What heals traumatized kids? Answers are lacking

CHICAGO (AP) — Shootings and other traumatic events involving children are not rare events, but there's a startling lack of scientific evidence on the best ways to help young survivors and witnesses heal, a government-funded analysis found.

School-based counseling treatments showed the most promise, but there's no hard proof that anxiety drugs or other medication work and far more research is needed to provide solid answers, say the authors who reviewed 25 studies. Their report was sponsored by the federal Agency for Healthcare Research and Quality.

According to research cited in the report, about two-thirds of U.S. children and teens younger than 18 will experience at least one traumatic event, including shootings and other violence, car crashes and weather disasters. That includes survivors and witnesses of trauma. Most will not suffer any long-term psychological problems, but about 13 percent will develop symptoms of post-traumatic stress, including anxiety, behavior difficulties and other problems related to the event.

The report's conclusions don't mean that no treatment works. It's just that no one knows which treatments are best, or if certain ones work better for some children but not others.

"Our findings serve as a call to action," the researchers wrote in their analysis, published online Monday by the journal Pediatrics.

"This is a very important topic, just in light of recent events," said lead author Valerie Forman-Hoffman, a researcher at RTI International, a North Carolina-based nonprofit research group.

She has two young children and said the results suggest that it's likely one of them will experience some kind of trauma before reaching adulthood. "As a parent I want to know what works best," the researcher said.

Besides the December massacre at Sandy Hook Elementary School in Connecticut, other recent tragedies involving young survivors or witnesses include the fatal shooting last month of a 15-year-old Chicago girl gunned down in front of a group of friends; Superstorm Sandy in October; and the 2011 Joplin, Mo., tornado, whose survivors include students whose high school was destroyed.

Some may do fine with no treatment; others will need some sort of counseling to help them cope.

Studying which treatments are most effective is difficult because so many things affect how a child or teen will fare emotionally after a traumatic event, said Dr. Denise Dowd, an emergency physician and research director at Children's Mercy Hospitals and Clinics in Kansas City, Mo., who wrote a Pediatrics editorial.

One of the most important factors is how the child's parents handle the aftermath, Dowd said.

"If the parent is freaking out" and has difficulty controlling emotions, kids will have a tougher time dealing with trauma. Traumatized kids need to feel like they're in a safe and stable environment, and if their parents have trouble coping, "it's going to be very difficult for the kid," she said.

The researchers analyzed 25 studies of treatments that included anti-anxiety and depression drugs, school-based counseling, and various types of psychotherapy. The strongest evidence favored school-based treatments involving cognitive behavior therapy, which helps patients find ways to cope with disturbing thoughts and emotions, sometimes including talking repeatedly about their trauma.

This treatment worked better than nothing, but more research is needed comparing it with alternatives, the report says.

"We really don't have a gold standard treatment right now," said William Copeland, a psychologist and researcher at Duke University Medical Center who was not involved in the report. A lot of doctors and therapists may be "patching together a little bit of this and a little bit of that, and that might not add up to the most effective treatment for any given child," he said.

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Online:

Pediatrics: http://www.pediatrics.org

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Benedict XVI First Pope to Resign in 600 Years

Pope Benedict XVI's unprecedented announcement today that he will resign Feb. 28 brings to a close one of the shortest papacies in history, for which the pontiff will leave a legacy as a leader with views in line with church tradition, but also as one who worked during a controversial reign to advance religious links cross the globe.

The pope's decision, which he announced in Latin today during a meeting of Vatican cardinals, makes him the first pontiff to resign in nearly 600 years. It was perhaps the most shocking moment of his nearly eight years as leader of the world's roughly 1 billion Catholics, years in which he worked on religious outreach.

"I think he deserves a lot of credit for advancing inter-religious links the world over between Judaism, Christianity and Islam," Israeli Chief Rabbi Yona Metzger's spokesman said today. "During his period, there were the best relations ever between the church and the chief rabbinate and we hope that this trend will continue."

FULL COVERAGE: Pope Benedict XVI Resignation

Horst Seehofer, minister-president of the German state of Bavaria, where Benedict was born as Joseph Aloisius Ratzinger 85 years ago, echoed the sentiments about his work for the greater good, adding that Benedict had a global reach.

"With his charisma and his tireless work for the good of the Church, the Pope from Bavaria has inspired people all over the world," he said.

