Microsoft Battles Google by Hiring Political Brawler Mark Penn

SEATTLE — Mark Penn made a name for himself in Washington by bulldozing enemies of the Clintons. Now he spends his days trying to do the same to Google, on behalf of its archrival Microsoft.

Since Mr. Penn was put in charge of “strategic and special projects” at Microsoft in August, much of his job has involved efforts to trip up Google, which Microsoft has failed to dislodge from its perch atop the lucrative Internet search market.

Drawing on his background in polling, data crunching and campaigning, Mr. Penn created a holiday commercial that has been running during Monday Night Football and other shows, in which Microsoft criticizes Google for polluting the quality of its shopping search results with advertisements. “Don’t get scroogled,” it warns. His other projects include a blind taste test, Coke-versus-Pepsi style, of search results from Google and Microsoft’s Bing.

The campaigns by Mr. Penn, 58, a longtime political operative known for his brusque personality and scorched-earth tactics, are part of a broader effort at Microsoft to give its marketing the nimbleness of a political campaign, where a candidate can turn an opponent’s gaffe into a damaging commercial within hours. They are also a sign of the company’s mounting frustration with Google after losing billions of dollars a year on its search efforts, while losing ground to Google in the browser and smartphones markets and other areas.

Microsoft has long attacked Google from the shadows, whispering to regulators, journalists and anyone else who would listen that Google was a privacy-violating, anticompetitive bully. The fruits of its recent work in this area could come next week, when the Federal Trade Commission is expected to announce the results of its antitrust investigation of Google, a case that echoes Microsoft’s own antitrust suit in the 1990s. A similar investigation by the European Union is also wrapping up. A bad outcome for Google in either one would be a victory for Microsoft.

But Microsoft, based in Redmond, Wash., has realized that it cannot rely only on regulators to scrutinize Google — which is where Mr. Penn comes in. He is increasing the urgency of Microsoft’s efforts and focusing on their more public side.

In an interview, Mr. Penn said companies underestimated the importance of policy issues like privacy to consumers, as opposed to politicians and regulators. “It’s not about whether they can get them through Washington,” he said. “It’s whether they can get them through Main Street.”

Jill Hazelbaker, a Google spokeswoman, declined to comment on Microsoft’s actions specifically, but said that while Google also employed lobbyists and marketers, “our focus is on Google and the positive impact our industry has on society, not the competition.”

In Washington, Mr. Penn is a lightning rod. He developed a relationship with the Clintons as a pollster during President Bill Clinton’s 1996 re-election campaign, when he helped identify the value of “soccer moms” and other niche voter groups.

As chief strategist for Hillary Clinton’s unsuccessful 2008 campaign for president, he conceived the “3 a.m.” commercial that raised doubts about whether Barack Obama, then a senator, was ready for the Oval Office. Mr. Penn argued in an essay he wrote for Time magazine in May that “negative ads are, by and large, good for our democracy.”

But his approach has ended up souring many of his professional relationships. He left Mrs. Clinton’s campaign after an uproar about his consulting work for the government of Colombia, which was seeking the passage of a trade treaty with the United States that Mrs. Clinton, then a senator, opposed.

“Google should be prepared for everything but the kitchen sink thrown at them,” said a former colleague who worked closely with Mr. Penn in politics and spoke on condition of anonymity. “Actually, they should be prepared for the kitchen sink to be thrown at them, too.”

Hiring Mr. Penn demonstrates how seriously Microsoft is taking this fight, said Michael A. Cusumano, a business professor at M.I.T. who co-wrote a book about Microsoft’s browser war.

“They’re pulling out all the stops to do whatever they can to halt Google’s advance, just as their competition did to them,” Professor Cusumano said. “I suppose that if Microsoft can actually put a doubt in people’s mind that Google isn’t unbiased and has become some kind of evil empire, they might very well get results.”

Nick Wingfield reported from Seattle and Claire Cain Miller from San Francisco.

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The Neediest Cases: Disabled Young Man and His Protective Mother Deal With Life’s Challenges

Though he would prefer to put his socks on without his mother’s help, Zaquan West, 25, does not have a choice.

Michelle V. Agins/The New York Times

Joann West is a constant caretaker for her son, Zaquan. Though Ms. West works as a receptionist, the family fell behind on rent.

For the past 100 years, The New York Times Neediest Cases Fund has provided direct assistance to children, families and the elderly in New York. To celebrate the 101st campaign, an article will appear daily through Jan. 25. Each profile will illustrate the difference that even a modest amount of money can make in easing the struggles of the poor.

Last year donors contributed $7,003,854, which was distributed to those in need through seven New York charities.

2012-13 Campaign

Previously recorded:

$3,104,694

Recorded Thursday:

$137,451

*Total:

$3,242,145

Last year to date:

$2,862,836

*Includes $596,609 contributed to the Hurricane Sandy relief efforts.

The Youngest Donors

If your child or family is using creative techniques to raise money for this year’s campaign, we want to hear from you. Drop us a line on Facebook or talk to us on Twitter.

