Antismoking Outlays Drop Despite Tobacco Revenue

Faced with tight budgets, states have spent less on tobacco prevention over the past two years than in any period since the national tobacco settlement in 1998, despite record high revenues from the settlement and tobacco taxes, according to a report to be released on Thursday.

Paul J. Richards/Agence France-Presse — Getty Images

State antismoking spending is the lowest since the 1998 national tobacco settlement.

States are on track to collect a record $25.7 billion in tobacco taxes and settlement money in the current fiscal year, but they are set to spend less than 2 percent of that on prevention, according to the report, by the Campaign for Tobacco-Free Kids, which compiles the revenue data annually. The figures come from state appropriations for the fiscal year ending in June.

The settlement awarded states an estimated $246 billion over its first 25 years. It gave states complete discretion over the money, and many use it for programs unrelated to tobacco or to plug budget holes. Public health experts say it lacks a mechanism for ensuring that some portion of the money is set aside for tobacco prevention and cessation programs.

“There weren’t even gums, let alone teeth,” Timothy McAfee, the director of the Office on Smoking and Health at the Centers for Disease Control and Prevention, said, referring to the allocation of funds for tobacco prevention and cessation in the terms of the settlement.

Spending on tobacco prevention peaked in 2002 at $749 million, 63 percent above the level this year. After six years of declines, spending ticked up again in 2008, only to fall by 36 percent during the recession, the report said.

Tobacco use is the No. 1 cause of preventable death in the United States, killing more than 400,000 Americans every year, according to the C.D.C.

The report did not count federal money for smoking prevention, which Vince Willmore, the vice president for communications at the Campaign for Tobacco-Free Kids, estimated to be about $522 million for the past four fiscal years. The sum — about $130 million a year — was not enough to bring spending back to earlier levels.

The $500 million a year that states spend on tobacco prevention is a tiny fraction of the $8 billion a year that tobacco companies spend to market their products, according to a Federal Trade Commission report in September.

Nationally, 19 percent of adults smoke, down from over 40 percent in 1965. But rates remain high for less-educated Americans. Twenty-seven percent of Americans with only a high school diploma smoke, compared with just 8 percent of those with a college degree or higher, according to C.D.C. data from 2010. The highest rate — 34 percent — was among black men who did not graduate from high school.

“Smoking used to be the rich man’s habit,” said Danny McGoldrick, the vice president for research at the Campaign for Tobacco-Free Kids, “and now it’s decidedly a poor person’s behavior.”

Aggressive antismoking programs are the main tools that cities and states have to reach the demographic groups in which smoking rates are the highest, making money to finance them even more critical, Mr. McGoldrick said.

The decline in spending comes amid growing certainty among public health officials that antismoking programs, like help lines and counseling, actually work. California went from having a smoking rate above the national average 20 years ago to having the second-lowest rate in the country after modest but consistent spending on programs that help people quit and prevent children from starting, Dr. McAfee said.

An analysis by Washington State, cited in the report, found that it saved $5 in tobacco-related hospitalization costs for every $1 spent during the first 10 years of its program.

Budget cuts have eviscerated some of the most effective tobacco prevention programs, the report said. This year, state financing for North Carolina’s program has been eliminated. Washington State’s program has been cut by about 90 percent in recent years, and for the third year in a row, Ohio has not allocated any state money for what was once a successful program, the report said.

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Apple to Resume U.S. Manufacturing

For the first time in years, Apple will manufacture computers in the United States, the chief executive of Apple, Timothy D. Cook, said in interviews with NBC and Bloomberg Businessweek.

“Next year, we will do one of our existing Mac lines in the United States,” he said in an interview to be broadcast Thursday on “Rock Center With Brian Williams” on NBC.

Apple, the biggest company in the world by market value, moved most of its manufacturing to Asia in the late 1990s. As an icon of American technology success and innovation, the California-based company has been criticized in recent years for outsourcing jobs abroad.

“I don’t think we have a responsibility to create a certain kind of job,” Mr. Cook said in the Businessweek interview. “But I think we do have a responsibility to create jobs.”

The company plans to spend $100 million on the American manufacturing in 2013, according to the interviews, a small fraction of its overall factory investments and an even tinier portion of its available cash.

In the interviews, Mr. Cook suggested the company would work with partners and that the manufacturing would be more than just the final assembly of parts. He noted that parts of the company’s ubiquitous iPhone, including the “engine” and the glass screen, were already made in America. The processor is manufactured by Samsung in Texas, while Corning makes the glass screen in Kentucky.

Over the last few years, sales of the iPhone, iPod and iPad have overwhelmed Apple’s line of Macintosh computers, the basis of the company’s early business. Revenue from the iPhone alone made up 48 percent of the company’s total revenue for its fiscal fourth quarter ended Sept. 30.

