Why Sanofi’s Zaltrap Deal Won t Help Patients
















Nurse administers chemotherapy to patient. Credit: National Cancer Institute.

I got excited when I read the New York Times story Nov. 9 (“Sanofi Halves Price of Cancer Drug Zaltrap After Sloan-Kettering Rejection)”. Zaltrap is an intravenous infusion colon cancer drug for metastatic colorectal cancer that is resistant to or has progressed with platinum-based chemotherapy. With a list price of $ 11,000 per patient per month, Zaltrap is about double the cost of Genentech’s Avastin. Sloan Kettering doctors rejected Zaltrap, claiming it offered no added value over Avastin, because it works no better than Avastin, and costs twice as much. Doctors from Sloan-Kettering Cancer Center, one the United States flagship cancer hospitals, published an op-ed in the NYTimes Oct. 14, titled “In Cancer Care, Cost Matters,” arguing that hospitals need to put their foot down when drugs are outrageously expensive with no added value. They wrote: “Soaring spending has presented the medical community with a new obligation. When choosing treatments for a patient, we have to consider the financial strains they may cause alongside the benefits they might deliver.” The importance of getting bang for your buck, or value in healthcare, has been a huge point in health policy circles in the United States. In fact, politicians of all stripes are quick to point to health outcomes data that show that despite the United States spending in the top tier of all nations for healthcare, health outcomes are far lower. What Sanofi announced in its response Nov. 8 to Sloan-Kettering, one could have easily thought that it was a victory for patients. However, the New York Times headline stating “Sanofi halves price…” is misleading. Sadly, the Zaltrap half-off deal is not a list price reduction at all. It is just a business discount plan for hospitals and oncologists. As Lisa Jane Hubbell, who uses high-cost disease modifying drugs for a noncancerous, chronic condition told me: “It won’t help patients, will it? Our copay will be based on full price, the docs will pocket the extra from insurance companies. It doesn’t really help anyone who is in need of help paying for healthcare.” Another woman with stage IV breast cancer says that she has been deemed ineligible for any discount for her high-priced cancer drugs because she is insured. In general, drug discount plans go to the uninsured. She emailed me: “The drug I took for five years was re-patented three times while I was on it, as I recall. It was orders of magnitude more expensive than the old standby tamoxifen for only a slight advantage in efficacy.” As The Times points out, Medicare patients are unlikely to see a lower price for Zaltrap for a long while until the discount is incorporated into Medicare payment calculations for Part B, which covers physician-administered drugs. In addition, oncologists have long marked up drugs that they administer for insurers and patients. Fortunately, Sloan-Kettering doctors are on the patients’ side and question whether Sanofi’s discount will make Zaltrap more affordable for patients. Peter Bach, MD, told me: “I don’t know if they’re going through steps to ensure reimbursement goes down to follow price or not. I’m hoping that is in their plans. If not, then yes, the windfall goes to providers, and our concern is the costs passed on to patients.” Leonard Saltzman, MD, the op-ed coauthor, and gastroenterology oncologist, from Sloan Kettering also called Sanofi to task for missing the boat in making Zaltrap affordable for patients. But pharmaceutical price fixing is nothing new, according to Frederic Kaye, MD, professor of hematology and oncology at the University of South Florida in Gainesville, Florida. “I saw this happen for the first time in the late 1980s when a veterinary pill levamisole, which cost pennies for the treatment of heartworm, underwent a 100 times price escalation when it was used for treating colon cancer. There was outrage at the time over lack of regulations for price fixing, but you see almost 25 years later, it is the same.” Sanofi’s drug discount plan is clearly a business imperative. If one of the US flagship cancer treatment centers says that they will not use Zaltrap, others could follow. But the refusal to lower Zaltrap’s list price is worrisome because patient copays are based on price. More importantly, if the Sanofi plan becomes the pharmaceutical industry’s modus operandi to the era of value-based healthcare, patients will still remain out in the cold, without any added relief for the high cost of drugs. Value-based healthcare will be something for facilities and hospitals and leave patients out in the cold. These days, you have to critically review the hoopla about “patient-centered health care” and the allegedly positive partnerships shaping healthcare. Were patients included when it really mattered in drafting this drug discount program? We need to maintain a high level of skepticism about deals made strictly between drug companies and hospitals, or arrangements made between industry and physicians, or industry and health plans. It’s been said before and it must be said again: “Nothing about me [the patient] that pertains to me should be done without me at the table.”  