A genetic disorder has encumbered Mr. West all his life, but he has needed assistance with this particular task since only last year. In November 2011, he had surgery to remove a cancerous tumor on his left thigh that was as big as a football, but he was left less flexible.

“He doesn’t do well with disability, with the label,” his mother, Joann West, 55, said. “He doesn’t tell people that he has a disability. If they can’t see it, they just can’t see it.”

When her son was 13 months old, Ms. West learned he had neurofibromatosis, a disorder that causes tumors to grow on the nerves and, in some cases, to infringe on vital organs, or as was the case last year, to become malignant. It also creates large bumps on the skin known as nodules.

At ages 5 and 8, Zaquan had operations to remove neurofibromatosis clusters that were eating away at his left hip bone. The disease has left his left leg a few inches shorter than his right. After each operation, he had to relearn how to walk.

Because of his physical disability, he was placed in a special-education class at school and given the same homework every night, his mother said.

“I advocated for him,” Ms. West said. “I kept fighting, because he was no dummy. He was physically impaired, not mentally. I went out of my way to try to give him a better life. The system would have failed him more than it did if I hadn’t stepped in.” Her efforts led to his being moved from a special-education classroom to a regular one in second grade.

Ms. West, a single mother, acknowledges that her protective instincts made her a very controlling parent, and she did not allow Zaquan out of the house much, which limited his friendships.

“I was afraid for him,” she said. “The streets, they don’t care about your disability.”

When Mr. West entered high school, it was the first time he had truly been away from his mother’s watchful eyes. He began skipping class, often going to the park or wandering their Bedford-Stuyvesant, Brooklyn, neighborhood with truant friends. He eventually dropped out of school.

“It was just me being out on my own and making my own choices,” Mr. West recalled.

Though she did not agree with her son’s decisions, Ms. West said that his need to explore was in some ways a result of her actions. “At a point, I stepped back,” she said, “to allow him to do certain things on his own and do what he wanted to do.”

In 2007, a couple of years after he dropped out, Mr. West joined the Door, an organization focused on empowering young people to reach their potential. There, he obtained his high school equivalency diploma.

Today, Mr. West is job hunting so that he can help pay his and his mother’s expenses.

But paying the monthly bills has become a struggle, Ms. West said, in part because of a recent change in her budget. In August, after an increase in income, they stopped receiving $324 a month in food stamps. The additional income did not cover all their expenses, however, and Ms. West eventually fell behind in the rent on their apartment.

Ms. West, who has been employed in various administrative jobs, currently works as a receptionist for Howie the Harp Advocacy Center, an agency that provides employment help to people with psychiatric disabilities. Her annual salary is about $25,000 before taxes. Her son receives $646 in Social Security disability benefits. After the family’s food stamps were cut off, Mr. West applied individually, and he now receives $200 in food stamps each month.

With the addition of Mr. West’s disability benefits and food stamps, their net monthly income is $2,213. Their contribution for the Section 8-subsidized apartment Ms. West has lived in for the past 30 years is $969.

Knowing she was in need of help, Ms. West’s boss told her about the Community Service Society, one of the organizations supported by The New York Times Neediest Cases Fund. And the society drew $1,598 from the fund to cover her debt.

Ms. West remains a constant caretaker for her independent-minded son, who, she says, has come to accept her help grudgingly. She says that even if they are not on speaking terms after a disagreement, she is there to lend him a hand.

Both are continuing to deal with the inevitable challenges: Mr. West is awaiting word from doctors on whether a new growth in his lungs is cancerous. But one of his greatest assets, given all that he has overcome, is that he is comfortable in his own skin.

“I’m just always going to be me,” he said, “so why deal with somebody else?”

Read More..

The Neediest Cases: Disabled Young Man and His Protective Mother Deal With Life’s Challenges

Though he would prefer to put his socks on without his mother’s help, Zaquan West, 25, does not have a choice.

Michelle V. Agins/The New York Times

Joann West is a constant caretaker for her son, Zaquan. Though Ms. West works as a receptionist, the family fell behind on rent.

For the past 100 years, The New York Times Neediest Cases Fund has provided direct assistance to children, families and the elderly in New York. To celebrate the 101st campaign, an article will appear daily through Jan. 25. Each profile will illustrate the difference that even a modest amount of money can make in easing the struggles of the poor.

Last year donors contributed $7,003,854, which was distributed to those in need through seven New York charities.

2012-13 Campaign

Previously recorded:

$3,104,694

Recorded Thursday:

$137,451

*Total:

$3,242,145

Last year to date:

$2,862,836

*Includes $596,609 contributed to the Hurricane Sandy relief efforts.

The Youngest Donors

If your child or family is using creative techniques to raise money for this year’s campaign, we want to hear from you. Drop us a line on Facebook or talk to us on Twitter.

A genetic disorder has encumbered Mr. West all his life, but he has needed assistance with this particular task since only last year. In November 2011, he had surgery to remove a cancerous tumor on his left thigh that was as big as a football, but he was left less flexible.

“He doesn’t do well with disability, with the label,” his mother, Joann West, 55, said. “He doesn’t tell people that he has a disability. If they can’t see it, they just can’t see it.”

