Sahara hostage siege turns Mali war global


ALGIERS/BAMAKO (Reuters) - Islamist fighters have opened an international front in Mali's civil war by taking dozens of Western hostages at a gas plant in the Algerian desert just as French troops launched an offensive against rebels in neighboring Mali.


Nearly 24 hours after gunmen stormed the natural gas pumping site and workers' housing before dawn on Wednesday, little was certain beyond a claim by a group calling itself the "Battalion of Blood" that it was holding 41 foreign nationals, including Americans, Japanese and Europeans, at Tigantourine, deep in the Sahara.


Algerian media said a Briton and an Algerian were killed in the assault. Another local report said a Frenchman had died.


One thing is clear: as a headline-grabbing counterpunch to this week's French buildup in Mali, it presents French President Francois Hollande with a daunting dilemma and spreads fallout from Mali's war against loosely allied bands of al Qaeda-inspired rebels far beyond Africa, challenging Washington and Europe.


A French businessman with employees at the site said the foreigners were bound and under tight guard, while local staff, numbering 150 or more, was held apart and had more freedom.


Led by an Algerian veteran of guerrilla wars in Afghanistan, the group demanded France halt its week-old intervention in Mali, an operation endorsed by Western and African allies who fear that al Qaeda, flush with men and arms from the defeated forces of Libya's Muammar Gaddafi, is building a haven in the desert.


Hollande, who won wide praise for ordering air strikes and sending troops to the former French colony, said little in response. In office for only eight months, he has warned of a long, hard struggle in Mali and now faces a risk of attacks on more French and other Western targets in Africa and beyond.


The Algerian government ruled out negotiating and the United States and other Western governments condemned what they called a terrorist attack on a facility, now shut down, that produces 10 percent of Algeria's gas, much of which is pumped to Europe.


The militants, communicating through established contacts with media in neighboring Mauritania, said they had dozens of men at the base, near the town of In Amenas close to the Libyan border, and that they were armed with mortars and anti-aircraft missiles.


They said they had repelled a raid by Algerian forces after dark on Wednesday. There was no government comment on that. Algerian officials said earlier about 20 gunmen were involved.


LIVES AT RISK


The militants issued no explicit threat but made clear the hostages' lives were at risk: "We hold the Algerian government and the French government and the countries of the hostages fully responsible if our demands are not met and it is up to them to stop the brutal aggression against our people in Mali," read one statement carried by Mauritanian media.


The group also said its fighters had rigged explosives around the site and any attempt to free the hostages would lead to a "tragic end." The large numbers of gunmen and hostages involved pose serious problems for any rescue operation.


Smaller hostage-taking incidents have been common in the Sahara and financial gain plays a part in the actions of groups whose members mingle extremist religious aims with traditional smuggling and other pursuits in the lawless, borderless region.


Algerian Interior Minister Daho Ould Kablia said the raid was led by Mokhtar Belmokhtar, who fought Soviet forces in Afghanistan in the 1980s and recently set up his own group in the Sahara after falling out with other local al Qaeda leaders.


A holy warrior-cum-smuggler dubbed "The Uncatchable" by French intelligence and "Mister Marlboro" by some locals for his illicit cigarette-running business, Belmokhtar's links to those who seized towns across northern Mali last year are unclear.


French media said the militants were also demanding that Algeria, whose government fought a bloody war against Islamists in the 1990s, release dozens of prisoners from its jails.


AMERICANS


The militants said seven Americans were among the 41 foreign hostages - a figure U.S. officials said they could not confirm.


Norwegian energy company Statoil, which operates the gas field in a joint venture with Britain's BP and the Algerian state company Sonatrach, said nine of its Norwegian employees and three of its Algerian staff were being held.


Also reported kidnapped, according to various sources, were five Japanese working for the engineering firm JGC Corp, a French national, an Austrian, an Irishman and a number of Britons.


U.S. Defense Secretary Leon Panetta said, "I want to assure the American people that the United States will take all necessary and proper steps that are required to deal with this situation."


He said he lacked firm information on whether there were links to the situation in Mali. Analysts pointed to shifting alliances and rivalries among Islamists in the region to suggest the hostage-takers may have a range of motives.