Follow Scientific American on Twitter @SciAm and @SciamBlogs. Visit ScientificAmerican.com for the latest in science, health and technology news.
© 2012 ScientificAmerican.com. All rights reserved.


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Housing recovery gains traction
















WASHINGTON (Reuters) – Home resales rose in October and a gauge of homebuilder sentiment climbed to a six-year high in November, signs of surprising vigor in the country’s still-struggling housing market.


The National Association of Realtors said on Monday that existing home sales climbed 2.1 percent last month to a seasonally adjusted annual rate of 4.79 million units, beating forecasts by Wall Street economists.













Separately, strengthening demand for new homes drove an increase in a monthly measure of home builder sentiment, which hit a more than six-year high in November, topping even the most optimistic forecast in a Reuters poll of analysts.


Rising home prices and a faster pace of sales have shown the housing market has finally turned the corner this year. The market collapsed when a mortgage debt bubble burst in 2006, helping trigger the 2007-09 recession.


The data on Monday suggested the recovery in housing is advancing even faster than many analysts had expected.


“The housing market is continuing to improve. It’s probably improving more than most economists were projecting earlier this year,” said Patrick Newport, an economist at IHS Global Insight in Lexington, Massachusetts.


The reports also support the view that the broader economic recovery is becoming increasingly self-sustaining, with job creation helping drive home sales, which in turn are supporting economic growth. Home building is expected to add to economic growth this year for the first time since 2005.


U.S. stock prices rose sharply, with investors heartened by the housing data and signs that lawmakers are making progress in talks aimed at avoiding sharp tax hikes and government spending cuts next year. Yields on U.S. government debt also rose.


The housing data also suggested that superstorm Sandy, a mammoth storm that slammed into the U.S. East Coast on October 29, continues to distort economic data in the United States.


The Northeast was the only region in the country where the pace of sales fell. NAR economist Lawrence Yun said Sandy would likely leave a bigger mark in November and December, although he expected the impact would only be temporary.


The storm, which killed more than 130 people in the United States and left millions of homes and businesses without electricity, led U.S. factories to cut production in October. It also weighed on auto sales as consumers stayed away from showrooms.


Economists, however, think Sandy’s impact on the economy will be temporary. Indeed, not all of the impact is negative. Home improvement retailer Lowes reported higher-than-expected profits on Monday as its sales got a lift from people buying items like generators, flashlights and batteries ahead of Sandy.


The housing data showed that home prices continue to rebound. In October, the median price for an existing home was $ 178,600, up 11.1 percent from a year earlier.


Supporting prices, fewer people sold their homes under distressed conditions, which include foreclosures, compared to the same period in 2011. Also, the nation’s inventory of existing homes for sale fell 1.4 percent during the month to 2.14 million, the lowest level since December 2002.


The shrinking supply of distressed and foreclosed inventory helped push U.S. homebuilder sentiment up for a seventh consecutive month in November.


The National Association of Home Builders said its sentiment index rose to 46 — the highest since May 2006 — from 41 the month before. Economists polled by Reuters had predicted the index would remain unchanged.


However, the gauge remained below 50, a reminder that the housing market was still some way off full recovery. Readings below 50 mean more builders view market conditions as poor than favorable. The index has not been above 50 since April 2006.


The measure has made strong progress over the last year, helping to cement optimism in the sector.


“Builders are reporting increasing demand for new homes as inventories of foreclosed and distressed properties begin to shrink in markets across the country,” said NAHB Chairman Barry Rutenberg.


(Additional reporting by Ed Krudy and Richard Leong in New York; Editing by Andrea Ricci and Tim Ahmann)


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Canada pledges again to balance budget by 2015
















OTTAWA/NEW YORK (Reuters) – The Canadian government on Friday reiterated its intention to balance its budget by 2015, three days after projecting there would be deficits until 2016-17.


In separate appearances in Quebec City and New York, Prime Minister Stephen Harper and Finance Minister Jim Flaherty were at pains to say they still intended to end the red ink by 2015.













“It remains the government’s plan, intention, to balance the budget prior to the next federal election. The recent economic and fiscal update by the minister indicates we are actually very close to that objective,” Harper told reporters in Quebec City. The next election is in October 2015.


