Well: A Rainbow of Root Vegetables

This week’s Recipes for Health is as much a treat for the eyes as the palate. Colorful root vegetables from bright orange carrots and red scallions to purple and yellow potatoes and pale green leeks will add color and flavor to your table.

Since root vegetables and tubers keep well and can be cooked up into something delicious even after they have begun to go limp in the refrigerator, this week’s Recipes for Health should be useful. Root vegetables, tubers (potatoes and sweet potatoes, which are called yams by most vendors – I mean the ones with dark orange flesh), winter squash and cabbages are the only local vegetables available during the winter months in colder regions, so these recipes will be timely for many readers.

Roasting is a good place to begin with most root vegetables. They sweeten as they caramelize in a hot oven. I roasted baby carrots and thick red scallions (they may have been baby onions; I didn’t get the information from the farmer, I just bought them because they were lush and pretty) together and seasoned them with fresh thyme leaves, then sprinkled them with chopped toasted hazelnuts. I also roasted a medley of potatoes, including sweet potatoes, after tossing them with olive oil and sage, and got a wonderful range of colors, textures and tastes ranging from sweet to savory.

Sweet winter vegetables also pair well with spicy seasonings. I like to combine sweet potatoes and chipotle peppers, and this time in a hearty lentil stew that we enjoyed all week.

Here are five colorful and delicious dishes made with root vegetables.

Spicy Lentil and Sweet Potato Stew With Chipotles: The combination of sweet potatoes and spicy chipotles with savory lentils is a winner.


Roasted Carrots and Scallions With Thyme and Hazelnuts: Toasted hazelnuts add a crunchy texture and nutty finish to this dish.


Carrot Wraps: A vegetarian sandwich that satisfies like a full meal.


Rainbow Potato Roast: A multicolored mix that can be vegan, or not.


Leek Quiche: A lighter version of a Flemish classic.


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Euro Watch: Euro Zone Unemployment Rose to New Record in January







PARIS — The unemployment rate in the euro zone edged up in January to a new record, official data showed Friday, as the ailing European economy continued to weigh on the job market.




That, and new data showing a decline in inflation in the euro zone, could prompt the European Central Bank to take steps to stimulate the economy when its Governing Council meets this week, analysts said.


Unemployment in the 17-nation euro zone climbed to 11.9 percent in January from 11.8 percent the previous month, according to Eurostat, the statistical office of the European Union.


For the 27 nations of the Union, the jobless rate in January stood at 10.8 percent, up from 10.7 percent in December. All of the figures were seasonally adjusted.


A separate Eurostat report showed price pressures easing in February. In the euro zone, the annual inflation rate came in at 1.8 percent, down from 2 percent in January and below the European Central Bank’s 2 percent target.


The jobless data “suggest that wage growth is set to weaken from already low rates” and further depress consumer spending, which has already been damped by government austerity measures, Jennifer McKeown, an economist at Capital Economics in London, wrote in a research note.


Ms. McKeown noted that the low inflation numbers and high joblessness “should leave the E.C.B.’s policy options open,” and said it was possible the central bank “might discuss an interest rate cut or other unconventional policies” when its Governing Council meets on Thursday.


There was some bright news Friday. A survey of European purchasing managers by Markit, a data and research firm, showed German manufacturing output growing in February for a second straight month, as new business levels improved.


The composite German purchasing managers’ index improved to 50.3 in February — just above 50, the level that separates growth from contraction — from 49.8 in January. And the Federal Statistical Office in Wiesbaden reported Friday that German retail sales rose 3.1 percent in January from December, when sales fell 2.1 percent.


Another bit of data this week also supports the view that the German economy will bounce back after a fourth-quarter slump. The European Commission’s economic sentiment indicator for the euro zone rose to 91.1 in February from 89.5 in January, with German confidence leading the gain.


“German industry is clearly rebounding and taking advantage from better external traction,” Gilles Moëc, an economist at Deutsche Bank in London, wrote.


Employment is sometimes seen as a lagging indicator of economic growth, because companies try to avoid adding to their costs until they are convinced that a rebound is at hand.


But despite the glimmers of hope in German industry, there are few reasons to regard a recovery as imminent. Markit’s overall euro zone purchasing managers’ index was unchanged in February at 47.9, signaling continued contraction.


