Where is aid for Syria going?






STORY HIGHLIGHTS


  • The U.S. ambassador to Syria says the U.S. has provided $210 million in humanitarian aid

  • The assistance has to be discrete, he said, to protect workers from being targeted

  • Washington has also provided $35 million worth of assistance to Syria's political opposition

  • Ambassador: We can help, but it's up to Syrians to find their way forward




(CNN) -- It has been more than a year since the United States government withdrew its ambassador to Syria and closed its embassy in Damascus.


On Thursday, that ambassador returned to the region along with a U.S. delegation, touring a Syrian refugee camp in Turkey to bring more attention to the growing humanitarian crisis. As the civil war has intensified in Syria, hundreds of thousands of people have sought refuge in Turkey, Lebanon, Jordan and other neighboring countries.


Ambassador Robert Ford gave an exclusive interview to CNN's Ivan Watson and described what the U.S. is doing to help the refugees and the Syrian opposition.


Ivan Watson: The U.S. has given $210 million in aid (to Syria), but I think that there is a perception problem because no one can actually point at what that help is. So people conclude there is no help.


Robert Ford: The assistance is going in. It's things like tents, it's things like blankets, it's things like medical equipment, but it doesn't come in big boxes with an American flag on it because we don't want the people who are delivering it to be targeted by the Syrian regime.


The regime is going after and killing people who are delivering supplies. You see them bombing even bakeries and bread lines. So we're doing that, in part, to be discrete.



The assistance is going in ... but it doesn't come in big boxes with an American flag on it.
Robert Ford, U.S. ambassador to Syria



The needs are gigantic. So even though a great deal of American materials and other countries' materials are arriving, the needs are still greater. And that's why we're going to Kuwait to talk to the United Nations and to talk to other countries about how we can talk together to provide additional assistance.


Watson: The head of the Syrian National Coalition, which the U.S. government has backed, came out with a statement very critical of the international community, saying we need $3 billion if you want us to have any say on events on the ground inside Syria. Where is that money?


Ford: (Sheikh Ahmed) Moaz al-Khatib is a good leader, and we think highly of him and we have recognized his (coalition) as the legitimate representative of the Syrian people. And, of course, he wants to get as many resources as possible because of the humanitarian conditions that I was just talking about. Especially the ones inside Syria.


But we also, at the same time, have to build up those (aid) networks I was talking about. In some cases, they start out with just a few people. We don't need just a few people, we need hundreds of people, thousands of people on the inside of Syria organized to bring these things in.


And so step by step, the Syrians, Moaz al-Khatib and his organization, need to build that capacity. We can help build it, we can do training and things like that. But in the end, Syrians have to take a leadership role in this.


Watson: Is Washington giving money to the Syrian National Coalition?


Ford: We absolutely are assisting the (coalition), with everything from training to, in some cases, limited amount of cash assistance so that they can buy everything ranging from computers to telephones to radios.








Frankly, if not for the American assistance in many cases, the activists inside Syria wouldn't be in contact with the outside world. It's American help that keeps them in contact with the outside world.


Watson: But, how much assistance has this coalition gotten from the U.S.?


Ford: So far, we've allocated directly to the coalition in the neighborhood of $35 million worth of different kinds of equipment and assistance. And over the next few weeks, couple of months, we'll probably provide another $15 million worth of material assistance.


Watson: Washington recently blacklisted Jabhat al-Nusra, the Nusra Front, calling it a terrorist organization even though inside Syria, it has attracted a lot of respect for its victories and for comparative lack of corruption compared to many rebel groups. How has blacklisting the Nusra Front helped the Syrian opposition?


Ford: We blacklisted the Nusra Front because of its intimate links with al Qaeda in Iraq, an organization with whom we have direct experience, which is responsible for the killings of thousands of Iraqis, hundreds of Americans. We know what al Qaeda in Iraq did and is still doing, and we don't want it to start doing that in Syria -- which is why we highlighted its incredibly pernicious role.


I think one of the things that our classification of Nusra as a terrorist group did is it set off an alarm for the other elements of the Free Syrian Army. There was a meeting of the Free Syrian Army to set up a unified command, (and) Nusra Front was not in that meeting -- which we think is the right thing to do. As Syrians themselves understand that Nusra has a sectarian agenda, as they understand better that Nusra is anti-democratic and will seek to impose its very strict interpretation of Islam on Syria -- which historically is a relatively moderate country in terms of its religious practices -- as Syrians understand that better, I think they will more and more reject the Nusra Front itself.


