Although recent months have seen improvement in the number of housing starts and permits pulled, it will be multi-family builders that feel the uptick initially, according to a panel of economists speaking at the International Builders' Show in Las Vegas Tuesday.
Apartment builders will be the first to benefit by an increasing number of new households as young adults move out on their own and fewer households double up, the experts said.
Continued low interest rates and an increase in homes prices in most markets are likely to bring back home buyers who have been sitting on the sidelines, they said.
"Finally, people feel if they buy a house, it will appreciate," said David Crowe, chief economist for the National Assn. of Home Builders.
Home loan rates are expected to remain below 4% in 2013, said Frank Nothaft, chief economist at Freddie Mac. However, he cautioned of some "headwinds" to housing growth, including strict mortgage qualification requirements, uncertainties about employment and consumer cautiousness.
Other questions clouding the picture include the spending and budget issues yet unresolved in Washington.
Describing his panel as "relatively conservative in our forecasts," David Berson, senior vice president and chief economist at Nationwide Insurance, cited low interest rates, job growth, new household formations and house price gains as other factors supporting a housing recovery.
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Home sales jump to highest pace in three years
Builder confidence in housing is highest in six years
WASHINGTON -- After a messy fight that highlighted strains with the White House, the Democratic National Committee completed what should have been the routine election of a new slate of officers Tuesday.
As expected, Rep. Debbie Wasserman Schultz of Florida was given another term as national party chairwoman. But below that level, chaos reigned for a time as DNC members balked at rubber-stamping a White House-approved list of replacements for several veterans of the pre-Obama era.
Among the incoming DNC leaders are vice chairwomen Maria Elena Durazo, a Los Angeles labor official, and Tulsi Gabbard, the newly elected congresswoman from Hawaii. Henry R. Munoz III of San Antonio was named finance chairman, the first Latino in that post.
Complete coverage of the 2013 inauguration
But many on the DNC strongly resisted the forced removal of longtime activist Alice Travis Germond as DNC secretary. Highly popular with the membership, Germond, who calls the roll of the states at presidential nominating conventions, is only the third person to hold that job since 1944. In order to tighten its control of the DNC, the White House wanted to replace her with Stephanie Rawlings-Blake, the mayor of Baltimore, who has no experience in national politics.
Angered by the handling of the leadership change by Patrick Gaspard, a former Obama organizer who serves as the party’s executive director, DNC members tried to postpone election of the secretary until the fall. A clearly flustered Schultz, after halting the proceedings and huddling offstage with Germond, returned to announce that Germond had agreed to become secretary emeritus of the party and an at-large DNC member. With that, the slate of officers, including Rawlings-Blake, was approved.
The unexpected drama came only days after President Obama announced creation of his new national advocacy operation, Organizing for Action, widely seen as undermining the DNC’s already weakened status as a political organization.
Schultz, who was Obama’s pick as party chairwoman during his first term, defended the president’s decision, telling the DNC that the new Obama group didn’t pose a threat to the national party.
PHOTOS: President Obama’s second inauguration
Schultz said that she was “thrilled” that Obama’s campaign hadn’t ended with the 2012 election and that his new organization would be “complementing the work we are doing.” She said the Obama group would be training and engaging grass-roots volunteers “so that our work at the Democratic Party can continue to be about electing Democrats up and down the ballot.”
The dispute during the meeting at a Washington hotel, one day after Obama’s inaugural celebration, dragged on for so long that Vice President Joe Biden was forced to cool his heels in a nearby ballroom until the DNC members finished their business.
Although the party organization’s influence may be fading, the hundreds of national committee members still retain at least one measure of clout: They are automatic “superdelegates” to the Democrats’ presidential nominating conventions (though Obama aides briefly considered, and then rejected, getting rid of their delegate power several years ago).
Biden, who would covet those DNC delegate votes if he ran for president in 2016, eventually was able to schmooze with the members at a private reception after the meeting.
RIM is set to announce the first devices running its new BlackBerry 10 operating system at an event on January 30. A lucky few, however, have already gotten their hands on what looks to be the new hardware, including German site TelekomPresse.