Such global reach and efforts to reach the masses resulted recently in a new Twitter account, which the Vatican launched in late-2012. But true to his traditional worldview, he cautioned the world's Catholics at his Christmas 2012 Mass about the risk of technology's pushing God out of their lives.

"The faster we can move, the more efficient our time-saving appliances become, the less time we have. And God? The question of God never seems urgent. Our time is already completely full," he said.

RELATED: Pope Benedict XVI Resigns: The Statement

Benedict XVI was the oldest pope to be elected at age 78 on April 19, 2005. He was the first German pope since the 11th century and his reign will rank as one of the shortest in history at seven years, 10 months and three days.

The last pope to resign was Pope Gregory XII, who stepped down in 1415.

Vatican officials said they've noticed that he has been getting weaker, while Benedict said he is aware of the significance of his decision and made it freely.

Pope Benedict XVI Resignation: Who Will Be Next? Watch Video

He was widely seen as a Catholic conservative who was in line with the politics of his predecessor, Pope John Paul, and Russian Orthodox Church spokesman Dimitriy Sizonenko pointed out today that the Vatican is unlikely to move away from that tradition.

INTERACTIVE: Key Dates in the Life of Pope Benedict XVI

"There are no grounds to expect that there will be any drastic changes in the Vatican's policies," he said.
"In its relations with Orthodox Churches, the Roman Catholic Church has always ensured continuity between Popes."

Benedict did court controversy, memorably with his speech in September 2006 at the University of Regensburg, in which he quoted a remark about Islam by Byzantine Emperor Manuel II Palaiologos that some of the teachings of the Prophet Muhammad are "evil and inhuman."

Pope Benedict XVI Never Aspired to Be Pope: Historian

A number of Islamic leaders around the world saw the remarks as an insult and mischaracterization of the religion. Mass protests ensued, notably in the West Bank and Gaza Strip. Benedict soon apologized.

John Thavis, Rome bureau chief for the Catholic News Service, said Catholics will remember him as a gentle and very deep teacher.

"I think the outside world will probably have a different impression of this pope," he said. "I think they will remember him as someone who probably found it hard to govern the church in the face of the scandals that the church has experienced over the last several years."

During his papacy, Benedict was forced to address accusations that priests had sexually abused boys, a scandal that hit in the United States more than a decade ago and soon spread across Europe.

As the Catholic church was rattled by such allegations, the Vatican published "Criteria for the Discernment of Vocation for Persons with Homosexual Tendencies."

It was widely viewed as the church's response to the worldwide scandal, but was also criticized for drawing a connection between pedophilia and homosexuality.

In 2008, the pope said the clergy sex abuse scandal in the United States made him feel "deeply ashamed." In 2010, Benedict apologized directly to victims and their families in Ireland.

"You have suffered grievously and I am truly sorry," he wrote to victims of child sex abuse by clergy in Ireland.

Benedict had plenty of critics during his papacy over what was perceived as archaic views on contraception. In March 2009, he commented that condoms are not the solution to the AIDS crisis, and can make the problem worse. He revised the comments in 2010, saying that male prostitutes who use condoms might be taking a first step toward a more responsible sexuality.

More controversy came in 2010, when, in what is seen as a gesture to traditional Catholics, Benedict removed restrictions on celebrating the old Latin Mass. The old rites include a Good Friday prayer for the conversion of Jews.

The year 2012 brought the "Vatileaks" scandal in which Benedict's former butler Paolo Gabriele was convicted of stealing the pope's private papers from his apartments and leaking them to a journalist, who published them in a best-selling book. Gabriele was sentenced to 18 months in an Italian prison.

Speaking today, Cardinal Donald Wuerl Archbishop of Washington said the pope's willingness to step aside is a sign of character

"I think it's a sign of the great humility of this pope and his love of the church and his courage," he said.

The role Benedict will play in retirement, as well as any enduring legacy of his brief but busy papacy, might be his love for the church, his humility or his courage. Or, perhaps, it has yet to be clearly understood.

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Gunbattle rocks Gao after rebels surprise French, Malians

GAO, Mali (Reuters) - Islamist insurgents launched a surprise raid in the heart of the Malian town of Gao on Sunday, battling French and local troops in a blow to efforts to secure Mali's recaptured north.

