Rate of Childhood Obesity Falls in Several Cities


Jessica Kourkounis for The New York Times


At William H. Ziegler Elementary in Northeast Philadelphia, students are getting acquainted with vegetables and healthy snacks.







PHILADELPHIA — After decades of rising childhood obesity rates, several American cities are reporting their first declines.




The trend has emerged in big cities like New York and Los Angeles, as well as smaller places like Anchorage, Alaska, and Kearney, Neb. The state of Mississippi has also registered a drop, but only among white students.


“It’s been nothing but bad news for 30 years, so the fact that we have any good news is a big story,” said Dr. Thomas Farley, the health commissioner in New York City, which reported a 5.5 percent decline in the number of obese schoolchildren from 2007 to 2011.


The drops are small, just 5 percent here in Philadelphia and 3 percent in Los Angeles. But experts say they are significant because they offer the first indication that the obesity epidemic, one of the nation’s most intractable health problems, may actually be reversing course.


The first dips — noted in a September report by the Robert Wood Johnson Foundation — were so surprising that some researchers did not believe them.


Deanna M. Hoelscher, a researcher at the University of Texas, who in 2010 recorded one of the earliest declines — among mostly poor Hispanic fourth graders in the El Paso area — did a double-take. “We reran the numbers a couple of times,” she said. “I kept saying, ‘Will you please check that again for me?’ ”


Researchers say they are not sure what is behind the declines. They may be an early sign of a national shift that is visible only in cities that routinely measure the height and weight of schoolchildren. The decline in Los Angeles, for instance, was for fifth, seventh and ninth graders — the grades that are measured each year — between 2005 and 2010. Nor is it clear whether the drops have more to do with fewer obese children entering school or currently enrolled children losing weight. But researchers note that declines occurred in cities that have had obesity reduction policies in place for a number of years.


Though obesity is now part of the national conversation, with aggressive advertising campaigns in major cities and a push by Michelle Obama, many scientists doubt that anti-obesity programs actually work. Individual efforts like one-time exercise programs have rarely produced results. Researchers say that it will take a broad set of policies applied systematically to effectively reverse the trend, a conclusion underscored by an Institute of Medicine report released in May.


Philadelphia has undertaken a broad assault on childhood obesity for years. Sugary drinks like sweetened iced tea, fruit punch and sports drinks started to disappear from school vending machines in 2004. A year later, new snack guidelines set calorie and fat limits, which reduced the size of snack foods like potato chips to single servings. By 2009, deep fryers were gone from cafeterias and whole milk had been replaced by one percent and skim.


Change has been slow. Schools made money on sugary drinks, and some set up rogue drink machines that had to be hunted down. Deep fat fryers, favored by school administrators who did not want to lose popular items like French fries, were unplugged only after Wayne T. Grasela, the head of food services for the school district, stopped buying oil to fill them.


But the message seems to be getting through, even if acting on it is daunting. Josh Monserrat, an eighth grader at John Welsh Elementary, uses words like “carbs,” and “portion size.” He is part of a student group that promotes healthy eating. He has even dressed as an orange to try to get other children to eat better. Still, he struggles with his own weight. He is 5-foot-3 but weighed nearly 200 pounds at his last doctor’s visit.


“I was thinking, ‘Wow, I’m obese for my age,’ ” said Josh, who is 13. “I set a goal for myself to lose 50 pounds.”


Nationally, about 17 percent of children under 20 are obese, or about 12.5 million people, according to the Centers for Disease Control and Prevention, which defines childhood obesity as a body mass index at or above the 95th percentile for children of the same age and sex. That rate, which has tripled since 1980, has leveled off in recent years but has remained at historical highs, and public health experts warn that it could bring long-term health risks.


Obese children are more likely to be obese as adults, creating a higher risk of heart disease and stroke. The American Cancer Society says that being overweight or obese is the culprit in one of seven cancer deaths. Diabetes in children is up by a fifth since 2000, according to federal data.


“I’m deeply worried about it,” said Francis S. Collins, the director of the National Institutes of Health, who added that obesity is “almost certain to result in a serious downturn in longevity based on the risks people are taking on.”


Read More..

Rate of Childhood Obesity Falls in Several Cities


Jessica Kourkounis for The New York Times


At William H. Ziegler Elementary in Northeast Philadelphia, students are getting acquainted with vegetables and healthy snacks.







PHILADELPHIA — After decades of rising childhood obesity rates, several American cities are reporting their first declines.




The trend has emerged in big cities like New York and Los Angeles, as well as smaller places like Anchorage, Alaska, and Kearney, Neb. The state of Mississippi has also registered a drop, but only among white students.


“It’s been nothing but bad news for 30 years, so the fact that we have any good news is a big story,” said Dr. Thomas Farley, the health commissioner in New York City, which reported a 5.5 percent decline in the number of obese schoolchildren from 2007 to 2011.


The drops are small, just 5 percent here in Philadelphia and 3 percent in Los Angeles. But experts say they are significant because they offer the first indication that the obesity epidemic, one of the nation’s most intractable health problems, may actually be reversing course.


The first dips — noted in a September report by the Robert Wood Johnson Foundation — were so surprising that some researchers did not believe them.