Olli Rehn, the European commissioner for economic and monetary affairs, forecast on Feb. 22 that the euro zone would shrink 0.3 percent this year, about the same as last year. The bloc’s debt problems, and the tax increases and government spending cuts that have been prescribed as the remedy, have sapped demand and spending power, reducing business demand for labor.


In absolute terms, Eurostat estimated Friday that 19 million people in the euro zone and more than 26 million people in the overall Union were unemployed.


Spain’s unemployment rate in January was 26.2 percent, and Portugal’s was 17.6 percent. Austria, at just 4.9 percent, had the lowest rate, followed by Germany and Luxembourg, both of which had 5.3 percent unemployed.


Greece’s unemployment rate in November, the latest month for which Eurostat has figures for the country, was 27 percent.


France, with the second-largest euro zone economy, after Germany’s, had a 10.6 percent jobless rate in January. In Britain, not a euro member, the jobless rate stood at 7.7 percent.


That compares with a January unemployment rate of 7.9 percent in the United States. In Japan, 4.2 percent of the work force was counted as unemployed in December.


This article has been revised to reflect the following correction:

Correction: March 1, 2013

An earlier version of this article carried a headline that misstated the month of the data. The report was for January, not February. An earlier version of the article also misstated the name of a federal agency in Wiesbaden, Germany. It is the Federal Statistical Office, not the Federal Statistics Office.



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W.H.O. Sees Low Health Risks From Fukushima Accident





TOKYO — A study published on Thursday by the World Health Organization on the health risks associated with the disaster at the Fukushima Daiichi Nuclear Power Plant suggested that the risk for certain types of cancers had increased slightly among children exposed to the highest doses of radioactivity, but that there would most likely be no observable increase in cancer rates in the wider Japanese population.




The study, which capped off a comprehensive, two-year analysis of the estimated doses of radioactivity from the 2011 Fukushima accident and their potential risks, also warned that the disaster’s psychological impact could have a consequence on health, and called for continued monitoring and health screenings for populations most exposed to the radiological fallout.


The study’s authors warned, however, that their assessment was based on limited scientific knowledge; much of the scientific data on health effects from radiation is based on acute exposures like those that followed the bombing of Hiroshima and Nagasaki and not chronic, low-level exposure. In Japan, some densely populated areas are expected to remain contaminated with relatively low levels of radioactive materials for decades.


“Because scientific understanding of the radiation effects, particularly at low doses, may increase in the future, it is possible that further investigation may change our understanding of the risks of this radiation accident,” the report said.


The Japanese government called the report overly cautious. “It overestimates the risks, and could lead to misunderstandings of the likelihoods of developing cancer,” Japan’s Environment Ministry said in a statement made to the public broadcaster, N.H.K. In particular, the ministry said the study failed to fully take into account government evacuations of residents closest to the plant, assuming many people were exposed for longer than they were.


According to the W.H.O. study, girls exposed as infants to radioactivity in the most contaminated regions of Fukushima Prefecture, where estimated doses ranged from 12 to 25 millisieverts for the first year, faced a 70 percent higher risk of developing thyroid cancer than what would normally be expected. The report pointed out, however, that the normal expected risk of thyroid cancer was just 0.75 percent, and that the additional lifetime risk would raise that to 1.25 percent.


Girls exposed to radioactivity as infants in the most heavily contaminated areas also had a 6 percent higher risk of developing breast cancer, and a 4 percent higher risk of developing cancers that cause tumors. Meanwhile, boys exposed as infants had a 7 percent higher chance of developing leukemia.


The study also said that about a third of the emergency workers who remained to try to stabilize the Fukushima Daiichi plant were estimated to have a slightly increased risk of developing leukemia, thyroid cancer and other types of cancer.


There would most likely be no observable increase in cancer rates for the general population in Fukushima Prefecture outside the most contaminated zones, in the rest of Japan and the world, the report said. It also said that the radiological fallout from the disaster was not expected to cause increases in miscarriages, stillbirths and other physical or mental disabilities.


Still, the study said that the psychological toll of the disaster, including the stresses of evacuation, were harmful to health and should color the Japanese government’s response.


The W.H.O. report “underlines the need for long-term health monitoring of those who are at high risk, along with the provision of necessary medical follow-up and support services,” Dr. Maria P. Neira, the Geneva-based organization’s director for public health and environment, said in a news release. “This will remain an important element in the public health response to the disaster for decades,” she said.


