Who's who in the Petraeus scandal

What started out as a leisurely stroll through the Philadelphia Museum of Art on Nov. 11 with his girlfriend, quickly turned into quite a surreal experience for Max Galuppo, 20, of Bloomsbury, N.J. Galuppo, a Temple University student, found his doppelganger in a 16th century...
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Canada seen needing to spell out rules for natural gas projects
















CALGARY, Alberta (Reuters) – The fate of a handful of liquefied natural gas projects planned for Canada’s Pacific coast may depend on the Canadian government‘s willingness to spell out rules for foreign investment in the country’s energy sector, according to a study released on Thursday.


Apache Corp, Royal Dutch Shell Plc, Petronas, BG Group Plc and others are in the planning stages for LNG projects that would take gas from the rich shale fields of northeastern British Columbia and ship it to Asian buyers.













But the federal government’s decision last month to stall the C$ 5.2 billion ($ 5.2 billion) bid by Malaysia’s state-owned Petronas C$ 5.2 billion for Canada‘s Progress Energy Resources Corp could lessen the appetite of Asian buyers for Canadian LNG, energy consultants Wood Mackenzie said.


“Some potential off-takers of Canadian LNG like the idea … because it’s perceived as having low political risk, and another reason is because they see the potential for investment opportunities,” said Noel Tomnay, head of global gas at the consultancy.


“If there are going to be restrictions on how they access those opportunities, if acquisitions are closed to them, then clearly that would restrict the attractiveness of those opportunities. If would-be Asian investors thought that corporate acquisitions were an avenue that was not open to them then Canadian LNG would become less attractive.”


The Canadian government is looking to come up with rules governing corporate acquisitions by state-owned companies and has pushed off a decision on the Petronas bid as it considers whether to approve the $ 15.1 billion offer for Nexen Inc from China’s CNOOC Ltd.


Exporting LNG to Asia is seen as a way to boost returns for natural-gas producers tapping the Montney, Horn River and Liard Basin shale regions of northeastern British Columbia.


Though Wood Mackenzie estimates the fields contain as much as 280 trillion cubic feet of gas, they are far from Canada’s traditional U.S. export market, while growing supplies from American shale regions have cut into Canadian shipments.


Because the region lacks infrastructure, developing the resource will be expensive, requiring new pipelines and multibillion-dollar liquefaction.


Still Wood Mackenzie estimates that the cost of delivery into Asian markets for Canadian LNG would be in the range of $ 10 million to $ 12 per million British thermal units, similar to competing projects in the United States and East Africa.


($ 1 = $ 1.00 Canadian)


(Reporting by Scott Haggett; Editing by Leslie Adler)


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U2′s Bono to urge U.S. politicians not to cut aid programs
















WASHINGTON (Reuters) – Irish rocker and anti-poverty campaigner Bono will appeal to Democrats and Republicans during a visit to Washington this week to spare U.S. development assistance programs from cuts as Congress tries to avert the looming “fiscal cliff” of tax hikes and spending reductions early next year.


The U2 lead singer’s visit comes as the Obama administration and congressional leaders try to forge a deal in coming weeks to avoid the economy hitting the “fiscal cliff” – tax increases and spending cuts worth $ 600 billion starting in January if Congress does not act.













Analysts say the absence of a deal could shock the United States, the world’s biggest economy, back into recession.


Kathy McKiernan, spokeswoman for the ONE Campaign, said Bono will hold talks with congressional lawmakers and senior Obama administration officials during the November 12-14 visit.


During meetings he will stress the effectiveness of U.S. foreign assistance programs and the need to preserve them to avoid putting at risk progress made in fighting HIV/AIDS, tuberculosis and malaria, she said.


Bono, a long-time advocate for the poor, will argue that U.S. government-funded schemes that support life-saving treatments for HIV/AIDS sufferers, nutrition programs for malnourished children, and emergency food aid make up just 1 percent of the U.S. government budget but are helping to save tens of millions of lives in impoverished nations.


The One Campaign would not elaborate which lawmakers and senior Obama administration officials Bono will meet.