Deanna M. Hoelscher, a researcher at the University of Texas, who in 2010 recorded one of the earliest declines — among mostly poor Hispanic fourth graders in the El Paso area — did a double-take. “We reran the numbers a couple of times,” she said. “I kept saying, ‘Will you please check that again for me?’ ”


Researchers say they are not sure what is behind the declines. They may be an early sign of a national shift that is visible only in cities that routinely measure the height and weight of schoolchildren. The decline in Los Angeles, for instance, was for fifth, seventh and ninth graders — the grades that are measured each year — between 2005 and 2010. Nor is it clear whether the drops have more to do with fewer obese children entering school or currently enrolled children losing weight. But researchers note that declines occurred in cities that have had obesity reduction policies in place for a number of years.


Though obesity is now part of the national conversation, with aggressive advertising campaigns in major cities and a push by Michelle Obama, many scientists doubt that anti-obesity programs actually work. Individual efforts like one-time exercise programs have rarely produced results. Researchers say that it will take a broad set of policies applied systematically to effectively reverse the trend, a conclusion underscored by an Institute of Medicine report released in May.


Philadelphia has undertaken a broad assault on childhood obesity for years. Sugary drinks like sweetened iced tea, fruit punch and sports drinks started to disappear from school vending machines in 2004. A year later, new snack guidelines set calorie and fat limits, which reduced the size of snack foods like potato chips to single servings. By 2009, deep fryers were gone from cafeterias and whole milk had been replaced by one percent and skim.


Change has been slow. Schools made money on sugary drinks, and some set up rogue drink machines that had to be hunted down. Deep fat fryers, favored by school administrators who did not want to lose popular items like French fries, were unplugged only after Wayne T. Grasela, the head of food services for the school district, stopped buying oil to fill them.


But the message seems to be getting through, even if acting on it is daunting. Josh Monserrat, an eighth grader at John Welsh Elementary, uses words like “carbs,” and “portion size.” He is part of a student group that promotes healthy eating. He has even dressed as an orange to try to get other children to eat better. Still, he struggles with his own weight. He is 5-foot-3 but weighed nearly 200 pounds at his last doctor’s visit.


“I was thinking, ‘Wow, I’m obese for my age,’ ” said Josh, who is 13. “I set a goal for myself to lose 50 pounds.”


Nationally, about 17 percent of children under 20 are obese, or about 12.5 million people, according to the Centers for Disease Control and Prevention, which defines childhood obesity as a body mass index at or above the 95th percentile for children of the same age and sex. That rate, which has tripled since 1980, has leveled off in recent years but has remained at historical highs, and public health experts warn that it could bring long-term health risks.


Obese children are more likely to be obese as adults, creating a higher risk of heart disease and stroke. The American Cancer Society says that being overweight or obese is the culprit in one of seven cancer deaths. Diabetes in children is up by a fifth since 2000, according to federal data.


“I’m deeply worried about it,” said Francis S. Collins, the director of the National Institutes of Health, who added that obesity is “almost certain to result in a serious downturn in longevity based on the risks people are taking on.”


Read More..

Huawei to Open Research Center in Finland





PARIS — Huawei Technologies, a Chinese maker of telecommunications equipment, said on Monday that it planned to open a research and development center in Helsinki next year, accelerating its investments in Europe, where its business is expanding rapidly.


The move illustrates a trans-Atlantic difference in attitudes toward Huawei. The company has been largely shut out of the United States market for network gear because of Congressional concerns about possible security threats — fears the company insists are unfounded.


While Huawei has faced difficulties in some European markets, like France, it has done better elsewhere. Huawei employs more than 7,000 people in the region, and it says that total could double in the next three to five years. Huawei already has a research center in Italy and is studying the possibility of opening one in Spain. It also recently announced a $2 billion investment in Britain.


The planned center in Helsinki, involving an investment of 70 million euros, or about $90 million, will work on smartphone development, including features like user interfaces and power management, the company said. When the center opens next year, it will employ 30 people, but this could grow to 100 over the next five years, the company said.


The announcement is a plus for the Finnish technology industry, which has been suffering from the woes at Nokia. The company was once the world’s biggest cellphone maker, but its market share has fallen sharply in recent years.


“The open and innovative environment in Finland,” Huawei said, “is an ideal place for Huawei to strengthen our global R.& D. capabilities for devices, creating opportunities for both Huawei and the Finnish telecommunications industry.”


Huawei has been known mostly for its network equipment, but the company is pushing to make a name for itself with its handsets.


Mobile devices accounted for 22 percent of its revenue last year, an increase of 37 percent. That compares with growth of 12 percent for the overall business.


Read More..

Italy’s Monti Is Cool to Running on His Own





ROME — While Prime Minister Mario Monti’s decision over the weekend to resign this month rattled Milan’s stock market and worried European leaders, Italian centrists stepped up their efforts on Monday to persuade him to join their political movements.




But even as some groups tried to recruit him as a candidate to challenge former Prime Minister Silvio Berlusconi, the leader of the center-left Democratic Party, Pierluigi Bersani, urged Mr. Monti to refrain from running.


“Precisely because Monti should still be able to be of service to this country, it would be better for him to stay out of the contest,” said Mr. Bersani, whose party now looks likely to place first in the coming national elections on a pro-Europe platform.