Dr. Angelika Tritscher, acting director for the food safety and zoonoses department at the health agency, said, “In addition to strengthening medical support and services, continued environmental monitoring, in particular of food and water supplies, backed by the enforcement of existing regulations, is required to reduce potential radiation exposure in the future.” .


Matthew L. Wald contributed reporting from Washington.



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Doctor and Patient: Why Failing Med Students Don’t Get Failing Grades

Tall and dark-haired, the third-year medical student always seemed to be the first to arrive at the hospital and the last to leave, her white coat perpetually weighed down by the books and notes she jammed into the pockets. She appeared totally absorbed by her work, even exhausted at times, and said little to anyone around her.

Except when she got frustrated.

I first noticed her when I overheard her quarreling with a nurse. A few months later I heard her accuse another student of sabotaging her work. And then one morning, I saw her storm off the wards after a senior doctor corrected a presentation she had just given. “The patient never told me that!” she cried. The nurses and I stood agape as we watched her stamp her foot and walk away.

“Why don’t you just fail her?” one of the nurses asked the doctor.

“I can’t,” she sighed, explaining that the student did extremely well on all her tests and worked harder than almost anyone in her class. “The problem,” she said, “is that we have no multiple choice exams when it comes to things like clinical intuition, communication skills and bedside manner.”

Medical educators have long understood that good doctoring, like ducks, elephants and obscenity, is easy to recognize but difficult to quantify. And nowhere is the need to catalog those qualities more explicit, and charged, than in the third year of medical school, when students leave the lecture halls and begin to work with patients and other clinicians in specialty-based courses referred to as “clerkships.” In these clerkships, students are evaluated by senior doctors and ranked on their nascent doctoring skills, with the highest-ranking students going on to the most competitive training programs and jobs.

A student’s performance at this early stage, the traditional thinking went, would be predictive of how good a doctor she or he would eventually become.

But in the mid-1990s, a group of researchers decided to examine grading criteria and asked directors of internal medicine clerkship courses across the country how accurate and consistent they believed their grading to be. Nearly half of the course directors believed that some form of grade inflation existed, even within their own courses. Many said they had increasing difficulty distinguishing students who could not achieve a “minimum standard,” whatever that might be. And over 40 percent admitted they had passed students who should have failed their course.

The study inspired a series of reforms aimed at improving how medical educators evaluated students at this critical juncture in their education. Some schools began instituting nifty mnemonics like RIME, or Reporter-Interpreter-Manager-Educator, for assessing progressive levels of student performance; others began to call regular meetings to discuss grades; still others compiled detailed evaluation forms that left little to the subjective imagination.

Now a new study published last month in the journal Teaching and Learning in Medicine looks at the effects of these many efforts on the grading process. And while the good news is that the rate of grade inflation in medical schools is slower than in colleges and universities, the not-so-good news is that little has changed. A majority of clerkship directors still believe that grade inflation is an issue even within their own courses; and over a third believe that students have passed their course who probably should have failed.

“Grades don’t have a lot of meaning,” said Dr. Sara B. Fazio, lead author of the paper and an associate professor of medicine at Harvard Medical School who leads the internal medicine clerkship at the Beth Israel Deaconess Medical Center in Boston. “‘Satisfactory’ is like the kiss of death.”

About a quarter of the course directors surveyed believed that grade inflation occurred because senior doctors were loath to deal with students who could become angry, upset or even turn litigious over grades. Some confessed to feeling pressure to help students get into more selective internships and training programs.

But for many of these educators, the real issue was not flunking the flagrantly unprofessional student, but rather evaluating and helping the student who only needed a little extra help in transitioning from classroom problem sets to real world patients. Most faculty received little or no training or support in evaluating students, few came from institutions that had remediation programs to which they could direct students, and all worked under grading systems that were subjective and not standardized.

Despite the disheartening findings, Dr. Fazio and her co-investigators believe that several continuing initiatives may address the evaluation issues. For example, residency training programs across the country will soon be assessing all doctors-in-training with a national standards list, a series of defined skills, or “competencies,” in areas like interpersonal communication, professional behavior and specialty-specific procedures. Over the next few years, medical schools will likely be adopting a similar system for medical students, creating a national standard for all institutions.

“There have to be unified, transparent and objective criteria,” Dr. Fazio said. “Everyone should know what it means when we talk about educating and training ‘good doctors.’”

“We will all be patients one day,” she added. “We have to think about what kind of doctors we want to have now and in the future.”

