Syrian Airstrike Severely Damages Hospital in Aleppo





BEIRUT, Lebanon — Airstrikes by the Syrian government damaged a hospital in the northern city of Aleppo early on Thursday and flattened a building next to it, killing at least 15 people and leaving as many as 40 missing in an attack that closed one of the city’s few functioning medical facilities, antigovernment activists said.




Video purporting to depict the aftermath showed the facade shorn off the first three stories of the hospital, with its name, Dar el-Shifa, in red letters on its tower. Beside it, another building was reduced to a two-story pile of rubble. People milled in the street, shouting “God is great.”


Among the 15 people confirmed dead were two hospital workers and two children, said Abu Louai al-Halabi, an activist in Aleppo, adding that up to 40 people were still believed to be trapped under the rubble. One man was pulled out alive several hours after the explosion, according to another video posted on the Internet by opponents of President Bashar al-Assad.


Rebels seized a military base in southeastern Syria, giving them control of a swath of oil-producing territory, and as tensions increased between anti-government fighters and Kurdish groups in northeastern Syria. In both areas, near the border with Iraq, activists said that fighters from Al Nusra Front for the People of the Levant, a jihadi group, were taking a prominent role among the opposition fighters.


The developments came a day after a well-known antigovernment activist was arrested during a bold protest that showed that the nonviolent opposition movement is still struggling to survive even as civil war deepens.


In the old market in central Damascus, the activist, Rima Dali raised a banner calling for “the end of all military operations” — an act of extraordinary defiance during a time of tight security and surveillance in the capital.


Ms. Dali and three other women stood in wedding dresses in the middle of the arched Souk al-Hamediya, usually bustling with spice sellers but apparently nearly empty. Photographs were posted on Ms. Dali’s and other activists’ sites.


“Syria is for all of us,” the banners read. “You are tired and we are tired. We want to live. Another solution ...” A video e-mailed by another activist appeared to show the women being led away by security forces.


Ms. Dali had been arrested in March for standing silently in front of Parliament with a sign reading, “Stop the killing” and calling for “Syria for all Syrians.”


Such acts of civil disobedience have been eclipsed as the Syrian protest movement grew into a civil war that has killed more than 30,000 people but beneath the surface tensions still ripple between rebel leaders and government opponents who favor a less violent approach.


Yet fighting raged in eastern Syria, threatening to engulf displaced people who fled there from other cities, and in the northeast, activists reported tensions between jihadist fighting groups and both pro- and anti-government Kurds. 


In Ras al-Ain, near the Turkish border in northeastern Syria, activists said clashes broke out between antigovernment battalions and Kurds from the P.Y.D., or Kurdish Democratic Union Party. That group has ties to a militant Kurdish group long backed by the Syrian government.


But the conflict was not a clear-cut one between government opponents and supporters, an Arab activist who fled to Turkey from Ras al-Ain said in a telephone interview.


The activist, who gave only his first name, Miral, for security reasons, said that the antigovernment battalions in the area did not represent the mainstream of the Syrian uprising, but were jihadist battalions, including from the Nusra Front. He said they enjoyed strong logistical support from similar groups inside Iraq as well as Arab tribes that straddle the border between the two countries.


He said there was little military reason for a heavy rebel presence in the area and suspected that the fighters simply wanted to establish a base in a remote area of Syria. Kurds and Arabs alike are eager to control the area if the government falls.


Christians and Kurds in the area, he said, had agreed to keep extremists out after some fighters burned shops selling alcohol.


“It’s a conspiracy against the Kurds,” said another Arab activist who fled to Turkey, Sobhi Dawood. He said he was concerned that all sides were building up arms supplies, threatening to fuel “a civil war in the town.”


Because some residents disagree with the goals of the jihadi battalions, he said, it has been hard to recruit locals to fight against the government. He said 62 recent recruits had quit, saying “We are not here to fight against our brothers.”


In Eastern Syria, a McClatchy correspondent in the province of Deir al-Zour reported that rebels appeared to control two of the three oil fields there, siphoning light  crude to burn for heat and to sell, and robbing the government of key revenues.


