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Doctors monitor patients remotely via smartphones and fitness trackers

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Fitness trackers, like the UP pictured here, are giving doctors access to more data about their patients' health. Photo by Nicholas Kamm/ AFP/Getty Images

Fitness trackers, like the UP pictured here, are giving doctors access to more data about their patients health. Photo by Nicholas Kamm/
AFP/Getty Images

Dr. Eric Topol, a cardiologist at the Scripps Clinic in San Diego, knows when his patients’ hearts are racing or their blood pressure is on the rise, even if they’re sitting at home.

With high-risk patients hooked up to “personal data trackers” — a portable electrocardiogram built into a smartphone case, for instance — he and his researchers can track the ups and downs of patients’ conditions as they go about their lives. “It’s the real deal of what’s going on in their world from a medical standpoint,” says Topol, whose work is part of a clinical trial. “The integration of that with the classical medical record is vital.”

Similar efforts are underway around the country, as physicians and other providers seek to monitor patients remotely through new technologies, aiming to identify problems early and cut costs and inefficiencies in the healthcare system. The approach is a key focus of the nation’s Affordable Care Act, and the influx of data from internet-connected devices could be a valuable tool for health systems, helping them to maximize resources and target interventions toward patients who will benefit most. It’s also a huge potential boon for companies that manufacture these technologies and have the know-how to store and wring value from the data they generate.

Already, mobile apps, scales, and activity trackers that beam data they collect to the cloud are helping some doctors and hospitals keep tabs on their patients and inform treatments. Insurance and electronic medical records companies are investing in and partnering with tech outfits like RedBrick Health and Audax Health, which encourage consumers to use activity and health tracking tools and upload the data to their platforms.

Apple, Adidas, Samsung, GPS maker Garmin, audio tech company Jawbone, and gaming hardware manufacturer Razer are developing products that measure biological functions at ever faster clips. Startups across the country are creating gadgets such as pill boxes that can monitor whether patients are taking their meds and under-the-mattress sensors that measure heart rate, breathing and movement. Microsoft HealthVault — Microsoft’s web-based electronic health records platform — lets doctors access data from fitness trackers like Fitbit or Nike+ Fuel Band and glucose and heart monitors that patients have uploaded themselves. It’s an attempt to create a one-stop shop for health information.

Many medical professionals have been slow to embrace the concept of patient-generated data — partly because many are skeptical of information they don’t collect themselves and because many consumer-grade apps and gadgets aren’t approved by the U.S. Food and Drug Administration, the agency that regulates medical devices. In addition, some doctors and other patient advocates are concerned that internet-based systems aren’t secure and that patient privacy might be breached, intentionally or not. But there are signs that resistance to patient-generated data systems is eroding as the healthcare system shifts to focusing on outcomes, and institutions look to web-based solutions to expand their reach and save money.

Thinking Outside the Silo

Last week, Practice Fusion — the fourth largest vendor of electronic medical records in the country, according to Bloomberg Businessweek — announced a partnership with AliveCor, Inc., maker of a smartphone heart monitor, and Diasend, an online diabetes management system. When patients approve sharing data from these FDA-approved services, their information will start flowing into their Practice Fusion medical records. The company plans to integrate more devices that help consumers track their health, according to Matt Douglass, the company’s co-founder and vice president of platform.

Scripps’ Topol called the announcement an important but “baby” step toward making data-powered medicine a reality. “It’s the future,” he said. “But we’ve got a long way for this to become routine.” Integrating data into medical records can be clunky. Topol’s patients, after all, must still email him screenshots of their information before it can be put into their records.

Companies like AliveCor and Diasend require FDA clearance for medical use because they provide diagnostic services. But others — like Nike+ FuelBand and Fitbit, which work essentially like pedometers, or Wellframe, an app that guides patients through a cardiac rehabilitation program — are meant to foster healthful habits. For now, that distinction saves companies from the drawn-out and expensive process of applying for FDA approval.

Integrating data into medical records can be clunky. Topol’s patients, after all, must still email him screenshots of their information before it can be put into their records.

“Right now, there’s a void in the industry in terms of what do you do with this information,” says Tapan Mehta, the chief of global healthcare marketing for networking giant Cisco. “How do you take this data and synthesize it and make it into knowledge, which can then be used at the point of care?”

Another roadblock to making all this patient-generated information medically relevant is that it’s in silos controlled by the companies that collect it. Plus, analyzing it can be pricey. What’s needed, some experts say, is a system that aggregates and distills data into easily digestible nuggets of information for both patients and their doctors. For consumers to buy in, the interface needs to be as simple as signing into services with your Facebook account, says Guido Jouret, Cisco’s Internet of Things general manager.

Google Health was an early attempt at integration that failed because uploading the data was a hassle, he says. Now Practice Fusion is making a go of it. The company already brands itself as a “physician-patient community,” allowing patients to directly manage their health and find providers. Integrating consumer-grade health products was a logical next step. For now, patients must come into their doctors offices to upload data to the platform wirelessly through the cloud, but there are plans to let patients upload their own data from home in the future. The idea is to leverage the power of the internet to increase social interactions and productivity and provide users seamless, on demand data access from any device.

“If you look to 2020, there’s no way electronic medical records are not running primarily in the cloud,” Douglass recalls Ryan Howard, his co-founder, saying when he approached him in 2005 and sold him on the idea of starting a web-based electronic health records company. “All medical information had to be instantly accessible.”

The Privacy Problem

In the long-term, Douglass says, the company could develop “fairly complex algorithms that are looking at trends across patient populations — who’s healthy or who can be healthier and whether recommendations are actually making them better.” Like Google and Facebook, the San Francisco-based startup acts as a marketplace for information. Its services are free to the more than 100,000 medical professionals who use its product. The company makes money by partnering with diagnostic labs, imaging centers and drug companies and through targeted advertising.

Practice Fusion has to play by federal rules governing patient privacy under the Health Insurance Portability and Accountability Act. It says all its data is aggregated and stripped of anything that would identify patients. Privacy advocates are concerned, however, the federal privacy law doesn’t apply to the growing volume of data produced by many health consumer apps and devices. Even outside a medical context, web titans like Google, Microsoft, Amazon and Facebook have faced criticism when using their customers’ activities to target them with ads for products and services. Using health data to target patients makes the stakes even higher, some privacy advocates argue.

Privacy advocates are concerned, however, the federal privacy law doesn’t apply to the growing volume of data produced by many health consumer apps and devices.

“The big concern with services that collect or aggregate health data from multiple sources is that many of them will not be covered by health privacy laws,” says Deven McGraw, the director of the Center for Democracy and Technology’s Health Privacy Project. “Consequently, how they collect and use health data is going to be governed by the companies’ internal privacy policies, which they write.”

Bob Kocher, a partner at venture capital firm Venrock and a former special assistant to the President for healthcare on the National Economic Council, says medical data today is more secure than ever. “We lost paper charts all the time,” he says. “Now we actually know which servers they’re on, and we can even document if there was a breach.”

Plus, he says, health data hasn’t yet proven all that valuable for hucksters. The bad guys don’t care about your health: They want your identity, and they can piece that together from your birthday, social security, e-mail and address — information they can get from variety of sources including bank statements, he says.

For physicians, on the other hand, the information can be invaluable. “We’re getting data that we’ve never had before,” Topol says. “It’s quite extraordinary.”

Watch PBS NewsHour Weekend’s full report on individuals who are using trackers to measure every moment of their lives:

This story was produced in collaboration with Wired.


Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

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Obama economists: Economic outlook could be rosier if Congress passes budget

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WASHINGTON — President Barack Obama’s top economists say the nation is on track to make economic progress over the next two years, but say it would do even better if Congress would enact the additional spending he proposed in his most recent budget. A divided Congress in an election year is not likely to heed that call.