Watson: But I've seen the opposite. As I go into Syria, I hear more and more support and respect for the Nusra Front, and more and more criticism for the U.S. government each time I go back.


Ford: I think that people, Ivan, are still understanding what Nusra is. I have heard criticism from the Nusra Front from people like Moaz al-Khatib who, in Marrakesh (Morocco) in his speech, said he rejected the kind of ideology which backs up Nusra. ... We have heard that from the senior commander of the Free Syrian Army as well. And so the more people understand inside Syria what Nusra is and represents, I think they will agree that is not the group on which to depend for freedom in Syria.


Watson: Do you think the U.S. government could have done more?


Ford: I think the Syrians, as I said, are the ones who will bring the answer to the problem -- just as in Iraq, Iraqis brought the solution to the Iraq crisis, to the Iraq war. The Americans can help, and we helped in Iraq, but ultimately it wasn't the Americans. Despite our help, it was Iraqis.


In Syria, again, it has to be Syrians who find their way forward. Twenty-three million Syrians need to find their way forward. We can help, and we are helping: $210 million in humanitarian assistance, $50 million to help the political opposition get organized for the day after (Bashar) al-Assad goes. These are important bits of help. But ultimately, it's not the American help. It's the Syrians themselves.







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Procter & Gamble raises outlook on soaring profit






NEW YORK: Procter & Gamble reported Friday profit more than doubled in the fiscal second quarter from a year ago, beating market expectations, and raised its forecasts for the year.

The US consumer goods giant said profit jumped 140 per cent due to strong productivity gains and the effects of cost-saving efforts.

Net income rose to US$4.1 billion, or US$1.39 per share, compared with the year-ago figure of US$1.7 billion, or 57 cents per share, the company said.

The results were well above analyst expectations.

Core earnings per share, which strips out special items and other items not related to sustainable earnings, were US$1.22, sharply more than the US$1.11 estimated.

Revenues came in at US$22.18 billion, above the US$21.91 billion forecast by analysts.

Shares in the Dow member were up 3.5 per cent at US$72.87 in late-afternoon trade in New York.

"Global market share trends improved as we continued to implement our growth strategy and made very good progress against our productivity and cost-savings goals," said chief executive Bob McDonald.

"Our strong first-half results have enabled us to raise our sales, earnings and share repurchase outlook for the fiscal year."

Procter & Gamble, which manufactures Pampers diapers, Head and Shoulders shampoo and other household products, said its growth was broad-based and that all five of its business segments grew organic sales by at least two per cent.

The biggest growth came in the company's baby care and family care segment with 5 per cent.

Procter & Gamble raised its full-year 2013 core earnings guidance to US$3.97-US$4.07 from the previous range of US$3.80-US$4.00.

In a conference call with analysts, P&G executives said the company had completed most of a previously announced downsizing to trim costs. In February, the company announced it was cutting 5,700 non-manufacturing posts. McDonald said that 5,500 of the job cuts had already been implemented.

At the end of October, the Cincinatti, Ohio-based company had a total of 126,000 employees. The group did not give figures for the end of December.

Procter & Gamble also raised its forecast of 2013 share repurchases to a range of US$5-6 billion, up from the previous range of US$4-6 billion.

- AFP/jc



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'Fighting' Casey Anthony gets two convictions tossed




























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STORY HIGHLIGHTS


  • An appeals court invalidates two of Casey Anthony's convictions, upholds two others

  • She was convicted of 4 counts of giving false information during a missing person investigation

  • Charges arose from statements Anthony made in 2008 after her daughter, Caylee, disappeared

  • Anthony's attorney said his client wanted to "keep fighting" after hearing about ruling




(CNN) -- One of the most infamous Americans in recent years took two big steps Friday toward clearing her name, and she's vowed to "keep fighting."


Florida's 5th District Court of Appeal threw out two of Casey Anthony's four convictions of "providing false information to a law enforcement officer during a missing person investigation," agreeing with her argument that the multiple convictions violated the ban on double jeopardy.


But the appeals judges upheld the other two convictions. According to the court filing, they rejected Anthony's claim that the trial court should have granted her motion to suppress statements made to law enforcement officers before they told her her Miranda rights. And they rejected her argument that the state statute she was convicted of violating is unconstitutionally vague.


Anthony's lawyer, Cheney Mason, said when he called his client to share the ruling, she said, "We keep fighting."


