Group of 20 Pledges to Let Markets Set Currency Values

MOSCOW — In a concerted move to quiet fears of a so-called currency war, finance officials from the world’s largest industrial and emerging economies expressed their commitment on Saturday to “market-determined exchange rate systems and exchange rate flexibility.”

In a statement issued at the conclusion of a conference here of the Group of 20, the finance ministers from the Group of 20 promised: “We will refrain from competitive devaluation. We will not target our exchange rates for competitive purposes.”

In its statement, the group also vowed to “take necessary collective actions” to discourage corporate tax evasion, particularly by preventing companies from shifting profits to avoid tax obligations. For instance, a number of big American companies, including Apple and Starbucks, have come under scrutiny recently for seeking out the friendliest tax jurisdictions.

Over all, the statement largely echoed one last week by seven top industrial nations pledging to let market exchange rates determine the value of their currencies. Currency devaluation can be used to gain competitive advantage because it makes a country’s exports cheaper.

“We all agreed on the fact that we refuse to enter any currency war,” the French finance minister, Pierre Moscovici, told reporters at the conference, which was held in a meeting center just a short walk from the Kremlin and Red Square.

In the statement on Saturday, the Group of 20 pointedly avoided any criticism of Japan, where stimulus programs backed by Prime Minister Shinzo Abe have kept interest rates near zero and flooded the economy with money — leading to a roughly 15 percent drop in the value of the yen against the dollar over the last three months.

The Japanese policies, which have reduced the cost of Japanese products around the world, were the primary cause of fears of a currency war.

In essence, the Group of 20 expressed a view that loose monetary policy, including steps that weaken currency values, are acceptable when used to stimulate domestic growth but should not be used to benefit in global trade.

Critics of that view say that it amounts to a distinction without a difference because loose monetary policies stimulate growth and bolster exports at the same time.

The United States has also used a loose monetary approach to aid in the economic recovery, in the form of “quantitative easing” by which the Federal Reserve buys tens of billions of dollars in bonds each month.

The chairman of the Federal Reserve, Ben S. Bernanke, who attended the conference in Moscow, gave brief remarks on Friday indicating support for Japan’s efforts.

Faster-growing, developing countries like Brazil and China have expressed concerns about the loose monetary policies of more established economies like Japan and the United States. The money created by policies like the Fed’s quantitative easing can prove destabilizing as it enters faster-growing economies.

The Group of 20 acknowledged this concern in its statement, saying: “Monetary policy should be directed toward domestic price stability and continuing to support economic recovery according to the respective mandates. We commit to monitor and minimize the negative spillovers on other countries of policies implemented for domestic purposes.”

As the three-day conference drew to a close, participants did not reach any new agreement on debt-cutting targets. Efforts to reach such a pact will continue at the annual Group of 20 summit meeting to be attended by President Obama and other world leaders in St. Petersburg in September.

But while the debt agreement was elusive, the Group of 20 leaders reiterated efforts to work together, promising to “resist all forms of protections and keep our markets open.”

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Livestrong Tattoos as Reminder of Personal Connections, Not Tarnished Brand

As Jax Mariash went under the tattoo needle to have “Livestrong” emblazoned on her wrist in bold black letters, she did not think about Lance Armstrong or doping allegations, but rather the 10 people affected by cancer she wanted to commemorate in ink. It was Jan. 22, 2010, exactly a year since the disease had taken the life of her stepfather. After years of wearing yellow Livestrong wristbands, she wanted something permanent.

A lifelong runner, Mariash got the tattoo to mark her 10-10-10 goal to run the Chicago Marathon on Oct. 10, 2010, and fund-raising efforts for Livestrong. Less than three years later, antidoping officials laid out their case against Armstrong — a lengthy account of his practice of doping and bullying. He did not contest the charges and was barred for life from competing in Olympic sports.

“It’s heartbreaking,” Mariash, of Wilson, Wyo., said of the antidoping officials’ report, released in October, and Armstrong’s subsequent confession to Oprah Winfrey. “When I look at the tattoo now, I just think of living strong, and it’s more connected to the cancer fight and optimal health than Lance.”

Mariash is among those dealing with the fallout from Armstrong’s descent. She is not alone in having Livestrong permanently emblazoned on her skin.

Now the tattoos are a complicated, internationally recognized symbol of both an epic crusade against cancer and a cyclist who stood defiant in the face of accusations for years but ultimately admitted to lying.

The Internet abounds with epidermal reminders of the power of the Armstrong and Livestrong brands: the iconic yellow bracelet permanently wrapped around a wrist; block letters stretching along a rib cage; a heart on a foot bearing the word Livestrong; a mural on a back depicting Armstrong with the years of his now-stripped seven Tour de France victories and the phrase “ride with pride.”

While history has provided numerous examples of ill-fated tattoos to commemorate lovers, sports teams, gang membership and bands that break up, the Livestrong image is a complex one, said Michael Atkinson, a sociologist at the University of Toronto who has studied tattoos.

“People often regret the pop culture tattoos, the mass commodified tattoos,” said Atkinson, who has a Guns N’ Roses tattoo as a marker of his younger days. “A lot of people can’t divorce the movement from Lance Armstrong, and the Livestrong movement is a social movement. It’s very real and visceral and embodied in narrative survivorship. But we’re still not at a place where we look at a tattoo on the body and say that it’s a meaningful thing to someone.”

Geoff Livingston, a 40-year-old marketing professional in Washington, D.C., said that since Armstrong’s confession to Winfrey, he has received taunts on Twitter and inquiries at the gym regarding the yellow Livestrong armband tattoo that curls around his right bicep.

“People see it and go, ‘Wow,’ ” he said, “But I’m not going to get rid of it, and I’m not going to stop wearing short sleeves because of it. It’s about my family, not Lance Armstrong.”

Livingston got the tattoo in 2010 to commemorate his brother-in-law, who was told he had cancer and embarked on a fund-raising campaign for the charity. If he could raise $5,000, he agreed to get a tattoo. Within four days, the goal was exceeded, and Livingston went to a tattoo parlor to get his seventh tattoo.

“It’s actually grown in emotional significance for me,” Livingston said of the tattoo. “It brought me closer to my sister. It was a big statement of support.”

For Eddie Bonds, co-owner of Rabbit Bicycle in Hill City, S.D., getting a Livestrong tattoo was also a reflection of the growth of the sport of cycling. His wife, Joey, operates a tattoo parlor in front of their store, and in 2006 she designed a yellow Livestrong band that wraps around his right calf, topped off with a series of small cyclists.

“He kept breaking the Livestrong bands,” Joey Bonds said. “So it made more sense to tattoo it on him.”

“It’s about the cancer, not Lance,” Eddie Bonds said.

That was also the case for Jeremy Nienhouse, a 37-year old in Denver, Colo., who used a Livestrong tattoo to commemorate his own triumph over testicular cancer.

Given the diagnosis in 2004, Nienhouse had three rounds of chemotherapy, which ended on March 15, 2005, the date he had tattooed on his left arm the day after his five-year anniversary of being cancer free in 2010. It reads: “3-15-05” and “LIVESTRONG” on the image of a yellow band.

Nienhouse said he had heard about Livestrong and Armstrong’s own battle with the cancer around the time he learned he had cancer, which alerted him to the fact that even though he was young and healthy, he, too, could have cancer.

“On a personal level,” Nienhouse said, “he sounds like kind of a jerk. But if he hadn’t been in the public eye, I don’t know if I would have been diagnosed when I had been.”

Nienhouse said he had no plans to have the tattoo removed.

As for Mariash, she said she read every page of the antidoping officials’ report. She soon donated her Livestrong shirts, shorts and running gear. She watched Armstrong’s confession to Winfrey and wondered if his apology was an effort to reduce his ban from the sport or a genuine appeal to those who showed their support to him and now wear a visible sign of it.

“People called me ‘Miss Livestrong,’ ” Mariash said. “It was part of my identity.”

She also said she did not plan to have her tattoo removed.

“I wanted to show it’s forever,” she said. “Cancer isn’t something that just goes away from people. I wanted to show this is permanent and keep people remembering the fight.”

Read More..

Livestrong Tattoos as Reminder of Personal Connections, Not Tarnished Brand

As Jax Mariash went under the tattoo needle to have “Livestrong” emblazoned on her wrist in bold black letters, she did not think about Lance Armstrong or doping allegations, but rather the 10 people affected by cancer she wanted to commemorate in ink. It was Jan. 22, 2010, exactly a year since the disease had taken the life of her stepfather. After years of wearing yellow Livestrong wristbands, she wanted something permanent.

A lifelong runner, Mariash got the tattoo to mark her 10-10-10 goal to run the Chicago Marathon on Oct. 10, 2010, and fund-raising efforts for Livestrong. Less than three years later, antidoping officials laid out their case against Armstrong — a lengthy account of his practice of doping and bullying. He did not contest the charges and was barred for life from competing in Olympic sports.

“It’s heartbreaking,” Mariash, of Wilson, Wyo., said of the antidoping officials’ report, released in October, and Armstrong’s subsequent confession to Oprah Winfrey. “When I look at the tattoo now, I just think of living strong, and it’s more connected to the cancer fight and optimal health than Lance.”

