The New Old Age Blog: Patience, Consciousness and White Lies

My wife and I are blessed with having three “semi-independent” parents in their mid-80s living within a few blocks of us. Our children grew up knowing their grandparents as integral parts of our nuclear family, within walking distance for most of their childhoods. But now that our nest is empty, we find ourselves reliving many of the parenting issues we faced when our children were little — now in geriatric versions, at close range. As it turns out, parenting was good practice for the issues we face with our own parents.

What exactly does semi-independence mean as applied to elderly parents? Among our three, we have two canes, five walkers, one wheelchair (for long walks), four artificial joints, a pacemaker, four hearing aides and a knee brace. The list of medical conditions is long, and the list of medications even longer, requiring different color pill box organizers for morning, afternoon and evening.

Our parents all live in the same homes they have been in for many years. Keeping them safe and healthy there, as well as when they leave the house, has become a big part of our day-to-day work these days. Therein the yin and yang of parenting has returned — independence versus helicoptering.

Children’s yearning for independence begins in toddlerhood: “I can do it myself!” It escalates through childhood, accelerates with the driver’s license, and crescendos, with pomp and circumstance, at high school graduation.

The urge for independence is seen in all animal species, but relinquishing independence and accepting assistance in old age is unique to humans. For most elderly, it comes with a struggle, reflecting how hardwired our brains are for independence. The thought of getting in-home help is antithetical to our parents’ sense of self worth, exceeded only by the dread of leaving their homes for assisted living facilities. So, as tasks that were once mundane and automatic have become onerous and stressful for them, we attempt to foster autonomy while protecting them from harm, as we did with our children just a few short years ago.

Childproofing – Our home has again become hazardous, as have theirs. Furniture must be rearranged, booster seats placed on chairs to ease standing up, slippery rugs removed, lighting improved, bathrooms accessorized with handles and rails.

Dressing – Body shapes change in childhood and in old age. Our parents’ wardrobes, like those of our children’s before them, need frequent attention to preserve self-esteem. Their unwillingness to part with old clothes turns us into tailors. And, once again, we shop for slip-on sneakers with Velcro ties.

Driving – For our teens, driving was the symbolic liberation from childhood to young adulthood. For our parents, driving is the symbolic resistance to infirmity and old age. Our attempt to wean them from their cars, in precisely the reverse order we used to phase our teens into driving, has been torture for our parents and for us.

Toys – We have filled our parents’ shelves with new toys to help them with everything from opening cartons of milk (I would like a word with whoever designed those plastic pull loops) and zipping their clothes, to opening jars and removing the protective seals from over-the-counter medicines. A “picker-upper” device helps them avoid bending too low, and a key turner gives them leverage to open their door. Large digital clock faces, easy-to-read telephone keypads, and magnifying glasses keep them in touch with the world, and an e-mail printer keeps them in touch with their grandchildren.

Medicating – Filling those plastic pill box organizers with a week’s worth of medicines has become a personal barometer of competence for our parents, yet, as with our children when they were young, we feel compelled to oversee the dosing.

Mobility – Despite numerous falls, it was only with much teeth gnashing (or denture gnashing, as the case may be) that our mothers consented to use canes; more gnashing when canes gave way to walkers. For long walks, we hide the wheelchair half way there and back so the neighbors don’t see.

The more we do for our parents, the more frail and guilty they feel. Our efforts are sometimes resented. Helping them get in and out of the car, or bracing them under the arm as they negotiate a bumpy sidewalk, can be an affront. “I can do it myself!”

Can I ride my bike to tennis practice if I’m really careful crossing Holly Street? Why can’t I take a cab home from the seniors program at the community center? Can I walk to grandma’s by myself this time? Can I take the bus to the supermarket today? Everyone is hanging out at the park after school, can I go? I’ll just walk down the block to the neighbor’s house this afternoon, O.K.?

What wisdom did we gain the first time around to help us now? Patience, consciousness and white lies.

Patience to wait for them to come to the same conclusions we did. Mom, do you think Rosalind would have fallen and broken both wrists if she had been using a walker?

Consciousness about their need for independence as ballast to our need for their well-being. Why don’t you just let us drive you at night for now?

And white lies: I’m going to the supermarket anyway, we can shop together.

The longer we can protect our parents from harm, the more we can share our lives with them and the more joy they can have from their grandchildren. The trick is doing it without hurting them in other ways.

We have been through this before. It was worth it then, and it is worth it now.

Dr. Harley A. Rotbart is professor and vice chairman of pediatrics at the University of Colorado School of Medicine and the author of “No Regrets Parenting.”

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The New Old Age Blog: Patience, Consciousness and White Lies

My wife and I are blessed with having three “semi-independent” parents in their mid-80s living within a few blocks of us. Our children grew up knowing their grandparents as integral parts of our nuclear family, within walking distance for most of their childhoods. But now that our nest is empty, we find ourselves reliving many of the parenting issues we faced when our children were little — now in geriatric versions, at close range. As it turns out, parenting was good practice for the issues we face with our own parents.

What exactly does semi-independence mean as applied to elderly parents? Among our three, we have two canes, five walkers, one wheelchair (for long walks), four artificial joints, a pacemaker, four hearing aides and a knee brace. The list of medical conditions is long, and the list of medications even longer, requiring different color pill box organizers for morning, afternoon and evening.

Our parents all live in the same homes they have been in for many years. Keeping them safe and healthy there, as well as when they leave the house, has become a big part of our day-to-day work these days. Therein the yin and yang of parenting has returned — independence versus helicoptering.

