Friday, June 28, 2013

Israeli leader signals readiness to compromise

JERUSALEM (AP) ? Israel's prime minister, known for his rigid negotiating positions, has been sending signals that he is ready for significant compromises in a peace deal with the Palestinians ? and that he accepts the narrative increasingly favored by his opponents that says ending the West Bank occupation is essential for Israel itself.

While some of Benjamin Netanyahu's political allies say he is serious, the Palestinians remain skeptical. This week's visit by U.S. Secretary of State John Kerry could show which way things can go.

In recent speeches, Netanyahu has stressed the importance of reaching a peace deal, saying it is essential to ensuring Israel's long-term survival.

On Thursday, he made reference to Israel's nightmare scenario in which the peace process breaks down, Palestinians drop their pursuit of an independent state and instead demand equal rights in a single, binational state compromising today's Israel plus the West Bank and Gaza. Most experts believe that given the high Palestinian birthrate, such an Israel could not long survive as a country that is both democratic and somehow Jewish in character.

"It's correct. We do not want a binational state," Netanyahu said at a memorial ceremony for the Zionist visionary Theodor Herzl.

On the front page of the Haaretz daily, an anonymous Cabinet minister in Netanyahu's Likud Party was quoted as saying Thursday that Netanyahu is prepared to withdraw from most of the West Bank and evacuate numerous Jewish settlement as part of a peace deal. The story became the focus of much discussion in Israel, widely taken as a trial balloon and an attempt to signal seriousness by the government.

Another Cabinet minister, Yaakov Peri, told the Army Radio station that Netanyahu "knows he will have to carry out a painful evacuation of a number of settlements" as part of any deal.

Netanyahu recently told the Washington Post that if Kerry were to pitch a tent to hold peace talks with the Palestinians, he would "stay in the tent and negotiate for as long as it takes to work out a solution of peace and security."

Such pronouncements were once unthinkable for Netanyahu, who for years was the leader of Israel's nationalist camp and an opponent of Palestinian independence.

That began to change after Netanyahu was elected four years ago and for the first time endorsed the idea of a Palestinian state.

Even so, peace efforts failed to get off the ground, in large part due to Palestinian suspicions toward Netanyahu.

The Palestinians have called on Netanyahu to freeze all Jewish settlement in the West Bank and east Jerusalem, territories captured by Israel in the 1967 Mideast war that the Palestinians claim for their future state along with the Gaza Strip, which Israel also occupied but pulled out of in 2005. More than 500,000 Israelis now live in such Jewish settlements, making it increasingly difficult to divide the land into two states.

The Palestinians also say Netanyahu should accept Israel's pre-1967 boundaries as the basis for a final border, with slight modifications worked out in negotiations. Previous Israeli leaders accepted the 1967 borders as a basis for talks.

Netanyahu has refused the Palestinian demands, saying talks should begin without any preconditions.

On Thursday, Israel's outgoing central bank chief, Stanley Fischer, lamented that Israel could have "done more efforts to reach an agreement" with the Palestinians. It was a rare political pronouncement by the internationally respected economist.

Given Netanyahu's refusal to spell out his vision for a final peace deal in any detail, and his past hardline policies and views , the Palestinians remain deeply suspicious.

They note the hundreds of housing starts on occupied land already this year, with thousands more in the pipeline ? including 69 homes that received final permission for construction in an area of east Jerusalem this week.

"Israel has a selected repertoire awaiting U.S. officials ... which includes settlements, settlements and more settlements," the chief Palestinian negotiator, Saeb Erekat, said Thursday. "The international community should understand that in order to create the right environment for negotiations it should not grant impunity to Israel over its repeated crimes and violations."

Following the re-elections of both Netanyahu and President Barack Obama, the U.S. has launched a new mission aimed at reviving peace talks.

Kerry has been shuttling between the sides in search of an acceptable formula. His arrival in Israel late Thursday marked his fifth visit to the region since taking office early this year.