Mariash is among those dealing with the fallout from Armstrong’s descent. She is not alone in having Livestrong permanently emblazoned on her skin.

Now the tattoos are a complicated, internationally recognized symbol of both an epic crusade against cancer and a cyclist who stood defiant in the face of accusations for years but ultimately admitted to lying.

The Internet abounds with epidermal reminders of the power of the Armstrong and Livestrong brands: the iconic yellow bracelet permanently wrapped around a wrist; block letters stretching along a rib cage; a heart on a foot bearing the word Livestrong; a mural on a back depicting Armstrong with the years of his now-stripped seven Tour de France victories and the phrase “ride with pride.”

While history has provided numerous examples of ill-fated tattoos to commemorate lovers, sports teams, gang membership and bands that break up, the Livestrong image is a complex one, said Michael Atkinson, a sociologist at the University of Toronto who has studied tattoos.

“People often regret the pop culture tattoos, the mass commodified tattoos,” said Atkinson, who has a Guns N’ Roses tattoo as a marker of his younger days. “A lot of people can’t divorce the movement from Lance Armstrong, and the Livestrong movement is a social movement. It’s very real and visceral and embodied in narrative survivorship. But we’re still not at a place where we look at a tattoo on the body and say that it’s a meaningful thing to someone.”

Geoff Livingston, a 40-year-old marketing professional in Washington, D.C., said that since Armstrong’s confession to Winfrey, he has received taunts on Twitter and inquiries at the gym regarding the yellow Livestrong armband tattoo that curls around his right bicep.

“People see it and go, ‘Wow,’ ” he said, “But I’m not going to get rid of it, and I’m not going to stop wearing short sleeves because of it. It’s about my family, not Lance Armstrong.”

Livingston got the tattoo in 2010 to commemorate his brother-in-law, who was told he had cancer and embarked on a fund-raising campaign for the charity. If he could raise $5,000, he agreed to get a tattoo. Within four days, the goal was exceeded, and Livingston went to a tattoo parlor to get his seventh tattoo.

“It’s actually grown in emotional significance for me,” Livingston said of the tattoo. “It brought me closer to my sister. It was a big statement of support.”

For Eddie Bonds, co-owner of Rabbit Bicycle in Hill City, S.D., getting a Livestrong tattoo was also a reflection of the growth of the sport of cycling. His wife, Joey, operates a tattoo parlor in front of their store, and in 2006 she designed a yellow Livestrong band that wraps around his right calf, topped off with a series of small cyclists.

“He kept breaking the Livestrong bands,” Joey Bonds said. “So it made more sense to tattoo it on him.”

“It’s about the cancer, not Lance,” Eddie Bonds said.

That was also the case for Jeremy Nienhouse, a 37-year old in Denver, Colo., who used a Livestrong tattoo to commemorate his own triumph over testicular cancer.

Given the diagnosis in 2004, Nienhouse had three rounds of chemotherapy, which ended on March 15, 2005, the date he had tattooed on his left arm the day after his five-year anniversary of being cancer free in 2010. It reads: “3-15-05” and “LIVESTRONG” on the image of a yellow band.

Nienhouse said he had heard about Livestrong and Armstrong’s own battle with the cancer around the time he learned he had cancer, which alerted him to the fact that even though he was young and healthy, he, too, could have cancer.

“On a personal level,” Nienhouse said, “he sounds like kind of a jerk. But if he hadn’t been in the public eye, I don’t know if I would have been diagnosed when I had been.”

Nienhouse said he had no plans to have the tattoo removed.

As for Mariash, she said she read every page of the antidoping officials’ report. She soon donated her Livestrong shirts, shorts and running gear. She watched Armstrong’s confession to Winfrey and wondered if his apology was an effort to reduce his ban from the sport or a genuine appeal to those who showed their support to him and now wear a visible sign of it.

“People called me ‘Miss Livestrong,’ ” Mariash said. “It was part of my identity.”

She also said she did not plan to have her tattoo removed.

“I wanted to show it’s forever,” she said. “Cancer isn’t something that just goes away from people. I wanted to show this is permanent and keep people remembering the fight.”

Read More..

Bits Blog: Facebook Says Hackers Breached Its Computers

Facebook admitted that it was breached by sophisticated hackers in recent weeks, two weeks after Twitter made a similar admission. Both Facebook and Twitter were breached through a well-publicized vulnerability in Oracle’s Java software.

In a blog post late Friday afternoon, Facebook said it was attacked when a handful of its employees visited a compromised site for mobile developers. Simply by visiting the site, their computers were infected with malware. The company said that as soon as it discovered the malware, it cleaned up the infected machines and tipped off law enforcement.

“We have found no evidence that Facebook user data was compromised,” Facebook said.

On Feb. 1, Twitter said hackers had breached its systems and potentially accessed the data of 250,000 Twitter users. The company suggested at that time that it was one of several companies and organizations to be have been similarly attacked.

Facebook has known about its own breach for at least a month, according to people close to the investigation, but it was unclear why the company waited this long to announce it. Fred Wolens, a Facebook spokesman, declined to comment.

Like Twitter, Facebook said it believed that it was one of several organizations that were targeted by the same group of attackers.

“Facebook was not alone in this attack,” the company said in its blog post. “It is clear that others were attacked and infiltrated recently as well.”

The attacks add to the mounting evidence that hackers were able to use the security hole in Oracle’s Java software to steal information from a broad range of companies. Java, a widely used programming language, is installed on more than three billion devices. It has long been hounded by security problems.

Last month, after a security researcher exposed a serious vulnerability in the software, the Department of Homeland Security issued a rare alert that warned users to disable Java on their computers. The vulnerability was particularly disconcerting because it let attackers download a malicious program onto its victims’ machines without any prompting. Users did not even have to click on a malicious link for their computers to be infected. The program simply downloaded itself.

After Oracle initially patched the security hole in January, the Department of Homeland Security said that the fix was not sufficient and recommended that, unless “absolutely necessary”, users should disable it on their computers completely. Oracle did not issue another fix until Feb. 1.

Social networks are a prime target for hackers, who look to use people’s personal data and social connections in what are known as “spearphishing” attacks. In this type of attack, a target is sent an e-mail, ostensibly from a connection, containing a malicious link or attachment. Once the link is clicked or attachment opened, attackers take control of a user’s computer. If the infected computer is inside a company’s system, the attackers are able to gain a foothold. In many cases, they then extract passwords and gain access to sensitive data.

Facebook said in its blog post that the updated patch addressed the vulnerability that allowed hackers to access its employees’ computers.

Hackers have been attacking organizations inside the United States at an alarming rate. The number of attacks reported by government agencies last year topped 48,500 — a ninefold jump from the 5,500 attacks reported in 2006, according to the Government Accountability Office.

In the last month alone, The New York Times, The Wall Street Journal and The Washington Post all confirmed that they were targets of sophisticated hackers. But security experts say that these attacks are just the tip of the iceberg.

A common saying among security experts is that there are now only two types of American companies: Those that have been hacked and those that don’t know they’ve been hacked.

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Karzai to Forbid His Forces From Requesting Foreign Airstrikes

KABUL, Afghanistan (AP) — President Hamid Karzai said Saturday that he would issue a decree barring Afghan security forces from asking international troops to carry out airstrikes under “any circumstances.”

The announcement came amid anger over a joint Afghan-NATO operation last week that Afghan officials said killed 10 civilians, including women and children, in northeast Kunar Province.

“I will issue a decree tomorrow that no Afghan security forces, in any circumstances, in any circumstances, can ask for the foreigners’ planes for carrying out operations on our homes and villages,” Mr. Karzai said in a speech here in Kabul at the Afghan National Military Academy.

Civilian deaths at the hands of foreign forces, particularly as a result of airstrikes, have been the cause of much conflict between Afghans and the international coalition, led by the United States, although it has devised measures to prevent them. But the Afghan military also relies heavily on air support to gain an advantage in the fight against Taliban militants and other insurgents.

Many analysts have expressed concern that the impending withdrawal of international combat forces by the end of 2014 will deprive government security forces of that crucial weapon.

President Obama has said that he will withdraw about half of the 66,000 American troops in Afghanistan within a year.

According to Gen. John R. Allen, the former top commander of American and NATO forces in Afghanistan, the coalition can provide air support to troops on the ground anywhere in Afghanistan within 12 minutes of a request. General Allen said that Afghan forces would have to get used to not having the same abilities in the future.

Jamie Graybeal, a spokesman for the coalition, declined to comment on Mr. Karzai’s remarks because alliance officials had not yet seen the decree.

Mr. Karzai said that General Allen’s successor, Gen. Joseph F. Dunford Jr., told him that Afghanistan’s intelligence agency, the National Directorate of Security, had requested the airstrike late Tuesday in the Shigal district of Kunar Province, which borders Pakistan.

Local Afghan officials said that five boys, four women and one man were killed in the bombardment. Coalition officials said that an investigation was under way. Four insurgents were also reported killed, but Mr. Karzai said that did not justify the loss of so many civilian lives.

Mr. Karzai said Afghan forces were ready to take over from foreign troops despite concerns about their abilities.

“We are happy that foreign forces are withdrawing from our country,” he said. “We are happy for all their help and assistance so far, but we don’t need foreign forces to defend our country. We want our Afghan forces to defend their homeland.”