For his part, Mr. Monti played down speculation about whether he would run in the elections, expected to take place in February. “I am not considering this particular issue at this stage,” he said in Oslo, where he was attending the ceremony at which the European Union was awarded the Nobel Peace Prize.


He said he would devote his remaining time to the work of his current government, adding that the reaction of financial markets to his decision to step down “should not be dramatized.”


In recent weeks, two centrist groupings have been actively courting Mr. Monti: the Union of Christian Democrats, led by Pier Ferdinando Casini, a former ally of Mr. Berlusconi; and Luca Cordero di Montezemolo, the president of Ferrari who started a civic movement last month and said it would endorse Mr. Monti.


In another significant development, Cardinal Angelo Bagnasco, the leader of the Italian Bishops’ Conference, all but endorsed Mr. Monti. “What leaves one astonished is the irresponsibility of those who think of arranging things for themselves while the house is still burning,” Cardinal Bagnasco told the newspaper Corriere della Sera on Monday.


No Italian government has survived without the blessing of the Roman Catholic Church, which is as much a political operation in Italy as a religious one.


The centrist movements do not have well-oiled political operations or even a clear constituency, but could be vessels for a potential Monti candidacy. If Mr. Monti gave them his support, that would significantly weaken the Democratic Party, which is unlikely to win enough seats in Parliament to govern without forming alliances with centrist groups.


A moderate former Communist, Mr. Bersani is seen as part of the old guard of the Democratic Party and recently won a hard-fought primary race against Matteo Renzi, the 37-year-old mayor of Florence. Mr. Bersani has pledged to adhere to Mr. Monti’s cost-cutting agenda. But his party is seen as beholden to unions, which have challenged changes to Italian labor laws that could make it easier for businesses to hire and fire employees.


Still, some analysts say that a Bersani government would be in tune with Prime Minister François Hollande of France, a Socialist, and could serve as a counterbalance in Europe to an increasingly powerful Germany.


But even if Mr. Monti decides to run, it remains to be seen whether his austerity program would win over Italian voters. Mr. Monti, an economist who was asked to form a government last year after Mr. Berlusconi resigned, may have raised Italy’s profile on the world stage, but many Italians know him as the unelected leader who raised taxes and the retirement age and made it harder for small businesses to survive.


Mr. Berlusconi, who is not expected to win enough votes to govern, is likely to try to tap into that popular discontent. The former prime minister has always been the id of Italy, but for his next act, he may well become the id of Europe, a populist force that rails against the single currency even as he outwardly supports it.


While saying that he had always been a “a convinced Europeanist” who had always fought for a Europe with single currency, Mr. Berlusconi, in a statement on Monday, criticized foreign news organizations that questioned, or even mocked, his return to politics.


“It would be too simple to connect this interference with the umpteenth speculative maneuver aimed at weakening our businesses and making them the easy prey of foreign buyers,” he said.


Read More..

Euro Watch: Italian Political Turmoil Weighs on Markets







ROME — Italian bond yields were sharply higher Monday, and Italian stocks led major European indexes lower, after a weekend of political turmoil in Italy gave rise to fears that the country was headed for renewed instability.




Former Prime Minister Silvio Berlusconi said he would again seek Italy’s highest office after pulling his party’s support from Mario Monti, the unelected official who currently holds the office. Mr. Monti decided over the weekend to step down.


Mr. Monti has restored Italy’s credibility with investors, giving the country a break on its borrowing costs. But those gains have come at the cost of painful austerity measures that have worsened the country’s economic situation, and given Mr. Berlusconi an opening to attack.


Mr. Monti will leave after Parliament passes a budget this month and may contest national elections against Mr. Berlusconi, with the vote — previously scheduled for April — now possible as early as February or March.


Mr. Berlusconi, a four time prime minister, left office a year ago as markets pushed Italy to the brink of financial collapse.


The Milan benchmark MIB index was down 3.6 percent in the early European afternoon, with trading halted in the shares of two banks, Monte Paschi and Banca Popolare di Milano, after they fell by their maximum daily limit.


The yield gap, or spread, between Italian 10-year sovereign bonds and equivalent German securities, the European benchmark for safety, grew to 3.61 percentage points Monday from 3.25 points late Friday, suggesting that investors were growing more wary of holding Italian debt.


A barometer of euro zone blue-chip stocks, the Euro Stoxx 50 index, fell 1.1 percent. The euro was little changed from its levels in New York Friday, at $1.2907.


“It’s as if a tank moved through” the market, said Mario Sechi, editor in chief of the Rome daily Il Tempo, speaking on Radio 24 on Monday morning. Like many Italian commentators, Mr. Sechi expressed reservations about Mr. Berlusconi’s decision to return to politics.


A dismal economic report Monday served as a reminder that despite Mr. Monti’s success with investors, the real economy continues to suffer. Italian industrial production fell a seasonally adjusted 1.1 percent in October from September, and by 6.2 percent from a year earlier, the national Istat statistics agency reported from Rome.


The coming Italian election “remains high on our list of tail risks for 2013,” Holger Schmieding, an economist in London with Berenberg Bank, wrote in a research note. “A Berlusconi campaign against ‘German austerity’ could potentially unsettle markets,” he noted, and possibly push Spain or Italy into a bailout and additional bond purchases by the European Central Bank to hold down borrowing costs.