On Monday, Bono will discuss the power of social movements with students at Georgetown University. He will also meet new World Bank President Jim Yong Kim for a web cast discussion on Wednesday on the challenges of eradicating poverty.


(Editing by W Simon)


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Spinal steroid shots may have little effect on sciatica
















NEW YORK (Reuters Health) – Despite the growing popularity of steroid injections to treat various kinds of back pain in recent years, a new review of past research finds the shots do little to alleviate sciatica, a common condition that causes leg and back pain.


Analyzing results from nearly two dozen clinical trials on thousands of patients, Australian researchers found that epidural injections (into the spine) of corticosteroids had no long- or short-term effect on sciatica back pain, and such a small short-term effect on leg pain it would make no difference to the patient.













“I think it’s pretty clear that this treatment is not good to do,” said Chris Maher, of The George Institute for Global Health in Sydney, Australia, who worked on the study.


Nonetheless, the use of epidural steroid injections to treat back pain of all sorts among Medicare patients nearly doubled from 741,000 in 2000 to about 1,438,000 in 2004, according to the researchers.


In the U.S., the cost of one shot can be several hundred dollars.


And a tainted supply of one of the steroids included in the trials under analysis – methylprednisolone – recently caused a nationwide outbreak of fungal meningitis that infected 400 people and led to 31 deaths, according to the Centers for Disease Control and Prevention.


For sciatica, which is thought to be caused by nerve damage, past studies have already questioned the effectiveness of spinal steroid shots.


In April, for instance, a study of 81 people found that whether they received steroids or a placebo for sciatica, their condition ended up improving about the same amount. (see Reuters Health article of April 16, 2012.)


Maher and his colleagues set out to see whether past studies supported the use of epidural corticosteroid injections to help manage sciatica, and collected results from “gold standard” randomized controlled trials.


Overall, 23 trials were included in the final analysis, which represented about 2,300 patients, whose pain was ranked on a scale from zero to 100 – with higher scores representing worse pain.


For the back pain component of sciatica, the researchers found that the injections didn’t seem to make a difference over short or long periods of time.


When it came to leg pain, there was no difference a year or so after the injection, but there was a statistically significant six-point drop in pain scores over the short term – about 2 weeks to 3 months.


But that, according to Maher, is not enough to mean anything to a doctor or patient.


“You can appreciate that six points on a hundred-point scale is a tiny difference, and in our view that is probably not clinically important,” he said.


‘QUESTION IS CLOSED’


“We really think the question is closed,” said Maher. “So in terms of our research agenda, we’re moving on to other treatments for sciatica.”


Maher told Reuters Health that, instead of steroid injections, people suffering with sciatica should consult their doctor, but other options include simple pain relievers, such as acetaminophen, drugs that treat pain by working throughout a person’s nervous system and, as a last resort, surgery.


Not everyone agrees that steroid injections should be excluded from the hierarchy of treatments for sciatica.


“In general, I think we’ve learned over the years that the epidural injections are turning out to be less and less successful… but there are times when they should be considered,” said Dr. Kirkham B. Wood, chief of the orthopedic spine service at Boston’s Massachusetts General Hospital.


He told Reuters Health that he believes an injection should be considered, for example, in someone with sciatica resulting from a relatively recent herniated disc, “who time and medication has not helped.”


Wood does believe, however, that the injections are overused, and said there was a time when the injections were the go-to treatment for simple back pain.


“I think the pendulum is certainly swinging away from their broad use,” he said.


The meningitis outbreak in the U.S. will also likely dampen enthusiasm for the shots, researchers acknowledged.


“If this was a treatment that worked, then you’d have to weigh the benefits and the harm,” Maher said, but it doesn’t work (for sciatica), he emphasized.


Maher and his team, who published their results in the Annals of Internal Medicine on Monday, hope doctors will pick up on their findings.


But Maher told Reuters Health that it may take some time to change how doctors see the injections.


“It’s been around for decades and it will take a while to stop,” he said.


SOURCE: Annals of Internal Medicine, online November 12, 2012.