Children’s yearning for independence begins in toddlerhood: “I can do it myself!” It escalates through childhood, accelerates with the driver’s license, and crescendos, with pomp and circumstance, at high school graduation.

The urge for independence is seen in all animal species, but relinquishing independence and accepting assistance in old age is unique to humans. For most elderly, it comes with a struggle, reflecting how hardwired our brains are for independence. The thought of getting in-home help is antithetical to our parents’ sense of self worth, exceeded only by the dread of leaving their homes for assisted living facilities. So, as tasks that were once mundane and automatic have become onerous and stressful for them, we attempt to foster autonomy while protecting them from harm, as we did with our children just a few short years ago.

Childproofing – Our home has again become hazardous, as have theirs. Furniture must be rearranged, booster seats placed on chairs to ease standing up, slippery rugs removed, lighting improved, bathrooms accessorized with handles and rails.

Dressing – Body shapes change in childhood and in old age. Our parents’ wardrobes, like those of our children’s before them, need frequent attention to preserve self-esteem. Their unwillingness to part with old clothes turns us into tailors. And, once again, we shop for slip-on sneakers with Velcro ties.

Driving – For our teens, driving was the symbolic liberation from childhood to young adulthood. For our parents, driving is the symbolic resistance to infirmity and old age. Our attempt to wean them from their cars, in precisely the reverse order we used to phase our teens into driving, has been torture for our parents and for us.

Toys – We have filled our parents’ shelves with new toys to help them with everything from opening cartons of milk (I would like a word with whoever designed those plastic pull loops) and zipping their clothes, to opening jars and removing the protective seals from over-the-counter medicines. A “picker-upper” device helps them avoid bending too low, and a key turner gives them leverage to open their door. Large digital clock faces, easy-to-read telephone keypads, and magnifying glasses keep them in touch with the world, and an e-mail printer keeps them in touch with their grandchildren.

Medicating – Filling those plastic pill box organizers with a week’s worth of medicines has become a personal barometer of competence for our parents, yet, as with our children when they were young, we feel compelled to oversee the dosing.

Mobility – Despite numerous falls, it was only with much teeth gnashing (or denture gnashing, as the case may be) that our mothers consented to use canes; more gnashing when canes gave way to walkers. For long walks, we hide the wheelchair half way there and back so the neighbors don’t see.

The more we do for our parents, the more frail and guilty they feel. Our efforts are sometimes resented. Helping them get in and out of the car, or bracing them under the arm as they negotiate a bumpy sidewalk, can be an affront. “I can do it myself!”

Can I ride my bike to tennis practice if I’m really careful crossing Holly Street? Why can’t I take a cab home from the seniors program at the community center? Can I walk to grandma’s by myself this time? Can I take the bus to the supermarket today? Everyone is hanging out at the park after school, can I go? I’ll just walk down the block to the neighbor’s house this afternoon, O.K.?

What wisdom did we gain the first time around to help us now? Patience, consciousness and white lies.

Patience to wait for them to come to the same conclusions we did. Mom, do you think Rosalind would have fallen and broken both wrists if she had been using a walker?

Consciousness about their need for independence as ballast to our need for their well-being. Why don’t you just let us drive you at night for now?

And white lies: I’m going to the supermarket anyway, we can shop together.

The longer we can protect our parents from harm, the more we can share our lives with them and the more joy they can have from their grandchildren. The trick is doing it without hurting them in other ways.

We have been through this before. It was worth it then, and it is worth it now.

Dr. Harley A. Rotbart is professor and vice chairman of pediatrics at the University of Colorado School of Medicine and the author of “No Regrets Parenting.”

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I.H.T. Special Report: Technology & Innovation: Guarding a 'Fundamental Right' of Privacy in Europe







PARIS — Is it impolitic to ask the French privacy regulator a personal question about her Internet habits? Perhaps, but Isabelle Falque-Pierrotin, head of the country’s data protection agency, is perfectly forthcoming in her answer.




“Facebook? I follow it but, to be perfectly honest, I don’t use it,” she said. As for Google, “Of course I use it, but I am prudent about what I do. I don’t give away any family secrets.”


Both Facebook and Google, along with a range of other Internet companies, have faced the scrutiny of Ms. Falque-Pierrotin and her colleagues at the Commission nationale de l'informatique et des libertés, also known as the CNIL.


The agency has taken the lead role among the 27 European authorities on data protection in an investigation of a new privacy policy that Google introduced this year to streamline the previously separate practices for data use in dozens of Google services. Last month, CNIL ordered the company to make changes to the policy or face disciplinary action.


European privacy officials worry that the mining and blending of data across different Google services, like the search engine and the YouTube video site, could result in privacy violations.


In an interview last week at the CNIL headquarters in Paris, Ms. Falque- Pierrotin said she wanted Google to report back with proposed solutions by February, nearly a year after the new policy was introduced. If the proposals are insufficient, she said, “we will move on to a sanctions phase.”


“This is not about taking the scalp of a big company,” she said. “It’s about pushing them to come into conformity. If a company that is at the heart of the digital economy cannot come up with a satisfactory solution, that is very serious.”


Google has said it has been reviewing a letter from Ms. Falque-Pierrotin to its chief executive, Larry Page. The company has consistently maintained that the new policy respects E.U. law.


CNIL has the power to fine companies as much as €300,000, or about $382,000, for violations.


Companies like Google are eager to use the personal data gleaned from the Internet in new ways to sell online advertising and to provide other services tailored to individual users.


But Ms. Falque-Pierrotin said her tough approach was justified by the importance that the French, and Europeans more generally, attach to privacy.