When her son was 13 months old, Ms. West learned he had neurofibromatosis, a disorder that causes tumors to grow on the nerves and, in some cases, to infringe on vital organs, or as was the case last year, to become malignant. It also creates large bumps on the skin known as nodules.

At ages 5 and 8, Zaquan had operations to remove neurofibromatosis clusters that were eating away at his left hip bone. The disease has left his left leg a few inches shorter than his right. After each operation, he had to relearn how to walk.

Because of his physical disability, he was placed in a special-education class at school and given the same homework every night, his mother said.

“I advocated for him,” Ms. West said. “I kept fighting, because he was no dummy. He was physically impaired, not mentally. I went out of my way to try to give him a better life. The system would have failed him more than it did if I hadn’t stepped in.” Her efforts led to his being moved from a special-education classroom to a regular one in second grade.

Ms. West, a single mother, acknowledges that her protective instincts made her a very controlling parent, and she did not allow Zaquan out of the house much, which limited his friendships.

“I was afraid for him,” she said. “The streets, they don’t care about your disability.”

When Mr. West entered high school, it was the first time he had truly been away from his mother’s watchful eyes. He began skipping class, often going to the park or wandering their Bedford-Stuyvesant, Brooklyn, neighborhood with truant friends. He eventually dropped out of school.

“It was just me being out on my own and making my own choices,” Mr. West recalled.

Though she did not agree with her son’s decisions, Ms. West said that his need to explore was in some ways a result of her actions. “At a point, I stepped back,” she said, “to allow him to do certain things on his own and do what he wanted to do.”

In 2007, a couple of years after he dropped out, Mr. West joined the Door, an organization focused on empowering young people to reach their potential. There, he obtained his high school equivalency diploma.

Today, Mr. West is job hunting so that he can help pay his and his mother’s expenses.

But paying the monthly bills has become a struggle, Ms. West said, in part because of a recent change in her budget. In August, after an increase in income, they stopped receiving $324 a month in food stamps. The additional income did not cover all their expenses, however, and Ms. West eventually fell behind in the rent on their apartment.

Ms. West, who has been employed in various administrative jobs, currently works as a receptionist for Howie the Harp Advocacy Center, an agency that provides employment help to people with psychiatric disabilities. Her annual salary is about $25,000 before taxes. Her son receives $646 in Social Security disability benefits. After the family’s food stamps were cut off, Mr. West applied individually, and he now receives $200 in food stamps each month.

With the addition of Mr. West’s disability benefits and food stamps, their net monthly income is $2,213. Their contribution for the Section 8-subsidized apartment Ms. West has lived in for the past 30 years is $969.

Knowing she was in need of help, Ms. West’s boss told her about the Community Service Society, one of the organizations supported by The New York Times Neediest Cases Fund. And the society drew $1,598 from the fund to cover her debt.

Ms. West remains a constant caretaker for her independent-minded son, who, she says, has come to accept her help grudgingly. She says that even if they are not on speaking terms after a disagreement, she is there to lend him a hand.

Both are continuing to deal with the inevitable challenges: Mr. West is awaiting word from doctors on whether a new growth in his lungs is cancerous. But one of his greatest assets, given all that he has overcome, is that he is comfortable in his own skin.

“I’m just always going to be me,” he said, “so why deal with somebody else?”

Read More..

Microsoft Battles Google by Hiring Political Brawler Mark Penn

SEATTLE — Mark Penn made a name for himself in Washington by bulldozing enemies of the Clintons. Now he spends his days trying to do the same to Google, on behalf of its archrival Microsoft.

Since Mr. Penn was put in charge of “strategic and special projects” at Microsoft in August, much of his job has involved efforts to trip up Google, which Microsoft has failed to dislodge from its perch atop the lucrative Internet search market.

Drawing on his background in polling, data crunching and campaigning, Mr. Penn created a holiday commercial that has been running during Monday Night Football and other shows, in which Microsoft criticizes Google for polluting the quality of its shopping search results with advertisements. “Don’t get scroogled,” it warns. His other projects include a blind taste test, Coke-versus-Pepsi style, of search results from Google and Microsoft’s Bing.

The campaigns by Mr. Penn, 58, a longtime political operative known for his brusque personality and scorched-earth tactics, are part of a broader effort at Microsoft to give its marketing the nimbleness of a political campaign, where a candidate can turn an opponent’s gaffe into a damaging commercial within hours. They are also a sign of the company’s mounting frustration with Google after losing billions of dollars a year on its search efforts, while losing ground to Google in the browser and smartphones markets and other areas.

Microsoft has long attacked Google from the shadows, whispering to regulators, journalists and anyone else who would listen that Google was a privacy-violating, anticompetitive bully. The fruits of its recent work in this area could come next week, when the Federal Trade Commission is expected to announce the results of its antitrust investigation of Google, a case that echoes Microsoft’s own antitrust suit in the 1990s. A similar investigation by the European Union is also wrapping up. A bad outcome for Google in either one would be a victory for Microsoft.