Anthony could appeal the remaining two convictions to the Florida Supreme Court next.










The four charges arose from statements Anthony made on July 16, 2008, to Orange County Detective Yuri Melich, who was investigating the disappearance of Anthony's 2-year-old daughter, Caylee.


Anthony gained notoriety after her mother, Cindy Anthony, called police to arrest her daughter the day before, when she thought Casey had stolen the family car and some money.


Read how Anthony's prosecutor has no regrets


During the call, Cindy Anthony told police she was concerned that her granddaughter might be missing, and said, "I found my daughter's car today, and it smelled like there's been a dead body in the damn car."


When questioned, Casey Anthony admitted to police that she hadn't seen Caylee for more than 30 days, and on July 16, she was arrested on suspicion of child neglect, filing false official statements and obstructing a criminal investigation. At that time, she made the statements to Melich, which led to her convictions.


In December 2008, a utility worker found remains in a wooded area near the Anthony home, and about a week later, authorities announced they were Caylee's.


After nearly three years of legal maneuvers, Anthony's capital murder trial began on May 24, 2011.


Prosecutors alleged that she killed Caylee by using chloroform and covering her nose and mouth with duct tape, and that she put her body in the trunk of her car before dumping it in the woods.


Defense attorney Jose Baez argued that Caylee drowned in the Anthony family pool on June 16, 2008, and that Casey Anthony and her father, George, covered up the death.


Watch: A year after trial, where's Anthony?


On July 5, 2011, a jury found Anthony not guilty of first-degree murder, aggravated child abuse and aggravated manslaughter of a child, while convicting her on the four "false information" counts.


Anthony was sentenced to four years in jail, to be served consecutively, including time served. She was released 10 days after her sentencing, on July 17. Even though she exited shortly after midnight, about 1,000 people jeered her as police guards and Baez escorted her to a waiting SUV and drove away quickly.


Anthony still faces a defamation lawsuit from Zenaida Fernandez-Gonzalez, of nearby Kissimmee, Florida.


During Anthony's disputed July 16, 2008, statements to Melich, she said the last time she had seen her daughter was when she dropped Caylee off at Gonzalez's apartment.


Gonzalez filed suit in September 2008, claiming that Anthony ruined her reputation.


Last April, a judge ruled that the suit needed to go to trial by jury and denied Gonzalez's request for a summary judgment.


In Session correspondent Jean Casarez reported for this story, and Mark Morgenstein wrote it in Atlanta.






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NRA chief to testify at Senate gun hearing

In the first congressional hearing on gun violence since President Obama announced sweeping new gun control proposals, stakeholders on both sides of the issue - including both the husband of a victim of gun violence and the CEO of the National Rifle Association -- will share a platform next week to testify on the subject in front of the Senate Judiciary Committee.

The January 30 hearing, entitled "What Should America Do About Gun Violence?", will feature testimony from both the NRA's Wayne LaPierre and Mark Kelly, the husband to former Rep. Gabrielle Giffords, D-Ariz., who was shot in the head during a mass shooting two years ago.

Kelly and Giffords recently co-founded Americans for Responsible Solutions, an advocacy group meant to combat the lobbying power of the NRA.

LaPierre, meanwhile, has been an outspoken and unapologetic ambassador for his pro-gun lobby: In comments a week after the Newtown shooting, LaPierre gave a press conference railing against gun control advocates, calling not for stricter gun laws but for an armed guard in every school in the country.

Other witnesses at the hearing include James Johnson, chief of police for Baltimore County, Md., and chairman of the National Law Enforcement Partnership to Prevent Gun Violence; Nicholas Johnson, a law professor at Fordham University School of Law, and Gayle Trotter, an attorney and senior fellow of the Independent Women's Forum.

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Apple Drops Manufacturer Using Underage Workers













Apple has stopped doing business with a Chinese manufacturer after a report said it had employed 74 underage workers. According to Apple's Supplier Responsibility Report, which was released by the company Thursday, Guangdong Real Faith Pingzhou Electronics was employing workers under the age of 16.


"Our auditors were dismayed to discover 74 cases of workers under age 16 — a core violation of our Code of Conduct. As a result, we terminated our business relationship with PZ," the company says in the report.


Apple has now lost its spot as the most valuable publicly traded company, one year after it first firmly overtook ExxonMobil. Even though it announced a record number of iPhone and iPad sales in its last quarter earnings, its stock price has fallen over 12 percent.