Flaherty’s fall fiscal update on Tuesday had pushed back the target date for eliminating the deficit by a year, to 2016-17, citing a weak global economy.


But the minister said in a speech in New York that the government was on track to balance the budget in the next two to three years, barring major external events, and he later clarified that he intended a balanced budget by 2015.


“The prime minister’s always correct,” he chuckled.


He sought to explain the discrepancy by saying the fiscal update had built in a C$ 3 billion ($ 3 billion) contingency cushion, meaning there was an underlying surplus of C$ 1.2 billion for 2015-16. He said the projection of a C$ 1.8 billion deficit amounted to about half a percent of the C$ 275 billion federal budget.


“There’s lots of water to go under the bridge between now and then,” he said.


The opposition New Democratic Party noted the discrepancy in a release headlined: “Stephen Harper makes stuff up about balancing the budget.”


It pointed out that balancing the budget by the next election was not the same as balancing it by 2016-17.


As it is, even the 2015-16 timetable is a year later than offered in the Conservative campaign for reelection in May 2011. They had promised a balanced budget by 2014-15, followed by major personal income tax relief before the 2015 election.


Flaherty’s timetable drew criticism this week from the Canadian Taxpayers Federation, which said the minister had become expert at kicking the can down the road.


The projections could be thrown out of whack if the United States goes off the fiscal cliff, a set of automatic tax hikes and spending cuts that are to be triggered on January 2 if legislators and the White House cannot agree on a more nuanced budget deal.


Flaherty said U.S. failure to avert the fiscal cliff would cause a significant and immediate decline in Canada’s gross domestic product, and he would counter it.


Referring to a possible economic shock from Europe or the United States, he said: “If that were to happen and if the Canadian economy were to be pushed back into recession with the resulting danger for higher unemployment and the danger always of a prolonged recession, then we would act.”


He added: “We would not stand by and let that happen. The kinds of measure we can take: there are various tax measures we can take, there are measures with respect to stimulus we can take, these are things that we have done before and we can do again.”


On Tuesday, Flaherty spoke of having prepared various contingency plans.


(Additional reporting by Louse Egan; Editing by David Gregorio)


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Wii U: New console launches in a sea of gadgets
















NEW YORK (AP) — In the six years since the last major video game system launched, Apple unveiled the iPhone and the iPad, “Angry Birds” invaded smartphones and Facebook reached a billion users. In the process, scores of video game consoles were left to languish in living rooms alongside dusty VCRs and disc players.


On Sunday, Nintendo Co. is launching the Wii U, a game machine designed to appeal both to the original Wii’s casual audience and the hardcore gamers who skip work to be among the first to play the latest “Call of Duty” release. Just like the Wii U’s predecessor, the Wii, which has sold nearly 100 million units worldwide since 2006, the new console’s intended audience “truly is 5 to 95,” says Reggie Fils-Aime, the president of Nintendo of America, the Japanese company’s U.S. arm.













But the Wii U arrives in a new world. Video game console sales have been falling, largely because it’s been so long since a new system has launched. Most people who wanted an Xbox 360, PlayStation 3 or a Wii already have one. Another reason: People in the broad 5-to-95 age range have shifted their attention to games on Facebook, tablet computers and mobile phones.


U.S. video game sales last month, including hardware, software and accessories, totaled $ 755.5 million, according to the research firm NPD Group. In October 2007, the figure stood at $ 1.1 billion.


The Wii U is likely to do well during the holiday shopping season, analysts believe —so well that shoppers may see shortages. But the surge could peter out in 2013. The Wii U is not expected to be the juggernaut that the Wii was in its heyday, according to research firm IHS iSuppli. The Wii outsold its competitors, the Xbox 360 and the PlayStation 3, in its first four years on sale, logging some 79 million units by the end of 2010. By comparison, IHS expects the Wii U to sell 56.7 million in its first four years.


In the age of a million gadgets and lean wallets, the storied game company faces a new challenge: convincing people that they need a new video game system rather than, say, a new iPad.


The Wii U, which starts at $ 300, isn’t lacking in appeal. It allows for “asymmetrical game play,” meaning two people playing the same game can have entirely different experiences depending on whether they use a new tablet-like controller called the GamePad or the traditional Wii remote. The GamePad can also be used to play games without using a TV set, as you would on a regular tablet. And it serves as a fancy remote controller to navigate a TV-watching feature called TVii, which will be available in December.