The Americans have been putting pressure on both sides without tangible signs of progress so far. Kerry's proposal is expected to call for compromises by both, including a partial halt to settlement construction, economic aid to the beleaguered Palestinian economy and guarantees that Israel will negotiate border issues in a timely manner.

U.S. officials traveling with Kerry said he will be using long-time relationships with officials from both sides to coax them into talks, and at the same time will remind them of what could happen if no accord is reached.

Earlier this month, in a speech to the American Jewish Committee Global Forum in Washington, Kerry said that the best way to truly ensure Israel's security is by ending the conflict and reaching a negotiated resolution that results in two states.

" The Palestinian Authority has committed itself to a policy of nonviolence," he said. "But if that experiment is allowed to fail, ask yourselves: What will replace it?" The failure of the moderate Palestinian leadership could very well invite the rise of the very thing that we want to avoid: the same extremism in the West Bank that we have seen in Gaza or from southern Lebanon."

It is far from clear whether Kerry will succeed, and Netanyahu's grand vision, if he has one, remains a secret.

Dore Gold, a former Netanyahu adviser who remains a confidant of the prime minister, said the Israeli leader "is determined to make the peace process work" and show "considerable Israeli flexibility."

"At the same time, he's cognizant of the fact that Israel is in a much more dangerous neighborhood," he said, referring to the civil war in neighboring Syria and the takeover of Gaza by Hamas militants. That requires far-reaching security guarantees, Gold said.

Yossi Beilin, a dovish former Israeli politician who helped negotiate interim peace accords with the Palestinians, said there is a complicated "dichotomy" with Netanyahu. Beilin said he has held discussions with Netanyahu and believes he truly is serious about pursuing peace. But he also remains a fervent nationalist and security hawk who will not make the concessions demanded by the Palestinians.

"He is not somebody with whom you cannot talk. But ... not really ready to pay the price of a permanent agreement," Beilin said.

Beilin said the Palestinians should consider pursuing an "interim" deal, granting them independence in 50 to 70 percent of the West Bank while leaving the most difficult issues, such as final borders and the status of Jerusalem, for later. As long as Hamas, which opposes a peace deal with Israel, controls Gaza, a partial deal is the best anyone can hope for anyway, he said.

"There is an opportunity with him," Beilin said, referring to Netanyahu.

___

Associated Press correspondent Deb Riechmann contributed to this report from Amman, Jordan.

Source: http://news.yahoo.com/israeli-leader-signals-readiness-compromise-191022140.html

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Thursday, June 27, 2013

AP Interview: Moniz sees coal's 'significant role'

(AP) ? Energy Secretary Ernest Moniz says coal will continue to play a role in meeting America's energy needs even as the Obama administration seeks to reduce carbon emissions and combat global warming.

In an interview with The Associated Press, Moniz refuted claims by Republicans and some coal-state Democrats that the president's climate plan would cripple the coal industry.

Moniz said Thursday that the administration plans to offer up to $8 billion in loan guarantees for technologies that can keep carbon dioxide produced by power plants from being released into the atmosphere. Several "carbon capture" demonstration projects are now underway, and Moniz said he expects them to be completed by the end of the decade.

He also said the administration would move more aggressively to make factories and appliances more energy efficient.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/89ae8247abe8493fae24405546e9a1aa/Article_2013-06-27-US-Climate-Change-Moniz-Interview/id-83c05991f91e469f8a3f1559506ae523

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Stress: It should never be ignored, experts say

June 27, 2013 ? Work pressure, tension at home, financial difficulties ? the list of causes of stress grows longer every day. There have been several studies in the past showing that stress can have negative effects on health (cardiovascular diseases, diabetes, high blood pressure and more). The Inserm researchers at unit 1018, "The Epidemiology and Public Health Research Centre," working in collaboration with researchers from England and Finland have demonstrated that it is essential to be vigilant about this and to take it very seriously when people say that they are stressed, particularly if they believe that stress is affecting their health. According to the study performed by these researchers, with 7268 participants, such people have twice as much risk of a heart attack, compared with others.