Spanish bonds also came under renewed pressure following Mr. Monti’s announcement, with the risk premium demanded by investors for holding Spanish 10-year bonds rather than equivalent German bonds rising to 4.38 percentage points on Monday morning, from 4.16 points on Friday.


Luís de Guindos, the economy minister, warned that Italy’s political turmoil would have an impact on Spain. “When doubts emerge over the stability of a neighboring country like Italy, which is also seen as vulnerable, there’s an immediate contagion for us,” he said Monday morning on Spanish national radio.


Asked whether Spain would itself seek further European rescue funding, the minister instead said that “the help that Spain needs is that the doubts over the future of the euro be removed.”


Speaking ahead of the Nobel prize awards on Monday, the European Commission president, José Manuel Barroso, said that Italy had to “continue on the road of structural reforms.” The elections, Mr. Barroso said on Sky News, “must not be used to postpone reforms.”


David Jolly reported from Paris. Raphael Minder contributed reporting from Madrid.


Read More..

The New Old Age Blog: Training Needed for Home Care Is Lacking

“H” from Chicago, I heard you when you joined a lively discussion over hospice at home here a couple of weeks ago and asked, “where can family members get the training to do all the nursing tasks?”

In the comments section, many readers wrote in to say that caring for relatives at the end of their lives was a duty and a privilege. Others said they were unprepared for the physical and emotional burdens of doing so.

Your question stood out because of its practical character. Do caregivers have to figure out how to handle all these complicated medical issues on their own? Or is some help out there?

For an answer, I called two of the authors of “Home Alone: Family Caregivers Providing Complex Chronic Care,” put out by the United Hospital Fund and the AARP Public Policy Institute. That study recently made headlines by reporting that 46 percent of the nation’s 42 million caregivers handle medical and nursing tasks such as giving injections, caring for wounds or administering I.V.s.

Susan Reinhard, senior vice president and director of the AARP Public Policy Institute, sighed when I reached her, and said “this is a huge gap,” referring to a notable absence of available training in demanding caregiving tasks.

To the extent training exists through local agencies on aging, disease-specific organizations or social service groups, it deals mostly with so-called “activities of daily living” — helping someone bath, dress, eat, or use the bathroom — not the demands of nursing-style care, Ms. Reinhard observed.

Really, this kind of training should be the responsibility of health care providers, but doctors and nurses often give only cursory, unsatisfactory explanations of complex tasks that fall to caregivers, said Carole Levine, director of the Families and Health Care Project of the United Hospital Fund.

That leaves the burden on caregivers to be assertive and ask for help, these experts agreed. If someone is hospitalized and ready to return home, they suggest asking a nurse or another provider “show me what you are doing so I can learn how to do it,” and then asking “now, watch me do it and tell me if I am doing it wrong or right.”

Don’t give up after the first time if you feel awkward or uncomfortable. Ask to do the task again, and ask again for feedback.

No videos or written manuals, can substitute for this one-on-one, hands-on instruction. If you don’t get it to your satisfaction before a loved-one is ready to go home, don’t sign the form that says you have been given instructions on what to do, Ms. Reinhard advised. The hospital is legally obligated to ensure that discharges are safe, and this operates in your favor.

The same goes for the pharmacy: don’t sign that sheet that the pharmacist hands you indicating that you have been adequately informed about the medications you are purchasing. If you are concerned about the number of prescriptions, what they are for, their possible side effects and whether all are necessary, ask the pharmacist to sit down with you and go over all this information. Again, don’t leave until you are satisfied.

Often, caregiving tasks will change as someone with a chronic condition like Parkinson’s disease or heart failure becomes more frail. Should this happen, consider calling a home care agency and asking for a nurse to come out and teach you how to administer oxygen or help transfer someone safely from a bed to a wheelchair, Ms. Reinhard said.

You may want to videotape the session so you can view it several times; most of us don’t pick these skills up right away and need repeat practice, Ms. Levine said.

Be as specific in your request for help as possible. Rather than complaining that you are overwhelmed, say something along the lines of, “I want to make sure I know how to clean this wound and prevent an infection” or “I need to know what texture the food should be so I can feed mom without having her choke,” Ms. Levine suggested.

Her organization has prepared comprehensive materials for caregivers called “Next Step in Care.” While the focus isn’t on nursing-style caregiving tasks, three might be useful: a self-assessment tool for family caregivers, a medication management guide, and a guide to hospice and palliative care.

Other helpful materials are few and far between. Ms. Levine’s staff identified a $24.95 American Red Cross training manual for family caregivers that has a DVD explaining the mechanics of transfers and a few other complicated tasks. Also, some videos are available for free at www.mmlearn.org, a Web site that says its mission is to provide caregivers with online training and education.

Asked about model programs, Ms. Reinhard said she knew of only one: the Schmieding Home Caregiver Training Program in Arkansas, operated by the Donald W. Reynolds Institute on Aging of the University of Arkansas for Medical Sciences. The Schmieding program trains family caregivers as well as professional caregivers who work in people’s homes or nursing homes.

On the family side, it offers eight hours of instruction in “physical needs” associated with caregiving — managing incontinence, skin care, turning someone regularly in bed, using adaptive equipment, transfers from a bed to a wheelchair, helping patients remain mobile, and more. Classes are offered at five sites and four more are planned in the next several years, said Robin McAtee, associate director of the Reynolds Institute on Aging. If people, churches or senior centers want the instruction, which is free, Schmieding nurses will take the program to them. One-on-one instruction for tasks is also available on request.