Nintendo, known for iconic game characters such as Mario, Donkey Kong and Zelda, is expected to sell the consoles quickly in the weeks leading up to the holidays. After all, it’s been six long years and sons, daughters, brothers and sisters are demanding presents. GameStop Corp., the world’s No. 1 video game retailer, said last week that advance orders sold out and it has nearly 500,000 people on its Wii U waitlist.


Even so, it’s a “very, very crowded space in consumer electronics” this holiday season, notes Ben Bajarin, a principal analyst at Creative Strategies who covers gaming.


Apple‘s duo of iPads, the full-size model and a smaller version called the Mini, will be competing for shoppers’ attention. Not to be outdone, Amazon.com Inc. has launched a trove of Kindle tablets and e-readers in time for the holidays. These range from the Paperwhite, a touch-screen e-reader, to the Kindle Fire HD, which features a color screen and can work with a cellular data plan. Then there are the new laptops and cheaper, thinner “ultrabooks” featuring Microsoft’s new Windows 8 operating system —not to mention smartphones from Apple Inc., Samsung and other manufacturers.


Nintendo has to be a cut above the noise here,” Bajarin says.


The Wii U is the first major game console to launch in years, but in some ways Nintendo is merely catching up with the HD trend. Sony Corp. and Microsoft Corp. began selling their own powerful, high-definition consoles six and seven years ago, respectively. Both Sony and Microsoft are expected to unveil new game consoles in 2013.


Baird analyst Colin Sebastian thinks the question is not how well the Wii U will do during the holidays, but how it will fare three and six months later.


Gaming has changed significantly in the past six years, especially when it comes to the type of mass-audience experiences that serve as Nintendo‘s bread and butter. Zynga Inc., the online game company behind Facebook games such as “FarmVille” and “Texas HoldEm Poker,” was founded in 2007. The first “Angry Birds” game, that addictive, quirky distraction that has players flinging cartoon birds at structures hiding smug green pigs launched in late 2009. The first iPad, of course, came out in 2010 —three years after the first iPhone.


Fils-Aime acknowledges that Nintendo competes in the broad entertainment landscape, “minute-by-minute,” for consumers’ time.


“That’s true today and that was true 20 years ago,” he says, adding that Nintendo‘s challenge is communicating to people “what is so fun and appealing about the new system.”


Analysts expect Wii U sales to be brisk over the holidays. Nintendo‘s loyal —some would say, fanatical— fan base has been placing advance orders and will likely keep the systems flying off store shelves well into next year. The classic Mario and Zelda games are a huge part of the appeal, since they can’t be played on any gaming system but Nintendo‘s.


Research firm IHS iSuppli estimates that by the end of the year, people will have snapped up 3.5 million Wii U consoles worldwide, compared with 3.1 million Wii units in the same period through the end of 2006.


After the Wii went on sale, shortages persisted for months. Stores were met with long lines of shoppers trying to get their hands on a Wii as late as July 2007, more than seven months after the system’s launch.


Though supply constraints are expected this time around, Fils-Aime says Nintendo will have more hardware available in the Americas than it had for the Wii’s initial months on the market. The company says it will also replenish retailers more frequently than it did six years ago.


An initial sell-out doesn’t mean the Wii U will be successful over the long term, IHS notes, citing its estimate that the Wii U won’t match the Wii’s sales over time.


Bajarin believes it’s going to take “a little bit of time” for the Wii U’s dual-screen gaming concept to sink in with people. If it proves popular, Nintendo could see even more competition at its hands.


“Technologically, it’s not a leap of the imagination to see Apple, Google, Microsoft do something like this,” he says.


____


Follow Barbara Ortutay on Twitter at https://twitter.com/BarbaraOrtutay


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DirecTV strikes deal to carry Time Warner Cable’s sports channels
















LOS ANGELES (TheWrap.com) – Los Angeles Lakers fans who subscribe to DirecTV will finally be able to watch their team again.


DirecTV, has struck a deal to carry Time Warner SportsNet, which now almost exclusively airs the Lakers games, along with Time Warner‘s Spanish-language Deportes.