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High & Low Finance: Report Lays Out Plan to Reduce Government Role in Home Financing





Can the American mortgage market ever function again without Uncle Sam guaranteeing that lenders will be repaid?




It is amazing just how few people think it can.


“For the foreseeable future, there is simply not enough capacity on the balance sheets of U.S. banks to allow a reliance on depository institutions as the sole source of liquidity for the mortgage market,” stated a report on the American housing market this week, issued by a group that was filled with members of the housing establishment.


The panel, which included Frank Keating, the president of the American Bankers Association and a former governor of Oklahoma, does not see that as an indictment of the American banking system, which would much rather trade leveraged derivatives than keep a lot of mortgage loans on its books.


“Given the size of the market and capital constraints on lenders, the secondary market for mortgage-backed securities must continue to play a critical role in providing mortgage liquidity,” added the report, issued by a housing commission formed by the Bipartisan Policy Center, a group that was begun by former Senate majority leaders from both parties. The group thinks investors will not be willing to finance enough mortgages — particularly 30-year fixed-rate loans — without a government guarantee.


The report does an excellent job of analyzing the history of the American housing finance system, as well as looking at the government’s efforts over the years to promote and subsidize rental housing. It calls for changes in those policies as well, aimed at assuring that those with very low incomes “are assured access to housing assistance if they need it.”


But those rental proposals are unlikely to lead to legislation any time soon, said Mel Martinez, one of four co-chairmen of the housing panel. Mr. Martinez, a former Republican senator from Florida and housing secretary under President George W. Bush, said in an interview that any proposal calling for spending government money, as this one does, would face tough sledding in Congress.


But he said it was possible that changes in the housing finance system, which is widely criticized on both sides of the aisle, had a better chance of getting approval.


Certainly, one principle enunciated by the panel will get wide support: “The private sector must play a far greater role in bearing housing risk.” But the details show that the panel still thinks sufficient money can be found for housing only if Uncle Sam remains the ultimate guarantor for most home mortgages.


Currently, the government backs about 90 percent of newly issued mortgages, more than ever before. The proportion fell in the years leading up to 2007 as subprime loans proliferated and then soared after that market collapsed. Since then, the Federal Housing Administration has expanded its role in backing home loans on the low end of the scale. But most mortgages are purchased by either Fannie Mae or Freddie Mac, the government-sponsored enterprises that the government took over after the housing bubble burst.


So-called jumbo mortgages, that is mortgages too large to qualify for purchase by Fannie or Freddie, account for most of the rest. Some mortgages are put into securitizations that have no government guarantee, but many jumbo mortgages end up being owned by the banks for the long term.


The F.H.A. appears to be more cautious than it used to be. The report notes that last year the average FICO score for an F.H.A. or Department of Veterans Affairs loan was close to 720 on a range of 300 to 850. That is about what the average Fannie Mae and Freddie Mac borrower had in 2001.


The commission, whose other co-chairmen were George J. Mitchell, the former Senate Democratic leader; Christopher S. Bond, a former Republican senator; and Henry Cisneros, who served as housing secretary under President Bill Clinton, wants to preserve the F.H.A., but orient it more to those who need the most help. It would phase out Fannie and Freddie — something that is politically necessary — but replace them with something that sounds sort of similar.


The new organization would be called a “public guarantor.” It would guarantee that investors in mortgage-backed securitizations would not lose money, much as Fannie and Freddie now do. But its responsibility would come after that of a “private credit enhancer,” which sounds like a monoline insurer that would make payments to securitization holders if the underlying mortgages were performing badly. That organization would be regulated by the public guarantor, and only after it goes broke — something that should happen only if housing prices fall more than they did in the recent crisis — would the public guarantor be responsible for making investors whole.


Floyd Norris comments on finance and the economy at nytimes.com/economix.



This article has been revised to reflect the following correction:

Correction: February 28, 2013

An earlier version of this column misstated the potential proportion of new mortgages that Mr. Martinez said he believed would eventually be financed by private capital. It is 40 to 55 percent, not 40 to 50 percent.



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The Lede: Syrians Describes Apparent Missile Strikes on Aleppo

A Human Rights Watch video report on the aftermath of apparent missile strikes in Syria’s largest city, Aleppo.