[More from Mashable: Watch These iPhone Knockoffs Get Bulldozed]
The site has the BlackBerry Z10, a touchscreen device with a similar look to some of the other popular smartphones out there — especially the iPhone 5.
Curious to see how the two compared, they put them side-by-side in the video above, running through both the physical design of both devices as well as some of their features.
[More from Mashable: RIM May License BlackBerry 10 to Other Manufacturers]
Notably, the video shows a Siri-like voice control functionality in BlackBerry 10, that we haven’t seen previously. As you can see in the test above, it beats Siri for speed.
SEE ALSO: RIM Adds 15,000 BlackBerry 10 Apps in a Weekend
While similar at first glance, design-wise the two phones do have some differences. The Z10 has a 4.2-inch screen, slightly larger than the iPhone 5’s 4-inch display. Both phones have a power button on top, however, the button on the BlackBerry is in the center of the top of the phone, while the iPhone’s is on the right on the device.
The volume controls are on the right side of the Z10, and left side of the iPhone 5. When it comes to power, the connection for the iPhone 5 is on the bottom of the device with the headphone jack, while the HDMI and USB connections on the Z10 are located on the left.
Check out the video above for a look at the full comparison of the two devices. Are you looking forward to BlackBerry 10? Can the new OS save RIM? Let us know your thoughts in the comments.
BlackBerry 10 Lock Screen
You unlock a BlackBerry 10 device by swiping up from the bottom of the screen.
Click here to view this gallery.
This story originally published on Mashable here.
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In the 1970s, women’s health advocates were highly suspicious of mastectomies. They argued that surgeons — in those days, pretty much an all-male club — were far too quick to remove a breast after a diagnosis of cancer, with disfiguring results.
But today, the pendulum has swung the other way. A new generation of women want doctors to take a more aggressive approach, and more and more are asking that even healthy breasts be removed to ward off cancer before it can strike.
Researchers estimate that as many as 15 percent of women with breast cancer — 30,000 a year — opt to have both breasts removed, up from less than 3 percent in the late 1990s. Notably, it appears that the vast majority of these women have never received genetic testing or counseling and are basing the decision on exaggerated fears about their risk of recurrence.
In addition, doctors say an increasing number of women who have never had a cancer diagnosis are demanding mastectomies based on genetic risk. (Cancer databases don’t track these women, so their numbers are unknown.)
“We are confronting almost an epidemic of prophylactic mastectomy,” said Dr. Isabelle Bedrosian, a surgical oncologist at M. D. Anderson Cancer Center in Houston. “I think the medical community has taken notice. We don’t have data that say oncologically this is a necessity, so why are women making this choice?”
One reason may be the never-ending awareness campaigns that have left many women in perpetual fear of the disease. Improvements in breast reconstruction may also be driving the trend, along with celebrities who go public with their decision to undergo preventive mastectomy.
This month Allyn Rose, a 24-year-old Miss America contestant from Washington, D.C., made headlines when she announced plans to have both her healthy breasts removed after the pageant; both her mother and her grandmother died from breast cancer. The television personality Giuliana Rancic, 37, and the actress Christina Applegate, 41, also talked publicly about having double mastectomies after diagnoses of early-stage breast cancer.
“You’re not going to find other organs that people cut out of their bodies because they’re worried about disease,” said the medical historian Dr. Barron H. Lerner, author of “The Breast Cancer Wars” (2001). “Because breast cancer is a disease that is so emotionally charged and gets so much attention, I think at times women feel almost obligated to be as proactive as possible — that’s the culture of breast cancer.”
Most of the data on prophylactic mastectomy come from the University of Minnesota, where researchers tracked contralateral mastectomy trends (removing a healthy breast alongside one with cancer) from 1998 to 2006. Dr. Todd M. Tuttle, chief of surgical oncology, said double mastectomy rates more than doubled during that period and the rise showed no signs of slowing.
From those trends as well as anecdotal reports, Dr. Tuttle estimates that at least 15 percent of women who receive a breast cancer diagnosis will have the second, healthy breast removed. “It’s younger women who are doing it,” he said.