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Probe shows federal power to access email

WASHINGTON (AP) — Your emails are not nearly as private as you think.


The downfall of CIA Director David Petraeus demonstrates how easy it is for federal law enforcement agents to examine emails and computer records if they believe a crime was committed. With subpoenas and warrants, the FBI and other investigating agencies routinely gain access to electronic inboxes and information about email accounts offered by Google, Yahoo and other Internet providers.


"The government can't just wander through your emails just because they'd like to know what you're thinking or doing," said Stewart Baker, a former assistant secretary at the Department of Homeland Security and now in private law practice. "But if the government is investigating a crime, it has a lot of authority to review people's emails."


Under the 1986 Electronic Communications Privacy Act, federal authorities need only a subpoena approved by a federal prosecutor — not a judge — to obtain electronic messages that are six months old or older. To get more recent communications, a warrant from a judge is required. This is a higher standard that requires proof of probable cause that a crime is being committed.


Public interest groups are pressing Congress for the law to be updated because it was written a quarter-century ago when most emails were deleted after a few months because the cost of storing them indefinitely was prohibitive. Now, "cloud computing" services provide huge amounts of inexpensive storage capacity. Other technological advances, such as mobile phones, have dramatically increased the amount of communications that are kept in electronic warehouses and can be reviewed by law enforcement authorities carrying a subpoena.


"Technology has evolved in a way that makes the content of more communications available to law enforcement without judicial authorization, and at a very low level of suspicion," said Greg Nojeim, a senior counsel at the Center for Democracy & Technology.


The chairman of the Senate Judiciary Committee, Patrick Leahy, has proposed changing the law to require a warrant for all Internet communications regardless of their age. But law enforcement officials have resisted because they said it would undercut their ability to catch criminals.


A subpoena is usually sufficient to require Internet companies to reveal names and any other information that they have that would identify the owner of a particular email account. Google, which operates the widely used Gmail service, complied with more than 90 percent of the nearly 12,300 requests it received in 2011 from the U.S. government for data about its users, according to figures from the company.


Even if a Gmail account is created with a fictitious name, there are other ways to track down the user. Logs of when messages are sent reveal the Internet address the user used to log onto the account. Matching times and dates with locations allow investigators to piece together the chain.


A Gmail account figured prominently in the FBI investigation that led to Petraeus' stunning resignation last week as the nation's spy chief. Petraeus, a retired Army general, stepped down after he confessed to an extramarital affair with Paula Broadwell, an Army Reserve officer and his biographer.


The inquiry began earlier this year after Jill Kelley, a Florida woman who was friends with Petraeus and his wife, Holly, began receiving harassing emails. Kelley is a Tampa socialite. That is where the military's Central Command and Special Operations Command are located.


Petraeus served as commander at Central Command from 2008 to 2010.


FBI agents eventually determined that the email trail led to Broadwell, according to two federal law enforcement officials, who spoke on condition of anonymity because the sources were not authorized to speak about the matter on the record. As they looked further, the FBI agents came across a private Gmail account that used an alias name. On further investigation, the account turned out to be Petraeus's.


The contents of several of the exchanges between Petraeus and Broadwell suggested they were having an affair, according to the officials. Investigators determined that no security breach had occurred, but continued their investigation into whether Petraeus had any role in the harassing emails that Broadwell had sent to Kelley, which was a criminal investigation.


Petraeus and Broadwell apparently used a trick, known to terrorists and teen-agers alike, to conceal their email traffic.


One of the law enforcement officials said they did not transmit all of their communications as emails from one's inbox to the other's inbox. Rather, they composed some emails in a Gmail account and instead of transmitting them, left them in a draft folder or in an electronic "dropbox." Then the other person could log onto the same account and read the draft emails there. This avoids creating an email trail which is easier to trace. It's a technique that al-Qaida terrorists began using several years ago and teen-agers in many countries have since adopted.


___


Associated Press writer Pete Yost contributed to this report.