Human Rights Watch investigators who visited Aleppo, Syria’s largest city, have concluded that the Syrian government fired at least four ballistic missiles into civilian neighborhoods there last week, killing more than 141 people, including 71 children. As my colleague Anne Barnard explained, the rights group released details of the four documented strikes, and a video report, on Tuesday.

On Wednesday, opposition activists added English subtitles to an emotional account of the devastation caused by one missile strike on Aleppo from a young boy who said he survived the bombing, but lost several family members and neighbors.

A video interview with a young boy who said that he had survived a missile attack on a civilian neighborhood in Aleppo, Syria’s largest city.

The original interview with the boy was posted on YouTube on Monday by Orient News, a private Syrian satellite channel that began broadcasting from Dubai before the anti-government uprising began. Within a week of the first protests in Syria, Ghassan Abboud, the Syrian businessman who owns the channel, told a Saudi broadcaster that senior government officials close to President Bashar al-Assad had threatened to kidnap his journalists if they did not stop covering the demonstrations.

The boy’s testimony was subtitled by the ANA New Media Association, a group of opposition video activists led by Rami Jarrah, who blogs as Alexander Page.

The new reports come weeks after experts told The Lede that video of a huge explosion at Aleppo University last month suggested that the campus had been hit by a ballistic missile.

When Liz Sly of the Washington Post visited Aleppo’s Ard al-Hamra neighborhood after two missile strikes, residents gave similarly graphic accounts of pulling the mangled bodies of victims from wrecked buildings. The scenes of devastation, she wrote, “more closely resembling those of an earthquake, with homes pulverized beyond recognition, people torn to shreds in an instant and what had once been thriving communities reduced to mountains of rubble.”

Ole Solvang, a Human Rights Watch researcher who helped document the damage in Aleppo, drew attention to video posted online by opposition activists, said to show the desperate search for survivors in the immediate aftermath of the strike on Ard al-Hamra.

Video said to show a neighborhood in Syria’s largest city, Aleppo, after a missile strike last week.

As Mr. Solvang assessed the wreckage in person on Thursday and Friday, he described the damage to Aleppo and a neighboring town in words and images posted on Twitter.

Late Tuesday, an Aleppo blogger who supported the uprising but has been critical of the armed rebellion on his @edwardedark Twitter feed, reported that another huge blast had shaken the city.

Ms. Sly reported on Twitter Wednesday night that two more missiles were fired at rural Aleppo. “They landed in fields,” she observed. “That’s how accurate they are. Seems a bit pointless.”

Late Wednesday, Mr. Solvang pointed to video posted on YouTube by opposition activists, showing what they said were distant images of a missile being launched from Damascus in the direction of Aleppo.

Video said to show a missile being fired by Syrian government forces outside the capital, Damascus, on Wednesday night.

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AP Source: 49ers to send Smith to KC


SAN FRANCISCO (AP) — Alex Smith quietly stayed behind the scenes after losing his job and watched from the sideline as San Francisco returned to the Super Bowl for the first time in 18 years. Yet the No. 1 overall draft pick from 2005 did make one thing known: The veteran quarterback still considers himself a starter.


And he hoped to get that chance again. Now, he appears to have it.


The Kansas City Chiefs have agreed to acquire Smith from the 49ers in the first major acquisition since Andy Reid took over as the team's new coach in early January, a person with knowledge of the trade told The Associated Press on Wednesday.


The person spoke on condition of anonymity because the deal cannot become official until March 12, when the NFL's new business year begins. Another person familiar with the swap said the 49ers will get a second-round pick in April's draft, No. 34 overall, and a conditional pick in the 2014 draft.


After spending his first eight up-and-down years with the 49ers, Smith will get a welcome new start. The Chiefs will get the proven play-caller they hope can help turn things around under a new coach much the way Smith did under Jim Harbaugh in San Francisco.


"You never know when your opportunity's going to come," Smith said late in the season. "The good ones are ready when they do come."


The Chiefs have gone this route before, acquiring Joe Montana from the 49ers nearly 20 years ago, in April 1993, after he won four Super Bowls but gave way to Steve Young — San Francisco's quarterback of the future.


Not so different from Smith's situation last season behind second-year QB Colin Kaepernick.


Moving Smith was hardly unexpected. He realized it once Kaepernick emerged as a capable starter over the season's final two months, and Smith all but said goodbye with his first pro team when he played briefly in the regular-season finale against Arizona to cheers of "Let's Go, Alex!" and "Alex! Alex!" from the Candlestick Park crowd.