However, a former Afghan officer, Gen. Amrullah Aman, expressed surprise over Mr. Karzai’s remarks, saying that international air power was essential since one of the main weaknesses of the Afghan military is the lack of a fully developed air force.

“In a country like Afghanistan, where you don’t have heavy artillery and you don’t have air forces to support soldiers on the ground, how will it be possible to defeat an enemy that knows the area well and can hide anywhere?” General Aman said. “There must be air support to help all those ground forces on the battlefield.”

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Supreme Court to Hear Monsanto Seed Patent Case

With his mere 300 acres of soybeans, corn and wheat, Vernon Hugh Bowman said, “I’m not even big enough to be called a farmer.”

Yet the 75-year-old farmer from southwestern Indiana will face off Tuesday against the world’s largest seed company, Monsanto, in a Supreme Court case that could deal a huge blow to the future of genetically modified crops, and also affect other fields from medical research to software.

At stake in Mr. Bowman’s case is whether patents on seeds — or other things that can self-replicate – extend beyond the first generation of the products.

It is one of two cases before the Supreme Court related to the patenting of living organisms, a practice that has helped give rise to the biotechnology industry but which critics have long considered immoral. The other case, involving a breast cancer risk test from Myriad Genetics, will determine whether human genes can be patented. It is scheduled to be heard on April 15.

Monsanto says that a victory for Mr. Bowman would allow farmers to essentially save seeds from one year’s crop to plant the next year, eviscerating patent protection. In Indiana, it says, a single acre of soybeans can produce enough seeds to plant 26 acres the next year.

Such a ruling would “devastate innovation in biotechnology,” the company wrote in its brief. “Investors are unlikely to make such investments if they cannot prevent purchasers of living organisms containing their invention from using them to produce unlimited copies.”

The decision might also apply to live vaccines, cells lines and DNA used for research or medical treatment, and some types of nanotechnology.

Many organizations have filed friend-of-the court briefs in support of Monsanto’s position — universities worried about incentives for research, makers of laboratory instruments, and some big farmer groups like the American Soybean Association, which say seed patents have spurred crop improvements. The Department of Justice is also supporting Monsanto’s argument.

BSA/The Software Alliance, which represents companies like Apple and Microsoft, said in a brief that a decision against Monsanto might “facilitate software piracy on a broad scale” because software can be easily replicated. But it also said that a decision that goes too far the other way could make nuisance software patent infringement lawsuits too easy to file.

Some critics of biotechnology say that a victory for Mr. Bowman could weaken what they see as a stranglehold that Monsanto and some other big biotech companies have over farmers, which they say has led to rising seed prices and the lack of high-yielding varieties that are not genetically engineered.

Patents have “given seed companies enormous power, and it’s come at the detriment of farmers,” said Bill Freese, science policy analyst for the Center for Food Safety, which co-authored a brief on the side of Mr. Bowman. “Seed-saving would act as a much needed restraint on skyrocketing biotech seed prices.”

Farmers who plant seeds with Monsanto’s technology must sign an agreement not to save the seeds, which means they must buy new seeds every year.

Monsanto has a reputation for vigorously protecting its intellectual property.

The Center for Food Safety, which has tracked the cases, said Monsanto has filed more than 140 patent infringement lawsuits involving 410 farmers and 56 small farm businesses, and has so far received $23.5 million in recorded judgments. The organization says there are numerous other cases in which farmers settle out of court or before a suit is filed.

Monsanto says it must stop infringers to be fair to the vast majority of farmers who do pay to use its technology.

But Monsanto typically exercises no control over soybeans or corn once farmers sell their harvested crops to grain elevators, which in turn sell them for animal feed, food processing or industrial use.

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Fat Dad: Baking for Love

Fat Dad

Dawn Lerman writes about growing up with a fat dad.

My grandmother Beauty always told me that the way to a man’s heart was through his stomach, and by the look of pure delight on my dad’s face when he ate a piece of warm, homemade chocolate cake, or bit into a just-baked crispy cookie, I grew to believe this was true. I had no doubt that when the time came, and I liked a boy, that a batch of my gooey, rich, chocolaty brownies would cast him under a magic spell, and we would live happily ever.

But when Hank Thomas walked into Miss Seawall’s ninth grade algebra class on a rainy, September day and smiled at me with his amazing grin, long brown hair, big green eyes and Jimi Hendrix T-shirt, I was completely unprepared for the avalanche of emotions that invaded every fiber of my being. Shivers, a pounding heart, and heat overcame me when he asked if I knew the value of 1,000 to the 25th power. The only answer I could think of, as I fumbled over my words, was “love me, love me,” but I managed to blurt out “1E+75.” I wanted to come across as smart and aloof, but every time he looked at me, I started stuttering and sweating as my face turned bright red. No one had ever looked at me like that: as if he knew me, as if he knew how lost I was and how badly I needed to be loved.

Hank, who was a year older than me, was very popular and accomplished. Unlike other boys who were popular for their looks or athletic skills, Hank was smart and talented. He played piano and guitar, and composed the most beautiful classical and rock concertos that left both teachers and students in awe.

Unlike Hank, I had not quite come into my own yet. I was shy, had raggedy messy hair that I tied back into braids, and my clothes were far from stylish. My mother and sister had been on the road touring for the past year with the Broadway show “Annie.” My sister had been cast as a principal orphan, and I stayed home with my dad to attend high school. My dad was always busy with work and martini dinners that lasted late into the night. I spent most of my evenings at home alone baking and making care packages for my sister instead of coercing my parents to buy me the latest selection of Gloria Vanderbilt jeans — the rich colored bluejeans with the swan stitched on the back pocket that you had to lay on your bed to zip up. It was the icon of cool for the popular and pretty girls. I was neither, but Hank picked me to be his math partner anyway.

With every equation we solved, my love for Hank became more desperate. After several months of exchanging smiles, I decided to make Hank a batch of my homemade chocolate brownies for Valentine’s Day — the brownies that my dad said were like his own personal nirvana. My dad named them “closet” brownies, because when I was a little girl and used to make them for the family, he said that as soon as he smelled them coming out of the oven, he could imagine dashing away with them into the closet and devouring the whole batch.

After debating for hours if I should make the brownies for Hank with walnuts or chips, or fill the centers with peanut butter or caramel, I got to work. I had made brownies hundreds of times before, but this time felt different. With each ingredient I carefully stirred into the bowl, my heart began beating harder. I felt like I was going to burst from excitement. Surely, after Hank tasted these, he would love me as much as I loved him. I was not just making him brownies. I was l showing him who I was, and what mattered to me. After the brownies cooled, I sprinkled them with a touch of powdered sugar and wrapped them with foil and red tissue paper. The next day I placed them in Hank’s locker, with a note saying, “Call me.”

After seven excruciating days with no call, some smiles and the usual small talk in math class, I conjured up the nerve to ask Hank if he liked my brownies.

“The brownies were from you?” he asked. “They were delicious.”

Then Hank invited me to a party at his house the following weekend. Without hesitation, I responded that I would love to come. I pleaded with my friend Sarah to accompany me.

As the day grew closer, I made my grandmother Beauty’s homemade fudge — the chocolate fudge she made for Papa the night before he proposed to her. Stirring the milk, butter and sugar together eased my nerves. I had never been to a high school party before, and I didn’t know what to expect. Sarah advised me to ditch the braids as she styled my hair, used a violet eyeliner and lent me her favorite V-neck sweater and a pair of her best Gloria Vanderbilt jeans.

When we walked in the door, fudge in hand, Hank was nowhere to be found. Thinking I had made a mistake for coming and getting ready to leave, I felt a hand on my back. It was Hank’s. He hugged me and told me he was glad I finally arrived. When Hank put his arm around me, nothing else existed. With a little help from Cupid or the magic of Beauty’s recipes, I found love.

---

Fat Dad’s ‘Closet’ Brownies

These brownies are more like fudge than cake and contain a fraction of the flour found in traditional brownie recipes. My father called them “closet” brownies, because when he smelled them coming out of the oven he could imagine hiding in the closet to eat the whole batch. I baked them in the ninth grade for a boy that I had a crush on, and they were more effective than Cupid’s arrow at winning his heart.

6 tablespoons unsalted butter, plus extra for greasing the pan
8 ounces bittersweet chocolate, chopped, or semisweet chocolate chips
3/4 cup brown sugar
2 eggs at room temperature, beaten
1 teaspoon vanilla extract
1/4 cup flour
1/2 cup chopped walnuts (optional)
Fresh berries or powdered sugar for garnish (optional)

1. Preheat oven to 350 degrees.

2. Grease an 8-inch square baking dish.

3. In a double boiler, melt chocolate. Then add butter, melt and stir to blend. Remove from heat and pour into a mixing bowl. Stir in sugar, eggs and vanilla and mix well.

4. Add flour. Mix well until very smooth. Add chopped walnuts if desired. Pour batter into greased baking pan.

5. Bake for 35 minutes, or until set and barely firm in the middle. Allow to cool on a rack before removing from pan. Optional: garnish with powdered sugar, or berries, or both.