A separate eight-hour program is available for caregivers dealing with dementia, who have additional concerns.

At a Web site called Elder Stay at Home, Schmieding sells a package of materials (three DVDs and a booklet, for $99) summarizing the content of its family caregiver training program. Separately, it has begun selling its curriculum for paid caregivers, and programs in California, Hawaii and Texas are among the first buyers. The University of Arkansas for Medical Sciences also has received a $3.7 million innovation grant from the government to expand the caregiver training program more broadly and develop online training materials.

Ms. Reinhard said AARP would like to see Schmieding-style programs rolled out across the country and begin to offer structured, reliable support to caregivers now providing nursing-style care in homes with little or no assistance.

What else am I missing here? Do you know of resources or other organizations providing intensive caregiver training along the lines of what I’ve been discussing? Where would you suggest people turn for this kind of help?

Read More..

The New Old Age Blog: Training Needed for Home Care Is Lacking

“H” from Chicago, I heard you when you joined a lively discussion over hospice at home here a couple of weeks ago and asked, “where can family members get the training to do all the nursing tasks?”

In the comments section, many readers wrote in to say that caring for relatives at the end of their lives was a duty and a privilege. Others said they were unprepared for the physical and emotional burdens of doing so.

Your question stood out because of its practical character. Do caregivers have to figure out how to handle all these complicated medical issues on their own? Or is some help out there?

For an answer, I called two of the authors of “Home Alone: Family Caregivers Providing Complex Chronic Care,” put out by the United Hospital Fund and the AARP Public Policy Institute. That study recently made headlines by reporting that 46 percent of the nation’s 42 million caregivers handle medical and nursing tasks such as giving injections, caring for wounds or administering I.V.s.

Susan Reinhard, senior vice president and director of the AARP Public Policy Institute, sighed when I reached her, and said “this is a huge gap,” referring to a notable absence of available training in demanding caregiving tasks.

To the extent training exists through local agencies on aging, disease-specific organizations or social service groups, it deals mostly with so-called “activities of daily living” — helping someone bath, dress, eat, or use the bathroom — not the demands of nursing-style care, Ms. Reinhard observed.

Really, this kind of training should be the responsibility of health care providers, but doctors and nurses often give only cursory, unsatisfactory explanations of complex tasks that fall to caregivers, said Carole Levine, director of the Families and Health Care Project of the United Hospital Fund.

That leaves the burden on caregivers to be assertive and ask for help, these experts agreed. If someone is hospitalized and ready to return home, they suggest asking a nurse or another provider “show me what you are doing so I can learn how to do it,” and then asking “now, watch me do it and tell me if I am doing it wrong or right.”

Don’t give up after the first time if you feel awkward or uncomfortable. Ask to do the task again, and ask again for feedback.

No videos or written manuals, can substitute for this one-on-one, hands-on instruction. If you don’t get it to your satisfaction before a loved-one is ready to go home, don’t sign the form that says you have been given instructions on what to do, Ms. Reinhard advised. The hospital is legally obligated to ensure that discharges are safe, and this operates in your favor.

The same goes for the pharmacy: don’t sign that sheet that the pharmacist hands you indicating that you have been adequately informed about the medications you are purchasing. If you are concerned about the number of prescriptions, what they are for, their possible side effects and whether all are necessary, ask the pharmacist to sit down with you and go over all this information. Again, don’t leave until you are satisfied.

Often, caregiving tasks will change as someone with a chronic condition like Parkinson’s disease or heart failure becomes more frail. Should this happen, consider calling a home care agency and asking for a nurse to come out and teach you how to administer oxygen or help transfer someone safely from a bed to a wheelchair, Ms. Reinhard said.

You may want to videotape the session so you can view it several times; most of us don’t pick these skills up right away and need repeat practice, Ms. Levine said.

Be as specific in your request for help as possible. Rather than complaining that you are overwhelmed, say something along the lines of, “I want to make sure I know how to clean this wound and prevent an infection” or “I need to know what texture the food should be so I can feed mom without having her choke,” Ms. Levine suggested.

Her organization has prepared comprehensive materials for caregivers called “Next Step in Care.” While the focus isn’t on nursing-style caregiving tasks, three might be useful: a self-assessment tool for family caregivers, a medication management guide, and a guide to hospice and palliative care.

Other helpful materials are few and far between. Ms. Levine’s staff identified a $24.95 American Red Cross training manual for family caregivers that has a DVD explaining the mechanics of transfers and a few other complicated tasks. Also, some videos are available for free at www.mmlearn.org, a Web site that says its mission is to provide caregivers with online training and education.

Asked about model programs, Ms. Reinhard said she knew of only one: the Schmieding Home Caregiver Training Program in Arkansas, operated by the Donald W. Reynolds Institute on Aging of the University of Arkansas for Medical Sciences. The Schmieding program trains family caregivers as well as professional caregivers who work in people’s homes or nursing homes.

