a rebel exclaims as two men are filmed carrying off a trunk of munitions.

Rebel forces had been besieging the dam’s defenses on the Euphrates River for days.

The footage seemed to have been recorded in darkness. The British-based Syrian Observatory for Human Rights, which compiles its reports from militants on the ground, said the rebels overran the facility before dawn. The dam supplies electricity to several parts of Syria, the activists said, and lies on an axis between the northern provinces of Raqa and Aleppo, apparently broadening the rebels’ potential supply lines in northern Syria.

Another clip, posted on the Internet and apparently recorded later when the sun had risen, showed several rebel fighters relaxing in the dam’ control room while one of them checks a computer and another man serves tea.

While the rebels called the reported capture of the dam a strategic victory, it was not clear whether they were able to operate it or to withstand a government counterattack.

Over the past month, rebels have seized or damaged major military bases around the country, making off with armored vehicles, antiaircraft weapons and other equipment they desperately need to break the stalemate in the grinding conflict, which has taken more than 30,000 lives. But they have not tried to hold all of the bases, as they become easy targets for government airstrikes.

The capture of the air base near Damascus, Marj al-Sultan, on Sunday could be significant because it was one of the principal bases used by the Syrian Air Force’s fleet of Mi-8 helicopters, said Joseph Holliday, a senior analyst covering Syria for the Institute for the Study of War in Washington. The government relies on the aircraft to resupply army units and to carry out bomb and rocket attacks, especially in the north where government forces are increasingly isolated and air power is the main way to harass the rebels.

Anne Barnard reported from Beirut, C.J. Chivers from the United States, and Alan Cowell from Paris. Reporting was contributed by Hwaida Saad, Hania Mourtada and Hala Droubi from Beirut

Read More..

Rolling Stones mark 50th year with London show

LONDON (AP) — The Rolling Stones made a triumphant return to the London stage on Sunday night in the first of five concerts to mark the 50th anniversary of their debut as an American-oriented blues band.

They showed no signs of wear and tear — except on their aging, heavily lined faces — as frontman Mick Jagger swaggered and strutted through a stellar two-and-a-half hour show. He looked remarkably trim and fit and was in top vocal form.

The Stones passed the half-century mark in style at the sometimes emotional gig that saw former bassist Bill Wyman and guitar master Mick Taylor join their old mates in front of a packed crowd at London's 02 Arena.

It was the first of five mega-shows to mark the passage of 50 years since the band first appeared in a small London pub determined to pay homage to the masters of American blues.

Jagger, in skin-tight black pants, a black shirt and a sparkly tie, took time out from singing to thank the crowd for its loyalty.

"It's amazing that we're still doing this, and it's amazing that you're still buying our records and coming to our shows," he said. "Thank you, thank you, thank you."

Lead guitarist Keith Richards, whose survival has surprised many who thought he would succumb to drugs and drink, was blunter: "We made it," he said. "I'm happy to see you. I'm happy to see anybody."

But the band's fiery music was no joke, fuelled by an incandescent guest appearance by Taylor, who played lead guitar on a stunning extended version of the ominous "Midnight Rambler," and Mary J. Blige, who shook the house in a duet with Jagger on "Gimme Shelter."

The 50th anniversary show, which will be followed by one more in London, then three in the greater New York area, lacked some of the band's customary bravado — the "world's greatest rock 'n' roll band" intro was shelved — and there were some rare nostalgic touches.

Even the famously taciturn Wyman briefly cracked a smile when trading quips with Richards and Ronnie Wood.

The concert started with a brief video tribute from luminaries like Elton John, Iggy Pop and Johnny Depp, who praised the Stones for their audacity and staying power. The Stones' show contained an extended video homage to the American trailblazers who shaped their music: Muddy Waters, John Lee Hooker, Otis Redding, Bob Dylan, Johnny Cash and others. The montage included rare footage of the young Elvis Presley.

The Stones began their professional career imitating the Americans whose music they cherished, but they quickly developed their own style, spawning hundreds — make that thousands — of imitators who have tried in vain to match their swagger and style.

The concert began with some early Stones' numbers that are rarely heard in concert, including the band's cover of the Lennon-McCartney rocker "I Wanna Be Your Man" and the Stones original "It's All Over Now."

They didn't shy away from their darker numbers, including "Paint It Black" and "Sympathy for the Devil" — Jagger started that one wearing a black, purple-lined faux fur cape that conjured up his late '60s satanic image.