The agreement ends a carriage dispute that left DirecTV viewers in Southern California out in the cold as the NBA season began last month. DirecTV, along with other carriers, had protested the price of the recently formed regional-sports networks, which would have cost an additional $ 3.95 per subscriber. Other carriers, such as Dish and Cox Communications, eventually reached agreements with Time Warner Cable, with DirecTV holding out the longest.


Under the agreement, DirecTV subscribers in Southern California will also have access to games from the LA Galaxy and Los Angeles Sparks.


DirecTV is pleased that Los Angeles Lakers, LA Galaxy and Los Angeles Sparks games and programming will now be seen by so many people whose loyalty remains the life’s blood to each team,” DirecTV chief content officer Dan York said. “We appreciate our customers’ patience and are happy to have arrived at an outcome that benefits everyone involved. We know that our customers will enjoy the great programming of these three franchises for many years to come.”


“Our partners at DirecTV value Southern California sports as much as we do and we’re thrilled to work with them to bring Lakers, Galaxy and Sparks games and programming to our viewers,” Time Warner Cable Sports’ senior vice president Dan Finnerty added. “Time Warner Cable SportsNet and Time Warner Cable Deportes will help bring DirecTV customers closer to these teams than they have ever been before.”


SportsNet will air on channel 691, while Deportes will run on channel 458.


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Questions of Blame Linger 34 Years After Jonestown
















From the age of 13, Leslie Wagner Wilson had been indoctrinated in the California-based Peoples Temple, led by the charismatic Jim Jones, whose mission was to foster racial harmony and help the poor.


But on Nov. 18, 1978, she and a handful of church members fought their way through thick jungle in the South American country of Guyana, escaping a utopian society gone wrong where followers were starved, beaten and held prisoner in the Jonestown compound.













She walked 30 miles to safety with her 3-year-old son, Jakari, strapped to her back and a smaller group of defectors. But just hours later, the mother, sister and brother and husband she left behind were dead.


“I was so scared,” said Wagner, now 55. “We exchanged phone numbers in case we died. I was prepared to die. I never thought I would see my 21st birthday.”


Today, on the 34th anniversary, Wilson said it’s important to remember the California-based Peoples Temple Jonestown massacre, especially the survivors who have wrestled with their consciences for decades.


PHOTOS: Jonestown Massacre Anniversary


Nine members of her family were among the 918 Americans who died that day, 909 of them ordered by Jones to drink cyanide-laced Kool-Aid in the largest ritual suicide in history.


Her husband, Joe Wilson, was one of Jones’ top lieutenants who helped assassinate congressman Leo Ryan and his press crew when they tried to free church members who were being held against their will.


After arriving back in the United States, Wilson said she “went through hell” — three failed marriages, drug use and suicidal thoughts she describes in her 2009 book, “Slavery of Faith.”


“I was like Humpty Dumpty, but you couldn’t put me back together again,” she said.


Survivors, many of them African-American like Wilson, say they felt guilt and shame and faced the most agonizing question surrounding the nation’s single largest loss of life until 9/11: Was it suicide or murder?


Full Coverage: Jonestown Massacre


In the now-famous “death tape,” supporters clapped and babies cried as Jones instructed families to kill the elderly first, then the youngest in protest against capitalism and racism. Mothers poisoned 246 children before taking their own lives.


“We really can’t understand the Peoples Temple without looking at the historical time period when it arose,” said Rebecca Moore, a professor of religious studies at San Diego State University.


“With the liberation movements of the ’60s and ’70s, the collapse of the black-power movement, the Peoples Temple was the main institution in the San Francisco Bay area that promoted a message of integration and racial equality.”


Moore lost her two sisters and her nephew, the son of Jim Jones. “They were hardcore believers,” she said of her siblings.


Jim Jones, who was white, came from a “wrong side of the tracks,” poor background in Indiana where in the 1950s he became known as a charismatic preacher with an affinity for African-Americans.


“A number of survivors, including those who defected, believe to this day he had paranormal abilities,” said Moore, who met him years later. “He could heal them and read their minds.”


In the 1960s, Jones moved to San Francisco, where at the height of the Peoples Temple there were about 5,000 members.


WATCH: A Look Back at Jonestown Massacre


“They wanted my parents to join,” she said. “Like most outsiders, we didn’t have any idea what was happening outside closed doors.”


Jones ingratiated himself with celebrities and politicians, mobilizing voters to help elect Mayor George Moscone in 1975 and becoming chairman of the city’s housing authority.