On the family side, it offers eight hours of instruction in “physical needs” associated with caregiving — managing incontinence, skin care, turning someone regularly in bed, using adaptive equipment, transfers from a bed to a wheelchair, helping patients remain mobile, and more. Classes are offered at five sites and four more are planned in the next several years, said Robin McAtee, associate director of the Reynolds Institute on Aging. If people, churches or senior centers want the instruction, which is free, Schmieding nurses will take the program to them. One-on-one instruction for tasks is also available on request.

A separate eight-hour program is available for caregivers dealing with dementia, who have additional concerns.

At a Web site called Elder Stay at Home, Schmieding sells a package of materials (three DVDs and a booklet, for $99) summarizing the content of its family caregiver training program. Separately, it has begun selling its curriculum for paid caregivers, and programs in California, Hawaii and Texas are among the first buyers. The University of Arkansas for Medical Sciences also has received a $3.7 million innovation grant from the government to expand the caregiver training program more broadly and develop online training materials.

Ms. Reinhard said AARP would like to see Schmieding-style programs rolled out across the country and begin to offer structured, reliable support to caregivers now providing nursing-style care in homes with little or no assistance.

What else am I missing here? Do you know of resources or other organizations providing intensive caregiver training along the lines of what I’ve been discussing? Where would you suggest people turn for this kind of help?

Read More..

John Silva, Maker of ‘Telecopter’ Camera, Dies at 92





Helicopter news footage is common today. But until myriad problems in sending live pictures from a moving aircraft were solved, television broadcasters could not show an eagle’s-eye view of a forest fire, or contemplate aerial coverage of, say, a famous man fleeing the police in a white Ford Bronco.




John Silva made that now-familiar vantage possible in 1958, when he converted a small helicopter into the first airborne virtual television studio.


The KTLA “Telecopter,” as it was called by the Los Angeles station where Mr. Silva was the chief engineer, became the basic tool of live television traffic reporting, disaster coverage and that most famous glued-to-the-tube moment in the modern era of celebrity-gawking, the 1994 broadcast of O. J. Simpson leading a motorcade of pursuers on Los Angeles freeways after his former wife and a friend of hers were killed.


Mr. Silva, who later earned two Emmy Awards for his pioneering technical work, died in Camarillo, Calif., on Nov. 27. His death was confirmed by a spokesman for KTLA-TV, where he worked from 1946 until leaving to become an electronics design consultant in 1978. He was 92.


Mr. Silva, an electronics engineer trained in radar science during World War II, faced three main roadblocks to transmitting black-and-white images live from helicopters. Rotor vibrations distorted the pictures, and sometimes even cracked the transmitter’s vacuum tubes. Directional antennas went haywire when helicopters changed direction suddenly, as helicopters sometimes do. And the camera equipment weighed a ton.


With help from fellow KTLA engineers, though mainly working alone to keep the project secret from competitors, Mr. Silva stabilized onboard cameras with a system of shock absorbers and cushions, designed aluminum parts to replace heavier metals in his equipment and commissioned an antenna that would extend below the chopper and rotate to maintain uninterrupted contact with KTLA’s mountaintop transmitter. By paring and remachining a basic set of broadcast equipment, he reduced it to 368 pounds from 2,000 pounds and distributed the load with precise symmetry throughout the tiny Bell 47G2 chopper leased for the project to prevent listing.


KTLA, the first commercially licensed television station west of the Rockies, faced growing competition in the late ’50s. New network-affiliated stations were scoring scoops with mobile broadcast units like ones Mr. Silva had pioneered, and everyone was fighting to get through increasingly clogged Los Angeles freeways.


The Telecopter was intended to kill the competition.


“If we could build a news mobile unit in a helicopter,” Mr. Silva recalled in a 2002 interview for the Archive of American Television, “we could get over it all, get there first, avoid the traffic and get to all the stories before anybody in the competition.”


“It’d be a wonderful thing,” he said.


By the time he began work on his airborne live television, Mr. Silva had already achieved a landmark in ground-level television history. In 1949, he was the technical director at KTLA who rigged the electronic connections — using duct-tape ingenuity and a borrowed generator — that carried what historians consider the first live television broadcast of a breaking news event.


The 27-hour rescue operation in San Marino, Calif., to save Kathy Fiscus, a 3-year-old trapped in an abandoned water pipe 94 feet below ground, was unsuccessful; but the station’s coverage was the precursor to every wall-to-wall television event broadcast since.


The Telecopter’s first flight took place at Los Angeles City Hall on July 24, 1958. It re-established KTLA’s dominance (until competitors put their own helicopters up). And for better and worse, it brought a Hollywood-style excitement to television news.


In the archive interview, Mr. Silva was asked what the first live helicopter pictures showed. They were panning shots, he said — zooming in and out of the L.A. landscape between the station’s Sunset Boulevard studio and City Hall.


Most of what they showed, he added, “was the freeway.”


John Daniel Silva was born in San Diego on Feb. 20, 1920, the youngest of three children of a commercial fisherman, Guy Silva, and his wife, Lottie, a homemaker. He attended M.I.T. for two years, and graduated with a bachelor’s degree after two years more at Stanford.


During World War II, he was a Naval officer who positioned radar defenses in the Pacific.


After the war, he worked for Paramount Pictures as an engineer for an experimental television station, W6XYZ, that later became KTLA.


Mr. Silva’s survivors include his wife, Mary Lou Steinkraus-Silva; three daughters, Patricia Vawter, Kathleen Silva and Karen Samaha; and a granddaughter.