In their own statements, they condemned Algeria's secularist government for "betraying" its predecessors in the bloody anti-colonial war against French rule half a century ago by letting French warplanes fly over its territory to Mali. They also accused Algeria of shutting its border to Malian refugees.


Panetta said Washington was still studying legal and other issues before providing more help to France in the war in Mali.


Hollande has called for international support against rebels who France says pose a threat to Africa and the West, and admits it faces a long struggle against well-equipped fighters who seized Timbuktu and other oasis towns in northern Mali and have imposed Islamic law, including public amputations and beheading.


Islamists have warned Hollande that he has "opened the gates of hell" for all French citizens.


Some of those held at the facility, about 1,300 km (800 miles) inland, had sporadic contact with the outside world.


The head of a French catering company said he had information from a manager who supervises some 150 Algerian employees at the site. Regis Arnoux of CIS Catering told BFM television the local staff was being prevented from leaving but was otherwise free to move around inside and keep on working.


"The Westerners are kept in a separate wing of the base," Arnoux said. "They are tied up and are being filmed. Electricity is cut off, and mobile phones have no charge.


"Direct action seems very difficult. ... Algerian officials have told the French authorities as well as BP that they have the situation under control and do not need their assistance."


MALI OFFENSIVE


French army chief Edouard Guillaud said ground forces were stepping up their operation to engage directly "within hours" the alliance of Islamist fighters, grouping al Qaeda's North African wing AQIM and Mali's home-grown Ansar Dine and MUJWA.


West African military chiefs said the French would soon be supported by about 2,000 troops from Nigeria, Chad, Niger and other states - part of a U.N.-mandated deployment that had been expected to start in September before Hollande intervened.


Chad's foreign minister, Moussa Faki Mahamat, told Radio France International his country alone would send 2,000 troops, suggesting plans for the regional force were already growing.


In Mali, residents said a column of some 30 French Sagaie armored vehicles had set off toward rebel positions from the town of Niono, 300 km (190 miles) from the capital, Bamako.


A Malian military source said French special forces units were taking part in the operation. Guillaud said France's strikes, involving Rafale and Mirage jet fighters, were being hampered because militants were sheltering among civilians.


Many inhabitants of northern Mali have welcomed the French attacks, although some also fear being caught in the cross-fire.


Hollande said on Tuesday that French forces would remain in Mali until stability returned to the West African nation.


The conflict, in a landlocked state of 15 million twice the size of France, has displaced an estimated 30,000 people and raised concerns across mostly Muslim West Africa of a radicalization of Islam in the region.


But many who have lived for many months under harsh and violent Islamist rule said they welcomed the French.


"There is a great hope," one man said from Timbuktu, where he said Islamist fighters were trying to blend into civilian neighborhoods. "We hope that the city will be freed soon."


(Additional reporting by Pascal Fletcher and Andrew Callus in London, Balazs Koranyi in Oslo, Laurent Prieur in Nouakchott, Daniel Flynn in Dakar, John Irish, Catherine Bremer and Nick Vinocur in Paris, David Alexander in Rome and Andrew Quinn in Washington; Writing by Alastair Macdonald; Editing by Peter Cooney)



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BlackBerry maker plans local skate, publicity in Waterloo to celebrate new phone






WATERLOO, Ont. – Call it BlackBerry Town, even if the name isn’t official.


In the lead up to the BlackBerry smartphone unveiling later this month, creator Research In Motion is turning its Waterloo, Ont., home base into a celebration of the device.






The company plans to decorate light poles in areas of Waterloo and neighbouring Kitchener with banners that promote its latest smartphone and thank the community for its support.


City councillors in Kitchener voted earlier this week to make an exception to rules that prevent corporations from using public property to advertise.


RIM says it is making plans for other events as well.


The company will hold skating rink parties at Kitchener City Hall and in Waterloo Town Square on Jan. 30 to coincide with the unveiling of its new BlackBerry devices.