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BBC must reform or die, says Trust chairman
















LONDON (Reuters) – The BBC could be doomed unless it makes radical changes, the head of its governing trust said on Sunday, after its director general quit to take the blame for the airing of false child sex abuse allegations against a former politician.


Chris Patten, chairman of the BBC Trust, said confidence had to be restored if the publicly funded corporation was to withstand pressure from rivals, especially Rupert Murdoch‘s media empire, which would try to take advantage of the turmoil.













“If you’re saying, ‘Does the BBC need a thorough structural radical overhaul?’, then absolutely it does, and that is what we will have to do,” Patten, a one-time senior figure in Prime Minister David Cameron‘s Conservative Party and the last British governor of Hong Kong, told BBC television.


“The basis for the BBC’s position in this country is the trust that people have in it,” Patten said. “If the BBC loses that, it’s over.”


George Entwistle resigned as director general on Saturday, just two months into the job, to take responsibility for the child sex allegation on the flagship news programme Newsnight.


The witness in the report, who says he suffered sexual abuse at a care home in the late 1970s, said on Friday he had misidentified the politician, Alistair McAlpine. Newsnight admitted it had not shown the witness a picture of McAlpine, or approached McAlpine for comment before going to air.


Already under pressure after revelations that a long-time star presenter, the late Jimmy Savile, was a paedophile, Entwistle conceded on the BBC morning news that he had not known – or asked – who the alleged abuser was until the name appeared in social media.


The BBC, celebrating its 90th anniversary, is affectionately known in Britain as “Auntie”, and respected around much of the world.


But with 22,000 staff working at eight national TV channels, 50 radio stations and an extensive Internet operation, critics say it is hampered by a complex and overly bureaucratic and hierarchical management structure.


THOMPSON’S LEGACY


Journalists said this had become worse under Entwistle’s predecessor Mark Thompson, who took over in the wake of the last major crisis to hit the corporation and is set to become chief executive of the New York Times Co on Monday.


In that instance, both director general and chairman were forced out after the BBC was castigated by a public inquiry over a report alleging government impropriety in the fevered build up to war in Iraq, leading to major organisational changes.


One of the BBC’s most prominent figures, Newsnight presenter Jeremy Paxman, said since the Iraq report furore, management had become bloated while cash had been cut from programme budgets.


“He (Entwistle) has been brought low by cowards and incompetents,” Paxman said in a statement, echoing a widely-held view that Entwistle was a good man who had been let down by his senior staff.


Prime Minister Cameron appeared ready to give the BBC the benefit of the doubt, believing that “one of the great institutions of this country” could reform and deal with its failings, according to sources in his office.


Patten, who must find a new director general to sort out the mess, agreed that management structures had proved inadequate.


“Apparently decisions about the programme went up through every damned layer of BBC management, bureaucracy, legal checks – and still emerged,” he said.


“One of the jokes I made, and actually it wasn’t all that funny, when I came to the BBC … was that there were more senior leaders in the BBC then there were in the Chinese Communist Party.”


Patten ruled out resigning himself but other senior jobs are expected to be on the line, while BBC supporters fear investigative journalism will be scaled back. He said he expected to name Entwistle’s successor in weeks, not months.


Among the immediate challenges are threats of litigation.


McAlpine, a close ally of former prime minister Margaret Thatcher, has indicated he will sue for damages.


Claims for compensation are also likely from victims who say Savile, one of the most recognisable personalities on British television in the 1960s, 70s and 80s, sexually abused them as children, sometimes on BBC premises.


INQUIRIES


Two inquiries are already under way, looking at failures at Newsnight and allegations relating to Savile, both of which could make uncomfortable reading for senior figures.


Police have also launched a major inquiry into Savile’s crimes and victims’ allegations of a high-profile paedophile ring. Detectives said they had arrested their third suspect on Sunday, a man in his 70s from Cambridgeshire in central England.


Funded by an annual licence fee levied on all TV viewers, the BBC has long been resented by its commercial rivals, who argue it has an unfair advantage and distorts the market.