But as recently as October, Apple introduced a new, thinner iMac, the product that pioneered the technique of building the computer innards inside the flat screen.

Mr. Cook did not say in the interviews where in the United States the new manufacturing would occur. But he did defend Apple’s track record in American hiring.

“When you back up and look at Apple’s effect on job creation in the United States, we estimate that we’ve created more than 600,000 jobs now,” Mr. Cook told Businessweek. Those jobs include positions at partners and suppliers.

Steve Dowling, a spokesman for Apple, declined on Thursday to provide additional details on Apple’s plans, referring to Mr. Cook’s interviews.

Apple has for years done the final assembly of some Macs in the United States, mainly systems that customers buy with custom configurations, like bigger hard drives and more memory than on standard machines.

Mr. Cook’s statements suggested Apple is planning to build more of the Mac’s ingredients domestically, although with partners. He told Businessweek that the plan “doesn’t mean that Apple will do it ourselves, but we’ll be working with people, and we’ll be investing our money.”

While Apple’s products are typically made in Asian factories owned by other companies, Apple itself often purchases the sophisticated manufacturing equipment required to make its cutting-edge designs, spending billions of dollars a year on such machines.

Foxconn Technology, which manufactures more than 40 percent of the world’s electronics, is one of Apple’s main overseas manufacturing contractors. Based in Taiwan, Foxconn is China’s largest private employer, with 1.2 million workers, and it has come under intense scrutiny over working conditions inside its factories.

In March, Foxconn pledged to sharply curtail the number of working hours and significantly increase wages. The announcement was a response to a far-ranging inspection by the Fair Labor Association, a monitoring group that found widespread problems — including numerous instances where Foxconn violated Chinese law and industry codes of conduct.

Apple, which recently joined the labor association, had asked the group to investigate plants manufacturing iPhones, iPads and other devices. A growing outcry over conditions at overseas factories prompted protests and petitions, and several labor rights organizations started scrutinizing Apple’s suppliers.

Almost all of the 70 million iPhones, 30 million iPads and 59 million other products Apple sold in 2011 were manufactured overseas. Apple employs 43,000 people in the United States and 20,000 overseas. An additional 700,000 people engineer, build and assemble iPads, iPhones and Apple’s other products, mostly abroad.

At a meeting with Silicon Valley executives in 2011, President Obama asked Steven P. Jobs, then the Apple chief executive, what it would take to make iPhones in the United States. Mr. Jobs, who died later that year, told the president, “Those jobs aren’t coming back.”

Nick Wingfield contributed reporting.

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Britons Are Warned of Lingering Austerity

Andrew Winning/Reuters

A closed business in London. A nonpartisan agency monitoring the data said it expected the economy to shrink this year.

LONDON — Britons, many already weary of government austerity budgets that some economists say are impeding the country’s recovery, are going to have to wait even longer for relief.

The architect of the austerity program, George Osborne, the chancellor of the Exchequer, told Parliament on Wednesday that the government had missed one of its self-imposed debt-cutting goals and would have to extend the belt-tightening into 2018, a year longer than previously promised.

Although Mr. Osborne maintained that the debt reduction plan was still on track, his presentation drew heckling and laughter from some opposition lawmakers, particularly after he argued that new tax measures would show that “we’re all in this together.”

The next general election in Britain will take place in 2015, well before the end of austerity measures that have included cuts in welfare services and the elimination of tens of thousands of public sector jobs.

On Wednesday, the Office for Budget Responsibility, a nonpartisan body that is monitoring the economy, said it now expected full-year data to show that the economy shrank 0.1 percent this year, instead of growing 0.8 percent, as the office had previously forecast.

It also said the economy would grow 1.2 percent next year as opposed to the 2 percent predicted earlier.

“It’s a hard road but we are getting there,” Mr. Osborne told Parliament. “Britain is on the right track. Turning back now would be a disaster.”

Reducing the budget deficit and truly getting the economy back on track has been the overriding objective binding the uneasy coalition between Prime Minister David Cameron’s Conservative Party and Liberal Democrat lawmakers that has governed Britain since 2010.

Both parties have been betting that imposing the most severe government spending cuts in recent decades will reap economic rewards before the next general election. But the last missed target for cutting debt, combined with a painfully slow recovery, risks undermining the entire political strategy and stoking tensions within the coalition. And it undermines the coalition’s message that it is better equipped to deal with the economy than the Labour Party.

“The government’s strategy is to combine deficit reduction with economic recovery, but at the moment we are not getting much of either,” said Andrew Smith, chief economist at the auditing and advisory firm KPMG.