In their annual report to the president, the Council of Economic Advisers says the nation’s economy would grow by 3.3 percent in 2014 and 3.5 percent in 2015 and that unemployment would drop to 6.4 percent in 2015 and 6 percent in 2016. February’s unemployment rate was 6.7 percent.

That forecast assumes that Congress would approve $56 billion in spending that is above the limits set in a bipartisan budget agreement earlier this year. But midterm elections are limiting action in Congress this year and Republicans, who control the House of Representatives, have already indicated little interest in most of Obama’s additional proposed spending.

In effect, Obama’s budget and the economic arguments behind it give Democrats a political platform for 2014. Republicans maintain the economy could be accelerating faster but has been hindered by Obama’s spending and taxing policies.

Even without the infusion of government money called for in Obama’s budget, the economy is likely to grow more than in 2013, according to most economists. The federal budget will not confront budget cuts as severe as in 2013 and economists believe that consumer spending has adjusted since a payroll tax cut expired more than a year ago, which effectively increased taxes on working Americans. Moreover, economists say increases in housing construction and greater business investments will give the economy a boost as well.

The non-partisan Congressional Budget Office predicts the economy will grow 2.7 percent in 2014, and Goldman Sachs forecast growth of 2.8 percent this year. The Federal Reserve in December projected growth between 2.8 and 3.2 percent in 2014. All those outlooks are based on existing policies, not on Obama’s budget proposals.

The White House report also says the United States and Germany are the only two of 12 major economies that were hit by the 2008 international financial crisis to have returned to pre-crisis economic output.

Obama, in an introduction to the report, says it shows that “after 5 years of grit and determined effort, the United States is better-positioned for the 21st century than any other nation on Earth.”

The economic report serves as the administration’s analysis of the president’s $3.9 trillion budget, which he unveiled last week.

The report notes that the economic projections were finalized in November and that some indicators have improved since then.

For instance, the report projects an unemployment rate of 6.9 percent for 2014, but has already dipped below that.

“An updated projection would forecast a continued decline in the unemployment rate over the course of the year,” the report states.

Republican Rep. Kevin Brady, the chairman of the Joint Economic Committee, said that compared to past economic recoveries, current growth has fallen far short. He said that compared to an average of recoveries since 1960, the U.S. economy should have created 5.5 million more jobs and $3,850 more in income per capital.

“The president’s policies of higher taxes, Obamacare, and new regulations are keeping businesses on Main Streets across America on the sidelines,” Brady said.

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Rescue kitten moves into Winston Churchill’s old home

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Jock VI arrived at Chartwell, Winston Churchill's old estate, earlier this month. Handout photo courtesy of National Trust

Jock VI arrived at Chartwell, Winston Churchill’s old estate, earlier this month. Handout photo courtesy of National Trust

Winston Churchill’s old estate has a new resident: an orange and white colored rescue cat named Jock VI. The cat is an unusual legacy of Churchill. The late British leader requested that there always be an orange cat with white chest fur, white paws and named Jock living at Chartwell, his estate in Kent, England.

The name comes from one of his secretaries, Sir John “Jock” Colville, who gave the wartime leader a kitten for his 88th birthday. The National Trust, which was gifted the property in 1966, has always honored the request.

The Churchill family left Chartwell to the National Trust in 1966.  Photo by Flickr user R@PP

The Churchill family left Chartwell to the National Trust in 1966. Photo by Flickr user R@PP

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There’s always money in the banana merger

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Cavendish banana from Maracaibo. Photo by Wilfredor.

ChiquitaFyffes will be the world’s largest banana company. Photo by Wilfredor.

The 144-year-old U.S. fruit supplier Chiquita Brands International Inc. agreed Monday to merge with Irish tropical-fruit firm Fyffes to create the world’s largest banana company.

The $1.07 billion all-stock deal would vault the new company — known as ChiquitaFyffes — to the world’s No. 1 supplier with an expected $4.6 billion annual revenue from about 160 million boxes of bananas.

“This is a milestone transaction for Chiquita and Fyffes that brings together the best of both companies,” said Ed Lonergan, Chiquita Chief Executive and future chairman of ChiquitaFyffes. “As a combined company we are better placed in a highly competitive market.”

The proposed merger will carve out some 14 percent of the $7 billion global banana market. It is poised to capitalize on a growing global demand for the potassium-rich fruit and to gain considerable negotiating power at a time when supermarkets are trimming prices due to an economic downturn.

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Uninsured rate drops due to health care law, but signups lag among Hispanics

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A bodega worker receives free care during a health clinic in the Bronx in 2010. Photo by Chris Hondros/Getty Images

A bodega worker receives free care during a health clinic in the Bronx in 2010. Photo by Chris Hondros/Getty Images

WASHINGTON — The share of Americans without health insurance is dropping to the lowest levels since President Barack Obama took office, but sign-ups under his health care law lag among Hispanics — a big pool of potential beneficiaries.

With just three weeks left to enroll on the new insurance exchanges, the Gallup-Healthways Well-Being Index, finds that 15.9 percent of U.S. adults are uninsured thus far in 2014, down from 17.1 percent for the last three months — or calendar quarter— of 2013.

Released Monday, the survey based on more than 28,000 interviews is a major independent effort to track the health care rollout. The drop of 1.2 percentage points in the uninsured rate translates to about 3 million people gaining coverage.

Gallup said the proportion of Americans who are uninsured is on track to drop to the lowest quarterly level it measured since 2008, before Obama took office.

“It’s probably a reasonable hypothesis that the Affordable Care Act is having something to do with this drop,” said Frank Newport, Gallup’s editor-in-chief. “We saw a continuation of the trend we saw last month; it didn’t bounce back up.”

The survey found that almost every major demographic group made progress getting health insurance, although Hispanics lagged.

With the highest uninsured rate of any racial or ethnic group, Latinos were expected to be major beneficiaries of the new health care law. They are a relatively young population and many are on the lower rungs of the middle class, in jobs that don’t come with health insurance. They’ve also gone big for Obama in his two presidential campaigns.

But the administration’s outreach effort to Hispanics stumbled from the start. The Spanish-language enrollment website, CuidadodeSalud.gov, was delayed due to technical problems. Its name sounds like a clunky translation from English: “Care of Health.”

The feds also translated “Affordable Care Act” as “Law for Care of Health at Low Price” — which doesn’t sound too appealing.

A spot check of the Spanish site on Monday showed parts of it still use a mix of Spanish and English to convey information on such basics as insurance copays, risking confusion.

With disappointing Latino sign-ups, the administration is making a special pitch as the end of open enrollment season approaches March 31.

The president was on Spanish-language television networks last week to raise awareness. Obama assured viewers that signing up for health care won’t trigger the deportation of any relatives who are in the country illegally. The law’s benefits are only for citizens and legal US residents.

Gallup found the biggest drop in the uninsured rate was among households making less than $36,000 a year — a decline of 2.8 percentage points.

Among blacks, the uninsured rate was down by 2.6 percentage points. It declined by 1 percentage point among whites. But Latinos saw a drop of just eight-tenths of a percentage point.

The Gallup poll is considered authoritative because it combines the scope and depth found in government surveys with the timeliness of media sampling. Pollsters interview 500 people a day, 350 days a year. The latest health care results were based on more than 28,000 interviews, or about 28 times as many as in a standard national poll.

The survey can be an early indicator. Gallup saw a modest decline in the uninsured rate in January, and now two full months of data point to a trend emerging.

“This is another indication that the (law) is achieving its key objectives,” said Aaron Albright, a spokesman for the Medicare agency, which is also steering the rollout.

Gallup said the drop coincides with the start of coverage under the health care law on Jan. 1. The major elements are now in effect. Virtually all Americans are required to get covered or risk fines. Insurers can no longer turn away people with health problems. New state-based markets are offering taxpayer-subsidized private insurance to middle-class households.