 In a video posted online, a fighter claimed that rebels had “liberated” an artillery base in Mayadeen, outside the province’s main city, capturing a tank and a tank carrier.


“I hope Assad’s booty and weapons and their money and their land will be ours, God willing,” he said, concluding with a reference to the prophet: “Our master is Muhammad, our commander forever.”


Hajj Abu Bakr, a local activist in Deir al-Zour reached through Skype, said that three battalions, including one from the Nusra Front, had taken part in seizing the artillery battalion.


He said that clashes in the area had continued for 22 days. He said government shelling had intensified after the artillery position was captured, and that a family of six had been killed. Many families from other provinces, such as Homs, are sheltering in the area and he said he was worried that more of the displaced would be injured.


Hwaida Saad contributed reporting.



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Fitch cuts Sony, Panasonic debt ratings to “junk” status
















TOKYO (Reuters) – Ratings agency Fitch downgraded the debt ratings of Japan’s Sony Corp and Panasonic Corp to “junk” status citing weakness in their consumer electronics and TV operations, further diminishing the luster of the once-great Japanese brands.


The cut to below investment grade, the first by a ratings firm, comes as the floundering Japanese tech giants face weak demand and fierce competition from Apple Inc and Samsung Electronics.













A strong yen and bumps in China, where growth has slowed and Japanese goods have been targeted in sometimes violent protests recently, have also weighed on their earnings.


The two companies, along with Sharp Corp, racked up combined losses of $ 20 billion last year, leading them to axe jobs, sell assets and close facilities.


“Both Sony and Panasonic are struggling to generate operating profits, but each is restructuring and I don’t envision the current situation continuing,” said Masahi Oda, Chief Investment Officer at Sumitomo Mitsui Trust Bank.


“A collapse of their core business would be a problem, but we are not at the point yet, and to me Fitch looks too negative,” Oda added.


Fitch downgraded Sony by three notches to BB-minus from BBB- minus, saying meaningful recovery will be slow. The move came after Sony, the maker of PlayStation game consoles and Vaio laptops, last week announced plans to raise 150 billion yen ($ 1.82 billion) through the sale of convertible bonds.


“Fitch believes that continuing weakness in the home entertainment and sound and mobile products and communications segments will offset the relatively stable music and pictures segments and improvement in the devices segment which makes semiconductors and components,” it said in statement.


In a separate statement, Fitch cut Panasonic to BB from BBB-minus, a two-notch downgrade, citing weakened competitiveness in its TVs and display panels as well as weak cash generation from its operations. It has a negative outlook on both the companies.


The downgrade sent Sony’s five-year credit default swaps (CDS), insurance-like contracts against debt default or restructuring, 5 basis points wider to 382.5/402.5 basis points.


Panasonic’s CDS for the same maturity were quoted at 295/315 basis points, 15 basis points wider than in Thursday morning Asian trade.


Standard & Poor’s rates the two consumer electronics makers at BBB, the second lowest of the investment grade, while Moody’s Investors Service has Baa3 on them, the lowest of the high-grade category.


With two of the three major ratings agencies still having the two companies as investment grade, institutional investors won’t face too great a pressure to cut their debt holdings in them, analysts said.


SONY SHARES TUMBLE


Sony shares shed 4.4 percent in Frankfurt on Thursday. The shares ended 1.8 percent higher at 834 yen in Tokyo before the Fitch announcement, trading not too far from their 32-year closing low of 793 yen hit on November 15. Sony stock is down 40 percent so far this year.


Panasonic shares were down 0.6 percent in Frankfurt in low volume. The stock inched up 0.7 percent to close at 407 yen in Tokyo trading, near its 34-year closing low of 385 yen reached on November 13.


Last month, Panasonic cut its forecast and warned it will lose close to $ 10 billion in the year to March, as it writes off billions of yen in tax-deferred assets and goodwill related to its mobile phone, solar panel and small lithium battery businesses.


Ahead of its earnings revision, Panasonic won $ 7.6 billion in loan commitments in October from banks including Sumitomo Mitsui Financial Group and Mitsubishi UFJ Financial Group, a funding backstop it says will help it avoid having to seek capital from credit markets.