Apple says it is working hard to improve labor conditions at the factories of its Chinese contractors. It said it also discovered that one of the region's labor agencies had conspired with the manufacturer, providing children to them and helping forge age-verification documents. Apple said in its report that it alerted the provincial government, which fined the agency and suspended its business license.


Apple To Start Making Some Mac Computers in America in 2013


"The children were returned to their families, and PZ was required to pay expenses to facilitate their successful return," Apple says in the report.










In an interview with Bloomberg, Apple's Senior Vice President of Operations, Jeff Williams, said child labor was being used more than companies care to admit. "Most companies, they either don't report on it at all, or they say they look for it and found none, or they obscure the data in some way," Williams told Bloomberg. "If they're not finding it, they're not looking hard enough."


ABC News' Bill Weir visited the factory of Apple's Foxconn supplier last year and did not see any underage workers. "But while we looked hard for the kind of underage and maimed workers we've read so much about, we mostly found people who face their days through soul-crushing boredom and deep fatigue," Weir wrote about his visit.


PHOTOS: Inside Apple's Factories in China


In the 37-page Supplier Responsibility Progress Report, which can be viewed here, Apple said there had been a 72 percent increase in facility audits. According to the report, Apple achieved an average of 92 percent compliance with the goal, for now, of a maximum 60-hour work week.


Apple vowed last year to improve working conditions at its manufacturing facilities in China, vowing to work specifically on reducing working hours for Chinese workers. In March 2012, the Fair Labor Association released a report on the poor conditions at Apple's Foxconn supplier. The organization gave a long list of recommendations to Apple and Foxconn, and both Apple and Foxconn agreed to follow them.


In August, the FLA said that that Foxconn had completed 280 action items on time or ahead of schedule. By July 1, 2013, Foxconn has promised to reduce workers' hours to 49 hours per week and stabilize pay -- though the limit is rarely enforced because workers often want to work overtime and make ends meet.


Apple announced in December that it would begin to make some of its Mac computers in America in 2013.



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Neanderthal cloning? Pure fantasy




A display of a reconstruction of a Neanderthal man and boy at the Museum for Prehistory in Eyzies-de-Tayac, France.




STORY HIGHLIGHTS


  • Arthur Caplan: It would be unethical to try and clone a Neanderthal baby

  • Caplan: Downsides include a good chance of producing a baby that is seriously deformed

  • He says the future belongs to what we can do to genetically engineer and control microbes

  • Caplan: Microbes can make clean fuel, suck up carbon dioxide, clean fat out of arteries




Editor's note: Arthur Caplan is the Drs. William F and Virginia Connolly Mitty professor and director of the Division of Bioethics at New York University Langone Medical Center.


(CNN) -- So now we know -- there won't be a Neanderthal moving into your neighborhood.


Despite a lot of frenzied attention to the intentionally provocative suggestion by a renowned Harvard scientist that new genetic technology makes it possible to splice together a complete set of Neanderthal genes, find an adventurous surrogate mother and use cloning to gin up a Neanderthal baby -- it ain't gonna happen anytime soon.


Nor should it. But there are plenty of other things in the works involving genetic engineering that do merit serious ethical discussion at the national and international levels.



Arthur Caplan

Arthur Caplan



Some thought that the Harvard scientist, George Church, was getting ready to put out an ad seeking volunteer surrogate moms to bear a 35,000-year-old, long-extinct Neanderthal baby. Church had to walk his comments back and note that he was just speculating, not incubating.


Still cloning carries so much mystery and Hollywood glamour thanks to movies such as "Jurassic Park," "The Boys From Brazil" and "Never Let Me Go" that a two-day eruption of the pros and cons of making Neanderthals ensued. That was not necessary. It would be unethical to try and clone a Neanderthal baby.



Why? Because there is no obvious reason to do so. There is no pressing need or remarkable benefit to undertaking such a project. At best it might shed some light on the biology and behavior of a distant ancestor. At worst it would be nothing more than the ultimate reality television show exploitation: An "Octomom"-like surrogate raises a caveman child -- tune in next week to see what her new boyfriend thinks when she tells him that there is a tiny addition in her life and he carries a small club and a tiny piece of flint to sleep with him.


The downsides of trying to clone a Neanderthal include a good chance of killing it, producing a baby that is seriously deformed, producing a baby that lacks immunity to infectious diseases and foods that we have gotten used to, an inability to know what environment to create to permit the child to flourish and a complete lack of understanding of what sort of behavior is "normal" or "appropriate" for such a long-extinct cousin hominid of ours.