The risk that a woman with breast cancer will develop cancer in the other breast is about 5 percent over 10 years, Dr. Tuttle said. Yet a University of Minnesota study found that women estimated their risk to be more than 30 percent.
“I think there are women who markedly overestimate their risk of getting cancer,” he said.
Most experts agree that double mastectomy is a reasonable option for women who have a strong genetic risk and have tested positive for a breast cancer gene. That was the case with Allison Gilbert, 42, a writer in Westchester County who discovered her genetic risk after her grandmother died of breast cancer and her mother died of ovarian cancer.
Even so, she delayed the decision to get prophylactic mastectomy until her aunt died from an aggressive breast cancer. In August, she had a double mastectomy. (She had her ovaries removed earlier.)
“I feel the women in my family didn’t have a way to avoid their fate,” said Ms. Gilbert, author of the 2011 book “Parentless Parents,” about how losing a parent influences one’s own style of parenting. “Here I was given an incredible opportunity to know what I have and to do something about it and, God willing, be around for my kids longer.”
Even so, she said her decisions were not made lightly. The double mastectomy and reconstruction required an initial 11 1/2-hour surgery and an “intense” recovery. She got genetic counseling, joined support groups and researched her options.
But doctors say many women are not making such informed decisions. Last month, University of Michigan researchers reported on a study of more than 1,446 women who had breast cancer. Four years after their diagnosis, 35 percent were considering removing their healthy breast and 7 percent had already done so.
Notably, most of the women who had a double mastectomy were not at high risk for a cancer recurrence. In fact, studies suggest that most women who have double mastectomies never seek genetic testing or counseling.
“Breast cancer becomes very emotional for people, and they view a breast differently than an arm or a required body part that you use every day,” said Sarah T. Hawley, an associate professor of internal medicine at the University of Michigan. “Women feel like it’s a body part over which they totally have a choice, and they say, ‘I want to put this behind me — I don’t want to worry about it anymore.’ ”
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Americans are going to chow down on 1.23 billion chicken wings during Super Bowl weekend this year. But there will be fewer wings available and they’ll cost more, according to an annual report.
The NFL championship game, this year between the San Francisco 49ers and the Baltimore Ravens, is the biggest day of the year for chicken wings, according to the National Chicken Council.
This time around, however, there will be 12.3 million fewer wings eaten than last year, or a 1% decline, according to the trade group.
The group attributed the slide to fewer chickens in 2012, as corn and animal feed prices soared to record highs amid a severe summer drought and ethanol fuel production regulations.
And with shrinking supply and strong demand, the chicken council said wholesale wings will be at their “most expensive ever.” Wings are currently the highest priced portion of a chicken and cost $2.11 a pound in the Northeast, up 12% from a year earlier.
So are we headed for a hot wings equivalent of the bacon shortage predicted last year? Not to worry, said Bill Roenigk, chief economist for the chicken trade group.
“The good news for consumers is that restaurants plan well in advance to ensure they have plenty of wings for the big game,” he said. “And some restaurants are promoting boneless wings and some are offering flexible serving sizes.”
One caveat, however.
“If you’re planning to cook your own wings, I wouldn’t advise being in line at the supermarket two hours before kickoff,” Roenigk said.
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Fifteen years before the clergy sex abuse scandal came to light, Archbishop Roger M. Mahony and a top advisor discussed ways to conceal the molestation of children from law enforcement, according to internal Catholic church records released Monday.
The archdiocese's failure to purge pedophile clergy and reluctance to cooperate with law enforcement has previously been known. But the memos written in 1986 and 1987 by Mahony and Msgr. Thomas J. Curry, then the archdiocese's chief advisor on sex abuse cases, offer the strongest evidence yet of a concerted effort by officials in the nation's largest Catholic diocese to shield abusers from police. The newly released records, which the archdiocese fought for years to keep secret, reveal in church leaders' own words a desire to keep authorities from discovering that children were being abused.