The government has been defending its austerity measures, which include tax increases and spending cuts, by saying they help to keep Britain’s borrowing costs low and so will contribute to a revival of the British economy. Compared with the Continent, Britain has a relatively better economic outlook, and its borrowing costs are much lower.

Mr. Osborne said the British economy was facing “a multitude of problems” at home and abroad, making the recovery more difficult. He mentioned uncertainty about averting the so-called fiscal cliff crisis in the United States in January, slowing growth in China and the euro zone recession.

“They really need some growth now,” said David Tinsley, an economist at BNP Paribas. “Making the cuts when the economy is stuck is really difficult.”

Ed Balls, economic spokesman for the Labour Party, said Wednesday that Mr. Osborne’s statements illustrated an economic failure of government. “The defining purpose of the government, the cornerstone of the coalition, the one test they set themselves — to balance the books and get the debt falling by 2015 — is now in tatters,” he said.

Labour, which is leading in some recent national polls, has been criticizing Mr. Osborne’s austerity plan as going too far and trying to cut debt too quickly without offering any investments to fuel economic growth. But economists said that with public finances stretched as they were, there was little Mr. Osborne could spend on a revival.

He announced a one percentage point cut in the corporation tax, to 21 percent, and canceled a planned increase in the fuel tax paid by consumers. He also said the government planned to be much stricter on going after tax dodgers.

“I know these tax measures will not be welcomed by all,” Mr. Osborne said. “But we must show we’re all in this together.”

So far, Mr. Osborne has managed to balance the competing demands of Conservatives, who generally favor tax and benefit cuts, and Liberal Democrats who would rather increase the burden on the wealthy if necessary. But blaming the weakness of the British economy for the euro zone crisis may become a less effective political weapon if the single-currency area begins to stabilize.

“The strains are muted because people understand the seriousness of the situation and the absence of any obvious way of getting out of it,” said one senior member of the Liberal Democrats, who was not authorized to speak publicly. “But as it goes on for longer, the strains under which the coalition begins to operate will become greater.”

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Storm Hits Hiring in November; Service Sector Expands

NEW YORK (Reuters) - Private-sector hiring took a hit in November due to the impact of storm Sandy that ravaged consumers and businesses in the northeastern United States, but the huge services sector continued to expand albeit at a modest pace.

The ADP National Employment Report, which is closely watched as it comes two days ahead of the government's monthly employment report, showed that the private sector added 118,000 jobs during the month, below expectations for a gain of 125,000.

The report largely confirmed economists' forecast for a weak reading in the Labor Department payrolls report on Friday. Economists expect the economy added 93,000 jobs in November, down from 171,000 the month before, according to a Reuters poll.

"It's close to what the market was expecting. If Friday's employment report from the U.S. Labor Department comes in similar to this, that would be a good outcome," said Terry Sheehan, economic analyst at Stone and McCarthy Research Associates in Princeton, New Jersey.

A separate report on the U.S. services sector showed a similar dip in hiring during the month. But forward-looking indicators pointed to faster growth as a rise in new orders and business activity helped offset a slowdown in employment and prices.

The Institute for Supply Management said its services index rose to 54.7 last month from 54.2 the month before, with 50 being the divide between growth and contraction. The reading topped economists' forecasts for growth of 53.5, according to a Reuters survey.

"The much larger service side of the U.S. economy remains relatively healthy," said Joseph Trevisani, chief market strategist at Worldwide Markets, Woodcliff Lake, New Jersey.

"It has so far avoided the contraction in manufacturing, but worse is probably coming in the first quarter of next year as the economy continues to slow."

A separate report on Monday showed that the manufacturing sector contracted after two months of growth.

U.S. stocks were little changed after the data but drifted lower by midmorning. The S&P 500 index, a broad measure of U.S. stocks, traded down 0.4 percent at 1,401.74 points.

Also on Wednesday, a report showed new orders received by U.S. factories unexpectedly rose in October as demand for motor vehicles and a range of other goods offset a slump in defense and civilian aircraft orders, a hopeful sign for the manufacturing sector.

That chimed with another report showing U.S. nonfarm productivity increased at a much faster clip than initially thought in the third quarter as businesses held the line on hiring even as output surged, with unit labor costs falling at their fastest pace in almost a year.

Mark Zandi, chief economist of Moody's Analytics, who helps compile the ADP report, said underlying jobs growth was closer to 150,000 in November after discounting the impact of the storm as well as seasonal jobs brought forward at the start of the holiday season.

"Abstracting from the storm, the job market turned in a good performance during the month," he said. "Superstorm Sandy wreaked havoc on the job market in November, slicing an estimated 86,000 jobs from payrolls."

Zandi said he was seeing little indication that budget negotiations in Washington aimed at averting the so-called "fiscal cliff," a series of automatic tax hikes and spending cuts due in 2013, were having a significant impact of hiring.