“In Europe, we consider privacy a fundamental right,” she said. “That doesn’t mean it is exclusive of other rights, but economic rights are not superior to privacy.”


In the United States, she said, despite signs of a new concern about privacy in the digital age, “personal data are seen as raw material for business.”


The inquiry illustrates a new level of cooperation among the various data protection agencies in Europe, which have sometimes struggled to respond in a consistent way to the challenges of regulating global Internet companies like Google and Facebook.


Viviane Reding, vice president of the European Commission, has proposed the creation of a central authority to oversee data protection at the E.U. level. Big Internet companies have generally welcomed this approach, saying they find it difficult to deal with a welter of local regulations.


Ms. Falque-Pierrotin said, however, that this approach would be “too centralized,” adding that she preferred to maintain the current decentralized system of regulation, but with greater cooperation among national agencies.


“We have to have a system where a citizen can go to their local data protection authority,” she said. “Otherwise it is too remote.”


Ms. Falque-Pierrotin has also been meeting with her counterparts at the Federal Trade Commission in Washington, which is responsible for data protection in the United States.


Even though the American approach to privacy has traditionally been more accommodating, she said that she had been encouraged by recent enforcement action by the F.T.C. against Google and Facebook.


“We are starting to learn, starting to get to know each other,” Ms. Falque-Pierrotin said. Just do not turn to Facebook for her biography.


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Cease-Fire Deal Elusive in Gaza Conflict as U.S. Widens Its Role





JERUSALEM — To a backdrop of air strikes and mounting casualties, American efforts to negotiate a cease-fire in the latest Gaza fighting between Israel and Hamas continued onWednesday but the struggle to achieve even a brief pause in the fighting emphasized the obstacles to finding any lasting solution.




Israeli airstrikes overnight continued into Wednesday morning, hitting government buildings, the smuggling tunnels under the southern Rafah border crossing, and a bridge on the beach road that is one of three linking Gaza City to the central area of the strip. The Hamas healthy ministry said the Palestinian death toll stood at 140 at noon, with 1,100 injured. At least a third of those killed are believed to have been militants.


The eight-day conflict in the Gaza Strip also appeared to have spilled onto the streets of Tel Aviv on Wednesday with what police described as a bomb blast aboard a civilian bus. Eleven people were injured, one of them seriously.


The latest exchanges, which included the interception of at least two rockets fired from Gaza, came as Secretary of State Hillary Rodham Clinton was reported to have held talks with Palestinian leaders in the West Bank and Israeli leaders in Jerusalem. She was scheduled to fly on Wednesday to Cairo where Egyptian-brokered ceasefire talks have thus far been inconclusive.


Around noon on Wednesday in the Gaza Strip, according to the Hamas government media office, a bomb hit the house of Issam Da’alis, an adviser to Ismail Haniya, the Hamas prime minister. The house had been evacuated. Earlier, a predawn airstrike near a mosque in the Jabaliya Refugee Camp killed a 30-year-old militant, a spokesman said, and F-16 bombs destroyed two houses in the central Gaza Strip.


There were 23 punishing strikes against the southern tunnels that are used to bring weapons as well as construction material, cars and other commercial goods into Gaza from the Sinai peninsula.


Within Gaza City, Abu Khadra, the largest government office complex, was obliterated overnight. Damage was also caused to shops, including two banks and a tourism office, and electricity cables fell on the ground and were covered in dust.


Separately, an F-16 bomb created a 20-foot crater in an open area in a stretch of hotels occupied by foreign journalists. Several of the hotels had windows blown out by the strike around 2 a.m., but no one was reported injured. By morning, the hole in the ground had filled with sludgy water, apparently from a burst pipe, appearing almost like a forgotten swimming hole with walls made of sand and cracked cinder block.


Surveying damage near a government complex, Raji Sourani of the Palestinian Center for Human Rights said Gaza civilians were “in the eye of the storm,” accusing Israel of “inflicting pain and terror” on them. Israeli officials accuse Hamas of locating military sites in or close to civilian areas. 


Overnight, as the conflict entered its eighth day, the Israeli military said in Twitter feeds that “more than 100 terror sites were targeted, of which approximately 50 were underground rocket launchers.” The targets included the Ministry of Internal Security in Gaza, described as “one of the Hamas’ main command and control centers.”


While there was no immediate or formal claim of responsibility for the bus bombing in Tel Aviv, a message on a Twitter account in the name of the Al Qassam Brigades, the armed wing of the Hamas authorities in the Gaza Strip, declared: “We told you IDF that our blessed hands will reach your leaders and soldiers wherever they are, ‘You opened the Gates of Hell on Yourselves.’” The letters IDF refer to the Israel Defense Forces.


On several occasions since the latest conflagration seized Gaza last week, militants have aimed rockets at Tel Aviv but they have either fallen short, landed in the sea or been intercepted. Hundreds of rockets fired by militants in Gaza have struck other targets.


But the bombing seemed to mark the first time in the current fighting that violence had spread directly onto the streets of Tel Aviv.


On Tuesday — the deadliest day of fighting in the conflict — Secretary of State Clinton arrived hurriedly in Jerusalem and met with Prime Minister Benjamin Netanyahu of Israel to push for a truce. Her planned visit to Cairo on Wednesday to consult with Egyptian officials in contact with Hamas placed her and the Obama administration at the center of a fraught process with multiple parties, interests and demands.


Before leaving for Cairo, news reports said, Mrs. Clinton headed to the West Bank to meet Mahmoud Abbas, the head of the Palestinian Authority, which is estranged from the Hamas rulers of the Gaza Strip and has increasingly strained ties with Israel over a contentious attempt to upgrade the Palestinian status at the United Nations to that of a nonmember state. Mrs. Clinton was to meet again with Mr. Netanyahu before heading for Egypt, the reports said.