Local residents hid in their homes or crouched behind walls as the crackle of gunfire from running street battles resounded through the sandy streets and mud-brick houses of the ancient Niger River town, retaken from Islamist rebels last month by a French-led offensive.

French helicopters clattered overhead and fired on al Qaeda-allied rebels armed with AK-47s and rocket-propelled grenades who had infiltrated the central market area and holed up in a police station, Malian and French officers said.

The fighting inside Gao was certain to raise fears that pockets of determined Islamists who have escaped the lightning four-week-old French intervention in Mali will strike back with guerrilla attacks and suicide bombings.

After driving the bulk of the insurgents from major northern towns such as Timbuktu and Gao, French forces are trying to search out their bases in the remote and rugged Adrar des Ifoghas mountains, far up in the northeast.

But with Mali's weak army unable to secure recaptured zones, and the deployment of a larger African security force slowed by delays and kit shortages, vast areas to the rear of the French forward lines now look vulnerable to guerrilla activity.

"They infiltrated the town via the river. We think there were about 10 of them. They were identified by the population and they went into the police station," said General Bernard Barrera, commander of French ground operations in Mali.

He told reporters in Gao that French helicopters had intervened to help Malian troops pinned down by the rebels, who threw grenades from rooftops.

Malian gendarme Colonel Saliou Maiga told Reuters the insurgents intended to carry out suicide attacks in the town.

SUICIDE BOMBERS

No casualty toll was immediately available. But a Reuters reporter in Gao saw one body crumpled over a motorcycle. Malian soldiers said some of the raiders may have come on motorbikes.

The gunfire in Gao erupted hours after French and Malian forces reinforced a checkpoint on the northern outskirts that had been attacked for the second time in two days by a suicide bomber.

Abdoul Abdoulaye Sidibe, a Malian parliamentarian from Gao, said the rebel infiltrators were from the MUJWA group that had held the town until French forces liberated it late last month.

MUJWA is a splinter faction of al Qaeda's North African wing AQIM which, in loose alliance with the home-grown Malian Islamist group Ansar Dine, held Mali's main northern urban areas for 10 months until the French offensive drove them out.

Late on Saturday, an army checkpoint in Gao's northern outskirts came under attack by a group of Islamist rebels who fired from a road and bridge that lead north through the desert scrub by the Niger River to Bourem, 80 km (50 miles) away.

"Our soldiers came under heavy gunfire from jihadists from the bridge ... At the same time, another one flanked round and jumped over the wall. He was able to set off his suicide belt," Malian Captain Sidiki Diarra told reporters.

The bomber died and one Malian soldier was lightly wounded, he added. In Friday's motorbike suicide bomber attack, a Malian soldier was also injured.

Diarra described Saturday's bomber as a bearded Arab.

Since Gao and the UNESCO World Heritage city of Timbuktu were retaken last month, several Malian soldiers have been killed in landmine explosions on a main road leading north.

French and Malian officers say pockets of rebels are still in the bush and desert between major towns and pose a threat of hit-and-run guerrilla raids and bombings.

"We are in a dangerous zone... we can't be everywhere," a French officer told reporters, asking not to be named.

One local resident reported seeing a group of 10 armed Islamist fighters at Batel, just 10 km (6 miles) from Gao.

OPERATIONS IN NORTHEAST

The French, who have around 4,000 troops in Mali, are now focusing their offensive operations several hundred kilometers (miles) north of Gao in a hunt for the Islamist insurgents.

On Friday, French special forces paratroopers seized the airstrip and town of Tessalit, near the Algerian border.

From here, the French, aided by around 1,000 Chadian troops in the northeast Kidal region, are expected to conduct combat patrols into the Adrar des Ifoghas mountains.

The remaining Islamists are believed to have hideouts and supply depots in a rugged, sun-blasted range of rocky gullies and caves, and are also thought to be holding at least seven French hostages previously seized in the Sahel.

The U.S. and European governments back the French-led operation as a defense against Islamist jihadists threatening wider attacks, but rule out sending their own combat troops.

To accompany the military offensive, France and its allies are urging Mali authorities to open a national reconciliation dialogue that addresses the pro-autonomy grievances of northern communities like the Tuaregs, and to hold democratic elections.

Interim President Dioncounda Traore, appointed after a military coup last year that plunged the West African state into chaos and led to the Islamist occupation of the north, has said he intends to hold elections by July 31.