But Microsoft, based in Redmond, Wash., has realized that it cannot rely only on regulators to scrutinize Google — which is where Mr. Penn comes in. He is increasing the urgency of Microsoft’s efforts and focusing on their more public side.

In an interview, Mr. Penn said companies underestimated the importance of policy issues like privacy to consumers, as opposed to politicians and regulators. “It’s not about whether they can get them through Washington,” he said. “It’s whether they can get them through Main Street.”

Jill Hazelbaker, a Google spokeswoman, declined to comment on Microsoft’s actions specifically, but said that while Google also employed lobbyists and marketers, “our focus is on Google and the positive impact our industry has on society, not the competition.”

In Washington, Mr. Penn is a lightning rod. He developed a relationship with the Clintons as a pollster during President Bill Clinton’s 1996 re-election campaign, when he helped identify the value of “soccer moms” and other niche voter groups.

As chief strategist for Hillary Clinton’s unsuccessful 2008 campaign for president, he conceived the “3 a.m.” commercial that raised doubts about whether Barack Obama, then a senator, was ready for the Oval Office. Mr. Penn argued in an essay he wrote for Time magazine in May that “negative ads are, by and large, good for our democracy.”

But his approach has ended up souring many of his professional relationships. He left Mrs. Clinton’s campaign after an uproar about his consulting work for the government of Colombia, which was seeking the passage of a trade treaty with the United States that Mrs. Clinton, then a senator, opposed.

“Google should be prepared for everything but the kitchen sink thrown at them,” said a former colleague who worked closely with Mr. Penn in politics and spoke on condition of anonymity. “Actually, they should be prepared for the kitchen sink to be thrown at them, too.”

Hiring Mr. Penn demonstrates how seriously Microsoft is taking this fight, said Michael A. Cusumano, a business professor at M.I.T. who co-wrote a book about Microsoft’s browser war.

“They’re pulling out all the stops to do whatever they can to halt Google’s advance, just as their competition did to them,” Professor Cusumano said. “I suppose that if Microsoft can actually put a doubt in people’s mind that Google isn’t unbiased and has become some kind of evil empire, they might very well get results.”

Nick Wingfield reported from Seattle and Claire Cain Miller from San Francisco.

Read More..

Panetta Orders Deployment of U.S. Antimissile Units in Turkey

Manu Brabo/Associated Press

In a part of Aleppo controlled by the Free Syrian Army, a woman hurt by Syrian Army shelling was wheeled in front of a hospital.

INCIRLIK AIR BASE, Turkey — Defense Secretary Leon E. Panetta signed an official deployment order on Friday to send 400 American military personnel and two Patriot air defense batteries to Turkey as its tensions intensify with neighboring Syria, where government forces have increasingly resorted to aerial attacks, including the use of ballistic missiles, to fight a spreading insurgency.

The American batteries will be part of a broader push to strengthen Turkey’s defenses that will include the deployment of four other Patriot batteries — two from Germany and two from the Netherlands. Each battery contains multiple rounds of guided missiles that can intercept and destroy other missiles and hostile aircraft flying at high speeds.

Mr. Panetta’s deployment order, the result of NATO discussions last week, represents the most direct American military action so far to help contain the Syrian conflict and minimize its risk of spilling across the 550-mile border with Turkey, a NATO member that is housing more than 100,000 Syrian refugees and providing aid to the Syrian rebels trying to oust President Bashar al-Assad.

Tensions between Turkey and Syria have escalated in recent months as Syrian forces have bombed rebel positions along the border and occasionally lobbed artillery rounds into Turkish territory. The Turks have also grown increasingly alarmed that Mr. Assad’s forces could fire missiles into Turkey.

News of the Patriot deployment order came as antigovernment activists inside Syria reported new mayhem, including an unconfirmed rebel claim to have shot down a government warplane attacking insurgent positions near the international airport in Damascus, the capital.

In Moscow, meanwhile, the Russian Foreign Ministry sought to distance itself from comments a day earlier by its Middle East envoy that the Syrian rebels might defeat Mr. Assad, a longstanding Kremlin ally and arms client. A ministry spokesman, Aleksandr K. Lukashevich, said Russia remained committed to a political solution in Syria.

“We have never changed our position and will not change it,” Mr. Lukashevich said. He rejected a comment made by a State Department spokesman on Thursday that Moscow had “woken up” and changed its position as dynamics shifted on the battlefield, saying, “We have never been asleep.”

All six Patriot units deployed in Turkey will be under NATO’s command and are scheduled to be operational by the end of January, according to officials in Washington.

George Little, the Pentagon spokesman, said Mr. Panetta signed the order as he flew from Afghanistan to this air base in southern Turkey, close to the Syrian border.

“The United States has been supporting Turkey in its efforts to defend itself,” Mr. Little said.

The order “will deploy some 400 U.S. personnel to Turkey to support two Patriot missile batteries,” Mr. Little added, and the personnel and Patriot batteries will arrive in Turkey in the coming weeks. He did not specify their deployment locations.

After landing at Incirlik on Friday, Mr. Panetta told a gathering of American Air Force personnel of his decision to deploy the Patriots.