When weighed against the risks and the harm that most likely would be done, it would take a mighty big guarantee of benefit to justify this cloning experiment. I am willing to venture that the possible benefit will never, ever reach the point where this list of horrible likely downsides could be overcome.




Even justifying trying to resurrect a woolly mammoth, or a mastodon, or the dodo bird or any other extinct animal gets ethically thorny. How many failures would be acceptable to get one viable mastodon? Where would the animal live? What would we feed it? Who would protect it from poachers, gawkers and treasure hunters? It is not so simple to take a long dead species, make enough of them so they don't die of isolation and lack of social stimulation and then find an environment that is close enough and safe enough compared with that which they once roamed.


In any event the most interesting aspects of genetic engineering do not involve making humans or Neanderthals or mammoths. They involve ginning up microbes to do things that we really need doing such as making clean fuel, sucking up carbon dioxide, cleaning fat out of our arteries, giving us a lot more immunity to nasty bacteria and viruses and helping us make plastics and chemicals more efficiently and cheaply.


In trying to make these kinds of microbes, you can kill all you want without fear of ethical condemnation. And if the new bug does not like the environment in which it has to exist to live well, that will be just too darn bad.


The ethical challenge of this kind of synthetic biology is that it can be used by bad guys for bad purposes. Biological weapons can be ginned up and microbes created that only infect people with certain genes that commonly associate with racial or ethnic groups.


Rather than worry about what will happen to real estate values should a new crop of "Flintstones" move in down the street, our public officials, religious groups and ethicists need to get serious about how much regulation the genetic engineering of microbes needs, how can we detect what terrorists might try to use, what sort of controls do we need to prevent accidents and who is going to pay if a bug turns out to cause more harm than good.


We love to think that the key to tomorrow lies in what humanity can be designed or empowered to do. Thus, the fascination with human cloning. In reality, at least for a long time to come, the future belongs to what we can do to design and control microbes. That is admittedly duller, but it is far better to follow a story that is true than one such as Neanderthal cloning that is pure, speculative fantasy.


Follow @CNNOpinion on Twitter.


Join us at Facebook/CNNOpinion.


The opinions expressed in this commentary are solely those of Arthur Caplan.






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Israel talks of military option as Kissinger warns over Iran






DAVOS: Israeli officials said Thursday that military action against Iran needed to stay on the table, as former US secretary of state Henry Kissinger warned of a crisis over Tehran's nuclear ambitions in the "very foreseeable future".

Speaking at the World Economic Forum in Davos, Israeli President Shimon Peres and Defence Minister Ehud Barak said the threat of military action was vital to efforts against Iran's nuclear programme.

"There will be more attempts to try and negotiate, but there will always be in the horizon a military option, because if the Iranians think it's only economic and political, they won't pay attention," Peres told global political and business leaders at the annual gathering in the Swiss ski resort.

Israel and Western powers accuse Iran of seeking to acquire a weapons capability under the guise of its nuclear energy programme but Iran denies the charge, saying its work is for peaceful purposes only.

Prime Minister Benjamin Netanyahu, who emerged from an election Tuesday with a new term as Israel's leader, has frequently warned about the danger of Iran's nuclear programme.

Israel has refused to rule out a military strike to prevent Iran from obtaining nuclear arms.

Barak, who has announced plans to retire after Netanyahu forms a new government, told the forum that stronger sanctions were needed against Iran.

"There is a need for much more drastic sanctions, a kind of quarantine of all imports and exports," Barak said, though he admitted that China and Russia were unlikely to agree.

He said he understood Washington's desire to have "all alternatives" exhausted before military action over Iran, but that there was also a need to be ready to carry out targeted attacks.

"If worst comes to worst, there should be a readiness and capability to launch a surgical operation that will delay them by a significant timeframe and probably convince them... the world is determined to block them," Barak said.

In a wide-ranging talk on foreign affairs, Kissinger said he expected the Iranian nuclear issue to soon come to a head.

"For 15 years, the permanent members of the United Nations Security Council have declared that a nuclear Iran is unacceptable, but it has been approaching," he said.

"People who have advanced their view will have to come to a determination about how to react or about the consequences of non-reaction," he said.

"I believe this point will be reached within a very foreseeable future."

Kissinger said negotiations with Iran needed to be given "a real chance" and that "unilateral action by Israel would be a desperate last resort."