But he faces splits within the divided Malian army, where rival units are still at loggerheads.

(Additional reporting by Tiemoko Diallo and Adama Diarra in Bamako; Writing by Joe Bavier and Pascal Fletcher; Editing by Kevin Liffey)

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Jordan king seeks 'consensus' on PM

AMMAN: King Abdullah II on Sunday told newly elected MPs that he seeks to reach "consensus" with them before naming a prime minister, and hailed the "historic transformation" towards parliamentary government in Jordan.

"We will start... this new approach by consulting over the government's formation with the lower house and parliamentary blocs as they take shape, in order to reach consensus that leads to the designation of a prime minister," he told the opening of parliament.

King Abdullah said the premier should in turn consult parliamentary blocs and other forces as he selects his cabinet, seeking confidence "based on a policy statement resulting from the consultation process, and on four-year programmes."

"You are also expected to shoulder your responsibility towards the success of this historic transformation towards parliamentary government and its development," the king said.

Prime Minister Abdullah Nsur submitted his cabinet's resignation to the king on January 29, six days after tribal leaders, pro-regime loyalists and independent businessmen swept a general election boycotted by the opposition Muslim Brotherhood and others.

"If a coalition of blocs that enjoys the support of the house's majority emerges, the consultation and government formation processes will be quick and smooth," the king said.

"In the absence of a majority coalition, on the other hand, this process will take more time and effort. This is a fundamental fact of parliamentary democracy."

The king, who has vowed to pursue democratic reforms and reach out to groups such as the Brotherhood, urged parliament to "serve as an incubator of national dialogue" and begin extensive talks with local communities and political forces.

Analysts have said loyalist MPs would resist pressure for much-needed real political reform.

The Islamists have said the king's plans for a parliamentary government fall far short of true democratic change and insist he should have no say in naming a premier. They also insist that they will not join the government.

"The speech needs to be translated into practical steps in reality, on the ground," said Hamzeh Mansur, chief of the Islamic Action Front, the political arm of the Brotherhood.

"This parliament is like other past parliaments. It will not come up with anything new. And the idea of parliamentary government is still elusive. Again, we need a process of dialogue led by the king himself."

King Abdullah admitted that the election was held under "a law that was not ideal, although it earned as much consensus as was possible.

"Therefore, I call for revisiting this law based on an assessment of your experience and for reviewing the electoral system in a way that wins consensus."

Meanwhile, the 150-seat lower house of parliament elected veteran MP and former interior minister Saad Hayel Srur as speaker for a one-year term after winning 80 votes.

- AFP/jc

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Why the rush to execute one? Hang Rajiv, Beant killers too: Omar

SRINAGAR/NEW DELHI: A day after Afzal Guru's hanging, Jammu & Kashmir chief minister Omar Abdullah cautioned the Centre against being selective in executing those convicted of attacking symbols of democracy, and suggested that the government now move to implement the death penalty of killers of Rajiv Gandhi and Beant Singh, both equally symbols of state.

Kashmir continued to remain tense, particularly after one youth, Tariq Ahmad Bhat, drowned in a river in Ganderbal on Sunday when security forces were chasing a group of violent protesters.

Omar also criticised the Centre's decision to not allow Afzal's family one last meeting with him, saying it was "one of the biggest tragedies of the execution". He added that this would lead to further alienation of Kashmiris from the Indian mainstream.

"Why is it that you are in such a rush to execute one and not execute the others?" Omar asked. The executions of Balwant Singh Rajoana, who killed former Punjab CM Beant Singh, and Santham, Murugan and Perarivalan, involved in the assassination of former PM Rajiv Gandhi, have been stayed by courts.

The stand-alone execution would only complicate matters in a state where many people identify themselves with Afzal, the CM said. "I think the onus will rest on both the judiciary and the political leadership to prove to the people in Kashmir and to the wider world that these were not selective executions for political purposes," he said in interviews to TV news channels.

Omar said the view that Afzal didn't get a fair trial was shared by people beyond his state. "The Supreme Court judgment talks about strong circumstantial evidence and about satisfying the collective conscience of society. You don't hang people because society demands it. You hang people because the law demands it," he said.

Taking on his political rivals, Omar said he had no say in the execution. "My rivals want to pin the execution on me whereas my only job has been dealing with its fallout," he said.