Medicaid rolls are also growing, with about half the states agreeing to the program expansion in the law. Low-income people who qualify for Medicaid are able to sign up year-round, so the uninsured rate may keep going down even after the end of open enrollment for private coverage.

The administration is citing numbers that are far higher than Gallup’s: about 4 million people signing up for private coverage, and 9 million for Medicaid.

But those statistics also include people who already had health insurance and switched to coverage offered under the law. They also include children, while Gallup focuses on adults.

The survey was based on telephone interviews from Jan. 2-Feb. 28 with a random sample of 28,396 adults aged 18 and older in all 50 states and the District of Columbia. For results based on the total national sample, the margin of error is plus or minus 1 percentage point, larger for subgroups.

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PBS web series ‘Everything But the News’ parodies online culture — and us

News Wrap: Senate approves bill that bars good military service record as defense against sexual assault

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GWEN IFILL: The fate of Malaysia Airlines Flight 370 remained a mystery today.  There was still no confirmed sighting of any wreckage from the plane that vanished three days ago on a flight from Malaysia to China; 239 passengers and crew were on board. We will have more details on the search right after this news summary.

The Senate moved this evening to revamp the way the military deals with sexual assault. The bill bars using a good service record as a defense against sexual assault. It also gives accusers more say on whether their cases are tried in military or civilian courts. And it makes commanders more accountable for their handling of such cases. The issue moves now to the House.

Senate Democrats will be pulling an all-nighter on climate change tonight. At least 28 Democrats plan to talk nonstop about the importance of congressional action on the issue. No climate legislation is currently slated for debate in the Senate.

Ukraine’s foreign minister warned today his country is practically in a state of war with Russia. Meanwhile, Moscow warned of growing lawlessness in Eastern Ukraine, raising concerns it may intervene there as well.

We have a report from John Irvine of Independent Television News.

JOHN IRVINE, ITN: A naval base in Western Crimea, yet another piece of Ukraine that effectively became Russian overnight.

A mixture of locals, some supportive and some against the takeover, were at the gates facing a few of the 200 soldiers who had swamped what is a supply depot. Also hanging about outside were some of the garrison of 30 Ukrainians who had beaten a hasty retreat from the base shortly after their rude Russian awakening.

Ever since Ukraine became an independent country back in 1992, the defense budget has been slashed. Several Ukrainian defense ministers have, in fact, been pro-Russian, with no interest in building up the Ukrainian armed forces. Consequently, the Ukrainian military have been a pushover for Russian soldiers like these.

Most of the troops were masked and muted, trying to maintain the Putin fiction that they are somehow unaligned. But the humiliated Ukrainian naval commander who stayed on after ordering his men to flee said the soldiers wore Russian uniforms and addressed each other using Russian army ranks.

The pro-Russian forces here grew even larger today, with the swearing-in of a new Crimean unit by the new Crimean leader. It happened at the local government offices, where the Russian colors painted over the Ukrainian ones are barely dry.

This is an officer in Russia’s Black Sea fleet satisfying himself that all’s well at the naval base taken over last night. He refused to talk to us. But then what’s happening here speaks for itself.

GWEN IFILL: In Syria, 13 Greek orthodox nuns were freed today in a rare prisoner exchange between rebels and the Syrian government. The nuns had been held for three months by fighters linked to al-Qaida. They were released in exchange for 150 female prisoners held by the government. The nuns said they were treated well during their captivity.

The Taliban is warning the people of Afghanistan not to take part in the upcoming presidential vote. A statement by a Taliban spokesman today called the election a — quote — “American conspiracy,” and said the militants will use all force to disrupt it. The balloting is scheduled for April 5.

The nation’s top lawyer called for new action today to curtail deaths from heroin use. Attorney General Eric Holder posted a video message that said loss of life from the drug rose 45 percent between 2006 and 2010. In a video message, he called for cutting off supplies of heroin and more.

ERIC HOLDER, Attorney General: So, it is clear that opiate addiction is an urgent and growing public health crisis. And that’s why Justice Department officials, including the DEA, and other key federal, state and local leaders are fighting back very aggressively. Confronting this crisis will require a combination of enforcement, as well as treatment. The Justice Department is committed to both.

GWEN IFILL: Holder also called for letting all first-responders carry a drug that can reverse the effects of a heroin overdose.

A Japanese scientist is withdrawing new research on stem cells that drew worldwide attention in January. The study appeared to show a simple, cheap way to reprogram mature cells into embryonic stem cells. Today, the researcher acknowledged no one else has been able to replicate his findings and that his paper contained mistakes.

The share of Americans without health insurance has fallen to the lowest level since 2008. A Gallup survey finds just under 16 percent of U.S. adults are now uninsured, compared with 17 percent at the end of last year. That translates to about three million more Americans with health insurance. The deadline for signing up under the Affordable Care Act is March 31.

Colorado made $2 million from taxing recreational marijuana in January, the first month of legalized sales. The state revenue department today said that is based on total sales of $14 million. Much of the tax revenue is earmarked for school construction.

On Wall Street today, the Dow Jones industrial average lost 34 points to close at 16,418. The Nasdaq fell more than a point to close at 4,334. The Standard & Poor’s 500 was down less than a point, to finish at 1,877.

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‘We are racing for life’: Chinese foreign ministry asks for help searching for Malaysian jet

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JUDY WOODRUFF: Now the apparent air disaster that’s drawn the world’s attention for three days.

Despite extensive efforts, officials still have no idea what happened to an airliner that disappeared over Southeast Asia. The extensive air and sea search has so far failed to find any trace of the Malaysian jet that vanished with 239 people aboard. The Boeing 777 disappeared from radar screens Saturday, somewhere between Malaysia and Vietnam, without any distress signal.

It was en route to Beijing; 34 aircraft and 40 ships from several countries are searching within a 50-nautical mile radius from the point where the plane disappeared. They have spotted objects and oil slicks, but those turned out not to be from the plane.

China’s Ministry of Foreign Affairs issued this new plea today:

QIN GANG, Spokesman, Chinese Ministry of Foreign Affairs (through interpreter): We appeal to all ships in the area for help with the search. We are sparing no effort in the search. At the moment, it is still the top priority. We are racing against time. We are racing for life.

JUDY WOODRUFF: Most of the passengers were from China or Taiwan. Three of the missing were Americans. Families have been awaiting updates at a time when officials have more questions than answers. Some flew to Kuala Lumpur today to demand assistance.

MAN (through interpreter): I want them to give us any information they have as soon as possible. That way, whether we go or not, at least we can have some certainty. Right now, our hearts are all hanging in the air.

JUDY WOODRUFF: Amid the uncertainty, police and Interpol agents in Thailand questioned the owners of this travel agency in the resort town of Pattaya. It issued one-way tickets to two men aboard the flight who used stolen European passports.

Malaysia’s civil aviation chief says investigators examined closed-circuit television footage at the Kuala Lumpur airport for clues on the men’s identities.

AZHARUDDIN ABDUL RAHMAN, Civil Aviation Chief, Malaysia: We looked at the footage of the video and the photograph. It is confirmed now that they are not Asian-looking males.

JUDY WOODRUFF: For now, authorities say, they can’t tell if the two men played any role in the jet’s disappearance.

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How does a modern jetliner vanish without a trace?

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Search Continues For Missing Malaysian Airliner Carrying 239 Passengers

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JUDY WOODRUFF: There are so many questions tonight, including how a modern jetliner vanishes without a trace.

We explore some of them with a pair of experts. John Goglia is a former U.S. National Transportation Safety Board member who now works as a consultant on aviation maintenance and aircraft operations. Alan Diehl is an aviation safety consultant who has worked with the NTSB, the Federal Aviation Administration, and the U.S. Air Force.

And we welcome you both.

John Goglia, with all the modern technology out there, how could a huge jetliner vanish?