Murdoch’s Sun tabloid gleefully reported Entwistle’s departure with the headline “Bye Bye Chump” and Patten said News Corp and others would put the boot in, happy to deflect attention after a phone-hacking scandal put the newspaper industry under intense and painful scrutiny.


He said that “one or two newspapers, Mr. Murdoch’s papers” would love to see the BBC lose its national status, “but I think the great British public doesn’t want to see that happen”.


Murdoch himself was watching from afar.


“BBC getting into deeper mess. After Savile scandal, now prominent news program falsely names senior pol as paedophile,” he wrote on his Twitter website on Saturday.


It is not just the BBC and the likes of Entwistle and Patten who are in the spotlight.


Thompson, whom Entwistle succeeded in mid-September, has also faced questions from staff at the New York Times over whether he is still the right person to take one of the biggest jobs in American newspaper publishing.


Britain’s Murdoch-owned Sunday Times queried how Thompson could have been unaware of claims about Savile during his tenure at the BBC as he had told British lawmakers, saying his lawyers had written to the paper addressing the allegations in early September, while he was still director general.


(Editing by Kevin Liffey and Sophie Hares)


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HTC shares jump after settles patent issues with Apple
















TAIPEI (Reuters) – Shares of HTC Corp jumped by their permitted daily limit on Monday after the Taiwanese smartphone maker announced a global patent settlement and 10-year licensing agreement with Apple Inc, allowing the struggling company to focus on product development.


The settlement would give HTC a short-term boost, analysts suggested, but long-term performance would still depend on the company’s ability to deliver competitive products to grab back some of the market share it has lost to Apple and South Korea’s Samsung Electronics Co.













HTC’s shares opened up by the maximum allowed 6.86 percent at T$ 241.50, and remained at that level in morning trade in a broader market that slipped 0.15 percent.


The shares have bounced 24.5 percent from a closing low of T$ 194 two weeks ago, which was the lowest since 2005 before the company transformed into a top brand from an obscure contract maker. But the shares remain some 80 percent below their record high last April.


HTC and Apple’s settlement and licensing agreement on Saturday ended one of the first major conflagrations of the smartphone patent wars. The California giant sued HTC in 2010, its first major legal salvo against a manufacturer that used Google’s Android operating system.


“The licensing agreement is beneficial to HTC’s future product development, especially in the U.S. market,” said Gartner analyst C.K. Lu.


“The settlement is positive to the consumer image of both camps (Apple and Google) as they are now unlocked from a constant patent war.”


The two companies did not disclose details of the settlement or the licensing agreement, but HTC said the agreement will not impact its financials and it will not change its fourth-quarter guidance.


HTC said last month it expected its fourth-quarter revenue to be about T$ 60 billion ($ 2.05 billion), down from T$ 70.2 billion in the third quarter and below expectations of T$ 74.0 billion in a poll of 23 analysts by Reuters.


It expected a gross margin and an operating margin of around 23 percent and 1 percent, respectively, falling from 25 percent and 7 percent in the previous quarter.


The company said the operating margin would be hit by higher spending on marketing.


Analysts’ forecasts on how much HTC needs to pay Apple range from “not a very high price” to as much as over $ 10 per phone, though they remain best guesses, based partly on the assumed $ 10 royalty that phone makers pay Microsoft per Windows 7 phone, and on the $ 5-6 dollar that Android phone makers are believed to pay Microsoft after a separate lawsuit last year.


However, some analysts warn that HTC’s other challenges outweigh the settlement.


Its phones have lost a lot of their appeal among consumers as Apple’s iPhones and Samsung’s Galaxy series dominate shopping lists, drawing parallels with the decline of Finland’s Nokia, once one of the dominant mobile phone players.


“Nokia settled with Apple in 2011 by winning royalties from Apple, but it did not change the landscape at all for smartphone competition. Samsung continued to win market share despite the losses to Apple,” wrote Barclays analyst Dale Gai in a research note.


“We believe the lawsuits remain non-events in terms of HTC’s fundamentals. HTC’s challenges remain and could get worse into 2013 from more competition.”