Abdullah, incidentally, was told of the execution plans only around 8pm on Friday. He immediately alerted the chief secretary and DGP to put in place security measures like curfew and police bandobast to avert a violent reaction in the Valley.

Although home secretary R K Singh has said that a letter was sent to intimate Afzal's family about his hanging, this was denied by the family. Professor S A R Geelani, who was acquitted in the Parliament attack case, had told TOI soon after Afzal's execution that his wife Tabassum had no information of the hanging.

The CM slammed the home ministry statement that Afzal's family was informed through speed post about the rejection of his clemency petition by the President. "Do you expect such kind of communication in the internet age?" he asked.

No national or local newspapers were available in the Valley on Sunday. While national newspapers could not reach the stands due to curfew, local newspapers were denied permission to print on Sunday. There would be no editions of newspapers on Monday.

Editors said they had put the edition to bed and left for home on Saturday night, but found on Sunday morning that the authorities had imposed a ban on the publication of newspapers in the state.

"A police team arrived at the printing press and asked the management at midnight to not publish the newspaper for Sunday," read a post at Greater Kashmir, the largest circulated daily in J&K. "Though no written orders were issued to the media groups..." The ban on publication is expected to last a few days.

Murugan, Santhan and Perarivalan were convicted by the Supreme Court in May 1999. Their mercy petitions were rejected by then President Pratibha Patil in August 2011. But they appealed against the rejection of their clemency petition by the President. Their hanging, scheduled for September 9, 2011, was stayed by Madras high court which is hearing the case. Rajoana was to hang on March 31, 2012, but his execution was also stayed as one his co-convicts moved the court for judicial review just two days before the hanging.

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Paterno Family Fights 'Rush to Injustice'

The Paterno family is fighting to restore the legacy of former Penn State football coach Joe Paterno, flatly denying the allegations in the report by former FBI Director Louis Freeh that the legendary coach was complicit in a coverup of child sexual abuse by a former assistant coach.

"The Critique of the Freeh Report: The Rush to Injustice Regarding Joe Paterno," the report prepared by King & Spalding and released on paterno.com this morning, is described as an attempt to set the record straight with independent expert analysis examining the "most glaring errors on which the Freeh report is based."

"The Freeh report reflects an improper 'rush to injustice,'" the 238-page critique says. "There is no evidence that Joe Paterno deliberately covered up known incidents of child molestation by Jerry Sandusky to protect Penn State football or for any other reason; the contrary statements in the Freeh report are unsupported and unworthy of belief."

In their critique of the Freeh report, former U.S. Attorney General Dick Thornburgh and experts Jim Clemente and Fred Berlin examined the Freeh report and found that the report is "deeply flawed and that key conclusions regarding Joe Paterno are unsubstantiated and unfair."

According to the critique, the Freeh report "uncovers little new factual information as to Joe Paterno and does very little to advance the truth regarding his knowledge, or more accurately lack of knowledge, of Jerry Sandusky's molestation of children."

Freeh called the critique a "self-serving report" that "does not change the facts."

Patrick Smith/Getty Images|Gene J. Puskar/AP Photo

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READ: Louis Freeh's Statement in Response to Critique

Penn State, which commissioned Freeh to conduct the investigation, stood by the report and said it is moving forward with the 119 recommendations Freeh made.

"To date, the University has implemented a majority of those recommendations, which are helping to make the University stronger and more accountable," the school said in a statement today. "The University intends to implement substantially all of the Freeh recommendations by the end of 2013."

Former assistant coach Jerry Sandusky was sentenced last year to 30 to 60 years in prison after he was convicted of 45 criminal counts of sexually abusing young boys.

Some of the abuse occurred at the Penn State campus, and at least one incident was observed by a graduate assistant who said he reported it to Paterno. However, school officials did not report the allegations to law enforcement.

PHOTOS: Jerry Sandusky Gets 30 Years in Prison for Sex Abuse

In the wake of the Sandusky scandal, Joe Paterno, who coached the Nittany Lions for 46 years and became the winningest coach in Division 1 football history in 2011, was dismissed.

The allegations of Paterno's involvement in a coverup came as a shock that reverberated beyond the Penn State campus, because of his reputation as a coach who valued character and academic achievement as much as winning.