In the confidential letters, filed this month as evidence in a civil court case, Curry proposed strategies to prevent police from investigating three priests who had admitted to church officials that they abused young boys. Curry suggested to Mahony that they prevent them from seeing therapists who might alert authorities and that they give the priests out-of-state assignments to avoid criminal investigators.
One such case that has previously received little attention is that of Msgr. Peter Garcia, who admitted preying for decades on undocumented children in Spanish-speaking parishes. After Garcia's discharge from a New Mexico treatment center for pedophile clergy, Mahony ordered him to stay away from California "for the foreseeable future" in order to avoid legal accountability, the files show. "I believe that if Monsignor Garcia were to reappear here within the archdiocese we might very well have some type of legal action filed in both the criminal and civil sectors," the archbishop wrote to the treatment center's director in July 1986.
The following year, in a letter to Mahony about bringing Garcia back to work in the archdiocese, Curry said he was worried that victims in Los Angeles might see the priest and call police.
"[T]here are numerous — maybe twenty — adolescents or young adults that Peter was involved with in a first degree felony manner. The possibility of one of these seeing him is simply too great," Curry wrote in May 1987.
Garcia returned to the Los Angeles area later that year, but the archdiocese did not allow him to work in any church because he refused to take medication to suppress his sexual urges. He left the priesthood in 1989, according to the church.
Garcia was never prosecuted and died in 2009. The files show he admitted to a therapist that he had sexually abused boys "on and off" since his 1966 ordination. He assured church officials his victims were unlikely to come forward because of their immigration status. In at least one case, according to a church memo, he threatened to have a boy he had raped deported if he went to police.
The memos are from personnel files for 14 priests submitted to a judge on behalf of a man who claims he was abused by one of the priests, Father Nicholas Aguilar Rivera. The man's attorney, Anthony De Marco, wrote in court papers the files show "a practice of thwarting law enforcement investigations" by the archdiocese. It's not always clear from the records whether the church followed through on all its discussions about eluding police, but it did in some cases.
Mahony, who retired in 2011, has apologized repeatedly for errors in handling abuse allegations. In a statement Monday, he apologized once again and recounted meetings he's had with "some 90" victims of abuse.
"I have a 3 x 5 card for every victim I met with on the altar of my small chapel. I pray for them every single day," he wrote. "As I thumb through those cards I often pause as I am reminded of each personal story and the anguish that accompanies that life story."
"It remains my daily and fervent prayer that God's grace will flood the heart and soul of each victim, and that their life-journey continues forward with ever greater healing," he added. "I am sorry."
Curry did not return calls seeking comment. He currently serves as the archdiocese's auxiliary bishop for Santa Barbara.
The confidential files of at least 75 more accused abusers are slated to become public in coming weeks under the terms of a 2007 civil settlement with more than 500 victims. A private mediator had ordered the names of the church hierarchy redacted from those documents, but after objections from The Times and the Associated Press, a Superior Court judge ruled that the names of Mahony, Curry and others in supervisory roles should not be blacked out.
Garcia's was one of three cases in 1987 in which top church officials discussed ways they could stymie law enforcement. In a letter about Father Michael Wempe, who had acknowledged using a 12-year-old parishioner as what a church official called his "sex partner," Curry recounted extensive conversations with the priest about potential criminal prosecution.
"He is afraid ... records will be sought by the courts at some time and that they could convict him," Curry wrote to Mahony. "He is very aware that what he did comes within the scope of criminal law."
Curry proposed Wempe could go to an out-of-state diocese "if need be." He called it "surprising" that a church-paid counselor hadn't reported Wempe to police and wrote that he and Wempe "agreed it would be better if Mike did not return to him."
Perhaps, Curry added, the priest could be sent to "a lawyer who is also a psychiatrist" thereby putting "the reports under the protection of privilege."
Curry expressed similar concerns to Mahony about Father Michael Baker, who had admitted his abuse of young boys during a private 1986 meeting with the archbishop.
In a memo about Baker's return to ministry, Curry wrote, "I see a difficulty here, in that if he were to mention his problem with child abuse it would put the therapist in the position of having to report him … he cannot mention his past problem."
