The New Old Age Blog: Hospital Alarms Fail to Prevent Injury, Study Finds

When it comes to protecting older people from falls, it can take a long time to figure out what helps and sometimes an even longer time to take action against things that were supposed to help but don’t.

A case in point: the so-called safety rails on hospital and nursing home beds. Their hazards, as The New Old Age reported more than two years ago, are well documented. They are intended to keep sick, drugged or confused people from climbing or falling out of bed. What they actually do is make falls more dangerous; they also trap patients between the rails and the mattress until they asphyxiate, causing hundreds of deaths annually.

The Consumer Product Safety Commission is finally investigating these hazards, with findings due soon.

Alarms — sensors that alert aides or nurses when someone at risk of falling attempts to get out of bed or up from a chair or toilet — sound better, right? Lots of health care facilities thought so.

Use of these alarms has increased “over the past 10 or 15 years as the problems of physical restraints and bed rails became better known,” said Ronald Shorr, who directs geriatric research at the V.A. Medical Center in Gainesville, Fla. “This was the next wave in fall prevention.”

The trouble is, hospital bed alarms don’t appear to reduce falls, according to the study that Dr. Shorr just published in The Annals of Internal Medicine.

Lots of patients, of all ages, fall in hospitals, and about a quarter of those falls cause injuries. They also cost hospitals money, because Medicare will no longer reimburse facilities for treating injuries from falls that in theory shouldn’t have happened.

Though there aren’t statistics on the number of systems, it is rare these days to find a large hospital that doesn’t use alarms, in some cases built right into the beds.

Yet “their efficacy hadn’t been established,” Dr. Shorr told me in an interview. The few studies that reported reduced falls from alarms were small, lacked control groups, or didn’t continue for very long. Dr. Shorr and his colleagues set out to remedy those shortcomings.

Over 18 months, they documented falls among patients in 16 medical and surgical units, with a combined 349 beds, at Methodist Healthcare-University Hospital in Memphis, Tenn. Half those units were randomly designated “usual care.” In the other eight, the “intervention” units, Dr. Shorr and study coordinator Michelle Chandler held repeated education sessions to explain the alarms — in this case, flexible pads made by Bed-Ex and widely-used — and demonstrate their use in beds and on chairs and commode seats.

Ms. Chandler visited the intervention units daily — the staff started calling her “Mrs. Falls” — and even brought fresh alarm pads and help set them up to encourage their use.

The intervention worked, in that those units used the alarms far more often. But when the researchers tallied up the falls among the 27,672 patients (half of them over age 63) in these units — controlling for many variables, including not only demographic factors but staffing levels and psychotropic drug regimens — they found the alarms had no significant effect.

Patients in the units that used alarms more heavily fell just as often as patients in the control units that used alarms much less frequently. (The numbers: 5.62 falls per 1,000 patient-days, a measure of how many people spent how long in the hospital, versus 4.56 falls in the control units, not a statistically significant difference.)

There were no fewer injuries in the more-alarmed units, nor any less use of physical restraints.

There were likely higher costs, though. A Bed-Ex monitor and cables cost about $350 at the time, and each disposable sensor pad cost $23.

Why didn’t the alarms help? Dr. Shorr hypothesized that the staff developed what he called alarm fatigue. “How many times a week do you hear a car alarm go off?” he asked. “You become desensitized.”

But it is also possible, he said, that when the alarms sounded and the nurses scampered, “the patients who weren’t alarmed fell more often.”

My own 2 cents: If an alarm sounds when someone stirs, is any hospital or nursing home so well-staffed that someone can materialize within seconds? Does a staff become less vigilant when patients have alarms and are presumed – wrongly, it seems – to be safer?

Nursing homes also frequently use alarms, and while this hospital data might not apply in another setting, Dr. Shorr said his findings made him skeptical about their effectiveness there, too.

So we probably shouldn’t feel reassured about our elders’ safety when they are in a hospital, alarms or no alarms. Even younger people, recovering from surgery and feeling the effects of anesthesia or sedatives, can and do fall.

“The more eyes on your loved one, the better,” said Dr. Shorr. “And it’s best if they’re your eyes.”

---

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

Read More..

Russian Envoy Says Syrian Leader Is Losing Control

MOSCOW — Deputy Foreign Minister Mikhail Bogdanov, Russia’s top envoy for Syria, said on Thursday that President Bashar al-Assad’s government was losing control of the country and might be defeated by rebel forces.

“Unfortunately, it is impossible to exclude a victory of the Syrian opposition,” he said — the clearest indication to date that Russia believed Mr. Assad, a longtime strategic ally, could lose in a civil war that has claimed tens of thousands of lives.

“We must look squarely at the facts and the trend now suggests that the regime and the government in Syria are losing more and more control and more and more territory,” said Mr. Bogdanov, in remarks to Russia’s Public Chamber carried by Russian news agencies.