Gadgets News Headlines – Yahoo! News




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The Bachelor Celebrates 25 Seasons






The Bachelor










01/15/2013 at 07:50 PM EST







Sean Lowe and past stars and contestants of The Bachelor


Warner Bros.


Happy anniversary!

The Bachelor's current star, Sean Lowe, was joined by past franchise favorites on Jan. 11 to celebrate 25 seasons of the hit ABC reality dating show.

The Texas hunk clinked glasses at the famed Agoura Hills, Calif., Bachelor mansion with series creator Mike Fleiss and past Bachelorettes Ali Fedotowsky, Trista Sutter, Jillian Harris, DeAnna Pappas and the show's most recent star, Emily Maynard.

Also on hand were former Bachelor Jason Mesnick and his wife, Molly, who is expecting the couple's first child in March, as well as former contestants Courtney Robertson, Michael and Stephen Stagliano, Erica Rose and Casey Shteamer.

Jake Pavelka was also there, though he didn't appear in a group photo (above).

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Risk to all ages: 100 kids die of flu each year


NEW YORK (AP) — How bad is this flu season, exactly? Look to the children.


Twenty flu-related deaths have been reported in kids so far this winter, one of the worst tolls this early in the year since the government started keeping track in 2004.


But while such a tally is tragic, that does not mean this year will turn out to be unusually bad. Roughly 100 children die in an average flu season, and it's not yet clear the nation will reach that total.


The deaths this year have included a 6-year-old girl in Maine, a 15-year Michigan student who loved robotics, and 6-foot-4 Texas high school senior Max Schwolert, who grew sick in Wisconsin while visiting his grandparents for the holidays.


"He was kind of a gentle giant" whose death has had a huge impact on his hometown of Flower Mound, said Phil Schwolert, the Texas boy's uncle.


Health officials only started tracking pediatric flu deaths nine years ago, after media reports called attention to children's deaths. That was in 2003-04 when the primary flu germ was the same dangerous flu bug as the one dominating this year. It also was an earlier than normal flu season.


The government ultimately received reports of 153 flu-related deaths in children, from 40 states, and most of them had occurred by the beginning of January. But the reporting was scattershot. So in October 2004, the government started requiring all states to report flu-related deaths in kids.


Other things changed, most notably a broad expansion of who should get flu shots. During the terrible 2003-04 season, flu shots were only advised for children ages 6 months to 2 years.


That didn't help 4-year-old Amanda Kanowitz, who one day in late February 2004 came home from preschool with a cough and died less than three days later. Amanda was found dead in her bed that terrible Monday morning, by her mother.


"The worst day of our lives," said her father, Richard Kanowitz, a Manhattan attorney who went on to found a vaccine-promoting group called Families Fighting Flu.


The Centers for Disease Control and Prevention gradually expanded its flu shot guidance, and by 2008 all kids 6 months and older were urged to get the vaccine. As a result, the vaccination rate for kids grew from under 10 percent back then to around 40 percent today.


Flu vaccine is also much more plentiful. Roughly 130 million doses have been distributed this season, compared to 83 million back then. Public education seems to be better, too, Kanowitz observed.


The last unusually bad flu season for children, was 2009-10 — the year of the new swine flu, which hit young people especially hard. As of early January 2010, 236 flu-related deaths of kids had been reported since the previous August.


It's been difficult to compare the current flu season to those of other winters because this one started about a month earlier than usual.


Look at it this way: The nation is currently about five weeks into flu season, as measured by the first time flu case reports cross above a certain threshold. Two years ago, the nation wasn't five weeks into its flu season until early February, and at that point there were 30 pediatric flu deaths — or 10 more than have been reported at about the same point this year. That suggests that when the dust settles, this season may not be as bad as the one only two years ago.


But for some families, it will be remembered as the worst ever.


In Maine, 6-year-old Avery Lane — a first-grader in Benton who had recently received student-of-the-week honors — died in December following a case of the flu, according to press reports. She was Maine's first pediatric flu death in about two years, a Maine health official said.


In Michigan, 15-year-old Joshua Polehna died two weeks ago after suffering flu-like symptoms. The Lake Fenton High School student was the state's fourth pediatric flu death this year, according to published reports.