He said the United States was working with Turkey, Jordan and Israel to monitor Syria’s stockpiles of chemical weapons, and warned of “serious consequences” if Syria used them, but he did not offer any specifics.

“We have drawn up plans for presenting to the president,” Mr. Panetta said. “We have to be ready.”

Turkey’s worries about vulnerability to Syrian missiles, including Scuds that might be tipped with chemical weapons, were heightened recently by intelligence reports that Syrian troops had mixed small amounts of precursor chemicals for sarin, a deadly nerve gas, at one or two storage sites, and loaded them into artillery shells and airplane bombs. “Their arsenal of chemical weapons has been configured for use at a moment’s notice,” Representative Mike Rogers, a Michigan Republican who heads the House Intelligence Committee, said in an interview on Friday. Mr. Panetta, however, said this week that intelligence about chemical weapons activity in Syria had “leveled off.”

Recent Scud missile attacks by Mr. Assad’s forces against rebels in northern Syria have only added to Turkey’s concerns. The Scud missiles were armed with conventional warheads, but the attacks showed that the Assad government was prepared to use missiles as it struggled to slow rebel gains.

With the nearly two-year-old Syrian conflict entering its second winter and many thousands of people struggling for food and warmth in cities ruined by protracted fighting, the humanitarian costs seemed to be mounting.

An activist in the central province Homs, who identified himself as Abu Ourouba, said the town of Houla — where, the United Nations confirmed in May, Syrian troops had killed more than 100 people, including 32 children — was facing catastrophe.

“Houla has been besieged from all directions for the past 10 days,” he said. “Until now, not even one loaf of bread has entered Houla. The food that was available is beginning to run out very quickly. Most children don’t have milk anymore. The kids are at risk of dying from hunger.”

Shelling along access routes means that no one can walk “unless they crawl” to avoid hundreds of strikes from tanks, warplanes and rocket launchers, the activist said.

Thom Shanker reported from Incirlik Air Base, Turkey, and Michael R. Gordon from Washington. Reporting was contributed by Eric Schmitt from Washington; Anne Barnard, Hania Mourtada and Hwaida Saad from Beirut, Lebanon; Alan Cowell from London; and Ellen Barry from Moscow.

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The New Old Age Blog: Hospital Alarms Fail to Prevent Injury, Study Finds

When it comes to protecting older people from falls, it can take a long time to figure out what helps and sometimes an even longer time to take action against things that were supposed to help but don’t.

A case in point: the so-called safety rails on hospital and nursing home beds. Their hazards, as The New Old Age reported more than two years ago, are well documented. They are intended to keep sick, drugged or confused people from climbing or falling out of bed. What they actually do is make falls more dangerous; they also trap patients between the rails and the mattress until they asphyxiate, causing hundreds of deaths annually.

The Consumer Product Safety Commission is finally investigating these hazards, with findings due soon.

Alarms — sensors that alert aides or nurses when someone at risk of falling attempts to get out of bed or up from a chair or toilet — sound better, right? Lots of health care facilities thought so.

Use of these alarms has increased “over the past 10 or 15 years as the problems of physical restraints and bed rails became better known,” said Ronald Shorr, who directs geriatric research at the V.A. Medical Center in Gainesville, Fla. “This was the next wave in fall prevention.”

The trouble is, hospital bed alarms don’t appear to reduce falls, according to the study that Dr. Shorr just published in The Annals of Internal Medicine.

Lots of patients, of all ages, fall in hospitals, and about a quarter of those falls cause injuries. They also cost hospitals money, because Medicare will no longer reimburse facilities for treating injuries from falls that in theory shouldn’t have happened.

Though there aren’t statistics on the number of systems, it is rare these days to find a large hospital that doesn’t use alarms, in some cases built right into the beds.

Yet “their efficacy hadn’t been established,” Dr. Shorr told me in an interview. The few studies that reported reduced falls from alarms were small, lacked control groups, or didn’t continue for very long. Dr. Shorr and his colleagues set out to remedy those shortcomings.

Over 18 months, they documented falls among patients in 16 medical and surgical units, with a combined 349 beds, at Methodist Healthcare-University Hospital in Memphis, Tenn. Half those units were randomly designated “usual care.” In the other eight, the “intervention” units, Dr. Shorr and study coordinator Michelle Chandler held repeated education sessions to explain the alarms — in this case, flexible pads made by Bed-Ex and widely-used — and demonstrate their use in beds and on chairs and commode seats.

Ms. Chandler visited the intervention units daily — the staff started calling her “Mrs. Falls” — and even brought fresh alarm pads and help set them up to encourage their use.

The intervention worked, in that those units used the alarms far more often. But when the researchers tallied up the falls among the 27,672 patients (half of them over age 63) in these units — controlling for many variables, including not only demographic factors but staffing levels and psychotropic drug regimens — they found the alarms had no significant effect.

Patients in the units that used alarms more heavily fell just as often as patients in the control units that used alarms much less frequently. (The numbers: 5.62 falls per 1,000 patient-days, a measure of how many people spent how long in the hospital, versus 4.56 falls in the control units, not a statistically significant difference.)