Russia, Mr. Bogdanov said, is preparing to evacuate its citizens — a complex task, since for decades, Russian women have married Syrian men sent to study in Russia and returned home with them to raise families. It was the first time an official at Mr. Bogdanov’s level had announced plans for an evacuation, which sent a clear message to Damascus that Russia no longer holds out hope that the government can prevail.

As the Russian official spoke, fresh evidence emerge of the intensity of the battle and its proximity to the capital, Damascus.

Syrian state media and anti-government activists reported that at least 16 people had been killed when a car bomb exploded near a school in the town of Qatana, southwest of the capital, on Thursday.

The bomb wounded more than 20 people, leaving some in critical condition, according to the Syrian Observatory for Human Rights, which tracks the conflict through a network of activists. Government forces still hold sway in Qatana, a town with a Sunni Muslim majority and Christian minority, Agence France-Presse reported.

The number of car bombs in residential areas appears to have increased in recent weeks, hitting neighborhoods perceived as housing many government supporters as well as others considered sympathetic to the uprising.

Agence France-Press also reported that Interior Minister Mohamed Ibrahim al-Shaar was wounded in a bomb attack on his ministry on Wednesday. But he was not seriously hurt, the agency said, quoting an unidentified security source who said that the bombing was believed to have been carried out by a saboteur because only official vehicles can approach the building.

Mr. Shaar was injured in an earlier bombing on July 18 that killed four senior security officials at a Damascus headquarters. Russia is eager to protect its strategic interests in Syria, including a naval facility at the port of Tartus, and has been meeting frequently with opposition delegations, presumably laying the groundwork for a possible transition. In his remarks to the Public Chamber, a Kremlin advisory group, Mr. Bogdanov said he believed that half the Russian citizens living in Syria support the rebels.

“Moreover, some of the people coming here as part of opposition coalitions have Russian passports,” he said.

Russia has cast its stance on Syria as a principled stand against Western-led intervention — a passionate topic for President Vladimir V. Putin, who feels Russia was deceived into supporting a no-fly zone in Libya that ultimately led to a military campaign that led to the overthrow of Col. Moammar el-Qadaffi. In recent days, Moscow has been adamant that its fundamental position has not changed.

For many months, the Russian authorities have resisted Western pressure on Moscow to persuade the Syrian leader to step down. Though Russia has said it supports the creation of a transitional government, it has been at odds with the West on whether Mr. Assad — and his ally Iran — would have a voice in it.

Mr. Bogdanov said on Thursday that Russia’s stance has been deliberately distorted in the Western media, an effort “intended to weaken our influence” in the Middle East, and that third-party governments have strengthened rebel forces by providing weapons.

“Massive supply of modern armaments have pushed the Syrian rebels to stake their hopes on force,” leading to “an acceleration of the spiral of violence,” he said.

Leonid Medvedko, a political analyst who covered Syria for Soviet news services, said officials have so far been reluctant to declare an evacuation of Russian citizens “because there are technical questions, political questions — because it will mean we are fully giving up Syria.”

“It is a humanitarian step, but each humanitarian step has a political meaning,” he said.

From the first, Russia has taken the view that Mr. Assad’s departure would usher in a long and chaotic process of fragmentation in Syria, but most experts this week said they were braced for the beginning of that process. Mr. Medvedko, the former journalist, said he expected Syria to split into four parts that would be home to distinct ethnic and religious groups, much as Yugoslavia did in the 1990s.

Fyodor Lukyanov, the editor of Russia in Global Affairs and head of an influential policy group, said that even if Mr. Assad left the country, his countrymen will keep fighting.

“The prevailing view is that it will be complete and desperate chaos,” said Mr. Lukyanov. “To remove Assad will not mean settlement of the Syrian conflict. You can remove him — I don’t know in which way — but what will you do to 300,000 Alawites? They will be fighting for their lives, not for power anymore,” he said, referring to the minority sect that rules the country.

Anne Barnard contributed reporting from Beirut, Lebanon.

Read More..

Familiar names line up for Golden Globe noms

BEVERLY HILLS, Calif. (AP) — A familiar lineup of Hollywood awards contenders are expected among Golden Globe nominations, whose prospects include past Oscar winners Daniel Day-Lewis, Helen Mirren, Robert De Niro and Sally Field.

Nominations come out Thursday morning for the 70th Globes ceremony, Hollywood's second-biggest film honors after the Academy Awards.

Among potential contenders are two-time Oscar winners Day-Lewis and Field for Steven Spielberg's Civil War saga "Lincoln," whose Globe possibilities also include past Oscar recipient Tommy Lee Jones.

Two-time Oscar winner De Niro is in the running for the lost-soul romance "Silver Linings Playbook," along with the film's lead performers, Bradley Cooper and Jennifer Lawrence.