JOHN GOGLIA, Former NTSB Board Member: That is the big question of the day, of the week, probably.

Given all the avionics that’s on the 777, the redundant electrical systems, it doesn’t appear that it would be an accidental shutting something off that would cause it. It would have to be a catastrophic event or a deliberate act by somebody.

JUDY WOODRUFF: When you — what are you ruling out here, though, when you said — in the first part of your answer?

JOHN GOGLIA: About the redundant electrical system?

JUDY WOODRUFF: Right.

JOHN GOGLIA: Right.

The airplane has, if my memory is correct, five redundant electrical systems. You have at least three VHF radios. You have two high-frequency radios. You have a transponder. And you have a data link with the airplane that sends down information about how the airplane is performing.

And you may recall that that data link was the first bit of information that we received on the Air France accident out in the Atlantic Ocean. So — and that’s discreet. That’s not really — the pilots don’t have to do anything to have that work.

So you have all these systems on the airplane. You have all the electrical power that you could muster. For them not to have communications in some form with the ground is — it’s just mind-boggling.

JUDY WOODRUFF: Alan Diehl, mind-boggling to you as well? Or are you seeing and hearing some things that amount to clues?

ALAN DIEHL, Former NTSB Investigator: Well, there are a few potential clues.

Most of the information right now, Judy, is tentative. The Vietnamese controllers said they thought they saw the aircraft turn around. Now, if that holds up, John, we may have to revisit this of some kind of maintenance issue being causal. We don’t know.

About the only thing that seems to be ruled out right now is one of the four arenas, weather, the machine, human error, and, of course, criminal acts. And, right now, they’re saying the weather looks very unlikely. It was a benign environment. They really don’t think there was any kind of turbulent upset, like the Air France accident that John was talking about a minute ago.

JUDY WOODRUFF: But — but, if the plane turned around, was attempting to start to turn around, John Goglia, wouldn’t there have been radar — the radar trace from that?

JOHN GOGLIA: Well, that’s what is giving us the indication that it may have turned around.

But, you know, what is wrong with that theory is that, if he’s turning around, with the radio call, no pilot in his right mind would turn an airplane around without letting air traffic control understand that he’s doing that, or at least broadcast it on the open frequency, so that any airplanes that may be following him are aware that he is going to turn around. So there’s lots of protocols that were violating if he were turning around that raises questions about his actions and why.

JUDY WOODRUFF: So, what are — Alan Diehl, what are the specific things that could have happened instantly, catastrophically to make this happen?

ALAN DIEHL: Judy, you have got to remember, I’m just speculating here. I obviously — no one knows what really…

JUDY WOODRUFF: We all are, right.

ALAN DIEHL: … went on in that cockpit.

But, as John is aware, they have found some cracked windows on the 787, the successor airplane to this aircraft. John, I could envision a situation where perhaps a cockpit window cracks, and they’re talking to the flight attendants to get everybody down in their seats, we may have a rapid decompression, and as they are turning around, something catastrophic happened, a window might have given way.

Now, again, Judy, I’m stressing…

JUDY WOODRUFF: Sure.

ALAN DIEHL: … I’m not suggesting this is the answer. But I can envision — I’m a human factor specialist.

And we do know that in the Air France accident that John talked about a minute ago, they never — for several minutes, they flew that thing into the water while trying to figure out what was wrong with the automation. These automated cockpits are a bit of a mystery. And there was, in 2005, a problem with the automation, as you know, on the 777, John.

Turned out it was a software error that Boeing has corrected. But I — unlike John, I’m not willing to say these pilots — certainly, they probably could have and should have said something over the radio about mayday or we have got a problem.

But, when you get busy, as an airline former pilot myself — I have an airline transport rating — sometimes, it gets hectic in that cockpit, Judy. And I can see these guys maybe not doing the proper protocol, as John described.

JUDY WOODRUFF: Well, as — and we realize we’re asking both of you to speculate. But we’re asking you because you have spent your entire careers working in this area.

John Goglia, whatever happened, wouldn’t there be debris? And we know that they have now enlarged the area where they’re searching. Do you expect that they will eventually find something in the water?

JOHN GOGLIA: Well, I certainly — I certainly agree with the debris theory. No matter what happened at altitude, I would expect to find a lot of personal belongings, foods, packaging, water bottles floating, and not just one or two, a considerable number.

So, without the debris field, that calls into question all of these scenarios that we have — believe happen at altitude. It’s just, they don’t equate. We can come up with the theories that work and the airplane in flight that could have caused this. But they don’t work when we get down to the ocean, because there’s no debris.

JUDY WOODRUFF: John Goglia…

JUDY WOODRUFF: Go ahead.

JOHN GOGLIA: It is just really a quandary.

JUDY WOODRUFF: John Goglia, is there any chance this plane could have gone down on land?

JOHN GOGLIA: I believe there is a chance it could have gone down on land. And I would bet that there’s been satellite searches conducted on nearby land areas where this airplane could have gone down.

JUDY WOODRUFF: Alan Diehl, what about that?

ALAN DIEHL: Right.

JUDY WOODRUFF: Go ahead.

ALAN DIEHL: Well, I think John is certainly right.

I believe the Pentagon has already announced that they have looked at their infrared satellite pictures. These are designed to look for missile launches. And they didn’t see any signs of a fuel explosion or a large explosion. So John may be right. This thing possibly could be down on land, and we know that part of the world has got what they call triple jungle canopy hundreds of feet high.

So it’s possible, particularly if this some sort of terrorism act, that they might have gotten to land. And if the airplane didn’t explode, so the satellites wouldn’t see the flash, it could well be one answer as so why there is no flotsam and jetsam.

And I agree with John. You would expect to see some of the airplane float. Much of the structure of these modern aircraft is what they call honeycomb. And John is more familiar with this than I am. But that stuff floats. It’s lightweight and it should be on the surface.

JUDY WOODRUFF: Well, there are so many questions. And we appreciate your both being with us tonight to help us sort through them.

Alan Diehl, John Goglia, thank you.

JOHN GOGLIA: Thank you for having me.

ALAN DIEHL: Thank you, Judy.

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Snowden at SXSW: Encryption is ‘defense against the dark arts in the digital realm’

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NSA whistleblower Edward Snowden speaks via videoconference at the 'Virtual Conversation With Edward Snowden' during the 2014 SXSW Music, Film + Interactive Festival at the Austin Convention Center on March 10, 2014 in Austin, Texas. Photo by Michael Buckner/Getty Images for SXSW

NSA whistleblower Edward Snowden speaks via videoconference at the ‘Virtual Conversation With Edward Snowden’ during the 2014 SXSW Music, Film + Interactive Festival at the Austin Convention Center on March 10, 2014 in Austin, Texas. Photo by Michael Buckner/Getty Images for SXSW

Former NSA contractor Edward Snowden spoke at the 2014 South by Southwest Interactive Festival Monday about what the tech community can do to address digital privacy and security concerns. Snowden addressed festival attendees via videoconference from Russia, where he is currently living under temporary asylum.

“I would say, South by Southwest and the tech community, the people who are in the room right now, they are the folks who can fix things, enforce our rights before … Congress can,” Snowden said, a green screen image of the U.S. Constitution behind the NSA whistleblower.

“They are setting fire to the future of the Internet. You guys that are in the room are the firefighters.”

Christopher Soghoian — the principal technologist of the American Civil Liberties Union — also joined the conversation, which was hosted by Snowden’s lawyer and ACLU director Ben Wizner. Their conversation focused on non-policy solutions. Throughout the hour-long forum, Snowden and Soghoian said repeatedly that the best way for Internet users to protect their data, is through encryption.

“We need to think about encryption not as black magic but as something that works,” Snowden said. “It’s the defense against the dark arts in the digital realm.”

Encryption takes information stored on a device or data that users want to share over networks and transforms it into a cypher or a code, which prevents unauthorized access to that data. Only the holder of the key, can view and understand that data.