He said he expected "Iran to be high on the agenda" of US President Barack Obama's new administration, and said failure to deal with the question could lead to a spread of nuclear weapons in the region.

"That would be a turning point in human history," Kissinger warned.

Israel has been pressing Obama to set a red line for Iran on the nuclear issue, after Netanyahu warned at the UN General Assembly in September that Tehran could have the necessary material for a first bomb by the summer of 2013.

The new US secretary of state nominee, Senator John Kerry, told a confirmation hearing on Thursday that "the clock is ticking", and that Washington will not be satisfied with just containing Iran.

- AFP/jc



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Man charged in Philly doctor's death









By Susan Candiotti and Sarah Hoye, CNN


updated 11:53 AM EST, Thu January 24, 2013









STORY HIGHLIGHTS


  • NEW: Doctor's alleged killer came to her house to deal with rodent problem, police say

  • NEW: Jason Smith is charged with murder, other counts in Melissa Ketunuti's death

  • NEW: Other than traffic offenses, Smith has no criminal record, police say

  • Ketunuti's dog walker found her bound, burned body in the basement of her home




Philadelphia (CNN) -- The unsettling case of a doctor killed and set on fire in her Philadelphia home took another turn Thursday as police identified her alleged killer as an exterminator sent to her home to help clear it of rodents.


Jason Smith, 36, of Levittown, Pennsylvania, was charged Thursday with murder and other counts after detectives, using surveillance video and tips, identified him as the alleged killer of Melissa Ketunuti, a well-liked doctor and researcher at Children's Hospital of Philadelphia.


Police say Smith got into an argument with Ketunuti in the basement of her row home in an affluent area of downtown Philadelphia. He knocked her down, then strangled her and then set her body on fire, police Capt. James Clark said at a news conference.


He declined to elaborate on the argument but said Ketunuti and Smith had never met.


"We're glad for the family we're at least able to give some closure with the arrest of this individual," Clark said.


Surveillance video shows Smith approaching her home and going inside at Ketunuti's invitation, he said.


"She was expecting him. They had an appointment," Clark said.


Once inside, an argument erupted that quickly escalated into a physical altercation.


Smith struck Ketunuti, knocked her to the ground and strangled her with a rope he found in the basement, Clark said. Eventually, he set her body on fire, he said.


Ketunuti's dog-walker discovered the body, according to police.


Smith lives in Levittown with his girlfriend and her young daughter, Clark said. Other than minor traffic offenses, he has no criminal record, he said.


He is charged with murder, possession of an instrument in a crime, abuse of a corpse and causing catastrophe, according to Tasha Jamerson, a spokeswoman for the Philadelphia district attorney's office.


It was not immediately clear when he was to appear in court.


Levittown is about 30 miles away from Ketunuti's home.


Ketunuti, who graduated from medical school in 2007, moved to Philadelphia from Washington in 2008 for a three-year residency in pediatrics. She was in her second year of working as a researcher and fellow in infectious diseases, the hospital said.


She previously had residencies in surgery at Georgetown University Hospital in Washington and cardiothoracic surgery at a veterans hospital.


Susan Candiotti reported from New York, and Sarah Hoye reported from Philadelphia.








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A question of access? Mental health and gun violence

As President Obama faces opposition from gun rights advocates over his recent proposals to combat gun violence, the challenge he faces of fixing flaws in the mental health care system may prove just as difficult a battle.

Mr. Obama outlined plans aimed at preventing mass shootings and reducing broader gun violence in the United States last week, while signing 23 executive actions that did not require Congressional approval. Alongside proposed changes to gun laws including universal background checks, a stronger ban on assault weapons and new restrictions on ammunition and magazines, mental health emerged as a core feature of the president's plan to prevent further tragedies like the Dec. 14 shooting in Newtown, Conn.

The executive actions related to mental health included:

  • A letter to health care providers clarifying that no federal law prohibits them from reporting threats of violence to law enforcement authorities
  • Incentives for schools to hire school resource officers
  • A letter to state health officials clarifying the scope of mental health services that Medicaid plans must cover
  • Finalization of regulations clarifying essential health benefits and parity requirements within health insurance exchanges
  • A commitment to finalizing mental health parity regulations
  • The launch of a national dialogue led by the departments of Health and Human Services and Education on mental health
  • A Presidential Memorandum directing the Centers for Disease Control to research the causes and prevention of gun violence
  • Clarification that the new health care law does not prohibit doctors from asking their patients about guns in their homes

Noting that it was the first of its kind to focus on mental health since 2007 -- and long overdue -- Iowa Sen. Tom Harkin chaired a hearing of the Senate Health, Education, Labor and Pensions Committee Thursday.