The field of contenders is loaded with other Oscar recipients such as Mirren and Anthony Hopkins for "Hitchcock," Philip Seymour Hoffman for "The Master," Helen Hunt for "The Sessions," Marion Cotillard for "Rust and Bone," Russell Crowe for "Les Miserables" and Alan Arkin for "Argo."

One of the year's big action hits, the James Bond adventure "Skyfall," could bring the latest Globe nomination for past Oscar winner Javier Bardem, who elevates his super-villain role into one of the year's most entertaining performances.

Presented by the Hollywood Foreign Press Association, a relatively small group of about 90 reporters covering Hollywood for overseas outlets, the Globes sometimes single out newcomers to Hollywood's awards scene. Hilary Swank's Globe win for 1999's "Boys Don't Cry" helped put her on the map on the way to winning her first Oscar.

The possibilities this time include veteran French performers Emmanuelle Riva and Jean-Louis Trintignant, who star as an elderly couple in "Amour," and first-time actors Quvenzhane Wallis and Dwight Henry for the low-budget critical darling "Beasts of the Southern Wild."

Globe acting winners often go on to receive the same prizes at the Oscars. All four Oscar winners last season — lead performers Meryl Streep of "The Iron Lady" and Jean Dujardin of "The Artist" and supporting players Octavia Spencer of "The Help" and Christopher Plummer of "Beginners" — won Globes first.

The Globes have a spotty record predicting which films might go on to earn the best-picture prize at the Academy Awards, however.

The Globes feature two best-film categories, one for drama and one for musical or comedy. Last year's Oscar best-picture winner, "The Artist," preceded that honor with a Globe win for best musical or comedy.

But in the seven years before that, only one winner in the Globe best-picture categories — 2008's "Slumdog Millionaire" — followed up with an Oscar best-picture win.

Along with 14 film prizes, the Globes hand out awards in 11 television categories.

Jodie Foster, a two-time Oscar and Globe winner for "The Accused" and "The Silence of the Lambs," will receive the group's Cecil B. DeMille Award for lifetime achievement at the Jan. 13 ceremony.

Tina Fey, a two-time Globe TV winner for "30 Rock," and Amy Poehler, a past nominee for "Parks and Recreation," will host the show, which airs live on NBC.

Fey and Poehler follow Ricky Gervais, who was host the last three years and rubbed some Hollywood egos the wrong way with sharp wisecracks about A-list stars and the foreign press association itself.

With stars sharing drinks and dinner, the Globes have a reputation as one of Hollywood's loose and unpredictable awards gatherings. Winners occasionally have been off in the restroom when their names were announced, and there have been moments of onstage spontaneity such as Jack Nicholson mooning the crowd or Ving Rhames handing over his trophy to fellow nominee Jack Lemmon.

___

Online:

http://www.goldenglobes.org

Read More..

Another Look at a Drink Ingredient, Brominated Vegetable Oil

James Edward Bates for The New York Times

Sarah Kavanagh, 15, of Hattiesburg, Miss., started an online petition asking PepsiCo to change Gatorade’s formula.

Sarah Kavanagh and her little brother were looking forward to the bottles of Gatorade they had put in the refrigerator after playing outdoors one hot, humid afternoon last month in Hattiesburg, Miss.

But before she took a sip, Sarah, a dedicated vegetarian, did what she often does and checked the label to make sure no animal products were in the drink. One ingredient, brominated vegetable oil, caught her eye.

“I knew it probably wasn’t from an animal because it had vegetable in the name, but I still wanted to know what it was, so I Googled it,” Ms. Kavanagh said. “A page popped up with a long list of possible side effects, including neurological disorders and altered thyroid hormones. I didn’t expect that.”

She threw the product away and started a petition on Change.org, a nonprofit Web site, that has almost 200,000 signatures. Ms. Kavanagh, 15, hopes her campaign will persuade PepsiCo, Gatorade’s maker, to consider changing the drink’s formulation.

Jeff Dahncke, a spokesman for PepsiCo, noted that brominated vegetable oil had been deemed safe for consumption by federal regulators. “As standard practice, we constantly evaluate our formulas and ingredients to ensure they comply with federal regulations and meet the high quality standards our consumers and athletes expect — from functionality to great taste,” he said in an e-mail.

In fact, about 10 percent of drinks sold in the United States contain brominated vegetable oil, including Mountain Dew, also made by PepsiCo; Powerade, Fanta Orange and Fresca from Coca-Cola; and Squirt and Sunkist Peach Soda, made by the Dr Pepper Snapple Group.

The ingredient is added often to citrus drinks to help keep the fruit flavoring evenly distributed; without it, the flavoring would separate.

Use of the substance in the United States has been debated for more than three decades, so Ms. Kavanagh’s campaign most likely is quixotic. But the European Union has long banned the substance from foods, requiring use of other ingredients. Japan recently moved to do the same.