Following his dismissal, Paterno was diagnosed with lung cancer and broke his hip. He died on Jan. 22, 2012, at the age of 85.

Former Penn State University President Graham Spanier, along with Penn State athletic director Tim Curley, and school vice president Gary Schultz are awaiting a hearing after they were accused of lying and concealing the sex abuse allegations against Sandusky.

Freeh Report Critique

Released in July, the 267-page report by Freeh concluded that Joe Paterno and his superiors valued the football program and the image of Penn State more than they valued the safety of Sandusky's victims.

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Israel's Lieberman says Palestinian peace accord impossible

JERUSALEM (Reuters) - Israel has no chance of signing a permanent peace accord with the Palestinians and should instead seek a long-term interim deal, the most powerful political partner of Prime Minister Benjamin Netanyahu said on Saturday.

The remarks by Avigdor Lieberman, an ultranationalist whose joint party list with Netanyahu narrowly won a January 22 election while centrist challengers made surprise gains, seemed designed to dampen expectations at home and abroad of fresh peacemaking.

A spring visit to Israel and the Palestinian territories by U.S. President Barack Obama, announced this week, has stirred speculation that foreign pressure for a diplomatic breakthrough could build - though Washington played down that possibility.

In a television interview, ex-foreign minister Lieberman linked the more than two-year-old impasse to pan-Arab political upheaval that has boosted Islamists hostile to the Jewish state.

These include Hamas, rivals of U.S.-backed Palestinian President Mahmoud Abbas, who control the Gaza Strip and spurn coexistence with Israel though they have mooted extended truces.

"Anyone who thinks that in the center of this socio-diplomatic ocean, this tsunami which is jarring the Arab world, it is possible to arrive at the magic solution of a comprehensive peace with the Palestinians does not understand," Lieberman told Israel's Channel Two.

"This is impossible. It is not possible to solve the conflict here. The conflict can be managed and it is important to manage the conflict ... to negotiate on a long-term interim agreement."

Abbas broke off talks in late 2010 in protest at Israel's settlement of the occupied West Bank. He angered Israel and the United States in November by securing a U.N. status upgrade that implicitly recognized Palestinian independence in all the West Bank, East Jerusalem and Gaza.

Israel insists it will keep East Jerusalem and swathes of West Bank settlements under any eventual peace deal. Most world powers consider the settlements illegal because they take up land seized in the 1967 Middle East war.

Lieberman, himself a West Bank settler, said the ball was "in Abu Mazen's (Abbas') court" to revive diplomacy.

Abbas has demanded Israel first freeze all settlement construction. With two decades gone since Palestinians signed their first interim deal with Israel, he has ruled out any new negotiations that do not solemnize Palestinian statehood.

Netanyahu's spokesman Mark Regev noted that Lieberman, in the Channel Two interview, had said he was expressing his own opinion.

Asked how Netanyahu saw peace prospects for an accord with the Palestinians, Regev referred to a speech on Tuesday in which the conservative prime minister said that Israel, while addressing threats by its enemies, "must also pursue secure, stable and realistic peace with our neighbors".

Netanyahu has previously spoken in favor of a Palestinian state, though he has been cagey on its borders and whether he would be prepared to dismantle Israeli settlements.

Lieberman's role in the next coalition government is unclear as he faces trial for corruption. If convicted, he could be barred from the cabinet. Lieberman denies wrongdoing and has said he would like to regain the foreign portfolio, which he surrendered after his indictment was announced last year.

(Writing by Dan Williams; Editing by Stephen Powell)

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Russian opposition activist put under house arrest: media

MOSCOW: A Russian court on Saturday put prominent opposition leader Sergei Udaltsov under house arrest amid accusations he incited mass disorder to overthrow President Vladimir Putin, local media reported.

The Basmanny court in Moscow was responding to a request by investigators who said Udaltsov was not showing good behaviour and not cooperating with the authorities.

The judge said that Udaltsov could flee abroad or "try to carry out his criminal intentions".

Under the terms of his house arrest, Udaltsov must stay at his home until April 6 and is banned from using the telephone or Internet. He may only speak to his family, his lawyers and investigators.

The 35-year-old leader of the Left Front, who until now has remained under travel restrictions that prevented him from leaving Moscow, faces 10 years in prison if a probe leads to a conviction.

Authorities opened a probe after state-controlled television broadcast a documentary in October that alleged Udaltsov was plotting a violent uprising against Putin's government.