And in Texas, the town of Flower Mound mourned Schwolert, a healthy, lanky 17-year-old who loved to golf and taught Sunday school at the church where his father was a youth pastor.


Late last month, he and his family drove 16 hours to spend the holidays with his grandparents in Amery, Wis., a small town near the Minnesota state line. Max felt fluish on Christmas Eve, seemed better the next morning but grew worse that night. The family decided to postpone the drive home and took him to a local hospital. He was transferred to a medical center in St. Paul, Minn., where he died on Dec. 29.


He'd been accepted to Oklahoma State University before the Christmas trip. And an acceptance letter from the University of Minnesota arrived in Texas while Max was sick in Minnesota, his uncle said.


Nearly 1,400 people attended a memorial service for Max two weeks ago in Texas.


"He exuded care and love for other people," Phil Schwolert said.


"The bottom line is take care of your kids, be close to your kids," he said.


On average, an estimated 24,000 Americans die each flu season, according to the Centers for Disease Control and Prevention. People who are elderly and with certain chronic health conditions are generally at greatest risk from flu and its complications.


The current vaccine is about 60 percent effective, and is considered the best protection available. Max Schwolert had not been vaccinated, nor had the majority of the other pediatric deaths.


Even if kids are vaccinated, parents should be watchful for unusually severe symptoms, said Lyn Finelli of the CDC.


"If they have influenza-like illness and are lethargic, or not eating, or look punky — or if a parent's intuition is the kid doesn't look right and they're alarmed — they need to call the doctor and take them to the doctor," she advised.


___


CDC advice on kids: http://www.cdc.gov/flu/protect/children.htm


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Dow, S&P 500 inch up with retailers but Apple drags again

NEW YORK (Reuters) - The Dow and S&P 500 edged higher on Tuesday after stronger-than-expected retail data, though tech heavyweight Apple dragged on the market for a third day.


Apple was the biggest weight on both the S&P 500 and Nasdaq 100 <.ndx> after reports on Monday of cuts to orders for iPhone parts. Shares declined 3.2 percent to $485.92 and closed below $500 for the first time since February.


Retail stocks advanced after a government report showing retail sales rose more than expected in December was seen as a favorable sign for fourth-quarter growth. A separate report showed manufacturing activity in New York state contracted for the sixth month in a row in January.


"A little better-than-expected news on retail sales once again reinforces that the consumer remains alive and reasonably well," said Mark Luschini, chief investment strategist at Janney Montgomery Scott in Philadelphia, which manages about $54 billion in assets.


Among retailers, American Eagle Outfitters Inc gained 4.8 percent to $20.58 and Gap Inc rose 3.4 percent to $32.46. The Morgan Stanley retail index <.mvr> advanced 1.5 percent.


Express Inc surged 23.8 percent to $17.40 after the apparel retailer raised its fourth-quarter and full year 2012 outlook.


The Dow Jones industrial average <.dji> was up 27.57 points, or 0.20 percent, at 13,534.89. The Standard & Poor's 500 Index <.spx> was up 1.66 points, or 0.11 percent, at 1,472.34. The Nasdaq Composite Index <.ixic> was down 6.72 points, or 0.22 percent, at 3,110.78.


Apple's stock has lost about 7 percent in the last three sessions and is down 8.7 percent since the start of the year.


"It's tough to discern exactly what's putting the pressure on it. But at the end of the day, its influence, considering it's still 3 1/2 to 4 percent of the S&P 500 index, is being felt," Luschini said.


"I attribute (it) to just some of the bloom coming off of the rose. They haven't necessarily done anything wrong, as much as others have caught up."


Also keeping investors on edge is the looming debt ceiling debate. On Monday, President Barack Obama rejected any negotiations with Republicans over raising the U.S. debt ceiling. The United States could default on its debt if Congress does not increase the borrowing limit.


Resolving the debt ceiling is more a question of how than if. Investors don't expect a U.S. default, but they are also wary of another eleventh-hour agreement like the one in August 2011.