“B.V.O. is banned other places in the world, so these companies already have a replacement for it,” Ms. Kavanagh said. “I don’t see why they don’t just make the switch.” To that, companies say the switch would be too costly.

The renewed debate, which has brought attention to the arcane world of additive regulation, comes as consumers show increasing interest in food ingredients and have new tools to learn about them. Walmart’s app, for instance, allows access to lists of ingredients in foods in its stores.

Brominated vegetable oil contains bromine, the element found in brominated flame retardants, used in things like upholstered furniture and children’s products. Research has found brominate flame retardants building up in the body and breast milk, and animal and some human studies have linked them to neurological impairment, reduced fertility, changes in thyroid hormones and puberty at an earlier age.

Limited studies of the effects of brominated vegetable oil in animals and in humans found buildups of bromine in fatty tissues. Rats that ingested large quantities of the substance in their diets developed heart lesions.

Its use in foods dates to the 1930s, well before Congress amended the Food, Drug and Cosmetic Act to add regulation of new food additives to the responsibilities of the Food and Drug Administration. But Congress exempted two groups of additives, those already sanctioned by the F.D.A. or the Department of Agriculture, or those experts deemed “generally recognized as safe.”

The second exemption created what Tom Neltner, director of the Pew Charitable Trusts’ food additives project, a three-year investigation into how food additives are regulated, calls “the loophole that swallowed the law.” A company can create a new additive, publish safety data about it on its Web site and pay a law firm or consulting firm to vet it to establish it as “generally recognized as safe” — without ever notifying the F.D.A., Mr. Neltner said.

About 10,000 chemicals are allowed to be added to foods, about 3,000 of which have never been reviewed for safety by the F.D.A., according to Pew’s research. Of those, about 1,000 never come before the F.D.A. unless someone has a problem with them; they are declared safe by a company and its handpicked advisers.

“I worked on the industrial and consumer products side of things in the past, and if you take a new chemical and put it into, say, a tennis racket, you have to notify the E.P.A. before you put it in,” Mr. Neltner said, referring to the Environmental Protection Agency. “But if you put it into food and can document it as recognized as safe by someone expert, you don’t have to tell the F.D.A.”

Read More..

Pope Benedict offers blessings with his first tweet

VATICAN CITY (Reuters) – After weeks of anticipation, Pope Benedict sent his first tweet on Wednesday.

“Dear friends, I am pleased to get in touch with you through Twitter. Thank you for your generous response. I bless all of you from my heart.”

The tweet was sent when the 85-year-old pope tapped on a touch screen at the end of his weekly general audience in the Vatican before thousands of people.

(Reporting By Philip Pullella, editing by Paul Casciato)

Internet News Headlines – Yahoo! News

Read More..

The New Old Age Blog: The Gift of Reading

This is the year of the tablet, David Pogue of The Times has told us, and that may be good news for seniors who open holiday wrappings to find one tucked inside. They see better with tablets’ adjustable type size, new research shows. Reading becomes easier again.

This may seem obvious — find me someone over 40 who doesn’t see better when fonts are larger — but it’s the business of science to test our assumptions.

Dr. Daniel Roth, an eye specialist and clinical associate professor at the Robert Wood Johnson Medical School in New Brunswick, N.J., offered new evidence of tablets’ potential benefits last month at the annual meeting of the American Academy of Ophthalmology.

His findings, based on tests conducted with 66 adults age 50 and over: older people read faster (a mean reading speed of 128 words per minute) when using an iPad, compared to a newspaper with the same 10-point font size (114 words per minute).

When the font was increased to 18 points — easy to do on an iPad — reading speed increased to 137 words per minute.

“If you read more slowly, it’s tedious,” Dr. Roth said, explaining why reading speed is important. “If you can read more fluidly, it’s more comfortable.”

What makes the real difference, Dr. Roth theorizes, is tablets’ illuminated screen, which heightens contrast between words and the background on which they sit.

Contrast sensitivity — the visual ability to differentiate between foreground and background information — becomes poorer as we age, as does the ability to discriminate fine visual detail, notes Dr. Kevin Paterson, a psychologist at the University of Leicester, who recently published a separate study on why older people struggle to read fine print.

“There are several explanations for the loss of sensitivity to fine detail that occurs with older age,” Dr. Paterson explained in an e-mail. “This may be due to greater opacity of the fluid in the eye, which will scatter incoming light and reduce the quality of the projection of light onto the retina. It’s also hypothesized that changes in neural transmission affect the processing of fine visual detail.”

Combine these changes with a greater prevalence of eye conditions like macular degeneration and diabetic retinopathy in older adults, and you get millions of people who cannot easily do what they have done all their lives — read and stay connected to the world of ideas, imagination and human experience.

“The No. 1 complaint I get from older patients is that they love to read but can’t, and this really bothers them,” Dr. Roth said. The main option has been magnifying glasses, which many people find cumbersome and inconvenient.