Yield: 16 brownies

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Dawn Lerman is a New York-based health and nutrition consultant and founder of Magnificent Mommies, which provides school lectures, cooking classes and workshops. Her series on growing up with a fat father appears occasionally on Well.

Read More..

Fat Dad: Baking for Love

Fat Dad

Dawn Lerman writes about growing up with a fat dad.

My grandmother Beauty always told me that the way to a man’s heart was through his stomach, and by the look of pure delight on my dad’s face when he ate a piece of warm, homemade chocolate cake, or bit into a just-baked crispy cookie, I grew to believe this was true. I had no doubt that when the time came, and I liked a boy, that a batch of my gooey, rich, chocolaty brownies would cast him under a magic spell, and we would live happily ever.

But when Hank Thomas walked into Miss Seawall’s ninth grade algebra class on a rainy, September day and smiled at me with his amazing grin, long brown hair, big green eyes and Jimi Hendrix T-shirt, I was completely unprepared for the avalanche of emotions that invaded every fiber of my being. Shivers, a pounding heart, and heat overcame me when he asked if I knew the value of 1,000 to the 25th power. The only answer I could think of, as I fumbled over my words, was “love me, love me,” but I managed to blurt out “1E+75.” I wanted to come across as smart and aloof, but every time he looked at me, I started stuttering and sweating as my face turned bright red. No one had ever looked at me like that: as if he knew me, as if he knew how lost I was and how badly I needed to be loved.

Hank, who was a year older than me, was very popular and accomplished. Unlike other boys who were popular for their looks or athletic skills, Hank was smart and talented. He played piano and guitar, and composed the most beautiful classical and rock concertos that left both teachers and students in awe.

Unlike Hank, I had not quite come into my own yet. I was shy, had raggedy messy hair that I tied back into braids, and my clothes were far from stylish. My mother and sister had been on the road touring for the past year with the Broadway show “Annie.” My sister had been cast as a principal orphan, and I stayed home with my dad to attend high school. My dad was always busy with work and martini dinners that lasted late into the night. I spent most of my evenings at home alone baking and making care packages for my sister instead of coercing my parents to buy me the latest selection of Gloria Vanderbilt jeans — the rich colored bluejeans with the swan stitched on the back pocket that you had to lay on your bed to zip up. It was the icon of cool for the popular and pretty girls. I was neither, but Hank picked me to be his math partner anyway.

With every equation we solved, my love for Hank became more desperate. After several months of exchanging smiles, I decided to make Hank a batch of my homemade chocolate brownies for Valentine’s Day — the brownies that my dad said were like his own personal nirvana. My dad named them “closet” brownies, because when I was a little girl and used to make them for the family, he said that as soon as he smelled them coming out of the oven, he could imagine dashing away with them into the closet and devouring the whole batch.

After debating for hours if I should make the brownies for Hank with walnuts or chips, or fill the centers with peanut butter or caramel, I got to work. I had made brownies hundreds of times before, but this time felt different. With each ingredient I carefully stirred into the bowl, my heart began beating harder. I felt like I was going to burst from excitement. Surely, after Hank tasted these, he would love me as much as I loved him. I was not just making him brownies. I was l showing him who I was, and what mattered to me. After the brownies cooled, I sprinkled them with a touch of powdered sugar and wrapped them with foil and red tissue paper. The next day I placed them in Hank’s locker, with a note saying, “Call me.”

After seven excruciating days with no call, some smiles and the usual small talk in math class, I conjured up the nerve to ask Hank if he liked my brownies.

“The brownies were from you?” he asked. “They were delicious.”

Then Hank invited me to a party at his house the following weekend. Without hesitation, I responded that I would love to come. I pleaded with my friend Sarah to accompany me.

As the day grew closer, I made my grandmother Beauty’s homemade fudge — the chocolate fudge she made for Papa the night before he proposed to her. Stirring the milk, butter and sugar together eased my nerves. I had never been to a high school party before, and I didn’t know what to expect. Sarah advised me to ditch the braids as she styled my hair, used a violet eyeliner and lent me her favorite V-neck sweater and a pair of her best Gloria Vanderbilt jeans.

When we walked in the door, fudge in hand, Hank was nowhere to be found. Thinking I had made a mistake for coming and getting ready to leave, I felt a hand on my back. It was Hank’s. He hugged me and told me he was glad I finally arrived. When Hank put his arm around me, nothing else existed. With a little help from Cupid or the magic of Beauty’s recipes, I found love.

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Fat Dad’s ‘Closet’ Brownies

These brownies are more like fudge than cake and contain a fraction of the flour found in traditional brownie recipes. My father called them “closet” brownies, because when he smelled them coming out of the oven he could imagine hiding in the closet to eat the whole batch. I baked them in the ninth grade for a boy that I had a crush on, and they were more effective than Cupid’s arrow at winning his heart.

6 tablespoons unsalted butter, plus extra for greasing the pan
8 ounces bittersweet chocolate, chopped, or semisweet chocolate chips
3/4 cup brown sugar
2 eggs at room temperature, beaten
1 teaspoon vanilla extract
1/4 cup flour
1/2 cup chopped walnuts (optional)
Fresh berries or powdered sugar for garnish (optional)

1. Preheat oven to 350 degrees.

2. Grease an 8-inch square baking dish.

3. In a double boiler, melt chocolate. Then add butter, melt and stir to blend. Remove from heat and pour into a mixing bowl. Stir in sugar, eggs and vanilla and mix well.

4. Add flour. Mix well until very smooth. Add chopped walnuts if desired. Pour batter into greased baking pan.

5. Bake for 35 minutes, or until set and barely firm in the middle. Allow to cool on a rack before removing from pan. Optional: garnish with powdered sugar, or berries, or both.

Yield: 16 brownies

---

Dawn Lerman is a New York-based health and nutrition consultant and founder of Magnificent Mommies, which provides school lectures, cooking classes and workshops. Her series on growing up with a fat father appears occasionally on Well.

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Gadgetwise Blog: App Smart Extra: Apps to Improve Your Singing

This week in my App Smart column, I talked about a few karaoke apps that can replicate many of the features of a full-fledged karaoke machine. I also mentioned one app that can help you train your singing voice.

There are, of course, numerous apps that try to help you improve your singing or let you groove to your own rendition of a popular hit.

One interesting app that can help teach you the subtleties of singing in harmonies is the $3 iOS app Sing Harmonies. This app is all about prerecorded adult voices singing harmony parts to well-known songs. The idea is that you can turn the backing music off at will, and also turn off each of the parts separately. In this way, you can learn the harmony parts by copying them individually, and perhaps teach yourself to listen to other singer’s voices when you’re performing. It’s fun and pleasingly simple to use, but $3 only gets you a very short list of songs.

For an app that’s got an element of karaoke, check out the free iOS app StarMaker: Karaoke + Auto Tune. Like other apps of this sort, you have to spend in-app “credits” to access tracks. To add credits, you have to sing songs, perform actions like uploading and sharing your experiences or watch video advertisements. You can also pay, with unlimited access for $3 a week. When you are singing each track from this app’s impressively up-to-date archive, it scores how well you’ve performed by analyzing your voice. Thus, the Starmaker may help you be a better singer — or at least a better karaoke performer. That is, if you don’t turn on the auto-tune system, which automatically fixes the notes you sing!

For a bit of musical fun, singers may enjoy the free Android app Pitch Lab Pro–Chromatic Tuner. In part, this is an app aimed at helping you tune an instrument like a guitar. But its core function of listening to an input sound and reporting what musical note that sound matches may also be good for training your singing. To do this, it has an array of different graphical visualizations that show the note you are singing — including how accurately you’re hitting the right frequency.

Remember that for many singing apps, the microphone built into your smartphone or tablet might not be the best option; plugging in a dedicated microphone or your hands-free set could yield better results.

Quick call

Runkeeper is one of the better apps for helping runners, cyclists and walkers keep track of their exercise regimes. It’s just been upgraded to version 3.0 for Android devices, complete with a more highly polished new look and extra features like in-activity splits.

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The Lede: Spectacular Video of Meteor Over Siberia

Video posted on YouTube Friday appeared to catch an explosion caused by a meteor streaking over the Russian city of Chelyabinsk.

Last Updated, 11:50 a.m. As our colleagues Ellen Barry and Andrew Kramer report, Russians recorded video of bright objects, apparently debris from a meteor, “streaking through the sky in western Siberia early on Friday, accompanied by a boom that damaged buildings across a vast area of territory.” Hundreds of injuries were reported, mainly from breaking glass.

Video recorded from the dashboard camera of a car in the Russian city of Chelyabinsk on Friday.

Video said to have been recorded on Friday in the Russian city of Chelyabinsk as a meteor passed low overhead. An explosion can be heard clearly at the 7-minute mark of the video.

The video clips, many recorded from cars on the dashboard cameras that are popular in Russia, quickly spread from social networks to Russian news sites. While it was not possible to confirm the authenticity of all of the clips posted online, several tracked closely with witness accounts and each other.

Dashboard-cam footage appeared to record a meteor plunging to Earth on Friday in Russia.

Video uploaded to YouTube on Friday was said to have been recorded over the Russian city of Chelyabinsk (although the camera’s time stamp displays an earlier date).