"I don't sense that businesses have pulled back on their hiring or increased their layoffs as a result of the angst surrounding the fiscal issues," said Zandi.

The current impasse over the fiscal cliff, which could impact the economy to the tune of $600 billion next year, has been blamed for fueling uncertainty and causing corporate managers to delay business decisions.

(Reporting By Edward Krudy; Editing by Clive McKeef and Chizu Nomiyama)

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Well: For Athletes, Risks From Ibuprofen Use

Phys Ed

Gretchen Reynolds on the science of fitness.

Many active people use the painkiller ibuprofen on an almost daily basis. In surveys, up to 70 percent of distance runners and other endurance athletes report that they down the pills before every workout or competition, viewing the drug as a preemptive strike against muscle soreness.

But a valuable new study joins growing evidence that ibuprofen and similar anti-inflammatory painkillers taken before a workout don’t offer any benefit and may be causing disagreeable physical damage instead, particularly to the intestines.

Studies have already shown that strenuous exercise alone commonly results in a small amount of intestinal trauma. A representative experiment published last year found that cyclists who rode hard for an hour immediately developed elevated blood levels of a marker that indicates slight gastrointestinal leakage.

Physiologically, it makes sense that exercise would affect the intestines as it does, since, during prolonged exertion, digestion becomes a luxury, said Dr. Kim van Wijck, currently a surgical resident at Orbis Medical Center in the Netherlands, who led the small study. So the blood that normally would flow to the small intestine is instead diverted to laboring muscles. Starved of blood, some of the cells lining the intestines are traumatized and start to leak.

Thankfully, the damage seems to be short-lived, Dr. van Wijck said. Her research has shown that within an hour after a cyclist finished riding, the stressed intestines returned to normal.

But the most common side-effect of ibuprofen is gastrointestinal damage. And since many athletes take the drug for pain before and after a workout, Dr. van Wijck set out to determine the combined effect of exercise and ibuprofen.

For the new study, published in the December issue of Medicine & Science in Sports & Exercise, researchers at Maastricht University in the Netherlands recruited nine healthy, active men and had them visit the university’s human performance lab four times.

During two of the visits, the men rested languorously for an hour, although before one of the visits, they swallowed 400 milligrams of ibuprofen the night before and also the morning of their trip to the lab. (Four hundred milligrams is the recommended non-prescription dosage for adults using the drug to treat headaches or other minor pain.)

During the remaining visits, the men briskly rode stationary bicycles for that same hour. Before one of those rides, though, they again took 400 milligrams of ibuprofen the night before and the morning of their workout.

At the end of each rest or ride, researchers drew blood to check whether the men’s small intestines were leaking. Dr. van Wijck found that blood levels of a protein indicating intestinal leakage were, in fact, much higher when the men combined bike riding with ibuprofen than during the other experimental conditions when they rode or took ibuprofen alone. Notably, the protein levels remained elevated several hours after exercise and ibuprofen.

The health implications of this finding are not yet clear, although they are worrying, Dr. van Wijck said. It may be that if someone uses ibuprofen before every exercise session for a year or more, she said, “intestinal integrity might be compromised.” In that case, small amounts of bacteria and digestive enzymes could leak regularly into the bloodstream.

More immediately, if less graphically, the absorption of nutrients could be compromised, especially after exercise, Dr. van Wijck said, which could affect the ability of tired muscles to resupply themselves with fuel and regenerate.

The research looks specifically at prophylactic use of ibuprofen and does not address the risks and benefits of ibuprofen after an injury occurs. Short-term use of Ibuprofen for injury is generally considered appropriate.

Meanwhile, the Dutch study is not the first to find damage from combining exercise and ibuprofen. Earlier work has shown that frequent use of the drug before and during workouts also can lead to colonic seepage. In a famous study from a few years ago, researchers found that runners at the Western States 100-Mile Endurance Run who were regular ibuprofen users had small amounts of colonic bacteria in their bloodstream.

Ironically, this bacterial incursion resulted in “higher levels of systemic inflammation,” said David C. Nieman, a professor of health and exercise science at Appalachian State University who conducted the study and is himself an ultramarathoner. In other words, the ultramarathon racers who frequently used ibuprofen, an anti-inflammatory, wound up with higher overall levels of bodily inflammation. They also reported being just as sore after the race as runners who had not taken ibuprofen.

Animal studies have also shown that ibuprofen hampers the ability of muscles to rebuild themselves after exercise. So why do so many athletes continue enthusiastically to swallow large and frequent doses of ibuprofen and related anti-inflammatory painkillers, including aspirin, before and during exercise?

“The idea is just entrenched in the athletic community that ibuprofen will help you to train better and harder,” Dr. Nieman said. “But that belief is simply not true. There is no scientifically valid reason to use ibuprofen before exercise and many reasons to avoid it.”