Harkin laid out that while Newtown has brought the issue to the forefront of discussion, mental illness only accounts for a small proportion of violent crimes.

Experts estimate only a small percentage of violent crimes -- less than 5 percent -- are caused by mentally ill people.

"People with mental illness are much more likely to be the victims of violent crimes than perpetrators of violence," said Harkin, who called mental health care's shortcomings a public health problem.

A common theme throughout the hearing was to avoid stigmatizing people with mental illness while discussing gun violence and problems facing mental health care.


Play Video


Mental health expert: "We can and must intervene early"




Pamela S. Hyde, administrator for the government's Substance Abuse and Mental Health Services Administration (SAMHSA) laid out the scope of the mental health care problem during the hearing (video at left). Of the 45 million U.S. adults suffering from mental illness, only 38.5 percent receive the treatment they need, she said. For children, only one in five receive necessary treatment for diagnosable mental disorders. Despite showing symptoms, many children and adults experience significant delays getting into treatment. Hyde argues that if the system shifts to a focus on early intervention, more people can be helped.

"Cost, access and recognition of the problems are the primary reason this treatment is not received. However it doesn't have to be this way," said Hyde. "For most of these conditions, prevention works, treatment is effective and people do in fact recover."

Mental health care spending has been dramatically cut in recent years. A 2011 report from the National Alliance on Mental Health that looked at state-by-state mental health budgets reported $1.6 billion in state funding cuts from 2009 through 2012. Medicaid cuts at this time also negatively affected mental health care, the report showed. States are mulling increases in funding in light of the Newtown shooting.

And the health care system may only become more burdened in the near future: A July 2012 study by the Institute of Medicine, an advisory medical organization to the government, found an aging baby boomer population could cause a mental health care crisis by 2030, when the number of U.S. seniors is expected to double and necessary resources will be woefully lacking.




Play Video


The dangerous stigma of mental illness




Dr. Jeffrey Lieberman, chairman of psychiatry at Columbia University Medical Center in New York City, told CBS News senior correspondent John Miller in December that mental health care is a societal problem because the U.S. has not taken on the treatment of mental illness as effectively as it could.

"I think mental health is a big issue," Lieberman said at the time. "It's definitely related to the frequency of these seemingly senseless and wanton killings that occur. And the way it relates is that unfortunately, individuals who have specific forms of mental illness, if untreated, can be more prone to act in a way which is socially destructive and results in harm or killing like we saw happen."

Lieberman said a person who needs treatment for mental illness often faces barriers such as insurance coverage and accessibility to care, in addition to stigma -- while people getting treated for a disease like cancer face fewer "disincentives" to getting the best care.

Following the president's announcement, Lieberman told CBSNews.com that the new proposals are "on the right track" in terms of addressing issues in the mental health system, but much work remains to clarify how these actions will be implemented.

By getting more people with mental illness, impulse disorders and substance abuse issues into constant treatment, he said, they may be prevented from ever getting to a point where they are showing symptoms of mental illness -- and acting on violent impulses.

"Trying to say we should only do something when they get dangerous is very late in the process," said Lieberman.

Details on the president's proposals still need to be worked out, said Lieberman, who is also president-elect of the American Psychiatric Association. For example, the Mental Health Parity Act, which the president wanted to finalize in his executive actions, requires that mental health benefits are covered by insurance, similar to non-psychiatric health care benefits. However, the rules to determine what services are covered, how people become reimbursed and other stipulations have not been established, he said. The president also asked for clarification on Medicaid mental health services, which now typically covers people who have severe forms of mental illness. Lieberman argues policymakers may find that these services are not adequate, and broader services are needed.

Right now, doctors cannot provide mental health care services in what Lieberman refers to as a "financially viable way." He explains that patients seeking help for mental health may require a lot of support, not only from a doctor who may provide medication, but from therapists, case managers and social and vocational rehabilitation counselors who need to be more actively involved in the patient's lives. These team-based "multi-element treatment approaches" have been shown in studies to be effective, however these types of paid services just aren't available for people suffering from mental health problems. Meanwhile, a person with heart disease may see a cardiologist, a surgeon, a different doctor about stent management, a nutritionist for lifestyle tips, and other providers all covered by insurance.