Several clips showed a flaming object streaking through the sky and a burst of blinding light followed by a smoke trail. One, shot by a driver named Alexander Mezentsev, showed a bright light over a city street in Chelyabinsk, a city of 1 million about 900 miles east of Moscow.

One clip, recorded on a street in Chelyabinsk, appeared to capture the chaotic aftermath of the event, as glass shattered following the shock wave and people shouted and tried to make sense of what was happening.

Video said to have been recorded in the Russian city of Chelyabinsk on Friday after a meteor passed overhead.

A very loud explosion could be heard about 25 seconds into another video, apparently recorded on a phone in the same city by a blogger named Sergey Hametov.

Video said to have been recorded on Friday in Chelyabinsk appeared to capture a loud explosion.

“There was panic. People had no idea what was happening,” Mr. Hametov told The Associated Press. “We saw a big burst of light, then went outside to see what it was and we heard a really loud, thundering sound.”

The blast, and breaking glass, was also captured about 70 seconds into another clip, which showed very clear images of the smoke trail after the meteor passed by.

Video posted on YouTube on Friday showed a smoke trail and a loud explosion after a meteor passed over Siberia.

Another video, shot from the window of a building, seemed to capture the long trail of smoke after the object passed through the sky.

Video posted on YouTube Friday appeared to show the trail of a meteorite fragment in the sky.

Several clips also showed what bloggers said was the damage caused by the sonic boom.

Damage to a school in the Chelyabinsk region of Russia, said to have been caused by the sonic boom from a meteor.

Video of what was described as damage caused by the sonic boom after a meteor passed over Russia on Friday.

As Radio Free Europe/Radio Liberty reports, a blinding flash on light was captured by traffic cameras on top of buildings in Nizhniy Tagil, around 220 miles north of Chelyabinsk

A blinding flash of light was captured by Web cameras in Nizhny Tagil, north of Chelyabinsk

Another view of the meteor streaking across the sky in Nizhniy Tagil was captured on a driver’s dashboard camera.

Video of a meteor from a dashboard camera in the Russian town of Nizhniy Tagil.

Our colleague William Broad from The Times Science desk will be answering questions on the meteor on The Lede later today.

Send us your questions on the meteor strike. We’re hosting a Q&A with science writer @WilliamJBroad. Include #NYTScience

— NYT Science (@nytimesscience) 15 Feb 13

Almost immediately after the spectacular images appeared online, Russian bloggers started making comic alterations, adding aliens and President Vladimir Putin to the pictures.

Some of the numerous videos that quickly emerged of the incident highlighted a distinctly Russian phenomenon: the dashboard cam. As the blogger Marina Galperina explained last year, they are commonplace in Russia partly because of the dangerous driving conditions that lead to so many accidents, and with an unreliable police force such cameras can provide valuable evidence following a crash.

The conditions of Russian roads are perilous, with insane gridlock in cities and gigantic ditches, endless swamps and severe wintry emptiness on the back roads and highways. Then there are large, lawless areas you don’t just ride into, the police with a penchant for extortion and deeply frustrated drivers who want to smash your face.

Psychopaths are abundant on Russian roads. You best not cut anyone off or undertake some other type of maneuver that might inconvenience the 200-pound, six-foot-five brawling children you see on YouTube hopping out of their SUVs with their dukes up. They will go ballistic in a snap, drive in front of you, brake suddenly, block you off, jump out and run towards your vehicle. Next thing you start getting punches in your face because your didn’t roll up your windows, or getting pulled out of the car and beaten because you didn’t lock the doors.

These fights happen all the time and you can’t really press charges. Point to your broken nose or smashed windows all you want. The Russian courts don’t like verbal claims. They do, however, like to send people to jail for battery and property destruction if there’s definite video proof.

Just last month, for instance, video recorded by a Russian driver on a dashboard-cam showed a tank suddenly cutting across a highway.

Last month, a Russian driver recorded video of a tank cutting across a highway.

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DealBook: American and US Airways Announce Merger Agreement

8:53 a.m. | Updated

Ending a yearlong courtship by US Airways, American Airlines agreed to merge with the smaller carrier, paving the way for the creation of the nation’s largest airline.

The boards of the companies have unanimously approved the deal, valued at $11 billion, according to a news release on Thursday morning. A merger would bolster American’s domestic footprint, strengthen its presence in the Northeast and give it a bigger network to attract business travelers and corporate accounts.

Under the terms of the deal, US Airways shareholders would own 28 percent of the combined airline, while American Airlines shareholders, creditors, labor unions and employees would own 72 percent.

The merger would create a company with the size and breadth to compete against United Airlines and Delta Air Lines, which have grown through mergers of their own in recent years and are currently the biggest domestic carriers. The combined airline will have more than 100 million frequent fliers.

But while United and Delta went through bankruptcies and mergers in the last decade, American has been steadily losing ground while racking up losses that have totaled more than $12 billion since 2001. It was the last major airline to seek court protection to reorganize its business, filing for bankruptcy in November 2011.

The wave of big mergers in the industry has created healthier and more profitable airlines that are now better able to invest in new planes and products, including Wi-Fi, individual entertainment screens and more comfortable seats for business passengers. But some consumer advocates said they worried that reducing the number of airlines would lead to higher fares over the long run and allow airlines to increase revenue by imposing new or higher fees.

The deal, which was completed in recent days, could be formalized as American leaves bankruptcy. W. Douglas Parker, the chairman and chief executive of US Airways, would take over as American’s chief executive. Thomas W. Horton, chairman and chief executive of the AMR Corporation, American’s parent, would be chairman of the combined company, though his tenure could be limited.

“I have been a long proponent of consolidation in the industry,” Mr. Parker said on a conference call. “And this is the last major piece needed to rationalize the industry and make it profitable.”

Mr. Parker said that the two airlines have only 12 routes overlapping out of a combined 900 routes that the two airlines serve together. In addition, he said, more cities would be service: American flies to 130 cities that US Airways does not fly, and, likewise, US Airways flies to 62 cities that are not served by American.

“This is an extremely complementary merger,” Mr. Parkersaid.

The combined airline will offer 6,700 daily flights to 336 destinations in 56 countries. It said that it expected to keep all its hubs.

The merger still needs to pass several steps. It must be approved by American’s bankruptcy judge in New York. US Airways shareholders would also have to approve the deal.

In addition, it will be reviewed by the Justice Department’s antitrust division, though analysts expect regulators to clear the deal. The two companies expect the merger be completed in the third quarter.

If approved, the nation’s top four airlines — American, United, Delta and Southwest Airlines — would control nearly 70 percent of the domestic market.

The merger is a victory for Mr. Parker. Over the last year, he persuaded American’s creditors that the carrier needed to expand its network to compete. In April, he won the critical backing of American’s three labor groups, which defied American’s management and publicly endorsed a deal with US Airways.

The biggest challenge for the merged company, to be called American Airlines, will be to integrate operations over the next couple of years. That is no easy task since airline mergers are often rocky — involving complex technological systems, big reservation networks as well as large labor groups with different corporate cultures that all need to be seamlessly combined.

United angered passengers last year after a series of merger-related computer and reservation mistakes, and late and delayed flights.

Mr. Parker has done this before. In 2005, when he was the head of America West, he engineered a merger with the larger US Airways.

In this case, the merged American Airlines will still be based in Fort Worth and have a combined 94,000 employees, 950 planes, 6,500 daily flights, eight major hubs and total revenue of nearly $39 billion. It would be the market leader on the East Coast, the Southwest and South America. But it would remain a smaller player in Europe, where United and Delta are stronger. The merger does little to bolster American’s presence in Asia, where it trails far behind its rivals.

American has major hubs in Dallas, Miami, Chicago, Los Angeles and New York. US Airways has hubs in Phoenix, Philadelphia and Charlotte, N.C., and has a big presence at Ronald Reagan National Airport in Washington.

In reviewing previous mergers, federal regulators have not focused on the overall size of the combined airline but instead looked at whether a merger would decrease competition in individual cities. To do so, regulators examine specific routes, or city-pairs, and look at whether a merger reduces the number of airlines there.

The last time the Justice Department challenged a merger was the proposed combination between United Airlines and US Airways in 2001. It rejected that on the ground that it would reduce consumer choice and possibly lead to higher fares.

Since then, the department has allowed a wave of big mergers that have reshaped the industry, said Alison L. Smith, a former antitrust official and now a partner in the law firm McDermott Will & Emery.

American and US Airways only have about 12 overlapping routes, a figure that is unlikely to set off regulatory opposition, she said. One problem, however, could come up at National Airport, where the combined carriers hold a market share of about 60 percent. There, regulators might request that American give up some takeoff and landing rights before approving the merger.

Regulators sought similar concessions from United at Newark Liberty International Airport after its merger with Continental Airlines.

It is also unclear whether American needs all of its combined hubs. Analysts pointed out that Phoenix was at risk because of its proximity to Dallas, since it makes little sense to have two big hubs so close to each other.

Despite the increased concentration, consumers can still expect to find vibrant competition, said William S. Swelbar, a research engineer at the Massachusetts Institute of Technology’s International Center for Air Transportation.

“We will have four very big, very vigorous competitors in the market,” he said.

Travelers are better served by bigger airlines offering more connecting flights and more destinations, analysts say. Consumers today can easily compare fares and shop for the cheapest flight online, which helps keep airfares in check.