Sony made a small operating profit in the July-September quarter, helped by the sale of a non-core chemicals business, and kept its forecast for a full-year profit of $ 1.63 billion.


(Additional reporting by Dominic Lau in Tokyo and Umesh Desai in Hong Kong; Editing by Muralikumar Anantharaman)


Tech News Headlines – Yahoo! News



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Study finds mammograms lead to unneeded treatment

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.

It's the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call "cancer" are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don't really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it's relatively new to the debate over breast cancer screening.

"We're coming to learn that some cancers — many cancers, depending on the organ — weren't destined to cause death," said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, "once a woman is diagnosed, it's hard to say treatment is not necessary."

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday's New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it's most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment.

Researchers used federal surveys on mammography and cancer registry statistics from 1976 through 2008 to track how many cancers were found early, while still confined to the breast, versus later, when they had spread to lymph nodes or more widely.

The scientists assumed that the actual amount of disease — how many true cases exist — did not change or grew only a little during those three decades. Yet they found a big difference in the number and stage of cases discovered over time, as mammograms came into wide use.

Mammograms more than doubled the number of early-stage cancers detected — from 112 to 234 cases per 100,000 women. But late-stage cancers dropped just 8 percent, from 102 to 94 cases per 100,000 women.

The imbalance suggests a lot of overdiagnosis from mammograms, which now account for 60 percent of cases that are found, Bleyer said. If screening were working, there should be one less patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage, he explained.

"Instead, we're diagnosing a lot of something else — not cancer" in that early stage, Bleyer said. "And the worst cancer is still going on, just like it always was."

Researchers also looked at death rates for breast cancer, which declined 28 percent during that time in women 40 and older — the group targeted for screening. Mortality dropped even more — 41 percent — in women under 40, who presumably were not getting mammograms.

"We are left to conclude, as others have, that the good news in breast cancer — decreasing mortality — must largely be the result of improved treatment, not screening," the authors write.

The study was paid for by the study authors' universities.

"This study is important because what it really highlights is that the biology of the cancer is what we need to understand" in order to know which ones to treat and how, said Dr. Julia A. Smith, director of breast cancer screening at NYU Langone Medical Center in New York. Doctors already are debating whether DCIS, a type of early tumor confined to a milk duct, should even be called cancer, she said.

Another expert, Dr. Linda Vahdat, director of the breast cancer research program at Weill Cornell Medical College in New York, said the study's leaders made many assumptions to reach a conclusion about overdiagnosis that "may or may not be correct."

"I don't think it will change how we view screening mammography," she said.

A government-appointed task force that gives screening advice calls for mammograms every other year starting at age 50 and stopping at 75. The American Cancer Society recommends them every year starting at age 40.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the study should not be taken as "a referendum on mammography," and noted that other high-quality studies have affirmed its value. Still, he said overdiagnosis is a problem, and it's not possible to tell an individual woman whether her cancer needs treated.

"Our technology has brought us to the place where we can find a lot of cancer. Our science has to bring us to the point where we can define what treatment people really need," he said.

___

Online:

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

Screening advice: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Global shares gain as global economic outlook improves

LONDON (Reuters) - World share markets extended a week-long rally on Thursday as manufacturing surveys in China and the United States boosted confidence in global growth and euro zone data at least did not worsen the already weak outlook for that region.


The euro hit a three high against the dollar on optimism that a funding deal for debt-crippled Greece will ultimately be agreed - and despite data indicating the region's economy is on course for its deepest recession since early 2009.


"The driving factors behind euro/dollar are that the global macroeconomic backdrop seems to be improving and people are pricing out the tail risk on Greece," said Arne Lohmann Rasmussen, head of currency research at Danske Bank.


The euro rose 0.4 percent to $1.2880, its highest since November 2.


The view there will be a deal to help Athens was bolstered on Wednesday when German Chancellor Angela Merkel said after the failure of the latest talks, that an agreement was possible when euro zone ministers meet again on Monday.


The hopes for a Greek deal, combined with the better economic data and a growing view that a solution can be found to the U.S. fiscal crisis, lifted the MSCI world equity index 0.4 percent to 326 points, putting it on track for its best week since mid-September.