With Smith now headed for Kansas City, Matt Cassel is likely headed out of town. And Reid will enter his first draft as Chiefs coach in April no longer needing to search for a quarterback.


The Chiefs' problems at quarterback are the single biggest reason they went 2-14 last season and secured the No. 1 pick in the draft for the first time in franchise history.


It's been a long-running problem for a franchise that has tried Steve Bono and Elvis Grbac (two more one-time 49ers), and more recently Damon Huard, Tyler Thigpen and Tyler Palko at quarterback. And then there's Cassel.


He was acquired by recently fired general manager Scott Pioli, and has two years left on a $63 million, six-year deal. He will likely be cut once Smith is acquired.


Cassel was benched last season in favor of Brady Quinn, who also is a free agent after going 1-7 as the starter.


If Smith can bring the steady form that defined his last two years, the Chiefs might be able to establish a much-needed consistency under center. They also found themselves a team-first player who led the 49ers through workouts during the 2011 lockout.


Under the three-year contract he signed last March, Smith is guaranteed $8.5 million in base salary for the 2013 season.


Smith thrived under 49ers coach and former NFL quarterback Harbaugh in one-plus season as the starter. Then, just like that, it all changed after he sustained a concussion.


Last week at the NFL combine, Harbaugh praised Smith and reiterated just how strong San Francisco was with Colin Kaepernick as the starter and someone with Smith's credentials at backup.


Yet everyone knew it was likely the 49ers would do their best to improve Smith's situation considering all he did for the franchise for nearly the past decade.


"Alex is really playing the best football of his career the last two years," Harbaugh said. "We think we got the best quarterback situation in the National Football League, feel strongly about that. Again, that'll be a process that plays out. Alex Smith continuing to be a 49er or if a trade occurs in the next weeks or months. Those are the two possibilities, most likely possibilities."


Smith acknowledged when he lost the job to Kaepernick back in November that he had done nothing wrong but get hurt. Not only had he completed 26 of his previous 28 passes — 18 of 19 for 232 yards and three touchdowns without an interception and a 157.1 passer rating in a Monday Night Football win at Arizona on Oct. 29 — Smith had just earned NFC Offensive Player of the Week honors after that victory in the desert.


He then sustained a concussion in the second quarter of a 24-24 tie against St. Louis on Nov. 11 — saying later he threw a touchdown pass with blurry vision. Smith sat out the next game as Kaepernick dazzled in his debut as an NFL starter, beating the Bears handily at home on Monday Night Football.


After that, Harbaugh vowed to stick with the "hot hand," as he regularly put it, while complicating matters by still referring to Smith as a starter.


Smith's most poignant response to the situation was, "I feel like the only thing I did to lose my job was get a concussion."


Kaepernick led the 49ers to the NFC championship and a 34-31 loss to Baltimore in the Super Bowl in his second season. Now the 49ers are looking for his backup.


The 28-year-old Smith struggled for most of his career in San Francisco, plagued as much by coaching and constant coordinator changes as by his own indecisiveness. But when Harbaugh became coach in January 2011, Smith blossomed under the former QB's guidance. He was among the league leaders in passer rating (104.1) with a 70.2 completion percentage when he got hurt last season.


Fox Sports first reported the deal Wednesday.


___


AP Pro Football Writer Barry Wilner and AP Sports Writer Dave Skretta contributed to this story.


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Global Health: After Measles Success, Rwanda to Get Rubella Vaccine


Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.


On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.


Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative. M.R.I. helped pay for previous vaccination campaigns in the country and the GAVI Alliance is helping to finance the upcoming one.


Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.


Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.


Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.


The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)


More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.


The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.


In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.


Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.


Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.


This article has been revised to reflect the following correction:

Correction: February 27, 2013

An earlier version of this article misstated the source of the vaccine and some financing for the campaign. The vaccine and financing is being provided by the GAVI Alliance, not the Measles and Rubella Initiative.




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DealBook: J.C. Penney’s Poor Showing Is Another Retail Miss for Ackman

With J.C. Penney‘s awful fourth-quarter results, William A. Ackman has found success in retail investments elusive once more.

It’s hard to call J.C. Penney’s latest quarterly report anything but breathtaking. The retailer lost $552 million for the quarter, which at $1.95 a share far exceeded the 17-cent loss that analysts had been expecting. Same-store sales tumbled nearly 32 percent from the same time a year ago.