The Telecopter had its greatest moments, predictably, at news events of Cecil B. DeMille dimensions: The 1963 dam break at the Baldwin Hills Reservoir in Los Angeles that sent 250 million gallons of water into surrounding neighborhoods, destroying many homes and claiming five lives. The 1965 Watts riots. The 1961 brush fire that swept through Bel Air, sending Hollywood stars scrambling to their roofs with garden hoses.


In his three-hour interview with the television archive, Mr. Silva never mentioned the 1994 O. J. Simpson freeway pursuit footage he made possible. But in answering a question about the future of helicopter reporting, he made clear that he had no regrets about the Telecopter’s role in creating an increasingly graphic television sensibility.


He would just like the lenses to get longer and the close-ups tighter, he said.


“When they’re doing freeway chases, they need to have a system that can come down in front, and be able to get pictures of suspects in the front windshield,” he said, describing one improvement he hoped to see.


Smiling, he added, “To fill the screen with their wonderful faces.”


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India Ink: Congress Party Craters in Gujarat

KESHOD, India
The prospects of the Indian National Congress party in the battleground state of Gujarat are dwindling by the day, analysts and potential voters say, a situation that could ultimately advance Gujarat chief minister Narendra Modi’s bid to become prime minister.

Sonia Gandhi, the president of the Congress party, drew smaller-than-expected crowds in Gujarat this weekend, just days ahead of state elections, and important party members and aides have defected in recent weeks. Some supporters say they have lost hope.

“I’ve been a Congress supporter since I was in college,” said Meena Raval, 44, a homemaker from Rajkot who holds a master’s degree in English literature. “But there is a vast difference between Congress leaders of the 1980s and 1990s and those of today,” she said. “It’s hard to win an election, let alone come to power, without a strong, powerful leader.”

Unlike in Rajkot in early October, when Mrs. Gandhi’s rally attracted nearly 150,000 people, there were only about 15,000 attendees at a rally in Mandvi and 10,000 at Keshod this weekend. Many seemed to be local tribal women, who were keener to see how Mrs. Gandhi, probably India’s best-known politician, looked than to listen to what she had to say.

“I didn’t understand what she was saying,” said Ramaben Prajapati, 34, a vegetable seller from a village near Keshod. “But I thought she was very honest. I was impressed by her personality and body language.”

Gujarat voters go to the polls on Dec. 13 and 17th in a two-part election, when they will decide whether to re-elect Mr. Modi for a third term. How he fares in this election could help determine whether he becomes the opposition Bharatiya Janata Party’s candidate for prime minister in India’s next national elections.

Allegations that Mr. Modi encouraged, or did not do enough to stop, the 2002 riots in Gujarat which left hundreds dead, mostly Muslims, have dogged his political career and made him one of India’s most polarizing politicians. Still, the state’s ability to attract foreign investment and build infrastructure since he took power have gained accolades, and new supporters.

Mr. Modi’s no-expenses-spared state election campaign includes rallies across the state led by a three-dimensional avatar that speaks in numerous locations at once.

The political fight has become increasingly nasty in recent weeks, with Congress party members accusing Mr. Modi of hypocrisy and lying, and he, in turn, calling Congress and the Gandhi family a corrupt organization with no other political agenda but to criticize Mr. Modi.

Meanwhile, key members of the party in Gujarat are abandoning it. Members of the state’s legislative assembly and hundreds of party officials have switched from the Congress to the opposition in recent weeks. Defectors include lawmakers Kuvarji Halpati, Lalsinh Vadodia, Brijrajsinh Jadeja, Bhavsinh Rathod and party officials Mahendrasinh Rana, Ashok Dangar, Girish Parmar, Asifa Khan Pathan and Poonam Madam.

The most high-profile departure has been former deputy chief minister Narhari Amin, from Ahmedabad, who was at the forefront of the party’s election campaign until Nov. 30. On Dec. 6, he joined the B.J.P., along with many of his aides. Mr. Amin’s defection came after the party denied him a spot on the ballot from the state capital of Gandhinagar. “As a sincere and senior leader I felt insulted because the Congress gave tickets to unknown faces,” Mr. Amin said in an interview. “Is this the price of loyalty? There was no way I could have stayed in Congress after being so treated.”

Mrs. Gandhi and one of her close aides, Ahmed Patel, rushed several top Congress leaders from New Delhi to Gujarat to persuade Mr. Amin to change his mind, but he refused. Nearly 80 key Congress workers from Ahmedabad and another 100 from across Gujarat have joined the B.J.P. along with him, Mr. Amin said. “In all, nearly 20,000 people from Congress across Gujarat have joined the B.J.P. in the last few weeks,” he said, including mayors and chiefs of district and village councils.

“Congress just can’t stop the B.J.P. juggernaut,” Mr. Amin said. “We’ll ensure that Modi makes a hat-trick of a win in Gujarat.”  

The Congress general secretary for Gujarat, Kashmira Nathwani, conceded in an interview that there have been “some cases” of defection and a “feeling of disappointment in some quarters.” Still, she said, “Congress is as strong as ever in Gujarat and it’s all thanks to its millions of supporters and strong leadership at the state as well as national level.”