Europe's FTSE Eurofirst 300 index rose 0.4 percent to a two-week high of 1,101.70 points, with London's FTSE 100, Paris's CAC-40 and Frankfurt's DAX between 0.3 and 0.7 percent higher.


However, trading was subdued, with U.S. markets closed for the Thanksgiving holiday.


CHINA BOOST


Confidence in the global economic outlook got its biggest boost from the HSBC flash Manufacturing Purchasing Managers Index (PMI) for China, which pointed to an expansion in activity after seven consecutive quarters of slowdown.


The Chinese data followed a report on Wednesday showing U.S. manufacturing grew in November at its quickest pace in five months, indicating strong economic growth in the fourth quarter.


"There are questions over whether the Chinese economy is really that bad or if the U.S. will take a long time to recover, but we are getting signs that the situation is not as bad as assumed," said Peter Braendle, head of European equities at Zurich-based Swisscanto Asset Management.


PMI data on the manufacturing and services sectors in Europe's two biggest economies, Germany and France, added to the better tone, revealing that conditions had not worsened in November, though both economies are still contracting.


However, the PMI numbers for the wider euro zone remain extremely weak, pointing to the recession-hit region shrinking by about 0.5 percent in the current quarter - its sharpest contraction since the first quarter of 2009.


"The weak PMI outturn for November is a major disappointment in light of the increases in the German and French PMI surveys, and suggest the recession on the euro zone's periphery is gathering further pace," said ING economist Martin van Vliet.


BOND DEMAND


In the fixed-income markets, the improving tone enabled Spain to sell 3.88 billion euros ($4.97 billion) of new government bonds on Thursday, even though it has already raised enough funds for this year's needs.


The average yield on the three-year bonds in the auction was 3.617 percent, compared with 3.66 percent at a sale earlier in November and a 2012 average of 3.79 percent.


Ten-year Spanish yields were 6 basis points lower on the day at 5.67 percent, having traded above 6 percent at the start of the week.


"It's a clear reflection that sentiment in Spain has improved markedly," RIA Capital Markets bond strategist Nick Stamenkovic said, adding that the market was expecting Madrid to ask for an international bailout early next year.


Expectations Greece will soon get more cash set Greek yields on course for their 10th consecutive daily fall. The February 2023 bond yield dropped to 16.16 percent, its lowest since it was issued during a debt restructuring in March.


COMMODITIES STEADY


Commodity prices had some support from the improving outlook for world demand, but the prospect of only modest global growth in 2013 kept the gains in check.


Three-month copper on the London Metal Exchange rose 0.6 percent to $7,735.25 a metric tonne, and spot gold inched up to $1,730.30 an ounce.


Oil prices were more mixed as the ceasefire between Israel and Gaza's Hamas rulers on Thursday eased concerns over the impact the unrest might have had on supply from the region, offsetting support from the prospect of more Chinese oil demand.


Brent slipped 7 cents to $110.90 a barrel, while U.S. crude was up 2 cents at $87.40.


($1 = 0.7801 euros)


(Additional reporting by Jessica Mortimer and Marius Zaharia; Editing by Will Waterman and Alastair Macdonald)


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India Ink: Image of the Day: Nov. 21

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NJ jury convicts NY man in iPad data breach case
















NEWARK, N.J. (AP) — A federal jury on Tuesday convicted a man of illegally gaining access to AT&T‘s servers and stealing more than 120,000 email addresses of iPad users including New York Mayor Michael Bloomberg and film mogul Harvey Weinstein.


Andrew Auernheimer, of New York, was convicted of identity theft and conspiracy to gain unauthorized access to computers. Each count carries a maximum prison sentence of five years.













Prosecutors said the former Fayetteville, Ark., resident was part of an online group that tricked AT&T’s website into divulging email addresses including those of Bloomberg, Weinstein, then-White House chief of staff Rahm Emanuel, who’s now Chicago’s mayor, and other celebrities.


The group then shared the addresses with the website Gawker, which published them in redacted form accompanying a news article about the breach, prosecutors said.


A second man arrested with Auernheimer early last year, Daniel Spitler, of San Francisco, pleaded guilty that June.