There were no fewer injuries in the more-alarmed units, nor any less use of physical restraints.

There were likely higher costs, though. A Bed-Ex monitor and cables cost about $350 at the time, and each disposable sensor pad cost $23.

Why didn’t the alarms help? Dr. Shorr hypothesized that the staff developed what he called alarm fatigue. “How many times a week do you hear a car alarm go off?” he asked. “You become desensitized.”

But it is also possible, he said, that when the alarms sounded and the nurses scampered, “the patients who weren’t alarmed fell more often.”

My own 2 cents: If an alarm sounds when someone stirs, is any hospital or nursing home so well-staffed that someone can materialize within seconds? Does a staff become less vigilant when patients have alarms and are presumed – wrongly, it seems – to be safer?

Nursing homes also frequently use alarms, and while this hospital data might not apply in another setting, Dr. Shorr said his findings made him skeptical about their effectiveness there, too.

So we probably shouldn’t feel reassured about our elders’ safety when they are in a hospital, alarms or no alarms. Even younger people, recovering from surgery and feeling the effects of anesthesia or sedatives, can and do fall.

“The more eyes on your loved one, the better,” said Dr. Shorr. “And it’s best if they’re your eyes.”

---

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

The New Old Age Blog: Hospital Alarms Fail to Prevent Injury, Study Finds

When it comes to protecting older people from falls, it can take a long time to figure out what helps and sometimes an even longer time to take action against things that were supposed to help but don’t.

A case in point: the so-called safety rails on hospital and nursing home beds. Their hazards, as The New Old Age reported more than two years ago, are well documented. They are intended to keep sick, drugged or confused people from climbing or falling out of bed. What they actually do is make falls more dangerous; they also trap patients between the rails and the mattress until they asphyxiate, causing hundreds of deaths annually.

The Consumer Product Safety Commission is finally investigating these hazards, with findings due soon.

Alarms — sensors that alert aides or nurses when someone at risk of falling attempts to get out of bed or up from a chair or toilet — sound better, right? Lots of health care facilities thought so.

Use of these alarms has increased “over the past 10 or 15 years as the problems of physical restraints and bed rails became better known,” said Ronald Shorr, who directs geriatric research at the V.A. Medical Center in Gainesville, Fla. “This was the next wave in fall prevention.”

The trouble is, hospital bed alarms don’t appear to reduce falls, according to the study that Dr. Shorr just published in The Annals of Internal Medicine.

Lots of patients, of all ages, fall in hospitals, and about a quarter of those falls cause injuries. They also cost hospitals money, because Medicare will no longer reimburse facilities for treating injuries from falls that in theory shouldn’t have happened.

Though there aren’t statistics on the number of systems, it is rare these days to find a large hospital that doesn’t use alarms, in some cases built right into the beds.

Yet “their efficacy hadn’t been established,” Dr. Shorr told me in an interview. The few studies that reported reduced falls from alarms were small, lacked control groups, or didn’t continue for very long. Dr. Shorr and his colleagues set out to remedy those shortcomings.

Over 18 months, they documented falls among patients in 16 medical and surgical units, with a combined 349 beds, at Methodist Healthcare-University Hospital in Memphis, Tenn. Half those units were randomly designated “usual care.” In the other eight, the “intervention” units, Dr. Shorr and study coordinator Michelle Chandler held repeated education sessions to explain the alarms — in this case, flexible pads made by Bed-Ex and widely-used — and demonstrate their use in beds and on chairs and commode seats.

Ms. Chandler visited the intervention units daily — the staff started calling her “Mrs. Falls” — and even brought fresh alarm pads and help set them up to encourage their use.

The intervention worked, in that those units used the alarms far more often. But when the researchers tallied up the falls among the 27,672 patients (half of them over age 63) in these units — controlling for many variables, including not only demographic factors but staffing levels and psychotropic drug regimens — they found the alarms had no significant effect.

Patients in the units that used alarms more heavily fell just as often as patients in the control units that used alarms much less frequently. (The numbers: 5.62 falls per 1,000 patient-days, a measure of how many people spent how long in the hospital, versus 4.56 falls in the control units, not a statistically significant difference.)

There were no fewer injuries in the more-alarmed units, nor any less use of physical restraints.

There were likely higher costs, though. A Bed-Ex monitor and cables cost about $350 at the time, and each disposable sensor pad cost $23.

Why didn’t the alarms help? Dr. Shorr hypothesized that the staff developed what he called alarm fatigue. “How many times a week do you hear a car alarm go off?” he asked. “You become desensitized.”

But it is also possible, he said, that when the alarms sounded and the nurses scampered, “the patients who weren’t alarmed fell more often.”

My own 2 cents: If an alarm sounds when someone stirs, is any hospital or nursing home so well-staffed that someone can materialize within seconds? Does a staff become less vigilant when patients have alarms and are presumed – wrongly, it seems – to be safer?

Nursing homes also frequently use alarms, and while this hospital data might not apply in another setting, Dr. Shorr said his findings made him skeptical about their effectiveness there, too.