Mahony's response to the memo was handwritten across the bottom of the page: "Sounds good —please proceed!!" Two decades would pass before authorities gathered enough information to convict Baker and Wempe of abusing boys.
Federal and state prosecutors have investigated possible conspiracy cases against the archdiocese hierarchy. Former Dist. Atty. Steve Cooley said in 2007 that his probe into the conduct of high-ranking church officials was on hold until his prosecutors could access the personnel files of all the abusers. The U.S. attorney's office convened a grand jury in 2009, but no charges resulted.
During those investigations, the church was forced by judges to turn over some but not all of the records to prosecutors. The district attorney's office has said its prosecutors plan to review priest personnel files as they are released.
Mahony was appointed archbishop in 1985 after five years leading the Stockton diocese. While there, he had dealt with three allegations of clergy abuse, including one case in which he personally reported the priest to police.
In Los Angeles, he tapped Curry, an Irish-born priest, as vicar of clergy. The records show that sex abuse allegations were handled almost exclusively by the archbishop and his vicar. Memos that crossed their desks included graphic details, such as one letter from another priest accusing Garcia of tying up and raping a young boy in Lancaster.
Mahony personally phoned the priests' therapists about their progress, wrote the priests encouraging letters and dispatched Curry to visit them at a New Mexico facility, Servants of the Paraclete, that treated pedophile priests.
"Each of you there at Jemez Springs is very much in my prayers and I call you to mind each day during my celebration of the Eucharist," Mahony wrote to Wempe.
The month after he was named archbishop, Mahony met with Garcia to discuss his molestation of boys, according to a letter the priest wrote while in therapy. Mahony instructed him to be "very low key" and assured him "no one was looking at him for any criminal action," Garcia recalled in a letter to an official at Servants of the Paraclete.
In a statement Monday on behalf of the archdiocese, a lawyer for the church said its policy in the late 1980s was to let victims and their families decide whether to go to the police.
"Not surprisingly, the families of victims frequently did not wish to report to police and have their child become the center of a public prosecution," lawyer J. Michael Hennigan wrote.
He acknowledged memos written in those years "sometimes focused more on the needs of the perpetrator than on the serious harm that had been done to the victims."
"That is part of the past," Hennigan wrote. "We are embarrassed and at times ashamed by parts of the past. But we are proud of our progress, which is continuing."
Hennigan said that the years in which Mahony dealt with Garcia were "a period of deepening understanding of the nature of the problem of sex abuse both here and in our society in general" and that the archdiocese subsequently changed completely its approach to reports of abuse.
"We now have retired FBI agents who thoroughly investigate every allegation, even anonymous calls. We aggressively assist in the criminal prosecution of offenders," Hennigan wrote.
Mahony and Curry have been questioned under oath in depositions numerous times about their handling of molestation cases. The men, however, have never been questioned about attempts to stymie law enforcement, because the personnel files documenting those discussions were only provided to civil attorneys in recent months.
In a 2010 deposition, Mahony acknowledged the archdiocese had never called police to report sexual abuse by a priest before 2000. He said church officials were unable to do so because they didn't know the names of the children harmed.
"In my experience, you can only call the police when you've got victims you can talk to," Mahony said.
When an attorney for an alleged victim suggested "the right thing to do" would have been to summon police immediately, Mahony replied, "Well, today it would. But back then that isn't the way those matters were approached."
Since clergy weren't legally required to report suspected child abuse until 1997, Mahony said, the people who should have alerted police about pedophiles like Baker and Wempe were victims' therapists or other "mandatory reporters" of child abuse.
"Psychologists, counselors … they were also the first ones to learn [of abuse] so they were normally the ones who made the reports," he said.
In Garcia's 451-page personnel file, one voice decried the church's failures to protect the victims and condemned the priest as someone who deserved to be behind bars. Father Arturo Gomez, an associate pastor at a Spanish-speaking church near Olvera Street, wrote to a regional bishop in 1989, saying he was "angry" and "disappointed" at the church's failure to help Garcia's victims. He expressed shock that the bishop, Juan A. Arzube, had told the family of two of the boys that Garcia had thought of taking his own life.