But Kevin Mitchell, chairman of the Business Travel Coalition, disagreed. He said consumers would see few benefits to offset the merger’s negative effects — including “reduced competition, higher fares and fees, and diminished service to small and midsize communities.”

Michael J. de la Merced contributed reporting.

A version of this article appeared in print on 02/14/2013, on page B1 of the NewYork edition with the headline: Air Carriers Are Said To Agree To a Merger.

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Well: Afraid to Speak Up to Medical Power

The slender, weather-beaten, elderly Polish immigrant had been diagnosed with lung cancer nearly a year earlier and was receiving chemotherapy as part of a clinical trial. I was a surgical consultant, called in to help control the fluid that kept accumulating in his lungs.

During one visit, he motioned for me to come closer. His voice was hoarse from a tumor that spread, and the constant hissing from his humidified oxygen mask meant I had to press my face nearly against his to understand his words.

“This is getting harder, doctor,” he rasped. “I’m not sure I’m up to anymore chemo.”

I was not the only doctor that he confided to. But what I quickly learned was that none of us was eager to broach the topic of stopping treatment with his primary cancer doctor.

That doctor was a rising superstar in the world of oncology, a brilliant physician-researcher who had helped discover treatments for other cancers and who had been recruited to lead our hospital’s then lackluster cancer center. Within a few months of the doctor’s arrival, the once sleepy department began offering a dazzling array of experimental drugs. Calls came in from outside doctors eager to send their patients in for treatment, and every patient who was seen was promptly enrolled in one of more than a dozen well-documented treatment protocols.

But now, no doctors felt comfortable suggesting anything but the most cutting-edge, aggressive treatments.

Even the No. 2 doctor in the cancer center, Robin to the chief’s cancer-battling Batman, was momentarily taken aback when I suggested we reconsider the patient’s chemotherapy plan. “I don’t want to tell him,” he said, eyes widening. He reeled off his chief’s vast accomplishments. “I mean, who am I to tell him what to do?”

We stood for a moment in silence before he pointed his index finger at me. “You tell him,” he said with a smile. “You tell him to consider stopping treatment.”

Memories of this conversation came flooding back last week when I read an essay on the problems posed by hierarchies within the medical profession.

For several decades, medical educators and sociologists have documented the existence of hierarchies and an intense awareness of rank among doctors. The bulk of studies have focused on medical education, a process often likened to military and religious training, with elder patriarchs imposing the hair shirt of shame on acolytes unable to incorporate a profession’s accepted values and behaviors. Aspiring doctors quickly learn whose opinions, experiences and voices count, and it is rarely their own. Ask a group of interns who’ve been on the wards for but a week, and they will quickly raise their hands up to the level of their heads to indicate their teachers’ status and importance, then lower them toward their feet to demonstrate their own.

It turns out that this keen awareness of ranking is not limited to students and interns. Other research has shown that fully trained physicians are acutely aware of a tacit professional hierarchy based on specialties, like primary care versus neurosurgery, or even on diseases different specialists might treat, like hemorrhoids and constipation versus heart attacks and certain cancers.

But while such professional preoccupation with privilege can make for interesting sociological fodder, the real issue, warns the author of a courageous essay published recently in The New England Journal of Medicine, is that such an overly developed sense of hierarchy comes at an unacceptable price: good patient care.

Dr. Ranjana Srivastava, a medical oncologist at the Monash Medical Centre in Melbourne, Australia, recalls a patient she helped to care for who died after an operation. Before the surgery, Dr. Srivastava had been hesitant to voice her concerns, assuming that the patient’s surgeon must be “unequivocally right, unassailable, or simply not worth antagonizing.” When she confesses her earlier uncertainty to the surgeon after the patient’s death, Dr. Srivastava learns that the surgeon had been just as loath to question her expertise and had assumed that her silence before the surgery meant she agreed with his plan to operate.

“Each of us was trying our best to help a patient, but we were also respecting the boundaries and hierarchy imposed by our professional culture,” Dr. Srivastava said. “The tragedy was that the patient died, when speaking up would have made all the difference.”

Compounding the problem is an increasing sense of self-doubt among many doctors. With rapid advances in treatment, there is often no single correct “answer” for a patient’s problem, and doctors, struggling to stay up-to-date in their own particular specialty niches, are more tentative about making suggestions that cross over to other doctors’ “turf.” Even as some clinicians attempt to compensate by organizing multidisciplinary meetings, inviting doctors from all specialties to discuss a patient’s therapeutic options, “there will inevitably be a hierarchy at those meetings of who is speaking,” Dr. Srivastava noted. “And it won’t always be the ones who know the most about the patient who will be taking the lead.”

It is the potentially disastrous repercussions for patients that make this overly developed awareness of rank and boundaries a critical issue in medicine. Recent efforts to raise safety standards and improve patient care have shown that teams are a critical ingredient for success. But simply organizing multidisciplinary lineups of clinicians isn’t enough. What is required are teams that recognize the importance of all voices and encourage active and open debate.

Since their patient’s death, Dr. Srivastava and the surgeon have worked together to discuss patient cases, articulate questions and describe their own uncertainties to each other and in patients’ notes. “We have tried to remain cognizant of the fact that we are susceptible to thinking about hierarchy,” Dr. Srivastava said. “We have tried to remember that sometimes, despite our best intentions, we do not speak up for our patients because we are fearful of the consequences.”

That was certainly true for my lung cancer patient. Like all the other doctors involved in his care, I hesitated to talk to the chief medical oncologist. I questioned my own credentials, my lack of expertise in this particular area of oncology and even my own clinical judgment. When the patient appeared to fare better, requiring less oxygen and joking and laughing more than I had ever seen in the past, I took his improvement to be yet another sign that my attempt to talk about holding back chemotherapy was surely some surgical folly.

But a couple of days later, the humidified oxygen mask came back on. And not long after that, the patient again asked for me to come close.

This time he said: “I’m tired. I want to stop the chemo.”

Just before he died, a little over a week later, he was off all treatment except for what might make him comfortable. He thanked me and the other doctors for our care, but really, we should have thanked him and apologized. Because he had pushed us out of our comfortable, well-delineated professional zones. He had prodded us to talk to one another. And he showed us how to work as a team in order to do, at last, what we should have done weeks earlier.

Read More..

Well: Afraid to Speak Up to Medical Power

The slender, weather-beaten, elderly Polish immigrant had been diagnosed with lung cancer nearly a year earlier and was receiving chemotherapy as part of a clinical trial. I was a surgical consultant, called in to help control the fluid that kept accumulating in his lungs.

During one visit, he motioned for me to come closer. His voice was hoarse from a tumor that spread, and the constant hissing from his humidified oxygen mask meant I had to press my face nearly against his to understand his words.

“This is getting harder, doctor,” he rasped. “I’m not sure I’m up to anymore chemo.”

I was not the only doctor that he confided to. But what I quickly learned was that none of us was eager to broach the topic of stopping treatment with his primary cancer doctor.

That doctor was a rising superstar in the world of oncology, a brilliant physician-researcher who had helped discover treatments for other cancers and who had been recruited to lead our hospital’s then lackluster cancer center. Within a few months of the doctor’s arrival, the once sleepy department began offering a dazzling array of experimental drugs. Calls came in from outside doctors eager to send their patients in for treatment, and every patient who was seen was promptly enrolled in one of more than a dozen well-documented treatment protocols.

But now, no doctors felt comfortable suggesting anything but the most cutting-edge, aggressive treatments.

Even the No. 2 doctor in the cancer center, Robin to the chief’s cancer-battling Batman, was momentarily taken aback when I suggested we reconsider the patient’s chemotherapy plan. “I don’t want to tell him,” he said, eyes widening. He reeled off his chief’s vast accomplishments. “I mean, who am I to tell him what to do?”

We stood for a moment in silence before he pointed his index finger at me. “You tell him,” he said with a smile. “You tell him to consider stopping treatment.”

Memories of this conversation came flooding back last week when I read an essay on the problems posed by hierarchies within the medical profession.

For several decades, medical educators and sociologists have documented the existence of hierarchies and an intense awareness of rank among doctors. The bulk of studies have focused on medical education, a process often likened to military and religious training, with elder patriarchs imposing the hair shirt of shame on acolytes unable to incorporate a profession’s accepted values and behaviors. Aspiring doctors quickly learn whose opinions, experiences and voices count, and it is rarely their own. Ask a group of interns who’ve been on the wards for but a week, and they will quickly raise their hands up to the level of their heads to indicate their teachers’ status and importance, then lower them toward their feet to demonstrate their own.

It turns out that this keen awareness of ranking is not limited to students and interns. Other research has shown that fully trained physicians are acutely aware of a tacit professional hierarchy based on specialties, like primary care versus neurosurgery, or even on diseases different specialists might treat, like hemorrhoids and constipation versus heart attacks and certain cancers.

But while such professional preoccupation with privilege can make for interesting sociological fodder, the real issue, warns the author of a courageous essay published recently in The New England Journal of Medicine, is that such an overly developed sense of hierarchy comes at an unacceptable price: good patient care.