An expected lackluster earnings season, too, kept investors from taking aggressive bets. Analyst estimates for the quarter have fallen sharply since October. S&P 500 earnings growth is now seen up just 1.8 percent from a year ago, Thomson Reuters data showed.


Homebuilder Lennar reported a sharp rise in quarterly profit, but the stock declined 0.8 percent to $40.68 on worries that growth in orders was slowing.


Dell Inc shares added to Monday's gains, ending up 7.2 percent to $13.17 after sources said talks to take the computer maker private are in an advanced stage.


On the down side, shares of Facebook dropped 2.7 percent to $30.10. The company unveiled a "graph search" feature that CEO Mark Zuckerberg said would help its billion-plus users sort through content within the social network and its content feeds.


Volume was roughly 5.8 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with the 2012 average daily closing volume of about 6.45 billion.


Advancers outpaced decliners on the NYSE by about 17 to 12 and on the Nasdaq by about 13 to 11.


(Additional reporting by Chuck Mikolajczak; Editing by Kenneth Barry and Nick Zieminski)



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France to stay in Mali until stability restored


BAMAKO/DUBAI (Reuters) - France pledged on Tuesday to keep troops in Mali until stability returned to the West African country, raising the specter of a long campaign against al Qaeda-linked rebels who held their ground despite a fifth day of air strikes.


Paris has poured hundreds of soldiers into Mali and carried out 50 bombing raids since Friday in the Islamist-controlled northern half of the country, which Western and regional states fear could become a base for terrorist attacks in Africa and Europe.


Defense Minister Jean-Yves Le Drian said that, despite French air support, Malian forces had not been able to dislodge Islamist fighters from the central Malian towns of Konna or Diabaly, just 350 km (220 miles) northeast of Bamako.


A column of French armored vehicles rolled northward from the dusty riverside capital of Bamako towards rebel lines on Tuesday, the first major northward deployment of ground troops. A military official declined to comment on their objective.


Thousands of African soldiers are due to take over the offensive. Regional armies are scrambling to accelerate an operation which was initially not expected until September and has been brought forward by France's surprise bombing campaign aimed at stopping a rebel advance on a strategic town last week.


President Francois Hollande, on a visit to the United Arab Emirates during which he sought Gulf states' financial backing for the African-led mission, suggested France would retain a major role in its former colony for months to come.


"We have one goal. To ensure that when we leave, when we end our intervention, Mali is safe, has legitimate authorities, an electoral process and there are no more terrorists threatening its territory," Hollande told a news conference.


Paris has said it plans to deploy 2,500 soldiers to bolster the Malian army and work with the intervention force provided by West African states.


AFRICAN TROOPS


West African Defense chiefs met in Bamako on Tuesday to approve plans for the swift deployment of 3,300 regional troops, foreseen in a United Nations-backed intervention plan. After failing to reach a final agreement, they adjourned their talks until Wednesday.


Nigeria pledged to deploy soldiers within 24 hours, and Belgium said it was sending transport planes and helicopters to help, but West Africa's armies need time to become operational.


Mali's north, a vast and inhospitable area of desert and rugged mountains the size of Texas, was seized last year by an Islamist alliance combining al Qaeda's north African wing AQIM with splinter group MUJWA and the home-grown Ansar Dine rebels.


Any delay in following up on the French air bombardments of Islamist bases and fuel depots with a ground offensive could allow the insurgents to slip away into the desert and mountains, regroup and counter-attack.


The rebels, who French officials say are mobile and well armed, have shown they can hit back, dislodging government forces from Diabaly on Monday.


Residents said the town was still under Islamist control on Tuesday despite a number of air strikes that shook houses.


An eye witness near Segou, to the south, told Reuters he had seen 20 French Special Forces soldiers driving toward Diabaly.


In Konna, whose seizure on Thursday sparked French involvement, residents said Islamist fighters were camped just outside town. Army troops had also withdrawn after entering the town on Saturday.


Malians have largely welcomed the French intervention, having seen their army suffer a series of defeats by the rebels.


"With the arrival of the French, we have started to see the situation on the front evolve in our favor," said Aba Sanare, a resident of Bamako.