He even cracked a joke about one of the band's low points, telling the audience it was in for a treat: "We're going to play the entire "Satanic Majesty's Request" album now," he said, referring to one of the band's least-loved efforts, a psychedelic travesty that has been largely, mercifully, forgotten.

He didn't make good on his threat.

He also made fun of the sky-high ticket prices, which had exposed the band to some criticism in the London press.

"How are you doing up in the cheap seats," he said, motioning to fans in the upper rows of the cavernous 02 Arena. "Except they're not cheap seats, that's the problem."

But Jagger seemed more mellow than usual, chatting a bit about the good old days and asking if there was anyone in the crowd who had seen them in 1962, when they first took to the stage.

He said 2012 had been a terrific year for Britain and that the Stones nearly missed the boat, playing no role in the celebration of the Queen's Diamond Jubilee, the London Olympics, or the new James Bond film.

"We just got in under the wire," he said. "We feel pretty good."

Read More..

Agency Investigates Deaths and Injuries Associated With Bed Rails

Thomas Patterson for The New York Times

Gloria Black’s mother died in her bed at a care facility.

In November 2006, when Clara Marshall began suffering from the effects of dementia, her family moved her into the Waterford at Fairway Village, an assisted living home in Vancouver, Wash. The facility offered round-the-clock care for Ms. Marshall, who had wandered away from home several times. Her husband Dan, 80 years old at the time, felt he could no longer care for her alone.

Thomas Patterson for The New York Times

Gloria Black, visiting her mother’s grave in Portland, Ore. She has documented hundreds of deaths associated with bed rails and said families should be informed of their possible risks.

But just five months into her stay, Ms. Marshall, 81, was found dead in her room apparently strangled after getting her neck caught in side rails used to prevent her from rolling out of bed.

After Ms. Marshall’s death, her daughter Gloria Black, who lives in Portland, Ore., began writing to the Consumer Product Safety Commission and the Food and Drug Administration. What she discovered was that both agencies had known for more than a decade about deaths from bed rails but had done little to crack down on the companies that make them. Ms. Black conducted her own research and exchanged letters with local and state officials. Finally, a letter she wrote in 2010 to the federal consumer safety commission helped prompt a review of bed rail deaths.

Ms. Black applauds the decision to study the issue. “But I wish it was done years ago,” she said. “Maybe my mother would still be alive.” Now the government is studying a problem it has known about for years.

Data compiled by the consumer agency from death certificates and hospital emergency room visits from 2003 through May 2012 shows that 150 mostly older adults died after they became trapped in bed rails. Over nearly the same time period, 36,000 mostly older adults — about 4,000 a year — were treated in emergency rooms with bed rail injuries. Officials at the F.D.A. and the commission said the data probably understated the problem since bed rails are not always listed as a cause of death by nursing homes and coroners, or as a cause of injury by emergency room doctors.

Experts who have studied the deaths say they are avoidable. While the F.D.A. issued safety warnings about the devices in 1995, it shied away from requiring manufacturers to put safety labels on them because of industry resistance and because the mood in Congress then was for less regulation. Instead only “voluntary guidelines” were adopted in 2006.

More warnings are needed, experts say, but there is a technical question over which regulator is responsible for some bed rails. Are they medical devices under the purview of the F.D.A., or are they consumer products regulated by the commission?

“This is an entirely preventable problem,” said Dr. Steven Miles, a professor at the Center for Bioethics at the University of Minnesota, who first alerted federal regulators to deaths involving bed rails in 1995. The government at the time declined to recall any bed rails and opted instead for a safety alert to nursing homes and home health care agencies.

Forcing the industry to improve designs and replace older models could have potentially cost bed rail makers and health care facilities hundreds of million of dollars, said Larry Kessler, a former F.D.A. official who headed its medical device office. “Quite frankly, none of the bed rails in use at that time would have passed the suggested design standards in the guidelines if we had made them mandatory,” he said. No analysis has been done to determine how much it would cost the manufacturers to reduce the hazards.

Bed rails are metal bars used on hospital beds and in home care to assist patients in pulling themselves up or helping them out of bed. They can also prevent people from rolling out of bed. But sometimes patients — particularly those suffering from Alzheimer’s — can get confused and trapped between a bed rail and a mattress, which can lead to serious injury or even death.

While the use of the devices by hospitals and nursing homes has declined as professional caregivers have grown aware of the dangers, experts say dozens of older adults continue to die each year as more rails are used in home care and many health care facilities continue to use older rail models.