Dr. van Wijck agrees. “We do not yet know what the long-term consequences are” of regularly mixing exercise and ibuprofen, she said. But it is clear that “ibuprofen consumption by athletes is not harmless and should be strongly discouraged.”

Read More..

Well: For Athletes, Risks From Ibuprofen Use

Phys Ed

Gretchen Reynolds on the science of fitness.

Many active people use the painkiller ibuprofen on an almost daily basis. In surveys, up to 70 percent of distance runners and other endurance athletes report that they down the pills before every workout or competition, viewing the drug as a preemptive strike against muscle soreness.

But a valuable new study joins growing evidence that ibuprofen and similar anti-inflammatory painkillers taken before a workout don’t offer any benefit and may be causing disagreeable physical damage instead, particularly to the intestines.

Studies have already shown that strenuous exercise alone commonly results in a small amount of intestinal trauma. A representative experiment published last year found that cyclists who rode hard for an hour immediately developed elevated blood levels of a marker that indicates slight gastrointestinal leakage.

Physiologically, it makes sense that exercise would affect the intestines as it does, since, during prolonged exertion, digestion becomes a luxury, said Dr. Kim van Wijck, currently a surgical resident at Orbis Medical Center in the Netherlands, who led the small study. So the blood that normally would flow to the small intestine is instead diverted to laboring muscles. Starved of blood, some of the cells lining the intestines are traumatized and start to leak.

Thankfully, the damage seems to be short-lived, Dr. van Wijck said. Her research has shown that within an hour after a cyclist finished riding, the stressed intestines returned to normal.

But the most common side-effect of ibuprofen is gastrointestinal damage. And since many athletes take the drug for pain before and after a workout, Dr. van Wijck set out to determine the combined effect of exercise and ibuprofen.

For the new study, published in the December issue of Medicine & Science in Sports & Exercise, researchers at Maastricht University in the Netherlands recruited nine healthy, active men and had them visit the university’s human performance lab four times.

During two of the visits, the men rested languorously for an hour, although before one of the visits, they swallowed 400 milligrams of ibuprofen the night before and also the morning of their trip to the lab. (Four hundred milligrams is the recommended non-prescription dosage for adults using the drug to treat headaches or other minor pain.)

During the remaining visits, the men briskly rode stationary bicycles for that same hour. Before one of those rides, though, they again took 400 milligrams of ibuprofen the night before and the morning of their workout.

At the end of each rest or ride, researchers drew blood to check whether the men’s small intestines were leaking. Dr. van Wijck found that blood levels of a protein indicating intestinal leakage were, in fact, much higher when the men combined bike riding with ibuprofen than during the other experimental conditions when they rode or took ibuprofen alone. Notably, the protein levels remained elevated several hours after exercise and ibuprofen.

The health implications of this finding are not yet clear, although they are worrying, Dr. van Wijck said. It may be that if someone uses ibuprofen before every exercise session for a year or more, she said, “intestinal integrity might be compromised.” In that case, small amounts of bacteria and digestive enzymes could leak regularly into the bloodstream.

More immediately, if less graphically, the absorption of nutrients could be compromised, especially after exercise, Dr. van Wijck said, which could affect the ability of tired muscles to resupply themselves with fuel and regenerate.

The research looks specifically at prophylactic use of ibuprofen and does not address the risks and benefits of ibuprofen after an injury occurs. Short-term use of Ibuprofen for injury is generally considered appropriate.

Meanwhile, the Dutch study is not the first to find damage from combining exercise and ibuprofen. Earlier work has shown that frequent use of the drug before and during workouts also can lead to colonic seepage. In a famous study from a few years ago, researchers found that runners at the Western States 100-Mile Endurance Run who were regular ibuprofen users had small amounts of colonic bacteria in their bloodstream.

Ironically, this bacterial incursion resulted in “higher levels of systemic inflammation,” said David C. Nieman, a professor of health and exercise science at Appalachian State University who conducted the study and is himself an ultramarathoner. In other words, the ultramarathon racers who frequently used ibuprofen, an anti-inflammatory, wound up with higher overall levels of bodily inflammation. They also reported being just as sore after the race as runners who had not taken ibuprofen.

Animal studies have also shown that ibuprofen hampers the ability of muscles to rebuild themselves after exercise. So why do so many athletes continue enthusiastically to swallow large and frequent doses of ibuprofen and related anti-inflammatory painkillers, including aspirin, before and during exercise?

“The idea is just entrenched in the athletic community that ibuprofen will help you to train better and harder,” Dr. Nieman said. “But that belief is simply not true. There is no scientifically valid reason to use ibuprofen before exercise and many reasons to avoid it.”