Ethan Bronner reported from Jerusalem, and David D. Kirkpatrick from Cairo. Reporting was contributed by Jodi Rudoren and Fares Akram from Gaza; Isabel Kershner from Jerusalem; Alan Cowell from London; Peter Baker from Phnom Penh, Cambodia; David E. Sanger and Mark Landler from Washington; Andrea Bruce from Rafah, and Rick Gladstone from New York.



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Election, Storm and Shaky Economy Affect Holiday Shopping


Many retailers have more than the usual riding on sales beginning this Thanksgiving weekend.


The presidential election pushed holiday shopping later than usual because some toy and game makers held off on their big introductions for maximum attention. The aftereffects of Hurricane Sandy have included logistics problems and merchandise delivery delays. And some retailers, trying to keep inventory lean during uncertain economic times, have given themselves little room for error: shipments of holiday toys, for instance, are down 13 percent this year, to the lowest level since 2007, according to the global trade research firm Panjiva.


All of that makes for a particularly strange holiday season, retailers and analysts say.


“The election sucks all of the oxygen out of the room in terms of attention,” said Eric Hirshberg, the chief executive of Activision Publishing, the video game company. “A lot of the best media inventory goes to the candidates. It gets more expensive because there’s this premium demand from the candidates.”


Hasbro is adding more shades of its Furby toy through the end of the year, and Mattel last week introduced a new Monster High video game. Last year, Activision introduced its big Call of Duty release in early November. This year, though, it did not release Call of Duty: Black Ops II until Nov. 13.


“We were also worried that if we released Call of Duty before the election, no one would show up to vote,” Mr. Hirshberg said. (He was speaking facetiously, but given that the game’s retail sales were more than $500 million in the first 24 hours after it made its debut, he may have a point.)


And while retailers were expecting the election to delay some shopping, they were not expecting a storm. RetailNext, which tracks shopper traffic, said that store visits and sales in the Northeast were down about 25 percent during the storm and afterward.


Major retailers have said the election and Hurricane Sandy affected sales. Saks and Target said the beginning of November was choppy, and Macy’s said that the storm seemed to have pushed sales later into the season.


“Some of it is lost, most is postponed,” Karen M. Hoguet, Macy’s chief financial officer, said of demand. “It’s a question of timing.” And Kohl’s chief executive, Kevin Mansell, said the company typically experienced sales slowdowns pre-election and postelection, “and then the business kind of accelerates.”


The late introductions and delayed shopping put toy companies, in particular, in a difficult position: they were under pressure to make hit toys, largely via preorders and layaway, months before people would actually be buying them. Retailers and toy companies started trying to gauge demand early, looking for preliminary data on which items were unpopular and which ones were stars.


Walmart started layaway a month earlier this year versus last year, and Toys “R” Us also started holiday layaway earlier, giving the stores a jump on things. Amazon and other e-commerce sites are promoting tools like preorders, wish lists and gift registries — anything that can give them a sense of what people will buy as the Christmas season churns on.


Preorders are “an important tool to gauge customer demand, and get some feedback from our customers earlier in the process,” said John Alteio, director of toys and games for Amazon. Product introductions later in the year “can be challenging in the toy industry, so we have to draw some comparisons when we can and make the best estimate.”


Paul Solomon, co-chief executive of Moose Toys, which makes Micro Chargers and The Trash Pack, said preorders and layaway were becoming increasingly important. “It’s giving us a good read, early, as to how things are performing, and it’s even more crucial now to make a lot of noise about the brand earlier than in previous years,” he said.


“Preorders are kind of a cottage industry for games like Call of Duty,” Mr. Hirshberg, the Activision chief, said. The company began promoting the game in March, when it ran spots during the NBA playoffs.


In May, it released an ad featuring Oliver North, the national security aide at the heart of the Iran-contra affair and a consultant on the game, talking about the future of warfare. It accepted preorders starting in May. Through the summer, Activision revealed different facets of the game at various conferences, and this month it began running international television, outdoor, digital and mobile ads.


“There’s not a clean math equation that says this many preorders equals this many sales, but it’s confidence-building for us in terms of orders, in terms of production,” Mr. Hirshberg said.


John Barbour, the chief executive of LeapFrog, learned the value of early promotion after last year, when the children’s tablet LeapPad1 became a surprise hit. “It was very hard for me to gauge how successful it would be. Everyone took their best shots,” he said. By November and December, the LeapPad was selling out, and Mr. Barbour had to pay a premium to source tablet screens, and paid for airplanes to fly in extra inventory.


This year, he focused on early promotions that would translate into preorders and layaway, so toy retailers could accurately adjust their orders in time for the holidays. A good response early on means not just bigger orders from retailers, he said, but also more promotional support and more shelf space: it becomes a self-fulfilling prophecy.


“For retailers, it’s phenomenal. It brings demand forward, and they get a better read on what they’re going to need,” he said. When the LeapPad2 became available for preorders in August, it sold as much in two days of preorders as it did in its first week on sale last year, Mr. Barbour said.


He is being careful not to get too jubilant, though. “The penalties for having too much inventory are greater than the penalties for being a little bit short,” he said.


Still, some brands were ignoring the strange events of this holiday season and proceeding as usual. Stephen Bebis, the chief executive of Brookstone, said some products were becoming available in the final months of the year, but that was because of production delays, not strategy.


“People are still going to have to buy gifts for Christmas no matter who’s the president,” he said.