These results have been published in European Heart Journal.

Today, stress is recognized as one of the main health problems. When people face a situation that is considered stressful, they may experience several physical, emotional and behavioural symptoms (anxiety, difficulty in concentrating, skin problems, migraines, etc.). Previous studies, particularly the recent studies performed within the Whitehall II cohort[1], composed of several thousand British civil servants, have already shown that the physiological changes associated with stress can have an adverse effect on health.

Herman Nabi, Inserm researcher at Unit 1018 "The Epidemiology and Public Health Research Centre," and his team went further and studied people who declared themselves to be stressed, in order to look more closely at whether there was a link between their feeling and the occurrence of coronary disease some years later.

Using a questionnaire prepared for the Whitehall II cohort, the participants were invited to answer the following question: "to what extent do you consider the stress or pressure that you have experienced in your life has an effect on your health," the participants had the following answers to choose from: "not at all," "a little," "moderately," "a lot" or "extremely."

The participants were also asked about their stress level, as well as about other factors that might affect their health, such as smoking, alcohol consumption, diet and levels of physical activity. Arterial pressure, diabetes, body mass index and socio-demographic data such as marital status, age, sex, ethnicity and socio-economic status were also taken into account.

According to the results, the participants who reported, at the start of the study, that their health was "a lot" or "extremely" affected by stress had more than twice the risk (2.12 times higher) of having or dying from a heart attack, compared with those who had not indicated any effect of stress on their health.

From a clinical point of view, these results suggest that the patient's perception of the impact of stress on their health may be highly accurate, to the extent that it can predict a health event as serious and common as coronary disease.

In addition, this study also shows that this link is not affected by differences between individuals related to biological, behavioural or psychological factors. However, capacities for dealing with stress do differ massively between individuals depending on the resources available to them, such as support from close friends and family.

According to Hermann Nabi, "the main message is that complaints from patients concerning the effect of stress on their health should not be ignored in a clinical environment, because they may indicate an increased risk of developing and dying of coronary disease. Future studies of stress should include perceptions of patients concerning the effect of stress on their health."

In the future, as Hermann Nabi emphasizes, "tests will be needed to determine whether the risk of disease can be reduced by increasing the clinical attention given to patients who complain of stress having an effect on their health."

[1] Created in 1985, the Whitehall II cohort, consisting of British civil servants, is making a major contribution to research in social epidemiology and is considered internationally to be one of the main sources of scientific knowledge concerning social determinant factors for health.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/health_medicine/heart_disease/~3/K2nponAqd5k/130627131839.htm

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Watch: Voting Rights Act Takes Hit by Supreme Court (ABC News)

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Wednesday, June 26, 2013

Health Insurer's App Helps Users Track Themselves ...

A smartphone app that launches this week from the health insurance company Aetna?helps users monitor their own health-tracking data. As costs spiral upward, health-care companies could eventually turn to such apps as a way to encourage healthy behavior.

At MIT Technology Review?s Mobile Summit in San Francisco last week, Martha Wofford, consumer platform vice president at Aetna, said the company would launch an app called CarePass to serve as a portal for an individual?s health-related activity and, if he allows it, his medical records, too.

Through CarePass, a person could enter a health goal?say, fitting into his jeans next month?and get personalized suggestions for how to go about achieving it. CarePass can integrate data from wearable tracking devices like Fitbit or Jawbone?s UP, as well as apps like MapMyRun; it can take into account doctor visits, prescriptions, and blood pressure or cholesterol records. It will also point users to trustworthy symptom and diagnosis information through iTriage, software that Aetna acquired last year.

A few other health-care providers, such as Kaiser Permanente, are getting into this area, but Aetna appears to be pushing forward more quickly than most. CarePass, for example, will include APIs so that patients can give access to their data to third parties, including doctors or other software developers, Wofford says.

Nearly 50,000 health-related mobile apps are already out there, letting people collect data about their well-being and interact with doctors and pharmacies from their mobile devices.