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Israel, Gaza fighting rages on as Egypt seeks truce
















GAZA/JERUSALEM (Reuters) – Israel bombed Palestinian militant targets in the Gaza Strip from air and sea for a fifth straight day on Sunday, preparing for a possible ground invasion though Egypt saw “some indications” of a truce ahead.


Militant rocket fire into Israel subsided during the night but resumed in the morning with three rockets fired at the nearby coastal city of Ashkelon, the Israeli army said.













“As of now we have struck more than 1,000 targets, so Hamas should do the math over whether it is or isn’t worth it to cease fire,” Israeli Vice Prime Minister Moshe Yaalon, over Twitter.


“If there is quiet in the South and no rockets and missiles are fired at Israel’s citizens nor terrorist attacks engineered from the Gaza Strip, we will not attack.”


Forty-eight Palestinians, about half of them civilians, including 13 children, have been killed in Israel’s raids, Palestinian officials said. More than 500 rockets fired from Gaza have hit Israel, killing three people and injuring dozens.


Israel unleashed intensive air strikes on Wednesday, killing the commander of the Hamas Islamist group that governs Gaza and spurns peace with the Jewish state. Israel’s declared goal is to deplete Gaza arsenals and press Hamas into stopping cross-border rocket fire that has plagued Israeli border towns for years.


Air raids continued past midnight into Sunday, with warships shelling from the sea. A Gaza City media building was hit, witnesses said, wounding 6 journalists and damaging facilities belonging to Hamas’s Al-Aqsa TV as well as Britain’s Sky News.


An Israeli military spokeswoman said the strike had targeted a rooftop “transmission antenna used by Hamas to carry out terror activity”.


Two other predawn attacks on houses in the Jabalya refugee camp killed two children and wounded 13 other people, medical officials said.


These attacks followed a defiant statement by Hamas military spokesman Abu Ubaida, who told a news conference: “This round of confrontation will not be the last against the Zionist enemy and it is only the beginning.”


The masked gunman dressed in military fatigues insisted that despite Israel’s blows Hamas “is still strong enough to destroy the enemy”.


An Israeli attack on Saturday destroyed the house of a Hamas commander near the Egyptian border.


Casualties there were averted however, because Israel had fired non-exploding missiles at the building beforehand from a drone, which the militant’s family understood as a warning to flee, and thus their lives were spared, witnesses said.


Israeli aircraft also bombed Hamas government buildings in Gaza on Saturday, including the offices of Prime Minister Ismail Haniyeh and a police headquarters.


Among those killed in air strikes on Gaza on Saturday were at least four suspected militants riding motorcycles, and several civilians including a 30-year-old woman.


ISRAELI SCHOOLS SHUT


Israel said it would keep schools in its south shut on Sunday as a precaution to avoid casualties from rocket strikes reaching as far as Tel Aviv and Jerusalem in the past few days.


Israel’s “Iron Dome” missile interceptor system destroyed in mid-air a rocket fired by Gaza militants at Tel Aviv on Saturday, where volleyball games on the beach front came to an abrupt halt as air-raid sirens sounded.


Hamas claimed responsibility for the attack on Tel Aviv, the third against the city since Wednesday. It said it had fired an Iranian-designed Fajr-5 at the coastal metropolis, some 70 km (43 miles) north of Gaza.


In the Israeli Mediterranean port of Ashdod, a rocket ripped into several balconies. Police said five people were hurt.


Israel’s operation has drawn Western support for what U.S. and European leaders have called Israel’s right to self-defense, but there was also a growing number of calls from world leaders to seek an end to the violence.


British Prime Minister David Cameron “expressed concern over the risk of the conflict escalating further and the danger of further civilian casualties on both sides,” in a conversation with Israeli Prime Minister Benjamin Netanyahu, a spokesperson for Cameron said.


London was “putting pressure on both sides to de-escalate,” the spokesman said, adding that Cameron had urged Netanyahu “to do everything possible to bring the conflict to an end.”


Ben Rhodes, a deputy national security adviser to President Barack Obama, said the United States would like to see the conflict resolved through “de-escalation” and diplomacy, but also believes Israel has a right to self-defense.


Egyptian President Mohamed Mursi said in Cairo as his security deputies sought to broker a truce with Hamas leaders, that “there are some indications that there is a possibility of a ceasefire soon, but we do not yet have firm guarantees.”