"You seemed to be at that moment more concern[ed] for the criminal rather than the victum! (sic)" Gomez wrote to Arzube in 1989.
Gomez urged church leaders to identify others who may have been harmed by Garcia and to get them help, but was told they didn't know how.
"If I was the father … Peter Garcia would be in prison now; and I would probably have begun a lawsuit against the archdiocese," the priest wrote in the letter. "The parents … of the two boys are more forgiving and compassionate than I would be."
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MOSCOW (Reuters) – President Vladimir Putin has ordered Russian authorities to protect state computers from hacking attacks, the Kremlin said on Monday, after an Internet security firm said a spy network had infiltrated government and embassy computers across the former Soviet bloc.
Dubbed Red October, the network used phishing attacks – or unsolicited emails to intended targets – to infect the computers of embassies and other state institutions with a program designed to harvest intelligence and send it back to a server.
Putin signed a decree on January 15 empowering the Federal Security Service (FSB) to “create a state system for the detection, prevention and liquidation of the effects of computer attacks on the information resources of the Russian Federation”.
State computer and telecommunications networks protected by the cyber security system should include those inside Russia and at its embassies and consulates abroad, according to the decree, which was published on a Kremlin website on Monday.
The Russian Internet security firm Kaspersky Labs said last week that the computer espionage network, discovered last October, had been seeking intelligence from Eastern European and ex-Soviet states including Russia since 2007. (http://r.reuters.com/mag45t )
Many of the systems infected belonged to diplomatic missions, Vitaly Kamluk, an expert in computer viruses at Kaspersky Labs, said last week. He declined to name specific countries.
Kamluk said last week that the network was still active, and that law enforcement agencies in several European countries were investigating it.
Kaspersky Labs said the infiltrators had created more than 60 domain names, mostly in Russia and Germany, that worked as proxies to hide the location of their real server.
The FSB declined immediate comment last week when asked whether Russia had taken action to bring any suspected members of the espionage network to justice, or acted to improve Internet security in light of the discovery.
The FSB – the main successor agency of the Soviet KGB – requested a written query, to which it has not yet responded. The Kremlin declined immediate comment on Monday when asked whether Putin’s decree was linked to Red October.
(Reporting by Steve Gutterman and Thomas Grove; Editing by Kevin Liffey)
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NEW YORK (AP) — The second inauguration of President Barack Obama gave television networks a chance to bask in the majesty of a Washington event that unites Americans of all beliefs and ideologies — at least for a moment.
Then it was back to business as usual: the dissemination of widely divergent views on what people had just seen for themselves.
ABC, CBS and NBC, along with the cable news networks, cast aside regular programming on Monday to carry the ceremonial swearing-in and Obama's inaugural address. It didn't carry the same sense of history that Obama's first inauguration did. In 2009, even ESPN and MTV covered the swearing-in. This year, ESPN stuck to talk about the upcoming Super Bowl, and MTV aired "Catfish: The TV Show."
Until the ceremony actually began, the networks were all challenged with the television equivalent of vamping for time. On MSNBC, Andrea Mitchell interviewed singer John Legend, who noted that one of his songs was on Obama's Spotify playlist. NBC discussed first lady Michelle Obama's new hairstyle.
"Well, what else are we going to talk about?" anchor Brian Williams said apologetically.
Obama's inaugural address lasted about 18 minutes, seemingly only slightly longer than the inaugural poem and definitely shorter than the evaluations of on-air pundits paid to dissect it.
CBS veteran Washington hand Bob Schieffer, sifting through a transcript of Obama's speech after it was delivered, said he "didn't hear a line that kind of sums it all up." His colleague, Scott Pelley, called it a civil rights speech and noted Obama's citation of key moments in fights for equality among black Americans, women and gays.
"I felt during much of the speech, I felt like I was listening to a Democratic Ronald Reagan," said ABC News correspondent Jonathan Karl. "Where Reagan was unabashedly conservative, Obama was unabashedly progressive."