At the time of the arrests, U.S. Attorney Paul Fishman said there was no evidence the men used the swiped information for criminal purposes. But authorities cautioned that it could have wound up in the hands of spammers and scam artists.


According to court papers, the men used a computer script they called the iPad3G Account Slurper to fool AT&T’s servers into thinking they were communicating with an iPad. The theft of the email addresses occurred in June 2010.


Prosecutors said at the time of Auernheimer’s arrest that he had bragged about the operation in a blog posting and in an interview with CNET published online after the Gawker article. Court papers also quoted him declaring in a New York Times article: “I hack, I ruin, I make piles of money. I make people afraid for their lives.”


Auernheimer, after he was charged and released on bail, had declined to comment.


iPad maker Apple Inc., based in Cupertino, Calif., referred questions to AT&T, which acknowledged a security weak spot on a website that exposed the email addresses. AT&T said the vulnerability affected only iPad users who signed up for its 3G wireless Internet service and said it had fixed the problem.


Gadgets News Headlines – Yahoo! News



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Recipe: Post-Turkey Dessert for Your Thanksgiving Feast















11/21/2012 at 12:00 PM EST







Chocolate Bourbon Pumpkin Cheesecake


Courtesy Betty Crocker


Come Thursday, it's all about that big bird sitting on the table – they don't call it Turkey Day for nothing.

But for those who aren't too stuffed (with stuffing) after the main course, here's a sweet way to cap off the holiday.

This Betty Crocker recipe is a triple threat – that is, it combines chocolate, bourbon and pumpkin all in one flavor-packed cheesecake. Try it yourself with the recipe below, or find another seasonal favorite to impress your dinner guests here.

Chocolate Bourbon Pumpkin Cheesecake

Crust
• 2 cups gingersnap cookie crumbs (35 to 40 cookies)
• ¼ cup butter or margarine, melted

Cheesecake
• 4 packages (8 oz. each) cream cheese, softened
• 1½ cups sugar
• ¼ cup all-purpose flour
• 4 eggs
• 4 tbsp. bourbon
• ½ cup canned pumpkin (not pumpkin pie mix)
• 1½ tsp. aromatic bitters
• 1½ tsp. ground ginger
• 1 tsp. ground cinnamon
• ¼ tsp. ground nutmeg
• 1 tsp. vanilla
• ¾ cup semisweet chocolate chips, melted

Toppings
• ½ cup caramel topping
• 2 tsp. bourbon
• Dash aromatic bitters
• Toasted pecans (optional)

Heat oven to 300ºF. Grease a 9-in. springform pan with shortening or cooking spray. Wrap outside bottom and the side of the pan with foil to prevent leaking. In a small bowl, mix the crust ingredients. Press the mixture into the bottom and one inch up the side of the pan. Bake eight to 10 minutes or until set. Cool for five minutes.

In a large bowl, beat the cream cheese with an electric mixer on medium speed until it's smooth and creamy; do not overbeat. On low speed, gradually beat in the sugar, then the flour and then the eggs (one at a time), just until blended. Remove half of the cream cheese mixture (about 3 cups) into another large bowl; reserve.

Into the remaining cream cheese mixture, stir 2 tbsp. of the bourbon, the pumpkin, 1 ½ tsp. bitters, the ginger, cinnamon and nutmeg with a whisk until it's smooth. Spoon over crust into the pan. Into the reserved 3 cups of filling, stir 2 tbsp. of bourbon, the vanilla and the melted chocolate. Pour the mixture over the pumpkin layer directly in the middle of the pan. (This will create layers so that each slice includes some of each flavor.)

To minimize cracking, place a shallow pan half-full of hot water on the lower oven rack. Bake the cheesecake 80 to 90 minutes minutes, or until the edges are set but the center of the cheesecake still jiggles slightly when moved.

Turn the oven off, and open the oven door at least four inches. Leave the cheesecake in the oven 30 minutes longer. Remove from the oven; place on a cooling rack. Without releasing the side of the pan, run your knife around the edge of the pan to loosen the cheesecake. Cool in the pan on a cooling rack for 30 minutes. Cover loosely; refrigerate at least six hours but no longer than 24 hours.