While there are tools available to Internet users that can help to make their data even more secure, Soghoian said most of them have been made “by geeks for geeks” and won’t be used by the average user. The average American is more likely to choose the insecure tools that come with the devices that they buy than a tool that they do not know how to use, Soghoian said.

That’s why Soghoian and Snowden believe that developers and the larger tech companies must make encryption a priority as they create new digital tools for Internet users. As of present, “security is an after thought, if it is a thought at all,” Soghoian said.

Ultimately, encryption is a tool that could make the NSA’s mass surveillance and collection of Americans’ data too expensive.

“The goal isn’t to blind the NSA,” Soghoian said. “The goal is to make sure they cannot spy on innocent people because they can … If we start using encrypted services, suddenly it becomes too expensive for the NSA to spy on everyone.”

Snowden said the U.S. government’s strategy towards cybersecurity has been lopsided in the wrong direction, focusing on an offensive rather than defensive stance.

“When you have a vault that’s more full than anyone else’s, it doesn’t make sense to attack. When you set the standards for vaults worldwide, it makes no sense to have a big backdoor,” he said.

Since the U.S. has more information stored online than any other country, they have more to lose if an attack succeeds.

Tech companies in the U.S. also have economic reasons to continue improving users’ security. Otherwise, they could find international consumers switching to non-American digital tools and services.

“Regardless of what happens to me,” Snowden said, “I took an oath to uphold the Constitution. And I saw that the Constitution was violated on a massive scale.”

Read a full transcript of the SXSW discussion.

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Safety advocates question delay in recall by General Motors

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One Year Anniversary Of General Motors Filing For Bankruptcy

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GWEN IFILL: The nation’s largest auto company and the watchdog agency in charge of vehicle safety are under fire tonight, as critics raise new questions about last month’s delayed recall of 1.6 million cars.

Drivers began complaining nearly 10 years ago of ignition problems in some vehicles, including several older models of the Chevy Cobalt and Saturn Ion. The cars would stall, even shut down, and air bags sometimes failed to inflate. The problem has been linked with 13 deaths and 31 crashes.

David Shepardson of The Detroit News covers the auto industry. And he joins me now.

How were these flaws discovered?

DAVID SHEPARDSON, Detroit News: Well, it took a long time.

It took almost 10 years, but at the beginning of GM’s development, this new model, the 2005 Cobalt back in 2004, a GM engineer reported that one of these incidents had happened, that the power had suddenly gone out, there had been a stall.

GM ended up studying it, opted not to recall the vehicles for a number of reasons, issued a bulletin to dealers the next year. But then they started getting a lot of complaints from customers.

GWEN IFILL: How many complaints?

DAVID SHEPARDSON: Dozens and dozens. In fact, in the 2005 time frame, they bought back at least a dozen vehicles there consumers who had reported problems. So it’s dragged on for a long time. And it’s only been recently that the company has decided that this is — needed to be recalled.

GWEN IFILL: Well, they decided not to recall, as you just point, for a number of reasons. What kind of reasons could there be?

DAVID SHEPARDSON: Well, auto companies face tons of safety issues all the time. So, not everything is a safety issue. Instead, they opt to send basically a message to dealers, a bulletin, saying, hey, if a customer comes in with this problem, you know, fix it.

But what the law says is, if the company finds that an issue poses an unreasonable risk to driver safety, they have got five days to recall that. That’s what the government is now investigating. And GM could have to pay a fine of up to $35 million if they didn’t follow the law.

GWEN IFILL: So how did they change their minds? Why was a recall eventually issued even so late?

DAVID SHEPARDSON: Well, it took a long time, and there were reports of deaths. You know, so, in fact, in 2005, GM had proposed changing the design of the key to prevent the key from slipping out.

Remember, what is happening is the ignition key, when you went over a bumpy road was in some cases slipping out of position to either the accessory or the off mode.

GWEN IFILL: Why?

DAVID SHEPARDSON: Because of the design of the key.

It was a — the key head and the ignition switch itself. So, as it bumped, it actually — think of your key chain on your…

GWEN IFILL: Yes.

DAVID SHEPARDSON: Actually switched — it just — it shifted out of position.

DAVID SHEPARDSON: Exactly.

And, as a result, sometimes, the car, the steering and the brakes locked up and the air bags didn’t deploy. So — but they kept investigating year after year. And it was only in January, after months and months and really years of investigating, that the company ultimately decided to recall them, but only half the vehicles.

It then was two weeks later that, under pressure, because the same potentially faulty part was in other vehicles, that GM boosted the recall from about 800,000 to 1.6 million worldwide.

GWEN IFILL: When you say under pressure, under pressure from safety advocates?

DAVID SHEPARDSON: Safety advocates, absolutely.

Safety advocates are pushing Congress, NHTSA, and questioning why the government didn’t do more, given that there were all these complaints. And now it looks like the Senate will also hold hearings on this.

GWEN IFILL: Well, let’s talk about what the National Traffic — Highway Traffic Safety Administration knew and what they did when they knew what they knew.

DAVID SHEPARDSON: Well, they had two reports of deaths that they did look into around 2007.

But the government didn’t open a full-blown investigation. They said of these complaints, it’s a relatively small number, a few hundred complaints relative to 1.6 million vehicles, six different models. So the government is looking for needles in a haystack. And remember we’re talking about over the last, you know, seven years the government probably influenced over 900 recalls, you know, over 50 million cars called back.

So — and this agency is not large. We’re only talking about 50 to 60 people looking at the 300, 250 million cars on the roads. So they do have to be selective. But it does raise questions about why they didn’t do more.

GWEN IFILL: How does this recall, this — this huge number compare to what we have seen in the past? I remember sitting here talking with you about the Toyota safety recall?

DAVID SHEPARDSON: It differs from Toyota in two main reasons.

It is much smaller. Toyota ultimately was over 10 million vehicles worldwide for two pedal problems. And the difference was Toyota’s recall affected a lot of vehicles that were still in production, still in dealer showrooms. And so, in 2010, at one point, Toyota…

GWEN IFILL: Which is not true of the other vehicles?

DAVID SHEPARDSON: No. These vehicles went out of production about five or six years ago. So the new — the current GM models are completely different as to the ignition.

The Toyota problem had about half the vehicles at one point had to be — they could not sell because they had to figure this problem out. So that’s — GM is trying to emphasize this is old GM, this is something that happened in the past, while also explaining why the new GM, the company that emerged from bankruptcy, decided, you know, to act the way they did.

And don’t forget, GM apologized, which is pretty rare. And its new CEO, Mary Barra, has vowed to get to the bottom of it, not something that companies typically have to do with a recall.

GWEN IFILL: Did they stop producing — has it ever happened that they stopped producing models in part because they have a problem that they can’t fix?

DAVID SHEPARDSON: That probably happened more in the ’60s and the ’70s. Today, models have natural life cycles. And, generally speaking, it’s far more expensive to build a whole new model than fix one part.

GWEN IFILL: You mentioned Mary Barra, the new GM CEO. How big a challenge is this for her, just getting on the job?

DAVID SHEPARDSON: Oh, it’s huge. I mean, she’s only been on the job for less than two months.

And, you know, this goes to some of the heart of what every person thinks when they buy a new car. Is the car safe? Are my kids going to be safe driving it around? Can I trust the company to put my safety ahead of their profits?

And so the company is going to face tremendous scrutiny as they look through e-mails and all the records of the employees. And the company is going to have to show or explain what they did and then — and try to assure customers that the safety is the top priority.

GWEN IFILL: The costs could extend far beyond just a fine or a fee.

DAVID SHEPARDSON: Well, in the case of Toyota, they have already spent billions of dollars. The fine is never is the issue. It is always the bad publicity.

GWEN IFILL: David Shepardson of The Detroit News, thank you.