Egypt has mediated previous ceasefire deals between Israel and Hamas, the latest of which unraveled with recent violence.


A Palestinian official told Reuters the truce discussions would continue in Cairo on Sunday, saying “there is hope,” but it was too early to say whether the efforts would succeed.


In Jerusalem, an Israeli official declined to comment on the negotiations. Military commanders said Israel was prepared to fight on to achieve a goal of halting rocket fire from Gaza, which has plagued Israeli towns since late 2000, when failed peace talks led to the outbreak of a Palestinian uprising.


Diplomats at the United Nations said Secretary-General Ban Ki-moon is expected to visit Israel and Egypt in the coming week to push for an end to the fighting.


POSSIBLE GROUND OFFENSIVE


Israel, with tanks and artillery positioned along the frontier, said it was still weighing a ground offensive.


Israeli cabinet ministers decided on Friday to more than double the current reserve troop quota set for the Gaza offensive to 75,000 and around 16,000 reservists have already been called up.


Asked by reporters whether a ground operation was possible, Major-General Tal Russo, commander of the Israeli forces on the Gaza frontier, said: “Definitely.”


“We have a plan. … It will take time. We need to have patience. It won’t be a day or two,” he added.


A possible move into the densely populated Gaza Strip and the risk of major casualties it brings would be a significant gamble for Netanyahu, favored to win a January election.


The last Gaza war, a three-week Israeli blitz and invasion over the New Year of 2008-09, killed 1,400 Palestinians, mostly civilians. Thirteen Israelis died in the conflict.


But the Gaza conflagration has stirred the pot of a Middle East already boiling from two years of Arab revolution and a civil war in Syria that threatens to spread beyond its borders.


One major change has been the election of an Islamist government in Cairo that is allied with Hamas, potentially narrowing Israel’s maneuvering room in confronting the Palestinian group. Israel and Egypt made peace in 1979.


(Writing by Allyn Fisher-Ilan; Editing by Douglas Hamilton)


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The Allure of Mass Apple Gadget Thefts


















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“Sister” Director Tackles Taboo of Switzerland’s Class Divide With Her Oscar Contender
















LOS ANGELES (TheWrap.com) – Director Ursula Meier can hardly believe that her film “Sister” – which depicts tenements, poverty and a seemingly rigid class system in lovely Switzerland – has made it over the Alps to Hollywood for Academy consideration.


“It shows a not-very-usual aspect of Switzerland,” Meier told the audience at a showing of “Sister” Thursday night at the Landmark, part of TheWrap’s Academy Screening Series. “We don’t show the beautiful mountains and the green and the lush life … For me it was important to show another point of view on this country to the world. Because usually it’s Montblanc, chocolate, and Swatch.”













Indeed, with her second film, Meier has given international audiences something else to associate with Switzerland: larcenous snow urchins.


“Sister” centers mostly around 12-year-old Simon (Kacey Mottet Klein), who lives in a high-rise tenement in a not-so-snowy valley far below a ski resort and takes gondolas to the top to steal wealthy tourists’ skis right out from under their goggles.


Wily Simon is financing not just his own existence but that of Louise (Lea Seydoux), the title character, who just might be the worst parental figure or caretaker in a cinematic year that did, after all, include “Beasts of the Southern Wild.”


It would involve spoilers to explain why Simon’s older sis is not everything she’s cracked up to be. But there’s nothing misleading about this boy-crazy, substance-abusing twentysomething gal’s unfitness to watch over Simon, the breadwinner of their sad two-person family.


He has to empty out his cash drawer to bribe Louise into snuggling with him, and when he entrusts her with the mere task of waxing skis, she can’t even do that without spilling cigarette ashes on the stolen merchandise.


“It was important for me, when we were at the ski resort, to showing the back door of the restaurant, and the workers inside … And it’s just at the end, when it’s finished, when there is no more snow and the ski resort is closed, for the first time Simon looks at the landscape. And we can see how beautiful this place is, but it’s too late now.”


Meier worked with her young leading man on her first theatrical feature, 2009′s “Home,” where he played Isabella Huppert’s son when he was just 7. She’s emphatic that Klein is not the kind of child actor who has to be tricked into giving a performance.