(Editing by Jonathan Standing)


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BBC head says broadcaster must reform or die
















LONDON (Reuters) – Britain‘s BBC could be doomed unless it makes radical changes, the head of its governing trust said, after its director general quit to take the blame for the airing of false child sex abuse allegations against a former politician.


BBC Trust chairman Chris Patten said on Sunday confidence had to be restored if the publicly funded corporation was to withstand pressure from rivals, especially Rupert Murdoch‘s media empire, which would try to take advantage of the turmoil.













“If you’re saying, ‘Does the BBC need a thorough structural radical overhaul?’, then absolutely it does, and that is what we will have to do,” Patten, a one-time senior figure in Prime Minister David Cameron‘s Conservative Party and the last British governor of Hong Kong, told BBC television.


“The basis for the BBC’s position in this country is the trust that people have in it,” Patten said. “If the BBC loses that, it’s over.”


George Entwistle resigned as director general on Saturday, just two months into the job, to take responsibility for the child sex allegation on the flagship news programme Newsnight.


The witness in the Newsight report, who says he suffered sexual abuse at a care home in the late 1970s, said on Friday he had misidentified the politician, Alistair McAlpine. Newsnight admitted it had not shown the witness a picture of McAlpine, or approached McAlpine for comment before going to air.


Already under pressure after revelations that a long-time star presenter, the late Jimmy Savile, was a paedophile, Entwistle conceded on the BBC morning news that he had not known – or asked – who the alleged abuser was until the name appeared in social media.


The BBC, celebrating its 90th anniversary, is affectionately known in Britain as “Auntie”, and respected around much of the world.


But with 22,000 staff working at eight national TV channels, 50 radio stations and an extensive Internet operation, critics say it is hampered by a complex and overly bureaucratic and hierarchical management structure.


THOMPSON’S LEGACY


Journalists said this had become worse under Entwistle’s predecessor Mark Thompson, who took over in the wake of the last major crisis to hit the corporation and is set to become chief executive of the New York Times Co on Monday.


In that instance, both director general and chairman were forced out after the BBC was castigated by a public inquiry over a report alleging government impropriety in the fevered build up to war in Iraq, leading to major organizational changes.


One of the BBC’s most prominent figures, Newsnight presenter Jeremy Paxman, said since the Iraq report furore, management had become bloated while cash had been cut from programme budgets.


“He (Entwistle) has been brought low by cowards and incompetents,” Paxman said in a statement, echoing a widely-held view that Entwistle was a good man who had been let down by his senior staff.


Prime Minister Cameron appeared ready to give the BBC the benefit of the doubt, believing that “one of the great institutions of this country” could reform and deal with its failings, according to sources in his office.


Patten, who must find a new director general to sort out the mess, agreed that management structures had proved inadequate.


“Apparently decisions about the programme went up through every damned layer of BBC management, bureaucracy, legal checks – and still emerged,” he said.


“One of the jokes I made, and actually it wasn’t all that funny, when I came to the BBC … was that there were more senior leaders in the BBC than there were in the Chinese Communist Party.”


Patten ruled out resigning himself but other senior jobs are expected to be on the line, while BBC supporters fear investigative journalism will be scaled back. He said he expected to name Entwistle’s successor in weeks, not months.


Among the immediate challenges are threats of litigation.


McAlpine, a close ally of former Prime Minister Margaret Thatcher, has indicated he will sue for damages.


Claims for compensation are also likely from victims who say Savile, one of the most recognizable personalities on British television in the 1960s, 70s and 80s, sexually abused them as children, sometimes on BBC premises.


INQUIRIES


Two inquiries are already under way, looking at failures at Newsnight and allegations relating to Savile, both of which could make uncomfortable reading for senior figures.


Police have also launched a major inquiry into Savile’s crimes and victims’ allegations of a high-profile paedophile ring. Detectives said they had arrested their third suspect on Sunday, a man in his 70s from Cambridgeshire in central England.


Funded by an annual license fee levied on all TV viewers, the BBC has long been resented by its commercial rivals, who argue it has an unfair advantage and distorts the market.