Some words of caution are in order. First, Dr. Roth’s study has not been published yet; it was presented as a poster at the scientific meeting and publicized by the academy, but it has not yet gone through comprehensive, rigorous peer review.

Second, Dr. Roth’s study was completed before the newest wave of tablets from Microsoft, Google, Samsung and others became available. The doctor made no attempt to compare different products, with one exception. In the second part of his study, he compared results for the iPad with those for a Kindle. But it was not an apples to apples comparison, because the Kindle did not have a back-lit screen.

This section of his study involved 100 adults age 50 and older who read materials in a book, on an iPad and on the Kindle. Book readers recorded a mean reading speed of 187 words per minute when the font size was set at 12; Kindle readers clocked in at 196 words per minute and iPad readers at 224 words per minute at the same type size. Reading speed improved even more drastically for a subset of adults with the poorest vision.

Again, Apple’s product came out on top, but that should not be taken as evidence that it is superior to other tablets with back-lit screens and adjustable font sizes. Both the eye academy and Dr. Roth assert that they have no financial relationship with Apple. My attempts to get in touch with the company were not successful.

A final cautionary note should be sounded. Some older adults find digital technology baffling and simply do not feel comfortable using it. For them, a tablet may sit on a shelf and get little if any use.

Others, however, find the technology fascinating. If you want to see an example that went viral on YouTube, watch this video from 2010 of Virginia Campbell, then 99 years old, and today still going strong at the Mary’s Woods Retirement Community in Lake Oswego, Ore.

Ms. Campbell’s glaucoma made it difficult for her to read, and for her the iPad was a blessing, as she wrote in this tribute quoted in an article in The Oregonian newspaper:

To this technology-ninny it’s clear
In my compromised 100th year,
That to read and to write
Are again within sight
Of this Apple iPad pioneer

Caregivers might be delighted — as Ms. Campbell’s daughter was — by older relatives’ response to this new technology, a potential source of entertainment and engagement for those who can negotiate its demands. Or, they might find that old habits die hard and that their relatives continue to prefer a book or newspaper they can hold in their hands to one that appears on a screen.

Which reading enhancement products have you used, and what experiences have you had?

Read More..

DealBook: China Woos Overseas Companies, Looking for Deals

HONG KONG — Even as Wall Street deal makers await a revival of the moribund merger market, Chinese companies are shopping abroad with their wallets out.

Yet they are also facing scrutiny, particularly in Washington, as Chinese corporate buying trips coincide with a growing assertiveness in Chinese foreign policy, including the deployment in recent months of surveillance vessels and even naval destroyers and frigates in a series of territorial confrontations with American allies like Japan, Vietnam and the Philippines.

So far this year, the dollar volume of Chinese acquisitions overseas is up 28 percent from the same period a year ago, according to Thomson Reuters data. That compares with a 2.8 percent slump in global merger and acquisition volume over all.

Chinese international acquisitions are ahead for the year despite a slump during the third quarter, as state-owned enterprises, which are the main Chinese buyers, and some private enterprises waited for a change in the country’s political leadership at the Communist Party Congress in mid-November. But now the Chinese buyers are back.

Two deals by Chinese companies were announced this week, and bankers and lawyers say that discussions are starting or are already under way on numerous other transactions. Many of those, however, may take as long as a year to complete given China’s bureaucratic approval processes.

“You will see an acceleration — you see it now,” although it would not amount to an immediate flood of transactions, said André Loesekrug-Pietri, the chairman and managing partner of A Capital, a Hong Kong-based private equity fund.

Indeed, Beijing is pushing for additional deals, and has encouraged the state-controlled banking sector to finance them.

“An increase in overseas investment by Chinese companies is an inevitable trend,” the commerce minister, Chen Deming, said at a conference two weeks ago, adding that China did not want to remain overwhelmingly invested in fixed-income securities.

“With foreign reserves of $3 trillion in hand,” he added, “we will not sit back and watch the assets depreciate with the third round of quantitative easing. We must inject it into the real economy and make our contribution to global prosperity.”

Wanxiang Group agreed on Sunday to pay $256 million to buy most of A123 Systems, a bankrupt manufacturer of high-tech batteries. And a consortium of Chinese investors agreed on the same day to pay $4.2 billion for a controlling stake in the American International Group’s aircraft leasing business.

On Friday, Canada approved the $15 billion acquisition of Nexen, an energy company, by the China National Offshore Oil Corporation, or Cnooc. That deal is still pending approval by the American committee that reviews foreign investments on national security grounds, commonly known as Cfius.

A few deals may be completed this winter, but the real surge is likely to happen by next summer, bankers and lawyers said. State-owned enterprises account for as much as four-fifths of China’s overseas acquisitions by value and many of their top executives are expected to change jobs this winter as the country’s new leaders start promoting their followers.