Since those first warnings in 1995, about 550 bed rail-related deaths have occurred, a review by The New York Times of F.D.A. data, lawsuits, state nursing home inspection reports and interviews, found. Last year alone, the F.D.A. data shows, 27 people died.

As deaths continued after the F.D.A. warning, a working group put together in 1999 and made up of medical device makers, researchers, patient advocates and F.D.A. officials considered requiring bed rail makers to add warning labels.

But the F.D.A. decided against it after manufacturers resisted, citing legal issues. The agency said added cost to small manufacturers and difficulties of getting regulations through layers of government approval, were factors against tougher standards, according to a meeting log of the group in 2000 and interviews.

Read More..

New Senate’s First Task Will Likely Be Trying to Fix Itself

Jacquelyn Martin/Associated Press

At a news conference after meeting with President Obama about the budget, from left, Nancy Pelosi, the House Democratic leader; Harry Reid, the Senate Democratic leader; Speaker John A. Boehner; and Mitch McConnell, the Senate Republican leader.

WASHINGTON — Senator Bob Dole had just assumed the mantle of Senate majority leader, after the Republican landslide of 1994, when he confronted a problem.

Piles of Republican legislation from Newt Gingrich’s self-styled “revolutionary” House were stacking up in a narrowly divided, more deliberate Senate, and Democrats were threatening to gum up the works with amendments that would stall the bills.

Mr. Dole turned to the Senate’s Democratic master of floor procedure, Robert C. Byrd of West Virginia, who taught him a parliamentary trick known to Senate insiders as “filling the tree,” Mr. Dole recalled.

The convoluted procedure allows the majority leader to claim all opportunity for offering changes to a bill, effectively preventing any other senator from proposing an amendment intended to slow down legislation or force a politically embarrassing vote.

“I never knew what ‘filling the tree’ was until I tried it, but it turned out to be pretty good,” Mr. Dole said, ruefully accepting a share of the blame for the parliamentary arms race that has consumed the Senate in recent years. “I don’t think there’s any credit.”

The increased use of the tactic, which had previously been rare, is part of the procedural warfare that has reached a zenith over the past two years in the Senate. Republicans threaten to filibuster and propose politically charged amendments, Democrats fill the amendment tree, and Republicans filibuster in retaliation.

The tactic initially meant to speed bills has instead helped slow them down. The Senate — the legislative body that was designed as the saucer to cool the House’s tempestuous teacup — has become a deep freeze, where even once-routine matters have become hopelessly stuck and a supermajority is needed to pass almost anything.

As a result, the first fight of the next Senate, which convenes in January, is not likely to be over a fiscal crisis, immigration, taxes or any issue that animated the elections of 2012. It will instead probably be over how and whether to change a troubled Senate, members and aides say.

With his majority enhanced and a crop of frustrated young Democrats pushing him hard, Senator Harry Reid of Nevada, the Democratic leader, says he will move on the first day of the 113th Congress to diminish the power of Republicans to obstruct legislation. “We need to change the way we do business in the Senate,” said Senator Tom Udall, Democrat of New Mexico. “Right now, we have gridlock. We have delay. We have obstruction, and we don’t have any accountability.”

The pressure leaves Mr. Reid with a weighty decision: whether to ram through a change in the rules with a simple majority that would significantly diminish Republicans’ power to slow or stop legislation.

The changes under consideration may sound arcane, but they would have such a profound impact that they are referred to as the “nuclear option.” In effect, they would remake a Senate that was long run on compromise and gentlemen’s agreements into something more like the House, where the majority rules almost absolutely.

Critics of the idea, who exist in both parties, say such a change would do great damage, causing Washington to career from one set of policies to another, depending on which party held power.

Senator Mitch McConnell of Kentucky, the Republican leader, said he would aggressively fight any rule change and blamed the Democratic majority for the Senate’s dysfunction. “This notion that the Senate is dysfunctional is not because of the rules,” he said. “It’s because of behavior.”

Supporters of the idea, who also do not fit a neat ideological profile, argue that the collegial Senate of the past no longer exists and that American democracy is often paralyzed as a result. Today’s Senate, they say, has left crucial positions unfilled, like a confirmed head for the new Consumer Financial Protection Bureau, and is preventing action on major issues like job creation proposals.

“There is a tendency to look to the past through rose-colored glasses, to some mythical golden era when everyone got along and cooperated. That’s not true. It’s always been tough, and it’s always been rough,” said George Mitchell, a former Democratic majority leader who would now back some changes. “But I do believe and accept the premise that it’s worse now.”

Read More..