Udaltsov denies the accusations.

Before appearing in court, he told the media: "In my opinion nothing has changed that justifies putting me under house arrest."

"I responded to all the investigators' summons and I did not leave Moscow," he added.

Russia's investigative committee had said Friday that Udaltsov was being uncooperative with authorities.

"Sergei Udaltsov has not lived where he is registered for a long time, his mobile phones are often switched off, making it more difficult to summon the accused by the investigator," the committee said in a statement.

The committee said that Udaltsov "continues to commit illegal acts", saying the activist had taken part in an unauthorised protest in January where he had called on demonstrators to "launch unlimited protest action".

Udaltsov's lawyers said they would appeal against the decision.

One of the most radical voices in the protest movement, the shaven-headed activist rose to prominence during unprecedented protests against Putin's 12-year political dominance in the winter of 2011, and has been one of the key speakers at opposition rallies.

He is the first prominent opposition leader to be put under house arrest since those protests -- a sign that the Russian authorities may be preparing to ramp up pressure on the opposition as they seek to cauterise dissent.

Another opposition activist, Ilya Yashin, described the arrest as "unpleasant news but pretty much expected".

"Arrests, searches and questioning of opposition figures by the authorities is becoming the norm now," he told Moscow's Echo radio. "Their methods are becoming harsher."

A total of 19 people are being prosecuted for last year's events, 12 of whom are in pre-trial detention. They each risk 10 years in jail.

Two of Udaltsov's allies have already been detained and charged in the probe, including Leonid Razvozzhayev, an aide to an opposition parliamentary lawmaker.

Razvozzhayev's case raised concern internationally after he said he was kidnapped in Ukraine and forced back to Russia, where he was detained and tortured.

He told rights groups that he admitted to the charges of causing mass unrest under duress and claims his family was given death threats.

Anti-corruption blogger Alexei Navalny was also detained but later released.

According to the non-government organisation Human Rights Watch, Russian civil society was subject last year to the worst repression since the fall of the Soviet Union in 1991.

- AFP/jc

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Needless hysterectomies on poor women rampant across India: Study

MUMBAI: Is India witnessing a spurt in unnecessary hysterectomies? Data released by international charity organization Oxfam on February 6 says as much. The agency said that unnecessary hysterectomies were being performed in Indian private hospitals to economically exploit poor women as well as government-run insurance schemes.

A right to information ( RTI) request filed by one of Oxfam's local NGOs in the Dausa district of Rajasthan showed that 258 of 285 women—65%—investigated over six months had undergone hysterectomies. Many of these women were under 30, with the youngest being 18 years old.

An editorial in the British Medical Journal quoted Oxfam's global spokesperson Araddhya Mehtta as saying that the "trend is seen all over India but is particularly disturbing in Rajasthan, Bihar and Chattisgarh where doctors simply abuse their power of being a doctor". In 2010, the Andhra Pradesh government tweaked its state-sponsored insurance scheme to disallow hysterectomies in private hospitals after surveys revealed that uteruses of a number of beneficiaries were removed merely to claim higher insurance amounts (the state insurance scheme is only available for the economically poor sections).

Dr Duru Shah, former president of FOGSI (Federation of Obstetric and Gynaecological Societies of India), said that modern medicines could fix 95% of woman's menstrual problems without the need for surgery.

However, experts fear the trend of unnecessary hysterectomies possibly exists in urban centres such as Mumbai as well.

Aniruddha Malpani, medical director of HELP (Health Education Library for People) in Fort, said, "It's easy to get data from a small centre such as Dausa but it would be impossible to get similar data from cities like Mumbai. However, if some doctors in small towns are performing unnecessary hysterectomies, why should it be any different in cities like Mumbai?"

Indeed, an audit performed by insurance companies in Chennai in 2009 had shown that more than 500 women in the 25-35 age group had undergone hysterectomies. A Central government study in the wake of the Andhra Pradesh scam had said that women under 45 rarely needed hysterectomy.

A 2011 research paper in medical journal Reproductive Health Matters, conducted by SEWA Health Cooperative doctors in Ahmedabad, showed that insured women—both in urban and rural areas—had higher rates of hysterectomy. "Among insured women, 9.8% of rural women and 5.3% of urban women had had a hysterectomy, compared to 7.2% and 4.0%, respectively, of uninsured women,'' said the study.