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Responding to Illnesses Manifesting Amid Recovery From Storm


Nicole Bengiveno/The New York Times


Dr. Aaron Gardener, center, attended to a patient at an ad hoc medical unit in Long Beach, N.Y. Many people have coughs, rashes and other ailments.







Day and night, victims of Hurricane Sandy have been streaming into ad hoc emergency rooms and relief centers, like the MASH-type medical unit on an athletic field in Long Beach, and the warming tent in the Rockaways the size of a small high school gym.




They complain of rashes, asthma and coughing. They need tetanus shots because — house-proud and armed with survivalist instincts — they have been ripping out waterlogged boards and getting poked by rusty nails. Those with back pain from sifting through debris receive muscle relaxants; those with chest pain from overexertion are hooked up to cardiac monitors.


“I’ve been coughing,” said Gabriel McAuley, 46, who has been working 16-hour days gutting homes and hauling debris in the Rockaways since the storm hit. “I’ve never felt a cough like that before. It’s deeper down.”


It is impossible to say how many people have been sickened by what Hurricane Sandy left behind: mold from damp drywall; spills from oil tanks; sewage from floodwater and unflushable toilets; tons upon tons of debris and dust. But interviews with hurricane victims, recovery workers, health officials and medical experts over the last week reveal that some of the illnesses that they feared would occur, based on the toxic substances unleashed by the storm and the experience of other disasters, notably Hurricane Katrina, have begun to manifest themselves.


Emergency rooms and poison control centers have reported cases of carbon monoxide exposure — and in New Jersey, several deaths have been attributed to it — from the misuse of generators to provide power and stoves to provide heat.


In Livingston, N.J., the Burn Center at St. Barnabas Medical Center had 16 burn cases over about six days, three times as many as usual, from people trying to dispel the cold and darkness with boiling water, gasoline, candles and lighter fluid.


Raw sewage spilled into homes in Baldwin and East Rockaway, in Nassau County, when a sewage plant shut down because of the surge and the system could not handle the backup. Sewage also spilled from a huge plant in Newark. “We tried to limit our presence in the house because the stink was horrible,” said Jennifer Ayres, 34, of Baldwin, who has been staying temporarily in West Hempstead. She said that she felt ill for several days, that her son had a scratchy throat, and that her mother, who lives in the house, had difficulty breathing, all problems she attributed to the two days they spent inside their house cleaning up last week. “I had stomach problems. I felt itchy beyond itchy on my face.”


Coughing — locally known as the Rockaway cough — is a common symptom that health officials said could come from mold, or from the haze of dust and sand kicked up by the storm and demolitions. The air in the Rockaways is so full of particles that the traffic police wear masks — though many recovery workers do not, worrying people who recall the fallout of another disaster.


“It’s just like 9/11,” said Kathy Smilardi, sitting inside the skeleton of her gutted home in Broad Channel, wrapped in a white puffy jacket, her breath visible in the afternoon cold. “Everyone runs in to clean up, and they’re not wearing masks. Are we going to wait 20 years to figure out that people are dying?”


Health officials and experts say the risks are real, but are cautioning against hysteria. Some coughing could be due to cold, damp weather. Lasting health effects from mold, dust and other environmental hazards generally require long-term, continuous exposure, they said. And the short-term effects can be mitigated by taking precautions like wearing masks, gloves and boots and removing mold-infested wallboard. “The reality is that cleaning up both muck and sewage and spills and removing walls and reconstruction and dealing with debris all do in fact pose concerns,” Daniel Kass, New York City’s deputy commissioner for environmental health, said Friday. “Are they vast or uncontrollable? No. But they depend on people doing work correctly and taking basic precautions.”


The Katrina cough was found to be temporary, said Roy J. Rando, a professor at Tulane’s School of Public Health and Tropical Medicine. Felicia Rabito, an epidemiologist at the school, said that healthy children exposed to mold after Hurricane Katrina showed no lasting respiratory symptoms when they moved back to new or renovated homes.


Immediately after Hurricane Katrina, lead levels in New Orleans’s soil dropped after the top layers of dirt, where lead from paint and gasoline can accumulate, were washed away. But in the two years afterward, soil testing found extremely high lead levels, Dr. Rabito said, which she theorized came from renovating old homes. “That’s a cautionary tale,” she said. Lead in soil can be tracked into homes and pose a health hazard to children playing inside or outside.


Though at least one outbreak of norovirus, a contagious gastrointestinal virus, occurred in a Brooklyn high school that was used as a shelter, New York and New Jersey health officials said they had not seen any significant spike in respiratory or gastrointestinal diseases related to the storm.


In Broad Channel, most homes on Noel Road, where Ms. Smilardi lives, have outdoor oil tanks that were overturned by the storm. The innards of many homes, built when asbestos was used, lie spilled among major and minor roads.


Ominous red spots covered both sides of Paul Nowinski’s burly torso. After the storm, Mr. Nowinski, a musician, waded into the basement of his childhood home on Beach 146th Street in the Rockaways to try to salvage records, books and instruments. He was up to his chest in water, which he thinks might have been contaminated with sewage. He said that he did not know the cause of the red marks; and that he had been too busy “schlepping” to go to the doctor.


Angela Macropoulos contributed reporting.



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Responding to Illnesses Manifesting Amid Recovery From Storm


Nicole Bengiveno/The New York Times


Dr. Aaron Gardener, center, attended to a patient at an ad hoc medical unit in Long Beach, N.Y. Many people have coughs, rashes and other ailments.