While the Communist Party Congress in November produced a new Politburo, a new slate of government ministers and vice premiers must still be selected at the National People’s Congress in March, a process that could also slow down deals.

Chinese regulations further require that at least three different agencies approve each overseas acquisition — the Ministry of Commerce, the National Development and Reform Commission and the State Administration of Exchange Control. The assent of a fourth, the Ministry of Industry and Information Technology, is needed to qualify for extra financing and faster approval in certain sectors deemed strategic, like clean energy, said Mao Tong, a partner at the law firm Squire Sanders.

But despite the long lead time for Chinese deals, bankers say the process is clearly starting.

Two of the biggest deals by Chinese companies this year were for control of North American companies. The bid for the A.I.G. business, the International Lease Finance Corporation, or I.L.F.C., is the biggest takeover by Chinese entities on record, according to data from Thomson Reuters.

The roots of that transaction were planted last fall. Members of China’s new government wanted to show the country’s seriousness in pursuing investments outside of China, and spent time assembling the most fitting consortium to pursue a deal for the business.

The government chose as the face of the deal Weng Xianding, a veteran of China’s financial regulatory agencies who has turned to investing. His company, New China Trust, is essentially a major Chinese commercial lender, counting Western firms like Barclays among its investors.

Once the preferred consortium was formed around September, it began talking with A.I.G., with many of the details being negotiated between Mr. Weng and the American insurer’s chief executive, Robert H. Benmosche. A goal for the Chinese, a person with direct knowledge of the matter said, was to conduct the talks in a “Western way,” using Western advisers and not getting bogged down in traditional bureaucratic mire.

The talks were completed in just over three months, and the buyers successfully negotiated a discount of nearly half of I.L.F.C.’s book value.

Two evolving trends are apparent in Chinese international deal making, Chinese government officials, bankers, lawyers and trade experts said in interviews.

The government is putting heavy pressure on Chinese companies to seek minority stakes, and not to automatically seek full control, so as to tap foreign management expertise, two officials said. At the same time, Chinese companies are broadening their range of acquisition targets to include more industrial manufacturers and consumer brand companies, even as they maintain their interest in natural resources and financial services.

“I wouldn’t say there’s a desire to buy minority stakes, but I think there’s a greater acceptance that’s an appropriate thing to do,” said Michael S. Weiss, the head of China mergers and acquisitions at Morgan Stanley.

Other bankers said that one big obstacle to the purchase of minority stakes lay in the wariness of many foreign companies in accepting a Chinese partner — particularly since nearly four-fifths of Chinese acquirers are state-owned enterprises, and most of the rest tend to have Chinese government links.

Many of today’s buyers have drawn lessons from past failures and moved to assuage government regulators before striking deals. Cnooc, in particular, learned from its failed bid to buy the oil company Unocal seven years ago, and tried to apply those lessons in its pursuit of Nexen.

The Chinese company considered the deal in part because it believed that a takeover could win approval, according to a person with direct knowledge of the matter. While a big player in Canada’s energy community, Nexen was not one of the country’s iconic companies, heading off the sort of brutal fight that surrounded a takeover battle for Potash, the producer of an important fertilizing ingredient.

Cnooc hired an army of advisers, including lobbyists and public relations specialists, to press the point that a deal would only strengthen the Canadian energy company. And Cnooc was open about much of its financing, aiming to halt concerns that it was being financed cheaply by state-run banks.

Still, national security concerns could also slow some deals. Bankers and lawyers say that Cfius, which stands for the Committee on Foreign Investment in the United States, can sometimes prove frustrating to would-be buyers. The group scrutinizes deals to ensure that they do not harm the country’s national security interests.

Unlike the process in Canada, where negotiations with the foreign investment watchdog are public, the Cfius review takes place largely behind closed doors, and buyers are not always told why deals are rejected.

A Treasury spokeswoman, Natalie Earnest, said in a statement: “As we consider foreign investments in the United States, of course, we have an obligation — like any country — to protect our national security, and that is the exclusive focus of Cfius.”

Michael R. Wessel, a Democratic appointee to the United States-China Economic and Security Review Commission, said that bipartisan concern was growing in Congress about the first of the Chinese deals to be announced this autumn, a $117.6 million acquisition of Complete Genomics, a company in Mountain View, Calif., that does DNA sequencing.

Mr. Wessel, who also advises the United Steelworkers union on trade issues, was also critical of the A.I.G. deal. He said that the Chinese government could pressure airlines to buy Chinese-made parts for their leases, and could eventually urge airlines to lease Chinese-made civilian airliners now being developed.

A spokesman for the buyers’ group said in a statement that I.L.F.C. already had one of the largest aircraft order books in aviation, with a commitment to purchase up to 279 Boeing and Airbus aircraft between now and 2020. “We will continue to add to this order book as we see opportunities in the marketplace based on the market appeal of the aircraft and the economics offered by the manufacturers,” he added.