The OXFAM report, in fact, says that India should end its public-private partnership programmes (that allow poor women with government insurance plan to undergo a hysterectomy in private hospitals) until better regulation is in place.

Oxfam official Mehtta has been quoted as saying, "When women came with abdomen pain, doctors prescribed hysterectomy to women from poor economic backgrounds, telling them that it might be a cancer or a hole or a stone in the uterus without doing any thorough necessary investigations."
Dr Duru Shah said that unnecessary hysterectomies affected the concerned woman's health. "A young woman who has undergone hysterectomy may suffer early menopause (stoppage of periods) and the accompanying health problems of increased risk of cardiac diseases and fractures due to brittle bones,'' she said.

Dr Rekha Daver who heads the gynaecology of J J Hospital, Byculla, said, "Generally speaking, there may be a marginal increase over the years. But this may only be because women from rural areas who travel to referral centres in cities don't want to prolong their suffering." She said it wasn't feasible for these women to return to cities a second time for any treatment that may be required.

Incidentally, Maharashtra doesn't allow hysterectomies in private hospitals under the insurance scheme launched last year for the economically weaker sections, called the Rajiv Gandhi Jeevandayee Arogya Scheme. "We have learnt from the Andhra Pradesh experience," said Dr K Venkatesam, CEO of the arogya scheme.

However, not all agree that hysterectomies are on the rise. Gynecologist Dr Rakesh Sinha from Mumbai said, "It would be wrong to say there is an epidemic of hysterectomies in Mumbai or India. What has changed over the past few years is that we have facilities such as USG to make early and accurate diagnosis. Moreover, there are procedures available that allow women to go home within a day or two."

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After early start, worst of flu season may be over

NEW YORK (AP) — The worst of the flu season appears to be over.

The number of states reporting intense or widespread illnesses dropped again last week, and in a few states there was very little flu going around, U.S. health officials said Friday.

The season started earlier than normal, first in the Southeast and then spreading. But now, by some measures, flu activity has been ebbing for at least four weeks in much of the country. Flu and pneumonia deaths also dropped the last two weeks, the Centers for Disease Control and Prevention reported.

"It's likely that the worst of the current flu season is over," CDC spokesman Tom Skinner said.

But flu is hard to predict, he and others stressed, and there have been spikes late in the season in the past.

For now, states like Georgia and New York — where doctor's offices were jammed a few weeks ago — are reporting low flu activity. The hot spots are now the West Coast and the Southwest.

Among the places that have seen a drop: Lehigh Valley Hospital-Cedar Crest in Allentown, Pa., which put up a tent outside its emergency room last month to help deal with the steady stream of patients. There were about 100 patients each day back then. Now it's down to 25 and the hospital may pack up its tent next week, said Terry Burger, director of infection control and prevention for the hospital.

"There's no question that we're seeing a decline," she said.

In early December, CDC officials announced flu season had arrived, a month earlier than usual. They were worried, saying it had been nine years since a winter flu season started like this one. That was 2003-04 — one of the deadliest seasons in the past 35 years, with more than 48,000 deaths.

Like this year, the major flu strain was one that tends to make people sicker, especially the elderly, who are most vulnerable to flu and its complications

But back then, that year's flu vaccine wasn't made to protect against that bug, and fewer people got flu shots. The vaccine is reformulated almost every year, and the CDC has said this year's vaccine is a good match to the types that are circulating. A preliminary CDC study showed it is about 60 percent effective, which is close to the average.

So far, the season has been labeled moderately severe.

Like others, Lehigh Valley's Burger was cautious about making predictions. "I'm not certain we're completely out of the woods," with more wintry weather ahead and people likely to be packed indoors where flu can spread around, she said.

The government does not keep a running tally of flu-related deaths in adults, but has received reports of 59 deaths in children. The most — nine — were in Texas, where flu activity was still high last week. Roughly 100 children die in an average flu season, the CDC says

On average, about 24,000 Americans die each flu season, according to the CDC.

According to the CDC report, the number of states with intense activity is down to 19, from 24 the previous week, and flu is widespread in 38 states, down from 42.

Flu is now minimal in Florida, Kentucky, Maine, Montana, New Hampshire and South Carolina.

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Online:

CDC: http://www.cdc.gov/flu/

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