“During the first casting, I ask him, ‘What do you like to do in your life, Kasey?’ And he told me, ‘Thinking.’ So I said ‘OK, think,’ and I turned on the camera, and he was amazing … He understands that acting is to be, not to look like. So I really wanted to write for him with this film, because it was such an amazing experience on my first film.”


The role of the severely neglectful “sister” was tougher to nail down, both for the director and her leading actress.


“This character was the challenge of the film,” Meier said. “Because Kacey’s character is a child, so for the spectator, of course he’s a victim. But with the character of Louise, for Lea as an actress, at the beginning for her it was very hard to find the fragility of the character. I showed her a lot of films like ‘Vagabond’ … I explained to her, you were 14 when you were pregnant; it was too young for a girl, and you stopped your studies and got bad jobs you cut with your family.”


Sometimes, she said, they’d fight because “she couldn’t find the fragility of the character, and suddenly, months later, wow – it was like we cut something open and all the emotion that came out from her was very deep. I was afraid of the spectators judging the character. It was not easy, in the writing, or in the directing with the actors, because I wanted that they would love these characters, even if they’re sometimes terrible. But I like terrible characters.”


Pond told Meier that when it came to supporting actress Gillian Anderson, of “X-Files” fame, “the first time I watched, I didn’t realize it was her till the end credits” – an experience probably shared by most of those in attendance at the screening.


“I’m very happy that you say that,” said Meier, “because if you recognize the actress, you think about the actress.” But the director did want Armstrong to provoke a where-have-I-seen-you-before vibe.


“I really wanted to be played by a star – not to have a star in my film, but because it was important for Simon to have a kind of phantasma this lady, of what he wants as a mother.


And as a spectator, you can have a phantasma on the star. So I like that she came from another country, and not speak French, because she’s almost an apparition.”


Meier admitted she was frightened before the Swiss premiere – before “Sister” went on to play various fests and win the special Golden Bear award at the Berlin Film Festival.


“When I had the first screening in Switzerland, a lady came back to me and was very moved by the film, because it’s usually a taboo to show poverty in Switzerland. She cried and told me, ‘I grew up in exactly the same place. My father was a worker in the factory we saw in the film, and as a child we never had the money to go up.’ I liked that she just said up.”


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Tulsa Town Hall: Nutrition a valuable tool in health care

















Weil spoke as part of the Tulsa Town Hall series of speakers.













The United States has an expensive health-care system that doesn’t produce good results, he said.


“Something is very wrong with this picture,” he said. “We’re spending more and more and we have less and less to show for it.”


Changes in diet can be an effective treatment for many conditions, but American physicians are functionally illiterate in nutrition, he said.


“The whole subject of nutrition is omitted in medical education,” he said.


There are many ways of managing diseases other than drugs, he said. Integrative medicine, which can include dietary supplements and practices like meditation, is the future of health care, he said.


The health system is resistant to change because of entrenched vested interests. That includes pharmaceutical companies that do direct-to-consumer advertising, which should be stopped, he said.


“As dysfunctional as our health-care system is at the moment – and it is very dysfunctional – it is generating rivers of money,” he said. “That money is going into very few pockets.”


Weil has developed an anti-inflammatory diet based on the Mediterranean diet but with Asian influences.


Inflammation is associated with some heart disease, Alzheimer’s disease and some cancers, he said. And as a result, people should be eating real, unprocessed foods and whole grains. They should stay away from sugar-sweetened beverages, including fruit juice, he said.


“The new research that’s being done on sugar is not very comforting,” he said.


The aging process can’t be avoided, but age-related diseases can be avoided by proper care, he said.


“The goal should be to live long and well with a big drop off at the end,” he said.


Weil is the director of the University of Arizona’s Center for Integrative Medicine.


Tickets to the Tulsa Town Hall series are sold as a $ 75 subscription and cover five lectures. Tickets for individual lectures are not available.


To subscribe, visit tulsaworld.com/tulsatownhall, call 918-749-5965 or write to: Tulsa Town Hall, Box 52266, Tulsa, OK 74152.


Future speakers include journalist Ann Compton on Feb. 8; author James B. Stewart on April 5; historian and cinematographer Rex Ziak on May 10.


Original Print Headline: Speaker highlights nutrition



Shannon Muchmore 918-581-8378
shannon.muchmore@tulsaworld.com3ed48  basic Tulsa Town Hall: Nutrition a valuable tool in health care
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