Murdoch’s Sun tabloid gleefully reported Entwistle’s departure with the headline “Bye Bye Chump” and Patten said News Corp and others would put the boot in, happy to deflect attention after a phone-hacking scandal put the newspaper industry under intense and painful scrutiny.


He said that “one or two newspapers, Mr. Murdoch’s papers” would love to see the BBC lose its national status, “but I think the great British public doesn’t want to see that happen”.


Murdoch himself was watching from afar.


“BBC getting into deeper mess. After Savile scandal, now prominent news program falsely names senior pol as paedophile,” he wrote on his Twitter website on Saturday.


It is not just the BBC and the likes of Entwistle and Patten who are in the spotlight.


Thompson, whom Entwistle succeeded in mid-September, has also faced questions from staff at the New York Times over whether he is still the right person to take one of the biggest jobs in American newspaper publishing.


Britain’s Murdoch-owned Sunday Times queried how Thompson could have been unaware of claims about Savile during his tenure at the BBC as he had told British lawmakers, saying his lawyers had written to the paper addressing the allegations in early September, while he was still director general.


(Editing by Kevin Liffey and Sophie Hares)


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Next-day discharge after C-section may be okay: study
















(Reuters) – Some women who deliver their babies by cesarean section may be able to check out of the hospital the next day without raising their risk of problems, according to a Malaysian study.


The study, which appeared in the journal Obstetrics & Gynecology, looked at 360 women in Malaysia, who were randomly assigned to go home either one or two days after having a C-section.













Both groups were equally satisfied with their care, and the women who were discharged sooner seemed to have no more problems with breastfeeding or mental well-being.


“Day 1 discharge compared with day 2 discharge after a planned cesarean delivery resulted in equivalent outcomes,” wrote lead author Peng Chiong Tan, at the University of Malaya in Kuala Lumpur.


Those results don’t mean that hospitals should start discharging women the day after a C-section, but they do suggest that a next-day discharge is something women can talk about with their doctors, researchers said.


In the United States, where C-sections are done in about one-third of births, women typically stay in the hospital for three to four days after the procedure. That compares with about two days for women who deliver vaginally.


In the past, there were concerns about insurers pushing mothers to leave the hospital before they’re ready. That led to a 1996 law requiring insurers to pay for a 48-hour hospital stay after a vaginal delivery and a 96-hour stay after a C-section.


Still, the American College of Obstetricians and Gynecologists (ACOG) says a shorter stay after a C-section is an option if the baby is ready to go home, though the mother should meet certain requirements first such as normal blood pressure, no signs of infection and adequate pain control.


At Tan’s hospital in Malaysia, women who have a C-section are routinely told to expect just a two-day stay, and some providers there have discharged new mothers the day after.


Tan’s team randomly assigned the 360 women having a planned C-section to go home either one or two days after delivering. In the end, 16 percent of the women in the day-after group were not discharged that early, because either they or their babies were having problems.


But when they did go home the day after, there didn’t seem to be a greater risk of difficulties. When the women were interviewed two weeks later, 87 percent were happy with their discharge timing.


The same was true for almost 86 percent of women who went home two days after their C-section.


While the findings would likely extend to women in other countries too, these Malaysian women typically went home to a lot of support – often, an extended family network, Tan said.


“Where this support is not available, next-day hospital discharge may not be associated with the same degree of satisfaction, acceptability and good outcome as we have found,” she added.


SOURCE:http://bit.ly/TzbGoz


(Reporting from New York by Amy Norton at Reuters Health; editing by Elaine Lies)


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Twin explosions strike southern Syrian city
















BEIRUT (AP) — Syria‘s state-run news agency says two large explosions have struck the southern city of Daraa, causing multiple casualties and heavy material damage.


SANA did not immediately give further information or say what the target of Saturday’s explosions was.













The Britain-based Syrian Observatory for Human Rights says the blasts went off near a branch of the country’s Military Intelligence in Daraa.


The Observatory, which relies on a network of activists on the ground, says the explosions were followed by clashes between regime forces and rebels fighting to topple President Bashar Assad.


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