Day and night, victims of Hurricane Sandy have been streaming into ad hoc emergency rooms and relief centers, like the MASH-type medical unit on an athletic field in Long Beach, and the warming tent in the Rockaways the size of a small high school gym.




They complain of rashes, asthma and coughing. They need tetanus shots because — house-proud and armed with survivalist instincts — they have been ripping out waterlogged boards and getting poked by rusty nails. Those with back pain from sifting through debris receive muscle relaxants; those with chest pain from overexertion are hooked up to cardiac monitors.


“I’ve been coughing,” said Gabriel McAuley, 46, who has been working 16-hour days gutting homes and hauling debris in the Rockaways since the storm hit. “I’ve never felt a cough like that before. It’s deeper down.”


It is impossible to say how many people have been sickened by what Hurricane Sandy left behind: mold from damp drywall; spills from oil tanks; sewage from floodwater and unflushable toilets; tons upon tons of debris and dust. But interviews with hurricane victims, recovery workers, health officials and medical experts over the last week reveal that some of the illnesses that they feared would occur, based on the toxic substances unleashed by the storm and the experience of other disasters, notably Hurricane Katrina, have begun to manifest themselves.


Emergency rooms and poison control centers have reported cases of carbon monoxide exposure — and in New Jersey, several deaths have been attributed to it — from the misuse of generators to provide power and stoves to provide heat.


In Livingston, N.J., the Burn Center at St. Barnabas Medical Center had 16 burn cases over about six days, three times as many as usual, from people trying to dispel the cold and darkness with boiling water, gasoline, candles and lighter fluid.


Raw sewage spilled into homes in Baldwin and East Rockaway, in Nassau County, when a sewage plant shut down because of the surge and the system could not handle the backup. Sewage also spilled from a huge plant in Newark. “We tried to limit our presence in the house because the stink was horrible,” said Jennifer Ayres, 34, of Baldwin, who has been staying temporarily in West Hempstead. She said that she felt ill for several days, that her son had a scratchy throat, and that her mother, who lives in the house, had difficulty breathing, all problems she attributed to the two days they spent inside their house cleaning up last week. “I had stomach problems. I felt itchy beyond itchy on my face.”


Coughing — locally known as the Rockaway cough — is a common symptom that health officials said could come from mold, or from the haze of dust and sand kicked up by the storm and demolitions. The air in the Rockaways is so full of particles that the traffic police wear masks — though many recovery workers do not, worrying people who recall the fallout of another disaster.


“It’s just like 9/11,” said Kathy Smilardi, sitting inside the skeleton of her gutted home in Broad Channel, wrapped in a white puffy jacket, her breath visible in the afternoon cold. “Everyone runs in to clean up, and they’re not wearing masks. Are we going to wait 20 years to figure out that people are dying?”


Health officials and experts say the risks are real, but are cautioning against hysteria. Some coughing could be due to cold, damp weather. Lasting health effects from mold, dust and other environmental hazards generally require long-term, continuous exposure, they said. And the short-term effects can be mitigated by taking precautions like wearing masks, gloves and boots and removing mold-infested wallboard. “The reality is that cleaning up both muck and sewage and spills and removing walls and reconstruction and dealing with debris all do in fact pose concerns,” Daniel Kass, New York City’s deputy commissioner for environmental health, said Friday. “Are they vast or uncontrollable? No. But they depend on people doing work correctly and taking basic precautions.”


The Katrina cough was found to be temporary, said Roy J. Rando, a professor at Tulane’s School of Public Health and Tropical Medicine. Felicia Rabito, an epidemiologist at the school, said that healthy children exposed to mold after Hurricane Katrina showed no lasting respiratory symptoms when they moved back to new or renovated homes.


Immediately after Hurricane Katrina, lead levels in New Orleans’s soil dropped after the top layers of dirt, where lead from paint and gasoline can accumulate, were washed away. But in the two years afterward, soil testing found extremely high lead levels, Dr. Rabito said, which she theorized came from renovating old homes. “That’s a cautionary tale,” she said. Lead in soil can be tracked into homes and pose a health hazard to children playing inside or outside.


Though at least one outbreak of norovirus, a contagious gastrointestinal virus, occurred in a Brooklyn high school that was used as a shelter, New York and New Jersey health officials said they had not seen any significant spike in respiratory or gastrointestinal diseases related to the storm.


In Broad Channel, most homes on Noel Road, where Ms. Smilardi lives, have outdoor oil tanks that were overturned by the storm. The innards of many homes, built when asbestos was used, lie spilled among major and minor roads.


Ominous red spots covered both sides of Paul Nowinski’s burly torso. After the storm, Mr. Nowinski, a musician, waded into the basement of his childhood home on Beach 146th Street in the Rockaways to try to salvage records, books and instruments. He was up to his chest in water, which he thinks might have been contaminated with sewage. He said that he did not know the cause of the red marks; and that he had been too busy “schlepping” to go to the doctor.


Angela Macropoulos contributed reporting.



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Bits Blog: Intel Chief Executive to Retire in May

8:21 p.m. |Update

SAN FRANCISCO — After almost 40 years at Intel, its chief executive, Paul S. Otellini, is retiring, just as the company struggles with a momentous challenge: computing’s big shift to mobile devices.

Mr. Otellini, 62, surprised the technology world Monday by announcing that he would retire as an officer and director of the chip company this May, three years before he hits Intel’s mandatory retirement age. The board said it would immediately begin a search for a successor.

During a tenure that began in May 2005, Mr. Otellini established a strong track record. He increased Intel’s revenue 57 percent, to $55 billion at the end of 2011, and slightly widened its gross profit margin. Along the way, Mr. Otellini had to settle an antitrust suit for $1.25 billion, persuaded Apple to put Intel chips in its computers and cut 20,000 workers. Intel, the world’s largest semiconductor maker, now employs 100,000 people.