Participants at last weekend’s rallies, though, said Mrs. Gandhi lacked the vigor and zeal she had displayed in Rajkot earlier this year.

“I was hoping she would forcefully answer some of the questions Narendra Modi had asked her at one of his public rallies,” said Manish Chauhan 22, an engineering student and Congress supporter from Junagadh, who had come to Keshod to hear her. “But she was a big disappointment. She appeared to be quite subdued and her attitude was defeatist.”

Some voters say that Congress has given them few reasons to vote for the party, instead telling them why they should vote against Mr. Modi.

“There are many issues the Congress leaders can take up, but all the time they are seen busy bashing Modi and hardly talking about any other serious matter,” said Popat Bharwad, 28, a roadside tea seller from Rajkot, who described himself as passionately interested in Indian politics and cricket. “This gives Modi more publicity and gradually distances people from Congress.”

Many Congress supporters in Gujarat now say they can’t see their party winning this state election, or any others in the near future.

“I’ve always been a Congress loyalist, but we have to face the reality – we have little hope to regain power in Gujarat,” said one sociology professor from Rajkot, who asked not to be identified because he did not want to offend associates from the Congress party. “The problem is Congress just doesn’t have a leader of Modi’s charisma and dynamism.”

Bharatiya Janata Party leaders, not surprisingly, agreed. “There is so much defection in Congress that it will be wiped out from Gujarat in coming years,” predicted Naresh Kanodiya, a Gujarati actor and a former member of the state legislative assembly for the B.J.P.

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Changes to Agriculture Highlight Cuba’s Problems





HAVANA — Cuba’s liveliest experiment with capitalism unfolds every night in a dirt lot on the edge of the capital, where Truman-era trucks lugging fresh produce meet up with hundreds of buyers on creaking bicycle carts clutching wads of cash.




“This place, it feeds all of Havana,” said Misael Toledo, 37, who owns three small food stores in the city. “Before, you could only buy or sell in the markets of Fidel.”


The agriculture exchange, which sprang up last year after the Cuban government legalized a broader range of small businesses, is a vivid sign of both how much the country has changed, and of all the political and practical limitations that continue to hold it back.


President Raúl Castro has made agriculture priority No. 1 in his attempt to remake the country. He used his first major presidential address in 2007 to zero in on farming, describing weeds conquering fallow fields and the need to ensure that “anyone who wants can drink a glass of milk.”


No other industry has seen as much liberalization, with a steady rollout of incentives for farmers. And Mr. Castro has been explicit about his reasoning: increasing efficiency and food production to replace imports that cost Cuba hundreds of millions of dollars a year is a matter “of national security.”


Yet at this point, by most measures, the project has failed. Because of waste, poor management, policy constraints, transportation limits, theft and other problems, overall efficiency has dropped: many Cubans are actually seeing less food at private markets. That is the case despite an increase in the number of farmers and production gains for certain items. A recent study from the University of Havana showed that market prices jumped by nearly 20 percent in 2011 alone. And food imports increased to an estimated $1.7 billion last year, up from $1.4 billion in 2006.


“It’s the first instance of Cuba’s leader not being able to get done what he said he would,” said Jorge I. Domínguez, vice provost for international affairs at Harvard, who left Cuba as a boy. “The published statistical results are really very discouraging.”


A major cause: poor transportation, as trucks are in short supply, and the aging ones that exist often break down.


In 2009, hundreds of tons of tomatoes, part of a bumper crop that year, rotted because of a lack of transportation by the government agency charged with bringing food to processing centers.


“It’s worse when it rains,” said Javier González, 27, a farmer in Artemisa Province who described often seeing crops wilt and rot because they were not picked up.


Behind him were the 33 fertile, rent-free acres he had been granted as part of a program Mr. Castro introduced in 2008 to encourage rural residents to work the land. After clearing it himself and planting a variety of crops, Mr. Gonzalez said, he was doing relatively well and earned more last year than his father, who is a doctor, did.


But Cuba’s inefficiencies gnawed at him. Smart, strong, and ambitious, he had expansion plans in mind, even as in his hand he held a wrench. He was repairing a tractor part meant to be grading land. It was broken. Again.


The 1980s Soviet model tractor he bought from another farmer was as about good as it gets in Cuba. The Cuban government maintains a monopoly on selling anything new, and there simply is not enough of anything — fertilizer, or sometimes even machetes — to go around.


Government economists are aware of the problem. “If you give people land and no resources, it doesn’t matter what happens on the land,” said Joaquin Infante of the Havana-based Cuban National Association of Economists.


But Mr. Castro has refused to allow what many farmers and experts see as an obvious solution to the shortages of transportation and equipment: Let people import supplies on their own. “It’s about control,” said Philip Peters, a Cuba analyst with the Lexington Institute, a Virginia-based research group.


Other analysts agree, noting that though the agricultural reforms have gone farther than other changes — like those that allow for self-employment — they remain constrained by politics.


“The government is not ready to let go,” said Ted Henken, a Latin American studies professor at Baruch College. “They are sending the message that they want to let go, or are trying to let go, but what they have is still a mechanism of control.”


For many farmers, that explains why land leases last for 10 years with a chance to renew, not indefinitely or the 99 years offered to foreign developers. It is also why many farmers say they will not build homes on the land they lease, despite a concession this year to allow doing so.


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