So we probably shouldn’t feel reassured about our elders’ safety when they are in a hospital, alarms or no alarms. Even younger people, recovering from surgery and feeling the effects of anesthesia or sedatives, can and do fall.

“The more eyes on your loved one, the better,” said Dr. Shorr. “And it’s best if they’re your eyes.”

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Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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Panetta Orders Deployment of U.S. Anti-Missile Units in Turkey

INCIRLIK AIR BASE, Turkey — Defense Secretary Leon E. Panetta signed an official deployment order on Friday to send 400 American military personnel and two Patriot air defense batteries to Turkey as cross-border tensions with Syria intensify.

The American batteries will be part of a broader push to beef up Turkey’s defenses that will also include the deployment of four other Patriot batteries — two from Germany and two from the Netherlands.

All six units will be under NATO’s command and control and are scheduled to be operational by the end of January, according to officials in Washington.

George Little, the Pentagon spokesman, said Mr. Panetta signed the order as he flew from Afghanistan to this air base in southern Turkey, close to the border with Syria.

“The United States has been supporting Turkey in its efforts to defend itself,” Mr. Little said.

The order “will deploy some 400 U.S. personnel to Turkey to support two Patriot missile batteries,” Mr. Little added, and the personnel and Patriot batteries will arrive in Turkey “in coming weeks.” He did not disclose where the Patriots would be located.

After landing at Incirlik Friday, Mr. Panetta told a gathering of American Air Force personnel of his decision to deploy the Patriots.

He said the United States was working with Turkey, Jordan and Israel to monitor Syria's stockpiles of chemical weapons, and warned of "serious consequences" if Syria used them, but he did not offer any specifics.

"We have drawn up plans for presenting to the president," Mr. Panetta said. "We have to be ready."

Turkey, which has been supporting the Syrian opposition to President Bashar al-Assad, has been worried it is vulnerable to Syrian missiles, including Scuds that might be tipped with chemical weapons. Those concerns were heightened by reports of increased activity at some of Syria’s chemical sites, though Mr. Panetta said this week that intelligence about chemical weapons activity in Syria had “leveled off.”

The recent Scud missile attacks mounted by forces loyal to Mr. Assad against rebels in northern Syria have only added to Turkey’s concerns. The Scud missiles fired at the rebels were armed with conventional warheads, but the attacks showed that the Assad government is prepared to use missiles as it struggles to slow rebel gains.

Syria denied Thursday that it had fired Scud missiles this week. But NATO’s secretary general, Anders Fogh Rasmussen, said that the intelligence gathered by the alliance indicated that they were Scud-type missiles. “In general, I think the regime in Damascus is approaching collapse,” he said. “I think now it’s only a question of time.”

NATO foreign ministers last week endorsed the decision to send Patriot batteries to Turkey. The details of how many each nation would send were not worked out until this week, officials said.

In preparation for the deployment, allied officials had conducted surveys of 10 potential sites, mostly in southeastern Turkey, that could be defended by one or more Patriot batteries.

But NATO nations do not have enough batteries to cover all of the sites. With tensions building with Iran and North Korea defying the United States and its Asian allies by launching a long-range rocket, American officials did not want to send more than a few Patriot batteries to Turkey, especially since it is not clear how long they will be needed.

But NATO diplomats said that the goal was to show enough of a commitment to Turkey’s defense to deter a Syrian attack.

It will take three weeks to ship and deploy the two American Patriot batteries, a Defense Department official said.

One allied official said it might be possible to speed up the deployment of the German and Dutch batteries if necessary. Each of those nations will also send up to 400 troops.

The United States, Germany and the Netherlands are the only NATO members that have the advanced PAC-3 Patriot system.

The Patriot batteries in Turkey will be linked to NATO’s air-defense system. The response by the missile batteries would be nearly automatic, firing interceptor missiles to destroy the target by ramming into it, a tactic the military calls “hit to kill.”

Thom Shanker reported from Incirlik Air Base, Turkey, and Eric Schmitt and Michael R. Gordon from Washington.

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DealBook: Sprint Looks to Buy Remaining Stake in Clearwire for $2.1 Billion

Sprint Nextel is ready to flex its new financial muscle.

After striking a partnership with the deep-pocketed SoftBank, Sprint Nextel is moving to secure access to a big chunk of spectrum. On Thursday, Sprint offered to buy the remaining stake in Clearwire for roughly $2.1 billion, a deal will helps bolster its spectrum.

Under the terms of the deal, Sprint is offering $2.90 a share for Clearwire, according to a regulatory filing. The bid by Sprint, which currently owns a 51.7 percent stake in Clearwire, will value the company at more than $4 billion.

Sprint is bulking up in the face of rising industry competition.

In early October, T-Mobile USA announced plans to merge with a smaller network operator, MetroPCS. The combined company will have 42.5 million users, making it a closer competitor to Sprint, the No. 3 carrier.

Shortly after the T-Mobile deal, Sprint bolstered its own resources. In mid October, Sprint sold a majority stake to SoftBank of Japan for $20.1 billion. With the deal, Sprint gained a well-funded partner to help finance the expansion of its network and pursue acquisitions.