While Karl's colleague, conservative commentator George Will, said too much of the speech reprised campaign themes, he found links in language used by Obama and inaugural addresses by Abraham Lincoln and John F. Kennedy.
On CNN, historian and Obama biographer David Marannis said Obama's address was much more positive and active than his first inaugural speech four years ago. "I could feel his heart beating this time," he said.
Chris Matthews said on MSNBC that parts of the speech were "going to drive the right crazy." A click away on the TV remote at Fox News Channel, analyst Charles Krauthammer was proving it.
"I found this sort of unrelenting," Krauthammer said. "You get a sense of a man who said, 'Alright, I've won my second election. I never have to face the electorate again. I'm going to be who I want to be, and I'm going to change the ideological trajectory of this country. That's my job, and that's why I'm here historically.'"
Fox's Brit Hume drew a joking rebuke from a colleague when the camera showed a picture of Beyonce, and he said, "She looks stunning, doesn't she?"
"Watch out," Chris Wallace quickly said. "Brent Musburger got in trouble for that, my friend." After the recent college football national championship, ESPN announcer Musburger was scolded by his bosses for lingering on the beauty of Alabama quarterback AJ McCarron's girlfriend, the 2012 Miss Alabama USA.
Beyonce "is an incredibly beautiful woman, and there's nothing wrong with pointing it out," Fox's Megyn Kelly said.
When the inauguration festivities moved indoors and cameras panned over politicians circling through the crowd, MSNBC's Rachel Maddow struck a note that a regular cable news viewer might question as too hopeful.
"I think the ceremony is cool, and the usual celebration is cool," she said. "It is also really nice to see Republicans and Democrats, and liberals and conservatives, chatting very casually with each other without talking politics."
As she spoke, the cameras focused on Supreme Court Chief Justice John Roberts smiling but standing alone.
“Go Beyond Your Father’s Annual Physical. Live Longer, Feel Better”
This sales pitch for the Princeton Longevity Center’s “comprehensive exam” promises, for $5,300, to take “your health beyond the annual physical.” But it is far from certain whether this all-day checkup, and others less inclusive, make a meaningful difference to health or merely provide reassurance to the worried well.
Among physicians, researchers and insurers, there is an ongoing debate as to whether regular checkups really reduce the chances of becoming seriously ill or dying of an illness that would have been treatable had it been detected sooner.
No one questions the importance of regular exams for well babies, children and pregnant women, and the protective value of specific exams, like a Pap smear for sexually active women and a colonoscopy for people over 50. But arguments against the annual physical for all adults have been fueled by a growing number of studies that failed to find a medical benefit.
Some experts note that when something seemingly abnormal is picked up during a routine exam, the result is psychological distress for the patient, further testing that may do more harm than good, and increased medical expenses.
“Part of the problem of looking for abnormalities in perfectly well people is that rather a lot of us have them,” Dr. Margaret McCartney, a Scottish physician, wrote in The Daily Mail, a British newspaper. “Most of them won’t do us any harm.”
She cited the medical saga of Brian Mulroney, former prime minister of Canada. A CT scan performed as part of a checkup in 2005 revealed two small lumps in Mr. Mulroney’s lungs. Following surgery, he developed an inflamed pancreas, which landed him in intensive care. He spent six weeks in the hospital, then was readmitted a month later for removal of a cyst on his pancreas caused by the inflammation.
The lumps on his lungs, by the way, were benign. But what if, you may ask, Mr. Mulroney’s lumps had been cancer? Might not the discovery during a routine exam have saved his life?
Logic notwithstanding, the question of benefits versus risks from routine exams can be answered only by well-designed scientific research.
Defining the value of a routine checkup — determining who should get one and how often — is especially important now, because next year the Affordable Care Act will add some 30 million people to the roster of the medically insured, many of whom will be eligible for government-mandated preventive care through an annual exam.
Dr. Ateev Mehrotra of the University of Pittsburgh School of Medicine, who directed a study of annual physicals in 2007, reported that an estimated 44.4 million adults in the United States undergo preventive exams each year. He concluded that if every adult were to receive such an exam, the health care system would be saddled with 145 million more visits every year, consuming 41 percent of all the time primary care doctors spend with patients.