QUESTIONS OVER READINESS


Aboudou Toure Cheaka, a senior regional official in Bamako, said the West African troops would be on the ground in a week.


The original timetable for the 3,300-strong U.N.-sanctioned African force - to be backed by western logistics, money and intelligence services - did not initially foresee full deployment before September due to logistical constraints.


Senegal, Burkina Faso, Niger, Nigeria and Guinea have all offered troops. Col. Mohammed Yerima, spokesman for Nigeria's Defense ministry, said the first 190 soldiers would be dispatched within 24 hours.


But Nigeria, which is due to lead the mission, has already cautioned that even if some troops arrive in Mali soon, their training and equipping will take more time.


Sub-Saharan Africa's top oil producer, which already has peacekeepers in Sudan's Darfur and is fighting a bloody and difficult insurgency at home against Islamist sect Boko Haram, could struggle to deliver on its troop commitment of 900 men.


One senior government adviser in Nigeria said the Mali deployment was stretching the country's military.


"The whole thing's a mess. We don't have any troops with experience of those extreme conditions, even of how to keep all that sand from ruining your equipment. And we're facing battle-hardened guys who live in those dunes," said the adviser, who asked not to be named.


FRENCH LINING UP SUPPORT


France, which has repeatedly said it has abandoned its role as policeman of its former African colonies, said on Monday that the U.S., Canada, Denmark and Germany had also offered logistical support.


Fabius has said Gulf Arab states would help the Mali campaign, while Belgium said on Tuesday it would send two C130 transport planes and two medical helicopters following a request from Paris.


A meeting of donors for the operation was expected to be held in Addis Ababa at the end of January.


Security experts have warned that the multinational intervention in Mali, couched in terms of a campaign by governments against "terrorism", could provoke a jihadist backlash against France and the West, and African allies.


U.S. officials have warned of links between AQIM, Boko Haram in Nigeria and al Shabaab Islamic militants fighting in Somalia.


Al Shabaab, which foiled a French effort at the weekend to rescue a French secret agent it was holding hostage, urged Muslims around the world to rise up against what it called "Christian" attacks against Islam.


"Our brothers in Mali, show patience and tolerance and you will win. War planes never liberate a land," Sheikh Ali Mohamud Rage, al Shabaab's spokesman, said on a rebel-run website.


U.S. officials said Washington was sharing information with French forces in Mali and considering providing logistics, surveillance and airlift capability.


"We have made a commitment that al Qaeda is not going to find any place to hide," U.S. Defense Secretary Leon Panetta told reporters as he began a visit to Europe. Panetta later said the U.S. had no plans to send troops to Mali.


One U.S. military source said the haphazard nature of French involvement reminded him of the U.S. entry into Afghanistan.


"I don't know what the French endgame is for this," the source said. "Air strikes are fine, but pretty soon you run out of easy targets. Then what do you do? What do you do when they head up into the mountains?"


(Additional reporting by Elizabeth Pineau and Raissa Kasolowsky in Abu Dhabi, Felix Onuah in Abuja and Tim Cocks in Lagos, Abdi Sheikh in Mogadishu, Michelle Nichols and Louis Charbonneau at the United Nations,; Richard Valdmanis in Dakar, Joe Bavier in Abidjan, Jan Vermeylen in Brussels; Writing by Pascal Fletcher, Daniel Flynn and David Lewis; editing by Richard Valdmanis, Giles Elgood and Will Waterman)



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Tablet shipments in 2013 could be lower than previously expected









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Bachelor Sean Lowe: My Girl Must Love Dogs




For any of the 25 women looking to win over this season's Bachelor, Sean Lowe, here's a tip straight from the source: "The girl I'm dating must be into my dogs," he tells PEOPLE.

The proud pet parent to two pooches, a boxer named Lola and a chocolate Labrador named Ellie, Lowe says, "For so long it's just been me and my two dogs, and I'm certainly not going to replace them with any woman."

Having had both animals for the past six years, the hunk has developed a special bond with the duo – though he admits his quest for love has forced him to make some changes.