With the entire U.S. health-care system under pressure to reduce costs, insurance companies could start creating financial incentives for people to voluntarily share this data and improve their health and fitness.

President Obama?s Affordable Care Act, Wofford says, allows insurers to increase so-called ?wellness incentives? to up to 30 percent of a premium, up from 20 percent before. This would allow employer health plans to create bigger ?carrots? for their employees to go to the gym or use a Fitbit. Under U.S. law, incentives have to be based on behaviors?say, joining a gym?rather than outcomes, such as losing 10 pounds versus two pounds, Wofford says. The same rules do not apply in Europe.

CarePass will be offered to individuals at first, but Aetna plans to launch a portal for employers, too. There they will receive anonymous and aggregated data about the overall health trends of their employees, Wofford says.

As health-care costs increase for employers as well, they are likely to become more aggressive in looking for ways to reduce costs.

?I think it will be led by employers,? says Wofford. ?We see some more aggressive employers like Safeway, where they are driving outcomes by swabbing the cheeks of employees to see whether they are smoking or not.? U.S. law says that smokers can be charged higher premiums.

More data is not enough to improve health outcomes, however. And the data can be difficult to make use of. Zeo, a company that made a sleep-tracking device, and which was a pioneer in this area, recently went out business because people found its data too complicated to understand, Wofford says. ?If we make it convenient enough, the question is whether we can actually drive behavior change,? she says.

Article source: http://www.technologyreview.com/news/516176/health-insurers-app-helps-users-track-themselves/
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Source: http://liveimmigration.com/2013/06/health-insurers-app-helps-users-track-themselves/

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Supreme Court to issue gay marriage decisions Wednesday in last session before summer break (Star Tribune)

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Weight loss's effect on heart disease risks

June 25, 2013 ? A landmark study investigating the long-term effects of weight loss on the risks of cardiovascular disease among patients with Type 2 diabetes has now concluded, with significant results to be published today in the New England Journal of Medicine.

Conducted at the University of Pittsburgh and at clinical facilities throughout the United States, the multicenter clinical trial investigated the effects of an intensive lifestyle intervention program, intended to achieve and maintain weight loss in overweight or obese people with Type 2 diabetes, on rates of cardiovascular disease. Begun in 2001, the trial enrolled more than 5,000 people at 16 clinical centers across the United States and is the longest intervention study of its type ever undertaken for patients with diabetes.

John Jakicic, chair and professor in the Department of Health and Physical Activity in Pitt's School of Education and Director of the Physical Activity and Weight Management Research Center, served as principal investigator for the University of Pittsburgh's role in the study. He, along with colleagues throughout the University, is among the researchers comprising the national Look AHEAD (Action for Health in Diabetes) Research Group, which carried out the study and authored the New England Journal of Medicine paper.

Among the study's main findings is that weight loss among members of the study's Intensive Lifestyle Intervention group, provided with a program of weight management and increased physical activity, resulted in no difference in heart attacks and strokes when compared with the study's control group, the Diabetes Support and Education group, which was provided with only general health information and social support.

The effect of the intervention program on weight loss, however, was significant: Participants in the intervention group lost 8.7 percent of their initial body weight after one year of the study versus 0.7 percent among the control group's members; the intervention group also maintained a greater weight loss, 6 percent of their initial weight, versus 3.5 percent for the control group, at the study's conclusion.

The Look AHEAD study is the first to achieve such sustained weight loss. A weight loss of 5 percent or more in short-term studies is considered to be clinically significant and has been shown to improve control of blood pressure, blood sugar, cholesterol, and other risk factors. Comparable weight loss can also help prevent the development of Type 2 diabetes in overweight and obese adults.

"While the findings from the Look AHEAD study did not support that engagement in a weight- loss intervention was effective for reducing the onset of cardiovascular disease incidence or mortality, this does not mean that overweight adults with diabetes should not lose weight and become more physically active," said Jakicic. "Rather, there is an overwhelming amount of evidence from this study to date that has shown that weight loss and physical activity were associated with numerous other health benefits.