Some would-be Chinese buyers have not fully considered how much work is needed to ensure that their investments will go through, advisers say.

“I think many Chinese companies in particular have not taken into account the need to be in touch with Washington policy makers about their needs,” said Nancy L. McLernon, the chief executive of the Organization for International Investment, a group that represents domestic subsidiaries of foreign companies. “Those who do, fare best.”

Keith Bradsher reported from Hong Kong, and Michael J. de la Merced from New York.

Read More..

Boeing 787 Plane Works to Overcome Snags

Stuart Isett for The New York Times

The upper deck of a Boeing 787 Dreamliner being assembled in Everett, Wash. The basic model, called the 787-8, can carry 210 to 250 passengers.

After years of delays in producing its much-anticipated 787 aircraft, Boeing seemed in recent months to be turning a corner, streamlining production and increasing the pace of deliveries.

But a pair of embarrassing problems last week revived concerns about the reliability of the plane, the first commercial aircraft to make extensive use of lightweight carbon composites that promise big fuel savings for airlines.

A United Airlines 787 flying from Houston to Newark was diverted to New Orleans last Tuesday after one of its six electric generators failed midflight. That same day, the Federal Aviation Administration ordered inspections of fuel line connectors on all 787s, warning of a risk of fuel leaks and fires.

Aviation experts cast these issues as minor hiccups and said it was typical for new planes to experience such problems, particularly in the first few years of production.

On Monday, an aerospace analyst, David E. Strauss of UBS, raised another concern — whether the cost of building the planes was coming down fast enough for individual plane sales to become profitable by early 2015, as Boeing has projected.

Boeing officials have said that the company will earn enough on subsequent sales to average a percentage profit in the low single digits on the first 1,100 planes, which includes deliveries into 2021. Company officials said late Monday that they remained confident in their projections.

But in a research report, Mr. Strauss said that Boeing’s costs did not appear to be declining rapidly enough for sales to turn profitable in 2015 and that the program could continue to spend $4 billion to $5 billion more than it gained in revenue over the next three years. Unless the company can bring down the costs more quickly as it gains experience in building the planes, Mr. Strauss wrote, Boeing may not begin to make a profit on each plane until 2021.

A lot is riding on the success of the 787 Dreamliner, a risky technological and commercial bet for Boeing, which is based in Chicago. The company has so far delivered 38 of the jets to eight airlines, including United Airlines, All Nippon Airways of Japan and Poland’s LOT. It has outlined ambitious plans to double its production rate to 10 planes a month by the end of 2013. It is also starting to build a stretched-out version and mulling an even larger one after that, to make the venture more profitable.

But with the combination of the problem on the United flight and the F.A.A. directive, “This was too much news about the 787 in one day,” said Addison Schonland, an aviation analyst and a partner at Airinsight.com. “But remember, it’s a brand-new airplane. When you start flying it around, you start discovering things. Over all, the number of hiccups has been fantastic.”

The basic model, called the 787-8, can carry 210 to 250 passengers about 8,000 nautical miles, the distance from New York to Singapore, and has a list price of $206.8 million. Early customers, however, are receiving big discounts to make up for the delays caused by a series of manufacturing problems. The first stretched version for 250 to 290 passengers, the 787-9, is listed at $243.6 million and could be ready in early 2014.

Mr. Strauss estimated that Boeing was recently spending $232 million to build each plane but charged customers, on average, only about half that.

Given Wall Street’s concerns, Boeing’s stock has been in limbo for more than three years, trading in a narrow range around $75 a share.

“Boeing has not had a major snafu on the 787 for over a year now, but we think most investors remain skeptical as to whether Boeing can keep this up,” Robert Stallard, an analyst at RBC Capital Markets, said in a note to clients last month.

Boeing has acknowledged that it outsourced too much of the work on the plane to suppliers who were willing, collectively, to cover billions of dollars of the development costs. Many parts needed reworking. That and other design changes forced the company to set up a separate line in Everett, Wash., to handle the extra work on the first 65 jets. It has also built a 787 plant in Charleston, S.C., with an entirely new work force.

Still, even with all of the headaches, the 787 has enabled Boeing to jump ahead of its European rival, Airbus, in exploiting the lightweight carbon composites. Half of the plane by weight is made with composites instead of aluminum and other metals. Airbus said last week that it had finished assembly on the first A350, its rival to the 787. Its entry into commercial service is not expected before the second half of 2014.

Passengers who have flown on 787s this year have raved about the experience, and the first airlines using them also seem satisfied.

United will begin using the 787 internationally in January, with flights from Houston to Lagos, Nigeria. “There is a tremendous amount of promise for customers preferring this airplane over others,” said Jeff Smisek, chief executive of United. “It still has a new-plane smell.”

Read More..

Luke Bryan cleans up at ACAs with 9 awards

Luke Bryan didn't want the American Country Awards to end.