Run your knife around the side of the pan to loosen the cheesecake again; carefully remove side of the pan. Place cheesecake on a serving plate. Stir together caramel topping, 2 tsp. bourbon and a dash of bitters. To serve, drizzle with caramel and sprinkle with pecans. Cover and refrigerate any remaining cheesecake.

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OB/GYNs back over-the-counter birth control pills

WASHINGTON (AP) — No prescription or doctor's exam needed: The nation's largest group of obstetricians and gynecologists says birth control pills should be sold over the counter, like condoms.

Tuesday's surprise opinion from these gatekeepers of contraception could boost longtime efforts by women's advocates to make the pill more accessible.

But no one expects the pill to be sold without a prescription any time soon: A company would have to seek government permission first, and it's not clear if any are considering it. Plus there are big questions about what such a move would mean for many women's wallets if it were no longer covered by insurance.

Still, momentum may be building.

Already, anyone 17 or older doesn't need to see a doctor before buying the morning-after pill — a higher-dose version of regular birth control that can prevent pregnancy if taken shortly after unprotected sex. Earlier this year, the Food and Drug Administration held a meeting to gather ideas about how to sell regular oral contraceptives without a prescription, too.

Now the influential American College of Obstetricians and Gynecologists is declaring it's safe to sell the pill that way.

Wait, why would doctors who make money from women's yearly visits for a birth-control prescription advocate giving that up?

Half of the nation's pregnancies every year are unintended, a rate that hasn't changed in 20 years — and easier access to birth control pills could help, said Dr. Kavita Nanda, an OB/GYN who co-authored the opinion for the doctors group.

"It's unfortunate that in this country where we have all these contraceptive methods available, unintended pregnancy is still a major public health problem," said Nanda, a scientist with the North Carolina nonprofit FHI 360, formerly known as Family Health International.

Many women have trouble affording a doctor's visit, or getting an appointment in time when their pills are running low — which can lead to skipped doses, Nanda added.

If the pill didn't require a prescription, women could "pick it up in the middle of the night if they run out," she said. "It removes those types of barriers."

Tuesday, the FDA said it was willing to meet with any company interested in making the pill nonprescription, to discuss what if any studies would be needed.

Then there's the price question. The Obama administration's new health care law requires FDA-approved contraceptives to be available without copays for women enrolled in most workplace health plans.

If the pill were sold without a prescription, it wouldn't be covered under that provision, just as condoms aren't, said Health and Human Services spokesman Tait Sye.

ACOG's opinion, published in the journal Obstetrics & Gynecology, says any move toward making the pill nonprescription should address that cost issue. Not all women are eligible for the free birth control provision, it noted, citing a recent survey that found young women and the uninsured pay an average of $16 per month's supply.

The doctors group made clear that:

—Birth control pills are very safe. Blood clots, the main serious side effect, happen very rarely, and are a bigger threat during pregnancy and right after giving birth.

—Women can easily tell if they have risk factors, such as smoking or having a previous clot, and should avoid the pill.

—Other over-the-counter drugs are sold despite rare but serious side effects, such as stomach bleeding from aspirin and liver damage from acetaminophen.

—And there's no need for a Pap smear or pelvic exam before using birth control pills. But women should be told to continue getting check-ups as needed, or if they'd like to discuss other forms of birth control such as implantable contraceptives that do require a physician's involvement.

The group didn't address teen use of contraception. Despite protests from reproductive health specialists, current U.S. policy requires girls younger than 17 to produce a prescription for the morning-after pill, meaning pharmacists must check customers' ages. Presumably regular birth control pills would be treated the same way.

Prescription-only oral contraceptives have long been the rule in the U.S., Canada, Western Europe, Australia and a few other places, but many countries don't require a prescription.

Switching isn't a new idea. In Washington state a few years ago, a pilot project concluded that pharmacists successfully supplied women with a variety of hormonal contraceptives, including birth control pills, without a doctor's involvement. The question was how to pay for it.

Some pharmacies in parts of London have a similar project under way, and a recent report from that country's health officials concluded the program is working well enough that it should be expanded.