"These include improving physical function and quality of life, reduction in risk factors such as lipids and blood pressure with less reliance on medication, better diabetes control with less reliance on medication, improved sleep, psychological and emotional health benefits, and many others," Jakicic said. "Thus, adults with diabetes can begin to realize many of these health benefits with even modest reductions in body weight and modest increases in physical activity."

The study sought to determine whether weight loss achieved with a lifestyle program would help individuals with diabetes live longer and develop less cardiovascular disease. While short-term studies had shown that weight loss improved control of blood sugar and mitigated risk factors for heart disease and stroke in overweight and obese individuals with Type 2 diabetes, the longer-term effects of weight loss were not well studied. In particular, it was unknown whether weight loss achieved with a lifestyle intervention alone could reduce the risk of heart disease in people with Type 2 diabetes.

Type 2 is the most common form of diabetes, affecting approximately 25 million Americans over the age of 20. Complications of Type 2 diabetes include heart disease and stroke, high blood pressure, blindness, kidney disease, the nervous system disease known as neuropathy, and amputations. The total cost of Type 2 diabetes in 2012 was estimated to be $245 billion. This disease, for which there is no cure but which involves ongoing treatment, can be managed with diet, physical activity including regular exercise equal to at least 30 minutes of brisk walking each day, modest weight loss, and a variety of medications. The Look AHEAD study has shown that these lifestyle factors are effective for improving the management of Type 2 diabetes.

Study participants were individuals between 45 and 75 years of age with Type 2 diabetes and a body-mass index of 25 or greater. Sixty percent of the study participants were women, while 37 percent were from ethnic and racial minority groups.

The University of Pittsburgh's General Clinical Research Center and Clinical Translational Research Center served as participating clinical sites, with researchers here recruiting more than 330 participants over a three-year span. Jakicic credited the Division of Endocrinology within the Department of Medicine and the Department of Psychiatry in Pitt's School of Medicine, and the Department of Epidemiology in Pitt's Graduate School of Public Health, with the success of the local clinical trials.

Participants were assigned randomly to the Intensive Lifestyle Intervention group or the Diabetes Support and Education group. Members of the Intensive Lifestyle Intervention group were enrolled in a weight management program that provided individual and group support for making changes in eating behaviors and engaging in physical activity. The intervention program focused on home-based, functional activities including helping participants balance, climb stairs, and get out of a chair, among other examples. Diabetes Support and Education group members received what Jakicic called "usual care, with some very infrequent support on general health topics that were not related to diet, physical activity, or weight loss."

Participants were required to have their own health care providers manage their diabetes and other conditions. Look AHEAD did not provide medical care, but it did assist participants in finding a health care provider if they did not have one.

The Look AHEAD study was intended to run for 13.5 years, the maximum length of time researchers had determined might be required to see a difference in heart disease between two groups. After 11 years, however, the Look AHEAD Data and Safety Monitoring Board, an independent monitoring board that provides recommendations to the National Institutes of Health, reviewed the data the study had collected and determined that Look AHEAD could reach the definite conclusion that there were no differences in cardiovascular disease rates between the study's two groups.

Speculating on the failure of weight loss to reduce the risk of cardiovascular disease, researchers suggested that even greater weight loss may be necessary to reduce cardiovascular risk in diabetes patients who are overweight or obese. They also suggested that by providing participants in both groups, and their health care providers, with annual feedback on the participants' blood pressure, lipids, and blood sugar control, the cardiovascular disease risks for all experiment participants may have been reduced at a comparable rate.

The paper is titled "Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes." It appeared online in the New England Journal of Medicine today, June 24, 2013. Research conducted at the University of Pittsburgh's General Clinical Research Center and Clinical Translational Research Center was funded by a Clinical and Translational Science Award and a National Institutes of Health grant.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/top_news/~3/glhgqGmNABs/130625074205.htm

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