He cleaned up during the fan-voted show, earning nine awards, including artist and album of the year. His smash hit "I Don't Want This Night To End" was named single and music video of the year.

Miranda Lambert took home the second most guitar trophies with three. Jason Aldean was named touring artist of the year. Carrie Underwood won female artist of the year, and a tearful Lauren Alaina won new artist of the year.

Bryan, Aldean, Keith Urban, Lady Antebellum and Trace Adkins with Lynyrd Skynrd were among the high-energy performances.

The third annual ACAs were held at Mandalay Bay in Las Vegas Monday night.

___

Online: http://www.theACAs.com

___

Follow http://www.twitter.com/AP_Country for the latest country music news from The Associated Press.

Read More..

Rate of Childhood Obesity Falls in Several Cities

Jessica Kourkounis for The New York Times

At William H. Ziegler Elementary in Northeast Philadelphia, students are getting acquainted with vegetables and healthy snacks.

PHILADELPHIA — After decades of rising childhood obesity rates, several American cities are reporting their first declines.

The trend has emerged in big cities like New York and Los Angeles, as well as smaller places like Anchorage, Alaska, and Kearney, Neb. The state of Mississippi has also registered a drop, but only among white students.

“It’s been nothing but bad news for 30 years, so the fact that we have any good news is a big story,” said Dr. Thomas Farley, the health commissioner in New York City, which reported a 5.5 percent decline in the number of obese schoolchildren from 2007 to 2011.

The drops are small, just 5 percent here in Philadelphia and 3 percent in Los Angeles. But experts say they are significant because they offer the first indication that the obesity epidemic, one of the nation’s most intractable health problems, may actually be reversing course.

The first dips — noted in a September report by the Robert Wood Johnson Foundation — were so surprising that some researchers did not believe them.

Deanna M. Hoelscher, a researcher at the University of Texas, who in 2010 recorded one of the earliest declines — among mostly poor Hispanic fourth graders in the El Paso area — did a double-take. “We reran the numbers a couple of times,” she said. “I kept saying, ‘Will you please check that again for me?’ ”

Researchers say they are not sure what is behind the declines. They may be an early sign of a national shift that is visible only in cities that routinely measure the height and weight of schoolchildren. The decline in Los Angeles, for instance, was for fifth, seventh and ninth graders — the grades that are measured each year — between 2005 and 2010. Nor is it clear whether the drops have more to do with fewer obese children entering school or currently enrolled children losing weight. But researchers note that declines occurred in cities that have had obesity reduction policies in place for a number of years.

Though obesity is now part of the national conversation, with aggressive advertising campaigns in major cities and a push by Michelle Obama, many scientists doubt that anti-obesity programs actually work. Individual efforts like one-time exercise programs have rarely produced results. Researchers say that it will take a broad set of policies applied systematically to effectively reverse the trend, a conclusion underscored by an Institute of Medicine report released in May.

Philadelphia has undertaken a broad assault on childhood obesity for years. Sugary drinks like sweetened iced tea, fruit punch and sports drinks started to disappear from school vending machines in 2004. A year later, new snack guidelines set calorie and fat limits, which reduced the size of snack foods like potato chips to single servings. By 2009, deep fryers were gone from cafeterias and whole milk had been replaced by one percent and skim.

Change has been slow. Schools made money on sugary drinks, and some set up rogue drink machines that had to be hunted down. Deep fat fryers, favored by school administrators who did not want to lose popular items like French fries, were unplugged only after Wayne T. Grasela, the head of food services for the school district, stopped buying oil to fill them.

But the message seems to be getting through, even if acting on it is daunting. Josh Monserrat, an eighth grader at John Welsh Elementary, uses words like “carbs,” and “portion size.” He is part of a student group that promotes healthy eating. He has even dressed as an orange to try to get other children to eat better. Still, he struggles with his own weight. He is 5-foot-3 but weighed nearly 200 pounds at his last doctor’s visit.

“I was thinking, ‘Wow, I’m obese for my age,’ ” said Josh, who is 13. “I set a goal for myself to lose 50 pounds.”

Nationally, about 17 percent of children under 20 are obese, or about 12.5 million people, according to the Centers for Disease Control and Prevention, which defines childhood obesity as a body mass index at or above the 95th percentile for children of the same age and sex. That rate, which has tripled since 1980, has leveled off in recent years but has remained at historical highs, and public health experts warn that it could bring long-term health risks.

Obese children are more likely to be obese as adults, creating a higher risk of heart disease and stroke. The American Cancer Society says that being overweight or obese is the culprit in one of seven cancer deaths. Diabetes in children is up by a fifth since 2000, according to federal data.

“I’m deeply worried about it,” said Francis S. Collins, the director of the National Institutes of Health, who added that obesity is “almost certain to result in a serious downturn in longevity based on the risks people are taking on.”

Read More..