Dr. van Wijck agrees. “We do not yet know what the long-term consequences are” of regularly mixing exercise and ibuprofen, she said. But it is clear that “ibuprofen consumption by athletes is not harmless and should be strongly discouraged.”

Read More..

Gadgetwise Blog: No More Need to 'Tap and Swipe'

Part of the appeal of apps like Angry Birds and Cut the Rope is their simplicity. Just tap and swipe. But some of the more advanced app games require more complex finger maneuvers, making you wish you could use a physical controller.

Enter Discovery Bay Games, the maker of the new Duo Gamer game controller for Apple devices.

Duo Gamer connects wirelessly to an iPad or iPhone to play a range of adventure games from the app publisher Gameloft, including titles like Modern Combat 3: Fallen Nation and Asphalt 7: Heat.

Duo Gamer mimics the shape and size of video game controllers and has similar buttons, like a D-pad, triggers and left and right thumb sticks. It’s comfortable to hold, and the buttons are easy to use. It’s not designed for hours of gameplay, but most game apps don’t last that long anyway.

In the hands of a casual game player, the Duo Gamer controls are intuitive, especially if you already have experience using a controller. First-person shooter games like Modern Combat are much easier to play with Duo Gamer than they are using tap and swipe movements because you can focus on the game and forget about where your thumbs are. I had less success with the Asphalt racing game, which is more fun to play using the gyroscope in the iPad 2 to steer the cars.

Duo Gamer comes with an iPad stand, but no content of its own. At $80, it should include some free games, but you have to pay separately for the Gameloft apps. It would be great if Discovery Bay had partnerships with other app publishers as well. The more games that are available, the better Duo Gamer becomes.

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Nasrin Sotoudeh, Iranian Rights Advocate, Ends Hunger Strike

TEHRAN — An imprisoned human rights lawyer serving a sentence for “acting against national security” ended a 49-day hunger strike on Tuesday after judicial authorities acceded to her demand to lift a travel ban imposed on her 12-year-old daughter, her husband said.

Mihan News Agency, via European Pressphoto Agency

Nasrin Sotoudeh, a human rights lawyer, at home. She was put in prison in 2010.

The lawyer, Nasrin Sotoudeh, 49, who until her imprisonment in 2010 was one of the last lawyers taking on high-profile human rights and political cases in Iran, decided in October to go on the hunger strike out of fear of increasing limitations imposed on her family. She fell into fragile health during the hunger strike, in which she would drink only water mixed with salts and sugar. Her weight dropped to 95 pounds.

It was the second time that Ms. Sotoudeh felt compelled to quit eating. She declared her first hunger strike in 2010, after her family was forbidden to visit or make phone calls. In that case, the authorities capitulated after four weeks, allowing her husband and two children to visit weekly.

Ms. Sotoudeh has also written several public letters from prison, one of which thanked the head of the judiciary for putting her in jail, saying she was horrified by the thought of being free while her former clients were still in prison.

In recent years, several lawyers representing people suspected of security crimes have been arrested while others, like Shirin Ebadi, who won the Nobel Peace Prize in 2003, have left the country. Tuesday’s ruling, which had not been officially confirmed by the authorities here, seemed to show that Iranian officials are receptive to pressure in human rights cases — something that Ms. Sotoudeh has argued consistently.

Iranian officials deny there are any political prisoners in Iran, saying that all those behind bars have been tried according to the country’s laws. Ms. Sotoudeh is serving a six-year prison term since her conviction last year on the national security charge and over “misusing her profession as a lawyer.”

During a news conference last week, Mohammad Javad Larijani, a member of an influential political family and the head of the judiciary’s self-appointed Human Rights Council, said that from Iran’s official point of view there was nothing out of the ordinary about Ms. Sotoudeh’s imprisonment.

“Her dossier has had its course,” he told reporters, emphasizing what he called the independence of Iran’s judicial system. “Judges and lawyers have exhausted all legal possibilities, and now she is doing her time in jail.” He said that contrary to reports, Ms. Sotoudeh was in good health. “We care about our inmates, whether they are on hunger strike or not,” Mr. Larijani said.

International rights activists and human rights groups have tried to highlight Ms. Sotoudeh’s case, and international lawyers, movie directors and politicians — among them Secretary of State Hillary Rodham Clinton — have called on Iran to set her free. Ten days into her hunger strike, on Oct. 26, Ms. Sotoudeh, together with Jafar Panahi, an Iranian filmmaker who is under house arrest, was awarded the Sakharov Prize for Freedom of Thought by the European Union.

The international attention, widely replayed on Persian-language satellite channels at odds with Iran’s rulers, has helped raise her profile among middle-class Iranians, who generally admire her persistence. The attention has made it increasingly hard for Iranian officials to ignore her case, Ms. Sotoudeh’s husband, Reza Khandan, a computer engineer, said in an interview.