"For many years, my dogs would sleep in the bed with me," he says. "I'm a big guy and I've got two good-sized dogs, so it's a full bed. Then I just realized one day, 'Alright, if I get married and a woman's going to join me in the bed, there's not going to be enough room.' I had to break the dogs of the habit of sleeping in the bed."

Luckily for Lowe, the pair have taken to their new accommodations easily.

"They're very intelligent dogs; they pick up on things really quickly," he says. "They learn pretty fast."

To hear more from Sean Lowe – including how his dogs help him navigate the dating world – check out the video above.

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Hospitals crack down on workers refusing flu shots


CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.


"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.


Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.


Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.


In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.


Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.


Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.


"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."


Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."


Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.


"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."


For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.


A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.


At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.


The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."


The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.


According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.


The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.


Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.


Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.


Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.


Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.


Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.


While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.


Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.


Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.


Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.


"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.


Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.


Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.


Calhoun, the Illinois nurse, says she is unsure of her options.


"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."


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Online:


R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf


CDC: http://www.cdc.gov


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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner


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Apple drags on S&P, Nasdaq; Dell jumps after report

NEW YORK (Reuters) - The S&P 500 and Nasdaq ended lower on Monday as worries over demand for Apple products drove down its shares and investors braced for earnings disappointments.


Running counter to that was Dell Inc's stock which jumped 13 percent to about a five-month high at $12.29 after Bloomberg reported the No. 3 personal computer maker is in talks with private equity firms to go private. Dell's gains offset some tech-sector weakness.


Tech heavyweight Apple lost 3.6 percent to $501.75 and was the biggest weight on both the S&P 500 and Nasdaq 100 <.ndx> indexes after reports the company has cut orders for LCD screens and other parts for the iPhone 5 this quarter due to weak demand. The stock hit a session low of $498.51, the first dip below $500 since February 16.


"With Apple, it seems as if the sentiment has shifted from this being the one stock that everybody wanted to own to people beginning to look at it as a company (whose) business is slowing down somewhat," said Eric Kuby, chief investment officer of North Star Investment Management Corp in Chicago.


Adding to investor unease, fourth-quarter earnings kick into high gear this week. Analyst estimates for the quarter have fallen sharply since October. S&P 500 earnings growth is now seen up just 1.9 percent from a year ago, Thomson Reuters data showed.


The Dow Jones industrial average <.dji> was up 18.89 points, or 0.14 percent, at 13,507.32. The Standard & Poor's 500 Index <.spx> was down 1.37 points, or 0.09 percent, at 1,470.68. The Nasdaq Composite Index <.ixic> was down 8.13 points, or 0.26 percent, at 3,117.50.


Apple suppliers also lost ground, with Cirrus Logic off 9.4 percent at $28.62 and Qualcomm down 1 percent at $64.24.


The Dow fared better than the other two indexes, helped in part by Hewlett-Packard shares, which rose 4.9 percent to $16.95. The stock, up early in the session after JPMorgan upgraded its rating on the shares and raised its price target to $21 from $15, added to gains following the Dell report.


Tech has "become the arena for private equity or other capital-restructuring type of maneuvers because of the way their valuations and their balance sheets are," Kuby said.


Appliance and electronics retailer Hhgregg Inc slumped 5.7 percent to $7.44 after the company cut its same-store sales forecast for the full year.


Earnings reports are due this week from Goldman Sachs , Bank of America , Intel and General Electric , among other companies. Third-quarter reports ended with a gain of just 0.1 percent, the worst for an S&P 500 profit period in three years, according to Thomson Reuters data.


President Barack Obama warned Congress at a news conference on Monday that a refusal to raise the U.S. debt ceiling next month could mean a government shutdown and trigger economic chaos.


S&P futures had little reaction to comments after the bell by Federal Reserve Chairman Ben Bernanke, who urged lawmakers to lift the country's borrowing limit to avoid a debt default.


Volume was roughly 5.6 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with the 2012 average daily closing volume of about 6.45 billion.


Decliners were about even with advancers on the NYSE while decliners outpaced advancers on the Nasdaq by about 12 to 11.


(Additional reporting by Chuck Mikolajczak; Editing by Kenneth Barry, Nick Zieminski and Andrew Hay)



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