There is already a shortage of such doctors and not nearly enough other health professionals — physician assistants and nurse practitioners — to meet future needs. If you think the wait to see your doctor is too long now, you may want to stock up on some epic novels to keep you occupied in the waiting room in the future.
Few would challenge the axiom that an ounce of prevention is worth a pound of cure. Lacking incontrovertible evidence for the annual physical, this logic has long been used to justify it:
¶ If a thorough exam and conversation about your well-being alerts your doctor to a health problem that is best addressed sooner rather than later, isn’t that better than waiting until the problem becomes too troublesome to ignore?
¶ What if you have a potentially fatal ailment, like heart disease or cancer, that may otherwise be undetected until it is well advanced or incurable?
¶ And wouldn’t it help to uncover risk factors like elevated blood sugar or high cholesterol that could prevent an incipient ailment if they are reversed before causing irreparable damage?
Even if there is no direct medical benefit, many doctors say that having their patients visit once a year helps to maintain a meaningful relationship and alert doctors to changes in patients’ lives that could affect health. It is also an opportunity to give patients needed immunizations and to remind them to get their eyes, teeth and skin checked.
But the long-sacrosanct recommendation that everyone should have an annual physical was challenged yet again recently by researchers at the Nordic Cochrane Center in Copenhagen.
The research team, led by Dr. Lasse T. Krogsboll, analyzed the findings of 14 scientifically designed clinical trials of routine checkups that followed participants for up to 22 years. The team found no benefit to the risk of death or serious illness among seemingly healthy people who had general checkups, compared with people who did not. Their findings were published in November in BMJ (formerly The British Medical Journal).
In introducing their analysis, the Danish team noted that routine exams consist of “combinations of screening tests, few of which have been adequately studied in randomized trials.” Among possible harms from health checks, they listed “overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, adverse psychosocial effects due to labeling, and difficulties with getting insurance.”
Furthermore, they wrote, “general health checks are likely to be expensive and may result in lost opportunities to improve other areas of health care.”
In summarizing their results, the team said, “We did not find an effect on total or cause-specific mortality from general health checks in adult populations unselected for risk factors or disease. For the causes of death most likely to be influenced by health checks, cardiovascular mortality and cancer mortality, there were no reductions either.”
What, then, should people do to monitor their health?
Whenever you see your doctor, for any reason, make sure your blood pressure is checked and get new blood tests, if a year or more has elapsed since your last ones.
Keep immunizations up to date, and get the screening tests specifically recommended based on your age, gender and known risk factors, including your family and personal medical history.
And if you develop a symptom, like unexplained pain, shortness of breath, digestive problems, a lump, a skin lesion that doesn’t heal, or unusual fatigue or depression, consult your doctor without delay. Seek further help if the initial diagnosis and treatment fails to bring relief.
The craft beer revolution kept charging ahead in 2012, when 12% more barrels were shipped than the year before, the sixth straight year of growth.
Of 27 major craft brewers – all of which saw some gain – 16 had double digit increases, according to industry research group Beer Marketer’s Insights' Craft Brew News publication.
In all, the craft beer industry enjoyed a 1.5 million barrel boost to 13.7 million barrels total.
Samuel Adams Boston Lager maker Boston Beer led the segment, with craft beer shipments rising as much as 3% to nearly 2.2 million barrels. But the company’s share of the industry has slid to 15.7% from 21% in 2008, according to the report.
Sierra Nevada, a brewer based in Chico, is the second largest in the sector. It’s 12.6% shipping gain to 966,000 barrels was its best advancement in more than a decade.
Petaluma brewer Lagunitas Brewing had a blockbuster year, with shipments booming 46% to 235,000 barrels. The company – which makes labels such as Hop Stoopid Ale and Little Sumpin’ Sumpin’ Ale, has more than quintupled its shipments in five years.
Unlike the general beer industry, where Anheuser-Busch and MillerCoors control some 80% of business, craft beer operators exist in more of a diaspora. More than three-quarters of the craft beer segment is split among 2,000 smaller rivals.
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