Mr. Khandan said that his wife is a great admirer of Daw Aung San Suu Kyi, the Burmese opposition leader and Nobel laureate, who spent years under house arrest, became an international symbol of resistance and is now a political leader herself.

“But this is her fight, and not our children’s,” Mr. Khandan said, “so Nasrin does everything she can in order to have something of a normal life.”

This article has been revised to reflect the following correction:

Correction: December 4, 2012

An earlier version of this article misstated the length of a hunger strike by Nasrin Sotoudeh. It was 49 days, not 47.

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Advertising: Stalled Budget Talks Cast Long Shadow

TOP advertising and media executives are expressing concern but not alarm — at least, not yet — about the potential effects that a fiscal crisis in the United States could have on their industries in 2013.

The executives spoke on Monday at the start of the 40th annual global media and communications conference, sponsored by UBS, in Midtown Manhattan. They addressed the possibility of a fiscal crisis in January as part of discussions about issues that could significantly curb growth in ad spending, among them the continued economic difficulties in the euro zone.

Widespread gloom about an inability to avert the fiscal crisis is one of four “gray swans” that are roiling markets, and marketers, said Martin Sorrell, chairman of WPP, the largest advertising holding group by revenue. The phrase is a play on the expression black swans, meaning highly improbable like the global financial crisis of 2008.

“I would err on the side of caution at the moment,” said Mr. Sorrell, whose hundreds of agencies include Grey, JWT, MEC, Mindshare, Ogilvy & Mather and Y&R.

“Whichever way it comes out, it creates tremendous uncertainty,” he added. “It’s much tougher sledding.”

For instance, Mr. Sorrell said, “clients used to look at calendar years” in their planning processes, but “now they look at quarters.”

“We had lunch with the C.E.O. of one of our major packaged-goods clients in New York last week,” he said, and the executive talked about “how hard it is to predict the behavior of consumers month to month.”

“This is packaged goods, not capital goods,” he added for emphasis, almost shaking his head in wonderment.

As a result, Mr. Sorrell said, as WPP agencies go through their fourth-quarter planning for the new year, they are “being told to be cautious” and to budget smaller gains in revenue for 2013 than might otherwise be expected.

Another gray swan influencing Mr. Sorrell’s outlook for next year is, of course, the tumult in the euro zone. He seemed more sanguine about that problem, saying, “By and large, we’ll muddle through.”

Mario Draghi, president of the European Central Bank, has “done a brilliant job,” Mr. Sorrell said, quoting approvingly a remark Mr. Draghi made on Friday that European governments had been “living in a fairy world.”

Mr. Sorrell expressed optimism for the year after next, pointing to a “strong ray of hope” that could shine on the ad industry in 2014 as a result of spending related to the Winter Olympics, the World Cup and, he added, laughing, “would you believe, we have another U.S. Congressional election.”

Another speaker, Michael I. Roth, chairman and chief executive of the Interpublic Group of Companies, repeatedly used the word uncertainty in his remarks, but also said he saw opportunity amid the question marks.

“When clients are faced with this economic uncertainty,” said Mr. Roth, whose agencies include Deutsch, Draftfcb, Initiative, Lowe & Partners and McCann Erickson, it is a chance for Interpublic to demonstrate that “we have the resources to move the needle” in selling goods and services for them.

Also, the current environment is not like the fourth quarter of 2008, Mr. Roth said, when the financial crisis led marketers to sharply and quickly cut their ad budgets.

“In this environment, our clients have plenty of cash,” he added. “The tone right now is O.K. and hopefully, we’ll see a good, vibrant December.”

“We don’t see a wholesale cutback in 2013,” Mr. Roth said, “at least so far,” adding that growth in American ad spending in the low single digits compared with this year “is a fair assumption to make.”

The Magna Global unit of Interpublic forecast on Monday that ad spending in the United States next year would increase 0.6 percent from 2012. That prediction assumes “we don’t fall off the fiscal cliff,” said Vincent Letang, executive vice president and director for global forecasting at Magna Global.

Also on Monday, the GroupM unit of WPP predicted a gain of 2.7 percent for American ad spending in 2013 and the ZenithOptimedia division of the Publicis Groupe forecast an increase of 3.5 percent. By comparison, their predictions for worldwide ad spending in 2013 compared with 2012 were somewhat stronger: Magna Global, up 3.1 percent; GroupM, up 4.5 percent; and ZenithOptimedia, up 4.1 percent.

Steve King, worldwide chief executive of ZenithOptimedia, said that in addition to the potential for a fiscal crisis, he was worried about “continued unrest in the Middle East and its impact on oil prices.”