"In mental health care it's the same thing -- you can't just see a psychiatrist and get a prescription," he said. "This is not just throwing different services at the problem, there's good evidence that these things work."

Dr. Jeffrey Swanson, a professor of psychiatry and behavioral sciences at Duke University School of Medicine, who has published several research papers on gun violence and mental health for more than a decade, agrees the current mental health system represents a complex public health problem facing the United States.

"The mental health system in the country, if you can call it that, is fragmented and grossly under-resourced," Swanson told CBSNews.com in an email. "It needs a lot of things, and more research into how to fix it -- at a time when there are more mentally ill people incarcerated than in hospitals -- is one of the needed things," he said.

A 2011 paper by Swanson published in Psychiatric Services examines the lack of data available on firearm use against strangers, and how it is impossible to reliably predict which specific individuals would engage in the most serious acts of violence.

But even if more CDC research stemming from the president's proposals strengthens the available data pool, Swanson argues these egregious acts of violence may still be impossible to predict.




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Can a mental disorder make someone violent?



"I think more access to evidence-based treatment and less access to guns, taken together, would have an impact on gun violence, at least on the margins. But prevent mass shootings? That's hard to say," Swanson said. "Those are almost inherently unpredictable, and often perpetrated by people with no gun-disqualifying mental health or criminal record -- until it's too late. Most of the measures in the President's proposal, even if enacted and implemented perfectly, would not necessarily have prevented the shootings in Tucson, Aurora, or Newtown."

While concerns persist on how the president's proposals will be implemented, the announcement was supported by various health organizations that had previously submitted recommendations to Vice President Joe Biden's White House Task Force on Gun Violence Prevention.

"NAMI applauds the President's plan for its significant provisions to strengthen and expand mental health services," Michael Fitzpatrick, executive director of the National Alliance on Mental Illness said in a statement following the proposals. "The mental health care system has long been broken. The challenge is not to fix it, but to build it anew, focusing on early screening, diagnosis, treatment and prevention. The President's plan takes important steps toward meeting that challenge."

Dr. Dilip V. Jeste, president of the American Psychiatric Association, added in statement, "We are heartened that the Administration plans to finalize rules governing mental health parity under the 2008 Mental Health Parity and Addiction Equity Act, the Affordable Care Act, and Medicaid. "We are glad that the President has clarified that doctors are not prohibited from asking their patients about guns in their homes. The APA has consistently advocated for such a position."


The American Academy of Pediatrics also offered its support.

"In addition to addressing firearm regulations, we must improve access to quality mental health care both to help prevent violent acts and to assist victims of trauma," AAP President Dr. Thomas K. McInerny, said in a statement following the proposals. "The AAP agrees with the President that we must improve the identification of mental illnesses through increased screening, address inadequate insurance coverage and high out-of-pocket costs that create barriers to access, strengthen the overall quality of mental health access, and improve and expand the Medicaid reimbursement policy to include mental health and developmental services.

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Will Women Register for Selective Service?


Jan 24, 2013 5:53pm







ap women combat nt 130124 wblog Will Women Register for Selective Service?


Defense Secretary Leon Panetta today lifted the ban on women serving in combat positions, opening the door to more than 200,000  new military posts and raising a number of important questions, including: Will women eventually be eligible for the draft?


By law, all male U.S. citizens and permanent residents must register with the Selective Service System within 30 days of their 18th birthday. Registration puts those “male persons” on the list the government uses if ever the draft returns and conscription in the military is deemed necessary in a time of war.


As of a 1994 review, women were still exempt from registering because they did not serve in combat positions. Today’s change in Pentagon policy, however, could ultimately result in a change to the law.


But it will take more than just the stroke of the defense secretary’s pen for the Selective Service Act to include mention of women.


With any change to personnel policies, the Defense Department  is “required to provide an analysis of its impact on the Selective Service Act,” said a senior Pentagon official said on the condition of anonymity.  “So that will be part of the notification to Congress.”


But what comes next is  unclear.


“With regard to what will happen from there, I can’t say,” said the official.


Defense Secretary Leon Panetta later admitted to reporters that he, too, did not know the potential impact of the change to the Selective Service Act.


“That’s not our operation,” said Panetta.


Known for his use of colorful language, Panetta then said, “I don’t know who the hell controls Selective Service, if you want to know the truth.”


“But, you know,” Panetta added. “Whoever does, they’re going to have to exercise some judgment based on what we just did.”


The Selective Service System is a federal agency independent of the Department of Defense.



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