Dr. Ranjana Srivastava, a medical oncologist at the Monash Medical Centre in Melbourne, Australia, recalls a patient she helped to care for who died after an operation. Before the surgery, Dr. Srivastava had been hesitant to voice her concerns, assuming that the patient’s surgeon must be “unequivocally right, unassailable, or simply not worth antagonizing.” When she confesses her earlier uncertainty to the surgeon after the patient’s death, Dr. Srivastava learns that the surgeon had been just as loath to question her expertise and had assumed that her silence before the surgery meant she agreed with his plan to operate.

“Each of us was trying our best to help a patient, but we were also respecting the boundaries and hierarchy imposed by our professional culture,” Dr. Srivastava said. “The tragedy was that the patient died, when speaking up would have made all the difference.”

Compounding the problem is an increasing sense of self-doubt among many doctors. With rapid advances in treatment, there is often no single correct “answer” for a patient’s problem, and doctors, struggling to stay up-to-date in their own particular specialty niches, are more tentative about making suggestions that cross over to other doctors’ “turf.” Even as some clinicians attempt to compensate by organizing multidisciplinary meetings, inviting doctors from all specialties to discuss a patient’s therapeutic options, “there will inevitably be a hierarchy at those meetings of who is speaking,” Dr. Srivastava noted. “And it won’t always be the ones who know the most about the patient who will be taking the lead.”

It is the potentially disastrous repercussions for patients that make this overly developed awareness of rank and boundaries a critical issue in medicine. Recent efforts to raise safety standards and improve patient care have shown that teams are a critical ingredient for success. But simply organizing multidisciplinary lineups of clinicians isn’t enough. What is required are teams that recognize the importance of all voices and encourage active and open debate.

Since their patient’s death, Dr. Srivastava and the surgeon have worked together to discuss patient cases, articulate questions and describe their own uncertainties to each other and in patients’ notes. “We have tried to remain cognizant of the fact that we are susceptible to thinking about hierarchy,” Dr. Srivastava said. “We have tried to remember that sometimes, despite our best intentions, we do not speak up for our patients because we are fearful of the consequences.”

That was certainly true for my lung cancer patient. Like all the other doctors involved in his care, I hesitated to talk to the chief medical oncologist. I questioned my own credentials, my lack of expertise in this particular area of oncology and even my own clinical judgment. When the patient appeared to fare better, requiring less oxygen and joking and laughing more than I had ever seen in the past, I took his improvement to be yet another sign that my attempt to talk about holding back chemotherapy was surely some surgical folly.

But a couple of days later, the humidified oxygen mask came back on. And not long after that, the patient again asked for me to come close.

This time he said: “I’m tired. I want to stop the chemo.”

Just before he died, a little over a week later, he was off all treatment except for what might make him comfortable. He thanked me and the other doctors for our care, but really, we should have thanked him and apologized. Because he had pushed us out of our comfortable, well-delineated professional zones. He had prodded us to talk to one another. And he showed us how to work as a team in order to do, at last, what we should have done weeks earlier.

Read More..

Gadgetwise Blog: Tip of the Week: Adjusting Facebook Photo Previews

Hate the way Facebook seems to arbitrarily crop photos you post on your Timeline to fit the square preview windows? On the desktop version, you can change which part of the picture shows in the preview when you’re using Facebook through your Web browser.

To do so, pass the cursor over the image and then click the pencil icon that appears in the top right corner of the post. On the menu that appears, choose Reposition Photo. Click the cursor onto the photo and drag the image until you have the crop you desire for the preview window. Click the Save button. Even though you have now made the photo more appealing for friends browsing your Timeline page, the original image remains uncropped and expands into the full view when someone clicks on the preview window.

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Way of the World: Technology, Trade and Fewer Jobs

NEW YORK — President Barack Obama’s State of the Union speech this week confirmed it: The pre-eminent political and economic challenge in the industrialized democracies is how to make capitalism work for the middle class.

There is nothing mysterious about that. The most important fact about the United States in this century is that middle-class incomes are stagnating. The financial crisis has revealed an equally stark structural problem in much of Europe.

Even in a relatively prosperous age — for all of today’s woes, we have left behind the dark, satanic mills and workhouses of the 19th century — this decline of the middle class is more than an economic issue. It is also a political one. The main point of democracy is to deliver positive results for the majority.

All of which is why understanding what is happening to the middle class is urgently important. There is no better place to start than by talking to David Autor, an economics professor at the Massachusetts Institute of Technology. Mr. Autor is one of the leading students of the most striking trend bedeviling the middle class: the polarization of the job market. That is a nice way of saying the economy is being cleaved into high-paying jobs at the top and low-paying jobs at the bottom, while the middle-skill and middle-wage jobs that used to form society’s backbone are being hollowed out.

But when I asked him this week what had gone wrong for the U.S. middle class, he gave a different answer: “The main problem is we’ve just had a decade of incredibly anemic employment growth. All of a sudden, around 2000 and 2001, things just slowed down.”

Academics can usually be counted on to have a confident explanation for everything. That is why I was surprised and impressed by Mr. Autor’s answer when I asked him where the jobs had gone. “No one really understands why that is the case,” he said.

It was a winningly modest reply. But work by Mr. Autor and two colleagues — David Dorn, a visiting professor at Harvard, and Gordon Hanson of the University of California, San Diego — is starting to untangle the two forces that both the conventional wisdom and the academy agree are probably responsible for a lot of what is happening to the middle class.

Those forces are technological change and trade. The easy assumption is that the two go together. After all, trade needs technology — it is hard to imagine outsourcing without the Internet, sophisticated logistics systems and jet travel. Technology is dependent on trade, too: The opportunity for global scale is one reason technological innovation has yielded such outsize rewards.

But in a careful study of local labor markets in the United States, Mr. Autor, Mr. Dorn and Mr. Hanson have found that trade and technology had very different consequences for jobs.

“We were surprised at how distinct the two were,” Mr. Autor said. “We found that the trade shock had a very measurable impact on the employment rate. Technology led to job polarization, but its employment effect was minimal.” Trade, at least in the short term, really did ship jobs overseas. Technology did not kill jobs per se, but it did hollow out those essential jobs in the middle.

The big surprise, at least for believers (like me) in the classic liberal economic view that trade benefits both parties, is the strong and negative impact of globalization on U.S. workers — Mr. Autor estimates it accounts for 15 to 20 percent of jobs lost.

“The rise of China was such a huge change. It really did matter,” Mr. Autor said. “First, China is such a huge country. Two, China was 40 or 50 years behind in technology, so it had a lot of catching up to do. Third, it happened so fast.”

What is striking, and frightening, is the extent to which, at least in the U.S.-China trade relationship, the knee-jerk, populist fears intellectuals tend to deride actually turned out to be true.

“U.S.-China trade is almost a one-way street. This trade relationship doesn’t clearly give you the benefit that you can sell a lot of stuff to your trade partner,” Mr. Dorn said. “If you talk to someone who is somehow involved in the promotion of free trade, they may say that maybe the headquarters of Apple benefits. That may be true. But the first-order effect is of job loss.”

The impact of technology is more familiar. Mr. Autor, Mr. Dorn and Mr. Hanson found that it did not create fewer jobs overall, but it did hollow out the jobs in the middle.

“Technology has really changed the distribution of occupation. That doesn’t necessarily go hand in hand with reduced unemployment, but it creates a more bimodal set of opportunities,” Mr. Autor said. “There is an abundance of work to do in food service and there is an abundance of work in finance, but there are fewer middle-wage, middle-income jobs.”

What is challenging about both of these trends, and what makes the hollowing out of the middle class a political problem as well as an economic one, is how different they look depending on whether you own a company or work for one.

Shipping middle-class jobs to China, or hollowing them out with machines, is a win for smart managers and their shareholders. We call the result higher productivity. But looked at through the lens of middle-class jobs, it is a loss. That profound difference is why politics in the rich democracies are so polarized right now. Capitalism and democracy are at cross-purposes, and no one yet has a clear plan for reconciling them.

Chrystia Freeland is editor of Thomson Reuters Digital.

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Deal Professor: Unusual Moves in Confronting Apple's Huge Pile of Cash

The fight over Apple’s $140 billion cash pile is proving the adage that money can make people do strange things.

And it is not just Apple that is doing things it would not have done before. The hedge fund manager David Einhorn, famous for shorting stocks like Lehman Brothers, has gone long on Apple, betting heavily that Apple’s stock is undervalued — and blaming that eye-popping mountain of money.

While most of us would think that having tens of billions would be wonderful, it’s actually a problem for Apple. The money just sits there, not earning much in an environment of extremely low interest rates. And the problem is only getting worse. Apple is accumulating money at an enormous rate — more than $23 billion in the last quarter alone.

It was a more manageable issue when Apple was a rapidly growing stock, but since September Apple’s share price has fallen to roughly $470, from over $700.

According to Mr. Einhorn, roughly $145 of that share price represents Apple’s cash mountain. This means that the market is assigning a low multiple, about seven times earnings, to the rest of Apple’s business.

Multiples for Google are almost three times as much. Apple’s multiple is even less than Microsoft’s — a company whose revenue largely comes from PC operating software, which some people worry is a melting iceberg.