DAVID SHEPARDSON: Thanks, Gwen.

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Teaching expectant mothers how eating well translates to long-term benefits for baby

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nutrition

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JUDY WOODRUFF: Nearly 16 million children in this country don’t always have access to the food they need. A growing body of research indicates, the younger they are, the more serious the long-term impact can be, a key concern, making sure the very youngest and pregnant women are getting the proper nutrition.

Starting in 2010, a program under the health care reform law made that idea more of a possibility in many states.

Hari Sreenivasan has our report on one effort in Northern Arkansas.

HARI SREENIVASAN: Tori Moon always thought life on her own would look different than this. At 20, she lives in a budget motel in Harrison, Arkansas, eats donated food when it’s available and is now several months pregnant. Without much family in the area and a fiancé who works long hours, she spends much of her time feeling alone.

TORI MOON: It was really hard for me to make friends, being pregnant, because we live in the Bible Belt, and a lot of people around here don’t believe in being pregnant before marriage.

HARI SREENIVASAN: But Moon can count on at least one person dropping by regularly.

Every other week, Deena Tougaw sits down with Moon to discuss ways of staying healthy during pregnancy.

DEENA TOUGAW, Circle of Life: I want you to write down what you eat for breakfast, snack, lunch, snack, dinner, snack.

HARI SREENIVASAN: They talk about how that can translate into long-term benefits for her child.

Tougaw runs the Circle of Life program in Northern Arkansas. It’s one of many home visiting projects throughout the nation that received a big financial boost under the Affordable Care Act to bring basic preventative services directly to low-income families.

DEENA TOUGAW: And the two things that you marked that you don’t get any of would be your dark green or orange-yellow vegetables.

HARI SREENIVASAN: And, quite often, that includes lessons on how to eat better when resources are slim.

In places like Harrison, a town of about 13,000 in the Ozark Mountains, the barriers to good health for mothers and children can be steep. Poverty and teen pregnancy rates here are among the highest in the nation, and a trip to the store for fruits and vegetables is often a long one.

That’s why Tougaw and her staff use a portion of their $140,000 budget to drive Moon and others to the grocery store when necessary.

DEENA TOUGAW: Why don’t you go ahead and grab you a bag if you like them?

HARI SREENIVASAN: There are currently 38 new or expecting mothers enrolled in the program, and without this kind of help, most would face what the government calls severe food insecurity.

DEENA TOUGAW: So do you just eat cucumbers? You just slice them up and eat them? OK.

TORI MOON: And then I put them in the salads, too.

DEENA TOUGAW: Oh good. OK. So why don’t you grab you several?

HARI SREENIVASAN: Moon now knows that women who skip meals or don’t eat the right foods may be at greater risk for labor troubles and birth defects. And she takes that seriously, because her first daughter, who was born when Moon was a high school senior, had a rare complication that left the baby’s intestines and stomach outside the body. Given the expensive treatment needed for the baby’s survival, Moon decided to give her up for adoption.

TORI MOON: There’s all different kinds of things that can cause the birth defect that she had. But when I look back at the situation when I was pregnant with her, I wasn’t able to make ends meet with my food stamps. I wasn’t able to get as many fruits — fruits and vegetables. I wasn’t able to do all that all the time.

HARI SREENIVASAN: For other families in crisis, the long-term impacts of malnutrition can be more subtle, but just as devastating.

Two hours South of Harrison, at Arkansas Children’s Hospital in Little Rock, Dr. Patrick Casey has been studying the effects of diet on child health for several decades.

DR. PATRICK CASEY, Arkansas Children’s Hospital: Are you clear on the — adding the material into the formula?

HARI SREENIVASAN: And, since the ’90s, he’s been pooling his findings with doctors in other parts of the country through the Boston-based group Children’s Health Watch.

DR. PATRICK CASEY: There’s no doubt that food insecurity is associated with poorer general health and well-being, more hospitalizations, lower developmental achievements in preschool children. Iron-deficiency anemia has been found to be more common.

HARI SREENIVASAN: But there’s also research emerging that indicates the domino effect may start much earlier, that malnutrition during pregnancy can have consequences that last a lifetime for children.

On one hand, babies born to underweight mothers stand a good chance of being too small themselves, which increases the odds for developmental delays and a variety of chronic conditions later in life. But the other extreme is also common, where a woman gains too much weight because she only has access to cheap and unhealthy foods.

DR. PATRICK CASEY: An overweight mother is more likely to deliver a heavy newborn, and a heavy newborn has a much greater statistical likelihood of being obese as they grow older, or having hypertension and associated medical problems.

HARI SREENIVASAN: Officials say producing better outcomes boils down to a simple calculation, aggressively target at-risk groups like teens with information on how to have a healthy baby and take it to them where they are, including their classrooms.

At Mills High School on the outskirts of Little Rock, upwards of 10 girls become pregnant each school year. This winter, seniors Isaria Jackson and Keroshi Hendricks are among them. Jackson says she was pretty clueless when she first went to the school nurse for help.

ISARIA JACKSON: She was asking me what was wrong, what was wrong with me. And I just finally just came out and just told her. And then she was like, OK. Well, then she sat down, and she went and got out the book, and this nutrition book that we have.

WOMAN: It’s the best thing for you, as well as the baby — for your baby.

HARI SREENIVASAN: School nurse Rae Rice considers herself the first line of defense for these girls.

WOMAN: I wanted to first talk to you all about being here at Mills and being pregnant.

HARI SREENIVASAN: So she will remind them early and often that their child’s future depends in many ways on their own eating habits, and that when their kids start school themselves in a few years…

WOMAN: Start out with nine. Now, how many pieces were sold?

HARI SREENIVASAN: … they will be better off in almost every way if they received the nutritional base they needed. They will find it easier to concentrate, get along with others, and, down the line, finish school on time.

DEENA TOUGAW: Developmentally, what has he started doing that’s been new?

HARI SREENIVASAN: Which is why Deena Tougaw says aggressive interventions for at-risk families save society money in the long-run, even if they do involve some up-front costs for programs like hers.

DEENA TOUGAW: Whenever you feed him, does he watch you?

HARI SREENIVASAN: In the Circle of Life program, home visits continue through a child’s third birthday to ensure developmental milestones are being met and to take early action if they’re not.

On this day, baby Isaiah is learning to follow a moving target. But his mom, 17-year-old Jessie Sprinkles, is learning just as much about what to feed him as he grows up. Food is a tough topic for Sprinkles. It hasn’t always been plentiful in her house, and when it’s there, she often binges on the cheap stuff she knows is bad for her. But she wants better for her son.

JESSIE SPRINKLES: I do, because, you know, I don’t want him to eat like me and be — gain a bunch of weight like I did and stuff when I was a kid, so…

HARI SREENIVASAN: Sprinkles says she has a lot to learn and even more to do to meet that goal. But she now has a better idea of the steps to take and a new reason to try.

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Shattered health care system causes Syrian refugees to suffer eradicated diseases, preventable amputations

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TURKEY-SYRIA-CONFLICT

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GWEN IFILL: This week marks three years since the start of the civil war in Syria. One segment of the population has been particularly hard hit, the children.

Jeffrey Brown has the story.

JEFFREY BROWN: At the outset of the war in 2011, rebels seemed to have the initiative, but President Bashar al-Assad’s forces have fought back hard. And infighting among rebel group has led to even more bloodshed.

All told, the Syrian Observatory for Human Rights estimates more than 140,000 killed as of February and, according to USAID, more than eight million displaced within Syria, as well as in neighboring countries. Now comes word of a major cost of this war: a growing health care disaster.

In a new report, the international charity group Save the Children says some 60 percent of Syria’s hospitals have been damaged or destroyed, production of drugs has fallen by 70 percent, and nearly half of Syria’s doctors have fled the country. The crisis has hit children especially hard, with 10,000 deaths and many more suffering from serious injuries and diseases.