But the company’s share price has fallen about 20 percent in Mr. Otellini’s time. That is because the world of personal computers and computer servers, which Intel dominated partly through a close relationship with Microsoft, now competes with a global explosion of smartphones and tablets, which connect to large data centers. While Intel has some presence in these areas, it faces many new competitors and challenges, both to its business and to its way of thinking about products.

The right successor to Mr. Otellini, said Andrew Bryant, Intel’s chairman, would preserve Intel’s engineering-driven culture but turn it into an organization that is better able to anticipate rapidly changing consumer tastes.

“We don’t see the PC category going away, but we see that the market has changed,” Mr. Bryant said. “We need to figure out what the market wants.”

Mr. Otellini could not be reached for comment. In a statement issued by Intel, he said that “after almost four decades with the company and eight years as C.E.O., it’s time to move on and transfer Intel’s helm to a new generation of leadership.”

Last month Intel reported that its third-quarter net income fell 14.3 percent from a year earlier, to $3 billion, largely because of poor demand for PCs. The research firm IDC said that worldwide PC shipments fell 8.6 percent to 87.8 million units in the third quarter. Adding to the woes, Microsoft’s Windows 8 operating system, which Intel hoped would lift sales, was released in October to tepid reviews.

While they are both hurting from the PC plunge, Intel and Microsoft may be the best off of a troubled bunch. Last week, Advanced Micro Devices, Intel’s top competitor in chips for PCs, was forced to deny rumors that it was looking for a buyer. Its stock is down about 65 percent this year. Hewlett-Packard and Dell, both big PC makers, are also struggling.

Mr. Bryant said that Mr. Otellini had informed the board of his decision last Wednesday, citing a need for new leadership. He credited Mr. Otellini with putting Intel on track to produce chips that require less power. That is important both for battery-dependent smartphones and for data centers running hundreds of thousands of servers.

He also noted Mr. Otellini’s efforts in spearheading a category of lightweight laptop computers called ultrabooks, which have yet to take off in the market. Mr. Otellini also championed a wireless technology called WiMAX that never lived up to its billing.

Intel influences PC manufacturers in a number of ways. Besides designing and making the very core of their products, Intel also invests heavily in related fields; for example, through its venture arm it created a $300 million fund to promote ultrabooks. And it teaches its customers what they can do with each new generation of Intel chips, which in turn leads to new software development.

While Intel will look at both internal and external candidates, Mr. Bryant said, an internal candidate would probably prove a better fit, as that person would understand the culture. In its 45-year history, all of Intel’s five chief executives have been insiders.

Mr. Otellini’s departure is the third exit of a prominent executive from a major tech company in the last few weeks. In late October, Scott Forstall, who was the head of Apple’s mobile software development, was fired by Timothy D. Cook, the chief executive. Steven Sinofsky, the head of Windows at Microsoft, left the company a week ago, just after the introduction of Windows 8 and the Surface tablet. His brash personality led to internal clashes, and he and Steven A. Ballmer, Microsoft’s chief executive, agreed that it was time for him to go, according to a person briefed on the situation who was not authorized to speak publicly about it.

While both of those men were regarded as abrasive by those who worked with them, Mr. Otellini was not. A generally well-liked San Francisco native with an M.B.A. from Berkeley, Mr. Otellini was considered a break from Intel’s norm when he became chief because he was not formally trained in engineering.

But Ken Dulaney, an analyst with Gartner, drew a connection between the departures of the Microsoft and Intel executives.

“While Sinofsky and Otellini are gone for different reasons, underneath it similar forces are at work,” said. “Microsoft and Intel haven’t done a good job making PCs more compelling, and people are spending their dollars for electronics differently.”

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Obama Receives Warm Welcome in Myanmar







YANGON, MYANMAR — The generals predicted that the Americans would come — but not like this.




In the paranoid decades of military rule, members of Myanmar’s junta told diplomats that they feared an American invasion and regime change.


On Monday, there was a large American deployment to Myanmar, but of an entirely different kind. Two jumbo jets carrying President Barack Obama, Secretary of State Hillary Rodham Clinton and their substantial entourage arrived for a six-hour visit. They were greeted by hundreds of people along Yangon’s streets, many of them waving U.S. flags.


“I saw Obama and nearly fainted,” said U Sein Hla Maung, an accounting teacher, who was perched on a hill overlooking the airport. “I’m very excited.”


Across the city there were symbols of how much mistrust has dissolved between the two governments and how much Myanmar has changed over the past two years as it moves from a dictatorship and toward a democracy. There were graffiti tributes to Mr. Obama, and shops sold T-shirts with his image.


“You are the legend hero of our world,” read a large sign in English held by a group of women standing along the road where Mr. Obama’s motorcade passed.


The warm greeting that Mr. Obama received here was partly government pomp and protocol. Hundreds of students in uniform were bused to the airport to line the roads and chanted in unison a rehearsed greeting: “President Obama is warmly welcomed to Myanmar!”


But the hundreds of others who came to greet the president’s motorcade on their own said they were deeply moved by Mr. Obama’s presence.


“We’ve been waiting 50 years for this visit,” said Kyaw Soe Moe, a restaurateur who had stood along the road with two large American flags. “There is justice and law in the United States. I want our country to be like that.”


During Myanmar’s military rule, American flags were taboo and symbols of defiance. On Monday, well-wishers said it was a measure of new freedoms in the country that they could greet Mr. Obama holding the Stars and Stripes.