When it came to the buildup of cash, Steven P. Jobs, Apple’s co-founder and former chief executive, simply ignored a problem he had helped create. Mindful of Apple’s past financial difficulties before his return in 1997, he wanted a fortress of cash to protect the company. So he drew a line in the sand, saying no to dividends. After his death, Apple caved a little, announcing a dividend and share repurchase program worth $45 billion.

It’s still not enough for shareholders who want to increase Apple’s multiple and stock price. The fundamental idea is that shareholders could put this money to better use than Apple can, and that its stock would trade higher without the cash.

The problem is that even if Apple wanted to return all its cash to shareholders, it can’t. Much of the cash is held abroad in foreign subsidiaries. If the company repatriates it to return to shareholders, it would have to pay taxes on it. Instead, the company is letting the cash sit there in the apparent expectation that there will be federal tax relief.

It’s here that Mr. Einhorn enters the picture. He has been buying Apple shares for a few years, and his fund owns more than 1.3 million shares. The hedge fund magnate wants Apple’s stock to earn a higher multiple by dealing with the cash problem.

But Mr. Einhorn is also impatient and unwilling to wait for federal tax relief. Instead, he has a clever idea. At an investment conference last May, Mr. Einhorn proposed that Apple issue $500 billion of perpetual preferred stock free to all shareholders. The preferred stock would yield 4 percent and be freely tradable.

So, how will this increase the value of the company? It’s financial wizardry. If Apple issued debt, the market would be expected to subtract this value from Apple’s worth. But the preferred stock would not be treated as debt, for accounting purposes at least.

The only change would be that Apple’s income would be reduced by the amount of the interest paid on $500 billion, or $20 billion a year. If Apple stays at the same multiple, it would give the company a net worth of $300 billion or so. But now the $500 billion in preferred stock would be added, making the company worth $800 billion.

How can one plus one equal four? It depends on whether the market thinks that the $500 billion is not debt and never has to be repaid. If so, then this amount will not be deducted from Apple’s worth. It’s something that may work in theory in our sometimes puzzling financial markets, but no company has ever tried it.

Some experts are skeptical. Aswath Damodaran, a finance professor at New York University, has called the plan financial alchemy and written that it would “not add value to the company, not one cent.” When asked to comment, Mr. Einhorn said, “Professor Damodaran’s analysis brings to memory the old joke about the economist who refused to pick up a $100 bill on the street because in an efficient economy, there can’t be $100 bills lying around.”

Apple’s response to Mr. Einhorn has been equally clever. One would think that the maker of the iPad would just sit above the fray and do what it has traditionally done — ignore its shareholders. But with a declining stock price, that may no longer be a luxury Apple can afford. So, it has engaged with Mr. Einhorn to discuss his proposal. And the notoriously shareholder-unfriendly company has turned strangely in favor of good corporate governance.

In its latest proxy statement, Apple proposes to amend its charter to allow for election of directors only by a majority of shareholders. It also proposes to eliminate a provision called “blank check preferred,” which allows a company to issue preferred shares in unlimited number and type. Almost every company has this provision, but shareholder activists hate it because it can be used as a takeover defense, allowing a company to issue preferred stocks with significant voting rights to a friendly party.

While the proposal to eliminate the preferred shares appears worthy and has been endorsed by the California Public Employees’ Retirement System, the giant pension fund, this proposal is really about Mr. Einhorn.

The amendment has the convenient effect of eliminating the board’s ability to adopt the hedge fund magnate’s plan. Apple says that it just wants to be a good corporate citizen and shareholders can still vote to adopt Mr. Einhorn’s plan. But let’s face it, Apple would be one of the few companies in the United States to ever abolish its blank check preferred provision.

Apple has not been a paragon of corporate governance. That may not be surprising, given that its board has directors like Millard S. Drexler of J. Crew, who surreptitiously took his company private. And Apple has received negative marks in recent years from proxy advisory firms like Institutional Shareholder Services for giving its chief executive, Timothy D. Cook, almost $400 million in stock options in one year.

It’s an odd state of events.

By all accounts, it would appear to be a topsy-turvy world. Apple has turned defensive, while Mr. Einhorn is picking a public fight with a company he is betting on, instead of betting against.

Perhaps this column should have instead started with an adage from the movie “Wall Street” that money “makes you do things you don’t want to do.”

Yet Apple is not doing itself any favors by trying to do an end run around Mr. Einhorn.

He has sued Apple, claiming that the company’s proposal violates the securities laws, but the dispute is “a silly sideshow,” as Mr. Cook put it on Tuesday. Even if Mr. Einhorn wins, it would only force Apple to have a separate vote on the preferred share issue, something it is likely to win.

Even so, it might be better if Apple simply addressed Mr. Einhorn’s proposal head-on. After all, his proposal is clever, but untested. It may work, but it may not. Why should the world’s most valuable company be run as an experiment in finance?

Still, the world is changing. Apple may be a highflier, but its growth prospects are not as exciting as they seemed to be a year ago. Its stock may simply be deflating from an overheated place.

And that’s the oddest thing of all. Despite Apple’s growing cash pile, the company’s value is shrinking. But instead of focusing on making Apple an even better business, shareholders are trying to rescue their bubblelike bets with financial gimmickry, and Apple is engaging in its own gimmicks to defeat them. Even Apple can be consumed by the strange world of Wall Street.

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A version of this article appeared in print on 02/13/2013, on page B7 of the NewYork edition with the headline: Unusual Moves in Confronting Apple’s Mountain of Cash.

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Phys Ed: Getting the Right Dose of Exercise

Phys Ed

Gretchen Reynolds on the science of fitness.

A common concern about exercise is that if you don’t do it almost every day, you won’t achieve much health benefit. But a commendable new study suggests otherwise, showing that a fairly leisurely approach to scheduling workouts may actually be more beneficial than working out almost daily.

For the new study, published this month in Exercise & Science in Sports & Medicine, researchers at the University of Alabama at Birmingham gathered 72 older, sedentary women and randomly assigned them to one of three exercise groups.

One group began lifting weights once a week and performing an endurance-style workout, like jogging or bike riding, on another day.

Another group lifted weights twice a week and jogged or rode an exercise bike twice a week.

The final group, as you may have guessed, completed three weight-lifting and three endurance sessions, or six weekly workouts.

The exercise, which was supervised by researchers, was easy at first and meant to elicit changes in both muscles and endurance. Over the course of four months, the intensity and duration gradually increased, until the women were jogging moderately for 40 minutes and lifting weights for about the same amount of time.

The researchers were hoping to find out which number of weekly workouts would be, Goldilocks-like, just right for increasing the women’s fitness and overall weekly energy expenditure.

Some previous studies had suggested that working out only once or twice a week produced few gains in fitness, while exercising vigorously almost every day sometimes led people to become less physically active, over all, than those formally exercising less. Researchers theorized that the more grueling workout schedule caused the central nervous system to respond as if people were overdoing things, sending out physiological signals that, in an unconscious internal reaction, prompted them to feel tired or lethargic and stop moving so much.

To determine if either of these possibilities held true among their volunteers, the researchers in the current study tracked the women’s blood levels of cytokines, a substance related to stress that is thought to be one of the signals the nervous system uses to determine if someone is overdoing things physically. They also measured the women’s changing aerobic capacities, muscle strength, body fat, moods and, using sophisticated calorimetry techniques, energy expenditure over the course of each week.

By the end of the four-month experiment, all of the women had gained endurance and strength and shed body fat, although weight loss was not the point of the study. The scientists had not asked the women to change their eating habits.

There were, remarkably, almost no differences in fitness gains among the groups. The women working out twice a week had become as powerful and aerobically fit as those who had worked out six times a week. There were no discernible differences in cytokine levels among the groups, either.

However, the women exercising four times per week were now expending far more energy, over all, than the women in either of the other two groups. They were burning about 225 additional calories each day, beyond what they expended while exercising, compared to their calorie burning at the start of the experiment.

The twice-a-week exercisers also were using more energy each day than they had been at first, burning almost 100 calories more daily, in addition to the calories used during workouts.

But the women who had been assigned to exercise six times per week were now expending considerably less daily energy than they had been at the experiment’s start, the equivalent of almost 200 fewer calories each day, even though they were exercising so assiduously.

“We think that the women in the twice-a-week and four-times-a-week groups felt more energized and physically capable” after several months of training than they had at the start of the study, says Gary Hunter, a U.A.B. professor who led the experiment. Based on conversations with the women, he says he thinks they began opting for stairs over escalators and walking for pleasure.

The women working out six times a week, though, reacted very differently. “They complained to us that working out six times a week took too much time,” Dr. Hunter says. They did not report feeling fatigued or physically droopy. Their bodies were not producing excessive levels of cytokines, sending invisible messages to the body to slow down.

Rather, they felt pressed for time and reacted, it seems, by making choices like driving instead of walking and impatiently avoiding the stairs.

Despite the cautionary note, those who insist on working out six times per week need not feel discouraged. As long as you consciously monitor your activity level, the findings suggest, you won’t necessarily and unconsciously wind up moving less over all.

But the more fundamental finding of this study, Dr. Hunter says, is that “less may be more,” a message that most likely resonates with far more of us. The women exercising four times a week “had the greatest overall increase in energy expenditure,” he says. But those working out only twice a week “weren’t far behind.”

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