“SoftBank brings so much more to Sprint than money,” Daniel R. Hesse, Sprint’s chief executive, said at the time. “This investment provides the opportunity to benefit from the knowledge and expertise of a leader in mobile Internet technology with a proven track record of challenging larger incumbent carriers.”

Almost immediately, speculation mounted that Sprint would seek to buy Clearwire. Shares of Clearwire jumped on the day the deal with SoftBank was announced, as investors bet its strategies would be closely aligned.

A couple days later, Sprint increased its holdings in Clearwire, buying shares from Craig O. McCaw’s Eagle River Holdings. With the transaction, Sprint gained a majority stake in the company.

Now, Sprint wants to buy the whole thing.

It’s part of the company’s greater ambitions to build out its next generation Long Term Evolution network. Sprint has already been converting its infrastructure, and the deal with Clearwire could help accelerate those efforts.

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Another Look at a Drink Ingredient, Brominated Vegetable Oil

James Edward Bates for The New York Times

Sarah Kavanagh, 15, of Hattiesburg, Miss., started an online petition asking PepsiCo to change Gatorade’s formula.

Sarah Kavanagh and her little brother were looking forward to the bottles of Gatorade they had put in the refrigerator after playing outdoors one hot, humid afternoon last month in Hattiesburg, Miss.

But before she took a sip, Sarah, a dedicated vegetarian, did what she often does and checked the label to make sure no animal products were in the drink. One ingredient, brominated vegetable oil, caught her eye.

“I knew it probably wasn’t from an animal because it had vegetable in the name, but I still wanted to know what it was, so I Googled it,” Ms. Kavanagh said. “A page popped up with a long list of possible side effects, including neurological disorders and altered thyroid hormones. I didn’t expect that.”

She threw the product away and started a petition on Change.org, a nonprofit Web site, that has almost 200,000 signatures. Ms. Kavanagh, 15, hopes her campaign will persuade PepsiCo, Gatorade’s maker, to consider changing the drink’s formulation.

Jeff Dahncke, a spokesman for PepsiCo, noted that brominated vegetable oil had been deemed safe for consumption by federal regulators. “As standard practice, we constantly evaluate our formulas and ingredients to ensure they comply with federal regulations and meet the high quality standards our consumers and athletes expect — from functionality to great taste,” he said in an e-mail.

In fact, about 10 percent of drinks sold in the United States contain brominated vegetable oil, including Mountain Dew, also made by PepsiCo; Powerade, Fanta Orange and Fresca from Coca-Cola; and Squirt and Sunkist Peach Soda, made by the Dr Pepper Snapple Group.

The ingredient is added often to citrus drinks to help keep the fruit flavoring evenly distributed; without it, the flavoring would separate.

Use of the substance in the United States has been debated for more than three decades, so Ms. Kavanagh’s campaign most likely is quixotic. But the European Union has long banned the substance from foods, requiring use of other ingredients. Japan recently moved to do the same.

“B.V.O. is banned other places in the world, so these companies already have a replacement for it,” Ms. Kavanagh said. “I don’t see why they don’t just make the switch.” To that, companies say the switch would be too costly.

The renewed debate, which has brought attention to the arcane world of additive regulation, comes as consumers show increasing interest in food ingredients and have new tools to learn about them. Walmart’s app, for instance, allows access to lists of ingredients in foods in its stores.

Brominated vegetable oil contains bromine, the element found in brominated flame retardants, used in things like upholstered furniture and children’s products. Research has found brominate flame retardants building up in the body and breast milk, and animal and some human studies have linked them to neurological impairment, reduced fertility, changes in thyroid hormones and puberty at an earlier age.

Limited studies of the effects of brominated vegetable oil in animals and in humans found buildups of bromine in fatty tissues. Rats that ingested large quantities of the substance in their diets developed heart lesions.

Its use in foods dates to the 1930s, well before Congress amended the Food, Drug and Cosmetic Act to add regulation of new food additives to the responsibilities of the Food and Drug Administration. But Congress exempted two groups of additives, those already sanctioned by the F.D.A. or the Department of Agriculture, or those experts deemed “generally recognized as safe.”

The second exemption created what Tom Neltner, director of the Pew Charitable Trusts’ food additives project, a three-year investigation into how food additives are regulated, calls “the loophole that swallowed the law.” A company can create a new additive, publish safety data about it on its Web site and pay a law firm or consulting firm to vet it to establish it as “generally recognized as safe” — without ever notifying the F.D.A., Mr. Neltner said.

About 10,000 chemicals are allowed to be added to foods, about 3,000 of which have never been reviewed for safety by the F.D.A., according to Pew’s research. Of those, about 1,000 never come before the F.D.A. unless someone has a problem with them; they are declared safe by a company and its handpicked advisers.

“I worked on the industrial and consumer products side of things in the past, and if you take a new chemical and put it into, say, a tennis racket, you have to notify the E.P.A. before you put it in,” Mr. Neltner said, referring to the Environmental Protection Agency. “But if you put it into food and can document it as recognized as safe by someone expert, you don’t have to tell the F.D.A.”

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