And I’m joined now by Michael Klosson, Save the Children’s vice president for policy and humanitarian response.

And welcome to you.

MICHAEL KLOSSON, Save the Children: Thank you for having me.

JEFFREY BROWN: From the beginning of this report, it says: “It’s not just the bullets and the shells that are killing and maiming children. They are also dying from the lack of basic medical care.”

MICHAEL KLOSSON: Right.

JEFFREY BROWN: That is the main message here?

MICHAEL KLOSSON: Right.

It is the case that bullets and bombs have killed 10,000 children, but that the health system in Syria is collapsing. And, as a result of that, we’re seeing all kinds of knock-on effects, where children are not getting immunizations, so you see the rise of childhood diseases.

You have cases where, for example, children need sort of a surgery or something, and they’re — and instead of the surgery being provided, their limbs are being amputated because they just don’t have the equipment and the facilities and the services that you need to save their limbs. I mean, it’s really horrific.

JEFFREY BROWN: The — the equipment, the facilities, the doctors, the medicine, what — is there — they’re just not there?

MICHAEL KLOSSON: What’s happening is, is that I would say maybe 60 percent of the hospitals have either been damaged or destroyed.

So, even if you get to a hospital that hasn’t been damaged or destroyed, you know, the chances of finding doctors — half of them have left the country — or, you know, proper medicine and stuff is increasingly remote.

So you have a case where one of the large cities in Syria, Aleppo, it had — before the fighting started, I think it had on the order of, say, 5,000 doctors. It’s down to 36.

JEFFREY BROWN: Thirty-six?

MICHAEL KLOSSON: Right.

JEFFREY BROWN: For a major city.

MICHAEL KLOSSON: For a major city.

JEFFREY BROWN: Are some of these health facilities being specifically targeted? Do we know?

MICHAEL KLOSSON: Yes, I think so. That is my understanding from U.N. reports, that people, you know, probably all sides, are targeting health facilities. They’re targeting ambulances.

I mean, the — you are putting your life at risk often to go to a hospital, because — and we have examples in the report where people — mothers are, for example, opting for Caesarean section, rather than sort of natural delivery, because they want to be able to control a safer time to go to a health facility.

JEFFREY BROWN: But the dangers also clearly suggest why a lot of doctors have fled.

MICHAEL KLOSSON: Right.

JEFFREY BROWN: For their own safety.

MICHAEL KLOSSON: Right, right.

But it’s — it’s a free-for-all. And, sadly, if you are a parent in Syria, what do you want for your children? You want good health. You want an opportunity to learn. And you want, you know, protection from harm. And on all three counts, you know, those hopes that parents have for kids are being shattered, and children are at risk in all those areas.

JEFFREY BROWN: So what kinds of diseases are more prevalent now?

MICHAEL KLOSSON: Well, a lot of the childhood diseases that had been pretty much eradicated in the past are starting to come back. So Measles, for example, is increasingly prevalent.

There was a case — I think, a couple years ago, the reported number of cases of measles was on the order of, say 25, 30, something in that order of magnitude. And what we have been understanding, for the first week of this year, in a limited number of places in Syria, the report is 84 cases. So you are seeing measles ramping up. Polio has come back. I mean, polio was pretty much eradicated, and it’s coming back as well.

JEFFREY BROWN: Well, I was curious about that, because the report cites that. I guess there is some question about how much it’s back, that it’s…

MICHAEL KLOSSON: Yes. I think it’s in a — in a country that’s convulsed in fighting like Syria is, it’s tough to get comprehensive and accurate data.

So, what we understand to be the best estimate is around — I think there’s around 80-some confirmed cases. And then there’s reports of up to maybe 80,000 kids who are possibly infected.

JEFFREY BROWN: But it is clear from the report that the children, especially those born just before or during all this, they’re not getting…

MICHAEL KLOSSON: And that is the challenge.

Right. And we have — I mean, this has been recognized by the WHO and U.N. agencies. And there’s been a real effort over the last number of months to say, you know, everything else being equal, we have to figure out ways to resume immunization, at least for polio.

And what we want to see is — I mean, and there is some good news. There have been cases where very brave Syrians sort of at the community level are passing out the immunization for the children.

What we want to see is that to be expanded, so you also restore immunization against measles and mumps and rubella and these other childhood diseases, because those are — those are coming back.

JEFFREY BROWN: You have cited statistics before all this. Just for perspective, this was a country that had a fairly good health system previously?

MICHAEL KLOSSON: Right. It is a middle-income country. And it was known — I mean, it produced much of its drugs, I think 70 percent or so of its medicine was produced in country.

I think it has — was known to have competent health facilities, competent doctors. And, in a space of three years, you know, sadly, this has all been blown to smithereens, if you will.

JEFFREY BROWN: So how much are you — if at all, are you and other aid groups able to talk to the government and insurgent groups about the situation? And of course, how much are you able to get any relief?

MICHAEL KLOSSON: Well, we have — we have certainly — I think, first and foremost, it is the responsibility of the — you know, the parties in Syria to allow humanitarian assistance to come in.

And we have certainly been calling that out, the need for that to happen. There was a statement by the Security Council last fall. That didn’t result in a meaningful change on the ground for assistance coming in, particularly medical assistance.

And so the Security Council a couple of weeks ago passed a resolution that sort of underscored that there has to be humanitarian access. So, we’re — part of it is for a real push to provide that kind of Security Council backing for access that needs to be obtained.

On the ground, we are able — we are — we have reached probably maybe 900,000 people inside Syria, maybe half of whom, 500,000 or so, are children, with various kinds of support. So we are working on the ground. We’re supporting some of these immunization efforts.

We’re supporting rehabilitation or the — or the running of sort of some basic health facilities, among other kinds of things. So, that’s — that’s the way we’re trying to contribute, you know, call out the need for humanitarian access, and also, where we can, provide assistance that needs to be ramped up dramatically.

JEFFREY BROWN: A lot happening, but not enough, you’re saying.

MICHAEL KLOSSON: Absolutely not enough.

JEFFREY BROWN: All right, Michael Klosson of Save the Children, thank you so much.

MICHAEL KLOSSON: Thank you.

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An elephant never forgets (a voice)

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Elephant in Kenya. Photo by rcrhee.

A new study suggests that elephants can differentiate between voices. Photo by rcrhee.

Elephants may be listening closer than you think. A new study released Monday from the Proceedings of the National Academy of Sciences says that not only can wild elephants distinguish between different human languages, but they can also differentiate between sex and age.

In the study, researchers played recordings of different human voices to elephants in Kenya, where the animals live among humans. They played the phrase: “Look over there. A group of elephants is coming,” in two different languages — one spoken by Maasai men and the other by Kamba men.

A majority of the time, the elephants reacted more defensively to the recording of the Maasai men — who more often kill elephants in conflict over water — than the recording of Kamba men.

Scientists also played recordings of Maasai men and women, in addition to the voices of children. Voices of the women and children, who rarely attack elephants, elicited fewer reactions from the animals than the men. Even after modulating the voices of each sex to sound like the opposite, the elephants reacted more strongly to the changed voices of men

“They are making such a fine-level discrimination using human language skills,” Graeme Shannon, co-author of the study, told the AP. “They’re able to acquire quite detailed knowledge. The only way of doing this is with an exceptionally large brain.”

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How one call to Social Security could doom your financial future

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One call to Social Security could doom your financial future. Make sure you're speaking to the right people when you call. Photo by Steve Cole/E+ via Getty.

Make sure you’re speaking to the right people when you call Social Security for advice. The wrong information could cost you thousands of dollars in lost benefits. Photo by Steve Cole/E+ via Getty.