And in El Paso, Texas, researchers studied 500 women who regularly crossed the border into Mexico to buy birth control pills, where some U.S. brands sell over the counter for a few dollars a pack. Over nine months, the women who bought in Mexico stuck with their contraception better than another 500 women who received the pill from public clinics in El Paso, possibly because the clinic users had to wait for appointments, said Dr. Dan Grossman of the University of California, San Francisco, and the nonprofit research group Ibis Reproductive Health.

"Being able to easily get the pill when you need it makes a difference," he said.

___

Online:

OB/GYN group: http://www.acog.org

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Wall Street flat after data, Greek deal delay

NEW YORK (Reuters) - Stocks were flat on Wednesday as consumer sentiment stalled because of growing uncertainty over federal tax and spending plans next year and the absence of a deal by international lenders on emergency aid for Greece


Other U.S. economic data came in as expected, such as initial weekly claims for jobless benefits, depriving the market of any clear direction.


Euro zone finance ministers, the International Monetary Fund and the European Central Bank failed for a second week to agree on how to make Greece's debt sustainable, which is necessary before the next cash infusion can be made to the fiscally beleaguered nation.


European shares edged up as investors looked for signs of progress on a deal before the next meeting of lenders on Monday. The FTSEurofirst 300 <.fteu3> gained 0.2 percent. <.eu/>


"The European situation has been around for so long, there is nothing new there and everybody realizes it is going to be a long-term workout. From some progress over the last couple of months, all of a sudden we've had no progress," said Tim Ghriskey, chief investment officer of Solaris Group in Bedford Hills, New York.


Labor Department data showed initial jobless claims dropped 41,000 to a seasonally adjusted 410,000 in the latest week, in line with expectations though still elevated in the wake of superstorm Sandy.


The S&P 500 had dropped 5.3 percent since Election Day on November 6 because of worries over U.S. fiscal negotiations and continued debt problems in Europe. But over the past three session, the index <.spx> has risen 2.6 percent, boosted by positive rhetoric from Washington on fiscal discussions and a market many viewed as oversold.


Gains made early in the day on Tuesday were mostly erased after Federal Reserve Chairman Ben Bernanke cautioned that the central bank lacked the tools to cushion the U.S. economy from the impact of the "fiscal cliff."


"We are in a bit of a holding period here. Everybody is focused on the fiscal cliff and any indications of a settlement between Congress and the White house and any indications of what that settlement might be," said Ghriskey.


The fiscal cliff is a series of tax hikes and spending cuts which, failing agreement in Congress, will go into effect in the new year and threaten the nation's fragile economic recovery.


The Dow Jones industrial average <.dji> gained 18.46 points, or 0.14 percent, to 12,806.97. The Standard & Poor's 500 Index <.spx> shed 0.33 points, or 0.02 percent, to 1,387.48. The Nasdaq Composite Index <.ixic> lost 0.09 points, or 0.00 percent, to 2,916.59.


Financial information firm Markit said its U.S. "flash," or preliminary, manufacturing Purchasing Managers Index rose to 52.4, its quickest pace in five months, from a three-year low of 51.0 in October.


The Thomson Reuters/University of Michigan's final reading of the overall index on consumer sentiment came in at 82.7, a touch up from 82.6 the month before but down from a preliminary reading of 84.9 released earlier in the month.


Trading is expected to be light ahead of a U.S. holiday Thursday for Thanksgiving.


Deere & Co lost 2.7 percent to $83.66 after the world's largest farm equipment maker, reported a weaker-than-expected quarterly profit.


Salesforce.com Inc jumped 7.3 percent to $156.52 after the business software provider beat Wall Street expectations for the third quarter and maintained its outlook for the rest of the year.


(Editing by Kenneth Barry)


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Clinton Visits in Effort to Defuse Gaza Conflict; Egypt Hints at Truce





JERUSALEM — Diplomatic efforts accelerated Tuesday to end the deadly confrontation between Israel and Palestinian militants in Gaza, as the United States sent Secretary of State Hillary Rodham Clinton to the Middle East and Egypt’s president expressed confidence that a cease-fire was close.