Shares in the company were down nearly 9 percent in after-hours trading.

So far, J.C. Penney’s chief executive, Ron Johnson — whom Mr. Ackman recruited from Apple — has asked for patience, citing all the changes that he has rolled out at the formerly dowdy department store chain. (Indeed, he spent the first several minutes of an investor Webcast on Wednesday enumerating the many innovations at the store.)

One wonders whether Mr. Ackman, whose Pershing Square Capital Management owns a 17.8 percent stake in J.C. Penney, can wait that long.

It isn’t the first time that he has taken a bath betting on a retailer. Mr. Ackman’s most recent failure in the industry was a bet on the Borders Group, taking a 17 percent stake in the troubled bookseller by late 2007.

Despite efforts by the hedge fund manager to help prop up the company, including offering to finance a merger with the much larger Barnes & Noble, Borders filed for bankruptcy in late 2010. Mr. Ackman has acknowledged losing at least $125 million on the investment.

Perhaps his most notable troubled investment was in Target, a wager in which Mr. Ackman actually created a special fund dedicated to the discount retailer. He also embarked on a lengthy and expensive campaign to gain seats on the company’s board, to forcefully advocate for a complicated restructuring he said would generate better returns for shareholders.

That didn’t quite work out either. Mr. Ackman lost the proxy fight. He sold Pershing’s stake by early 2011, having lost about 90 percent of his firm’s $2 billion investment.

Last month, it appeared that Mr. Ackman was willing to give Mr. Johnson room to prove naysayers wrong. “We put Ron in charge, and we’re letting him run the company,” the hedge fund manager told CNBC in an interview.

But he added that he’ll run out of patience — in three year’s time.

“If three years from now, Ron Johnson is still struggling to turn around J.C. Penney,” Mr. Ackman said to CNBC, “he’s probably the wrong guy.”

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Rocket From Gaza Hits Israel, Breaking Cease-Fire


Tsafrir Abayov/Associated Press


Israeli explosives experts gathered near a rocket believed to have been fired from the Gaza Strip, landing near Ashkelon, on Tuesday.







JERUSALEM — A Grad rocket fired from the Gaza Strip struck in southern Israel early Tuesday, threatening to further escalate tensions that have been mounting since Saturday, when a 30-year-old Palestinian prisoner died in an Israeli jail.




The rocket, which came down on a road outside the city of Ashkelon and caused no injuries, was the first from Gaza to hit Israel in the three months since a cease-fire agreement ended eight days of cross-border violence. Israel has violated the cease-fire several times by firing on fishermen and farmers approaching newly relaxed security perimeters, but the agreement has otherwise held.


A subgroup of the Al Aksa Martyrs Brigade, the military wing of the Palestinians’ Fatah faction, said it fired the rocket in response to what it called the “assassination” of Arafat Jaradat, the prisoner who died on Saturday. Palestinian leaders have blamed Mr. Jaradat’s death on what they described as “severe torture” during interrogation, though Israeli officials say the bruising and broken ribs cited as evidence of torture could have been caused by resuscitation efforts.


Mushir al-Masri, a lawmaker from the militant Hamas faction that rules the Gaza Strip, said in an interview that Israel was “fully responsible for the consequences of the wave of the Palestinian public fury.”


After the rocket attack, Israel shut its border crossings with Gaza to goods and people, allowing only “medical, humanitarian and exceptional cases,” according to a statement from the military. President Shimon Peres, who was visiting southern Israel on a previously scheduled tour, said, “Quiet will be met with quiet; missiles will be met with a response.”


Giora Eiland, a senior research fellow at Israel’s Institute for National Security Studies, said renewed rocket fire could change the current delicate balance between Israel and the Palestinians, because international opinion is largely critical of Israel’s actions in the West Bank but is sympathetic when Israel comes under attack from Gaza.


“I believe that it is under control, it can be contained, and with some gestures from both sides and clear messages from Washington — which I understand are coming every few hours — it will be able to prevent an escalation and not to deteriorate ourselves to a third intifada,” Mr. Eiland said, using the Arabic word for uprising. “There is a very delicate line between two conflicting interests: to do something in order to preserve the Jihadiic identity, to preserve the spirit of resistance, to serve so many domestic interests, but not to do something that would bring some unproportional response.”


Fares Akram contributed reporting from Gaza City.



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