Mr. Roth said that a possible fiscal crisis loomed larger as a “challenge” for Interpublic because Interpublic derived more of its revenue from the United States than did competitors like WPP, the Omnicom Group or Publicis.

To help insulate Interpublic, he said, “we will continue to invest in emerging markets” and “make sure we have powerful offerings” in fields like advertising, media services and digital marketing.

In a research note last week, Brian Wieser, an analyst at the Pivotal Research Group, estimated that an inability to resolve the fiscal crisis could result in American ad spending declining next year by 4 percent, or $9 billion, rather than growing by 1 percent as he has forecast.

“While economists’ consensus and our model speaks of optimism that this won’t happen,” Mr. Wieser wrote, “our brain increasingly thinks it just might.”

The UBS conference continues through Wednesday afternoon.

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Well: New Meaning and Drive in Life After Cancer

When people hear the words “You have cancer,” life is suddenly divided into distinct parts. There was their life before cancer, and then there is life after cancer.

The number of people in that second category continues to grow. In June, the National Cancer Institute reported that an estimated 13.7 million living Americans are cancer survivors, and the number will increase to almost 18 million over the next decade. More than half are younger than 70.

A new book, “Picture Your Life After Cancer,” (American Cancer Society) focuses on the living that goes on after a cancer diagnosis. It’s based on a multimedia project by The New York Times that asked readers to submit photos and their personal stories. So far, nearly 1,500 people have shared their experiences — the good, the bad, the challenging and the inspirational — creating a dramatic photo essay of the varied lives people live in the years after diagnosis.

For Susan Schwalb, a 68-year-old artist from Manhattan, a diagnosis of early-stage breast cancer at the age of 62 led to a lumpectomy, followed by a mastectomy and then failed reconstruction surgery. She discovered that cancer was not only a physical challenge but a mental one as well, and she turned to friends and support groups to cope with the emotional strain. When she saw the “Picture Your Life” project, she submitted a photo of herself wearing a paint-splattered artist’s apron.

“What cancer made me do in my own professional life is to pedal faster,” Ms. Schwalb said in an interview. “I’ve encountered some people who decide to enjoy life, retire, work in a garden. I decided I had to have more of what I wanted in life, and I better move fast because maybe I don’t have the long life I imagined I would have.”

Indeed, a common theme of the “Picture Your Life” project is that cancer spurs people to take long-delayed trips, seek out adventure and spend time with their families. Photos of mountain climbs, a ride on a camel, scuba diving excursions and bicycle trips are now part of the online collage.

Dr. David Posner, associate program director of pulmonary medicine at Lenox Hill Hospital in Manhattan, says a diagnosis of metastatic colon cancer at the age of 47 has helped him relate to his own patients with cancer. The past decade has included nine operations, six recurrences and three rounds of chemotherapy, but Dr. Posner said he never missed more than three weeks of work.

“My salvation has been my family and my work,” he said. “When I was at work I wasn’t thinking about myself, and it was very therapeutic. I see my share of cancer patients, and I motivate them and they motivate me.”

Dr. Posner said he decided to be part of “Picture Your Life” because he wants to get the word out that a cancer diagnosis — even a dire one like his — doesn’t have to define your life.

“I think about someone asking me, ‘So how was your last decade — was it wasted or was it a life filled with a lot of happiness and joy?’ ” he said. “The cancer thing was a pain, but for the most part I’ve had a pretty good time.”

The “Picture Your Life” collage includes photo after photo of survivors with their pets. Sandra Elliott, 59, of Claremont, Calif., submitted a picture of herself with her two golden retrievers, Buddy and Molly. They were just puppies when she received a diagnosis of Stage 2 breast cancer in 2003. During her recovery from surgery and chemotherapy treatments, she took the dogs to romp on the Pomona College campus, near her home, and one day a professional photographer snapped the picture.

“No matter how bad I felt that day, no matter how many chemo treatments or doctors appointments, those two little puppies with these big black eyes would look at me with their tails wagging as if to say, ‘It’s time. It’s time. It’s time to go out!’  ” Ms. Elliott recalled.

“I felt so physically horrible, and I’d look at them and the pure joy on their faces and in their bodies for just being out in nature and being able to smell the air, smell the trees, chase a squirrel — that sheer in-the-moment love of life they showed me really lifted my spirit on a daily basis.”

Ms. Elliott still lives with chronic pain as a result of nerve damage from her cancer treatment, and she can relate to others in the “Picture Your Life” project who worry that their cancer will recur or that they’ll never feel completely normal again. But she says a stronger theme runs through all the pictures and stories.

“We have all been forced to find the joy in the smallest things,” she said. “I’m sitting here looking at a geranium about to bloom. These things are out there — we just have to be reminded to look at them. And cancer is a big reminder.”

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