“America always meant support for democracy for us,” Win Min, a former student activist who was one of two interpreters of a speech Mr. Obama delivered during his visit. “It was the country that had the strongest criticism of the military regime. We looked up to America.”


In 1988, when students and striking workers rose up against military rule, they marched almost daily to the U.S. Embassy. The military put down the uprising in a crackdown that killed many. It has only been 20 months since the junta in Myanmar ceded power to the civilian government of President Thein Sein. Therefore, American flags strewn across the capital, and Air Force One parked at the airport in Yangon, were a novel and somewhat jarring sight.


“There were people in the old regime and there are probably some people in the new government who still fear America,” said U Thant Myint-U, a historian who was in the audience for Mr. Obama’s speech. “They are afraid of what American influence could unleash here.”


Mr. Obama’s visit suggests that the Myanmar government “now has gained a level of confidence,” Mr. Thant Myint-U said.


Some members of the governing party, which is led by former generals of the junta, sought to play down the visit.


“I want to say that America is not the only friend of our nation — China and India are our friends too,” said U Khin Maung Htoo, a member of Parliament with the Union Solidarity and Development Party.


Mr. Khin Maung Htoo also said it was inappropriate for Mr. Obama to have met Myanmar’s president in Yangon instead of Naypyidaw, the capital built and conceived by the military.


The timing of the visit was awkward for Mr. Thein Sein, who flew from a regional meeting of the Association of Southeast Asian Nations in Cambodia to meet Mr. Obama and then flew back to Cambodia immediately afterward.


In his speech at the University of Yangon, Mr. Obama spoke about the changes to the country and offered a “hand of friendship” between two countries that had become “strangers.” The speech was carried live on Myanmar television, but without explanation the announcers stopped simultaneous interpretation in Burmese after several minutes.


Mr. Obama spoke about Myanmar’s continuing ethnic strife and said the country should harness the “power of diversity.” He said that people with his skin color were once denied the right to vote in the United States.


“And so that should give you some sense that if our country can transcend its differences,” Mr. Obama said, “then yours can too.”


On the street outside the university was U Ko Ni, a former political prisoner, who held up a sign: “Welcome Americans. No other nation has full human rights and democracy. We need and want democracy. Do help.”


Wai Moe contributed reporting from Yangon.


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Spain Seeks Investment From Latin America





CÁDIZ, SPAIN — Starting in the late 1990s, Spanish companies began a drive into Latin America that resulted in their takeover of some of the region’s most prized assets. Now, Prime Minister Mariano Rajoy of Spain wants the investment to flow in the other direction.







Jon Nazca/Reuters

“Spain receives Latin American investment with open arms,” Mr. Rajoy said at a meeting on Saturday.







Mr. Rajoy used a weekend summit meeting here to try to persuade Latin American leaders to invest more in recession-hit Spain, suggesting that his country could be “the closest platform” for companies to make forays into the rest of Europe, and even North Africa.


“Spain receives Latin American investment with open arms,” he said Saturday in a speech.


Mr. Rajoy’s investment plea underlines the extent to which Spain and Portugal, among those hit hardest by the European debt crisis, are scrambling to find new ways to exploit their historical and cultural ties to Latin America.


The International Monetary Fund forecast last month that growth in Latin America would accelerate to 3.9 percent next year from 3.2 percent this year, with Brazil’s economy growing 4 percent.


Luis Alberto Moreno, the president of the Inter-American Development Bank, said during an interview that “for years you had capital going from north to south and immigration going from south to north and what we are increasingly going to see is a reverse of the flows.”


At a time of soaring unemployment in Spain and Portugal, Mr. Moreno added, a reversal of migration — from parts of Europe to Latin America — is likely to accelerate also because “there is now a skills gap in Latin America.”


In fact, some of the participants in the two-day summit meeting suggested that Spain and other European countries should pay closer attention to Latin America’s recent recipes for economic success in order to help them emerge from their own economic quagmire.


“I think Latin America now has a lot more to show Spain and others in Europe than the other way round,” said Heraldo Muñoz, a former member of the Chilean government who is now assistant secretary general at the United Nations Development Program.


One of the lessons from Latin America’s ability to overcome several rounds of financial crisis, he suggested during an interview, is that “the idea cannot simply be to tighten the belt.”


“I’m very concerned by the tendency now in Europe to dismantle the welfare state and the social gains that have been achieved,” Mr. Muñoz said.


While Mr. Rajoy maintains that Spain can meet the budgetary targets it told its European Union counterparts that it would meet, his administration has been debating since September whether to seek further European rescue funds amid concerns in Madrid that such help would require Spain to introduce further austerity measures.


“To get out of the crisis, austerity is necessary but not sufficient,” José Manuel García-Margallo, the Spanish foreign minister, said at a news conference here Friday. “Growth is the key.”


For now, however, the economies of Spain and Portugal are expected to contract through next year. And with unemployment already at 25 percent in Spain and nearly 16 percent in Portugal, expectations of a prolonged recession are helping to fuel an exodus to Latin America and other growth markets. Mr. Rajoy, for instance, noted on Saturday that already more than one million Spaniards lived in Latin America.


In order to strengthen their presence in Latin America, Spanish companies will increasingly have to be “bringing people over, given the scarcity of local talent, particularly in the engineering and technical fields,” said Javier García-Ramos, a Spanish investment banker who moved to São Paulo this year to work for VGL Finanças Corporativas, an advisory firm specializing in mergers and acquisitions. Still, he warned job seekers that “immigration requirements are cumbersome to say the least and don’t facilitate the process.”


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