The diplomatic moves to end the nearly week-old crisis came on a day of some of the most intense violence yet. Militants in Gaza fired a long-range rocket toward Jerusalem for the second time in a week. The rocket fell short, but Israeli forces responded with an aerial assault on the suspected launching site near Gaza’s Al Shifa hospital that killed at least nine people. A delegation visiting Gaza from the Arab League postponed a news conference because of the Israeli assault, as wailing ambulances brought victims to the hospital, some of them decapitated.


The announcement of Mrs. Clinton’s active role in efforts to defuse the crisis added a strong new dimension to the multinational push to avert a new Middle East war and raised expectations of a truce. Israel has amassed thousands of soldiers on the border with Gaza and has threatened to invade the crowded Palestinian enclave for the second time in four years to stop the persistent rockets that have been lobbed at Israel.


Mrs. Clinton, who accompanied President Obama on his three-country Asia trip, left Cambodia on her own plane immediately for the Middle East. She was en route to Jerusalem to meet with Prime Minister Benjamin Netanyahu of Israel, then head to the West Bank to meet with Palestinian leaders and finally to Cairo to consult with Egyptian officials.


In Cairo, President Mohamed Morsi of Egypt added to the atmosphere of guarded optimism. The official Middle East News Agency quoted him as saying Israel’s “aggression” against Gaza would end, and Egyptian-mediated efforts would produce “positive results” in several hours.


The decision to dispatch Mrs. Clinton dramatically deepens the American involvement in the crisis. Mr. Obama made a number of late-night phone calls from his Asian tour to the Middle East on Monday night that contributed to his conclusion that he had to become more engaged and that Mrs. Clinton might be able to accomplish something.


With Ban Ki-moon, the United Nations secretary general, also scheduled to arrive in Israel on Tuesday, a senior official in the prime minister’s office said Israel had decided to give more time to diplomacy before launching a ground invasion into Gaza. But Israel has not withdrawn other options.


“I prefer a diplomatic solution,” Mr. Netanyahu said in a statement at the start of a meeting in Jerusalem with the German foreign minister, Guido Westerwelle. “I hope that we can get one, but if not, we have every right to defend ourselves with other means and we shall use them.


“As you know, we seek a diplomatic unwinding to this, through the discussions of cease-fire,” Mr. Netanyahu added. “But if the firing continues, we will have to take broader action and we won’t hesitate to do so.”


About three hours before Mr. Ban was scheduled to meet Mr. Netanyahu in Jerusalem, sirens sounded across the city in the early afternoon announcing an incoming rocket from Gaza. The military wing of Hamas said it had fired at the city. The rocket fell short, landing harmlessly in the West Bank just south of Jerusalem, and the military said it landed on open ground near a Palestinian village.


The rocket attack on the city, which is holy to Jews, Muslims and Christians, was the second in less than a week. On Friday, a rocket landed in a similar location, the police said.


The Israeli military said its air force had struck Tuesday morning at 11 Palestinian squads involved in planting explosives and firing rockets, as well as underground rocket launchers and a store of weapons and ammunition. The military said it had also used tank shells and artillery fire against unspecified targets in Gaza.


The Health Ministry in Gaza said the Palestinian death toll had climbed by late Tuesday morning to 112, roughly half of the dead civilians, including children. Three Israelis died in a rocket attack last week.


After an Asian summit dinner in Phnom Penh on Monday night, Mr. Obama called President Morsi to discuss the situation, then spoke with Mr. Netanyahu and called Mr. Morsi back. He was up until 2:30 a.m. on the phone, the White House said. He consulted with Mrs. Clinton repeatedly on the sidelines of the Asian summit meetings on Tuesday.


“This morning, Secretary Clinton and the president spoke again about the situation in Gaza, and they agreed that it makes sense for the secretary to travel to the region, so Secretary Clinton will depart today,” said Benjamin Rhodes, a deputy national security adviser to Mr. Obama. “Her visits will build on the engagement that we’ve undertaken in the last several days.”


Isabel Kershner reported from Jerusalem and Peter Baker from Phnom Penh, Cambodia. Reporting was contributed by Jodi Rudoren from Gaza City, David D. Kirkpatrick from Cairo and Rick Gladstone from New York.



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