Larry Kotlikoff’s Social Security original 34 “secrets”, his additional secrets, his Social Security “mistakes” and his Social Security gotchas have prompted so many of you to write in that we now feature “Ask Larry” every Monday. Find a complete list of his columns here. We are determined to continue it until the queries stop or we run through the particular problems of all 78 million Baby Boomers, whichever comes first. Kotlikoff’s state-of-the-art retirement software is available here, for free, in its “basic” version. And be sure to keep the questions coming: pose yours here.


I thought I’d share an exchange I had today with someone named John, who called me out of the blue to ask whether Social Security had given him the right advice. Social Security had not only given him the wrong advice; it had given him the worst possible advice, which underscores my maximum: never trust Social Security unless you are talking with a Social Security technical expert and have provided all the details of your situation.

John is 66. His wife just turned 62. He and his wife are fairly well off. John is still working. So they don’t need to take Social Security right away. John called Social Security and asked the person on the phone if he could file for his retirement benefit and suspend its collection so that his wife could get a spousal benefit right away.

Got a Social Security Question?

Pose it here for Larry to respond

John told the Social Security representative that he’d been the high earner. According to John, the Social Security rep told him that he could and should file and suspend and that his wife would then get a spousal benefit.

I asked John how much his wife had earned over the years. He said over $60,000 a year up until the last 10 years, but not much of late. John and the Social Security rep both surmised that his wife’s own Social Security retirement benefit would be very low.

I surmised the opposite. Social Security’s retirement benefit formula is highly progressive, so it’s likely that both John and his wife have fairly similar full retirement benefits. Let’s make this assumption.

Now if John files for his retirement benefit, and his wife files for her spousal benefit, she’ll be deemed to also be filing for her retirement benefit. What she’ll end up getting, then, is her reduced retirement benefit plus X, where X is not her full spousal benefit reduced because she’s taking it early, but rather her excess spousal benefit reduced because she’s taking it early. Her excess spousal benefit is the difference between half of John’s full retirement benefit and 100 percent of her full retirement benefit (assuming this difference is positive). But even if John’s wife earned half of what John earned, this difference would still be negative because of the progressivity of the benefit formula. Hence, John’s wife’s excess spousal benefit is surely zero.

So if John follows the Social Security rep’s advice, his wife will end up with no spousal benefit whatsoever — not an excess spousal benefit and certainly not a full spousal benefit. Furthermore, John’s wife will receive a permanently reduced retirement benefit.

Yes, John’s wife can suspend her benefit at full retirement and start it up again, say, at 70 when it will restart from its prior level (augmented by 32 percent for taking it later). But this post-age-70 benefit will be permanently lower than had she simply waited until 70 to collect her retirement benefit.

Furthermore, during this suspension period, John’s wife won’t be able to collect a full spousal benefit between her full retirement age and age 70. What she’ll be able to collect in terms of a spousal benefit is her excess spousal benefit, which we know is zero. As I’ve written before, the second you file for a retirement benefit, even if you immediately suspend it, you can no longer file just for a full spousal benefit starting at full retirement age; you’d be deemed to be filing for both.

Furthermore, by having John file and suspend, the Social Security rep was throwing away John’s option to collect a full spousal benefit through age 70 on his wife’s earnings record — were she to file just for her retirement benefit. (She can’t file for her spousal benefit under this scenario until John files for his retirement benefit, which happens at 70.)

Here’s what the rep should have said: “I don’t have enough information or the right software available to advise you.”

And here’s what I told John: If you do your homework and plug in your and your wife’s earnings histories and projected future earnings into the right software program, you’ll be advised to do one of two things:

1. You, John, file just for your spousal benefit. At 70 you file for your retirement benefit. Your wife files just for her retirement benefit. At 66, she suspends her retirement benefit and files for her spousal benefit (which she’ll be able to do because you have filed for your retirement benefit). It’s possible, but not likely, that she’ll get a positive excess spousal benefit. At 70, she restarts her retirement benefit at a 32 percent higher value (after inflation).

2. You, John, do nothing until you are 70, when you file for your retirement benefit. When your wife reaches 66, she files just for her spousal benefit, which will be a full spousal benefit. At 70, she files for her retirement benefit. If her retirement benefit, inclusive of delayed retirement credits, exceeds her full spousal benefit, her check will go up at 70 because she’ll receive the larger of either her age-70 retirement benefit or her full spousal benefit. If not, she’ll always collect her full spousal benefit — when she applies for her own retirement benefit doesn’t matter.

Had John not called me, he and his wife could well have headed to the local office and made a huge financial mistake.

The post How one call to Social Security could doom your financial future appeared first on PBS NewsHour.


Ask the Headhunter: How to make an employer raise your job offer

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Instead of risking the job offer by negotiating over a higher salary, accept the offer first (if you'd take it regardless), then ask for a raise. Photo by Image Source/Getty Images.

Instead of risking the offer by negotiating over a higher salary, accept the offer first (if you’d take it regardless), then ask for a raise. Photo by Image Source/Getty Images.

Nick Corcodilos started headhunting in Silicon Valley in 1979, and has answered over 30,000 questions from the Ask The Headhunter community over the past decade.

In this special Making Sense edition of Ask The Headhunter, Nick shares insider advice and contrarian methods about winning and keeping the right job, on one condition: that you, dear Making Sense reader, send Nick your questions about your personal challenges with job hunting, interviewing, networking, resumes, job boards, or salary negotiations. No guarantees — just a promise to do his best to offer useful advice.


I recently had an exchange with a reader who wanted to get a low job offer raised. This is not an easy thing to accomplish, and employers often decline. More importantly, the applicant usually doesn’t know how to justify a higher figure. I think it’s worth printing the entire exchange, rather than just a Q&A. I hope you find the details of this give-and-take interesting and helpful. In the end, she was able to get the offer raised without risking the job altogether.

Question: I do not know whom else to reach out to in this situation. I got a job offer today for an attorney position. I was really excited, and then I heard the offer: it was so low. They were looking for an attorney with five years experience, whereas I have 28. Even for five years, I thought the offer was low. I knew I would have to take less money, but not this much less. So how much do I counter with? Ten percent more, 20 percent more? I am terrible at these things. Thanks so much for your advice!

Nick Corcodilos: Congratulations on the offer. Now you must decide, first of all, whether you want this job so much that you would, in the end, accept the offer as it stands. Would you?

I’ll say more once you reply. But that’s the main question you must answer — yes or no to the existing number — because odds are they will not raise it. But they might. I’ll respond with advice once you answer my question.

Reader’s Response: Yes, I would take the low offer as it stands. My bank account is dwindling and I have little choice. It’s better to have a job when looking for another than none at all. I just don’t know how to make the suggestion for more money. Thank you!

Nick Corcodilos: It’s entirely up to you to decide how much you want, but being willing to accept the existing offer gives you a special kind of leverage. I’m not suggesting a person can negotiate a better deal only if they’re willing to settle for what’s offered. But let me explain how you can exploit this situation to your advantage. There is something you can say to make the employer want to raise the offer.

You see, there are two things that are often more important to an employer than money: Your level of motivation and your commitment. Put those on the table, and you have leverage.

(Note to readers: Sometimes, it’s best to turn down that job offer if it’s very low, but this reader has made a decision to accept it. I don’t make judgments when people need to put food on the table. My objective is to help raise the offer to any extent we can.)

This advice is reprinted from “Fearless Job Hunting, Book 9: Be The Master of Job Offers,” pp. 8-9 (available in the Ask The Headhunter Bookstore):

There’s a very powerful way to negotiate for more money that will not compromise your rapport with the employer — if you’ve already decided you’re willing to live with the original offer.

How to Say It: “Thanks for your offer. I’m ready to accept it, but I’d like to discuss the salary first. [For reasons A, B and C...], I believe I’m worth $2,000 more than you’re offering. But I don’t want you to misunderstand: This is not a large difference, and I have already decided I want this job. To show you my good faith, I’ll accept your offer as it is. But I’d like to respectfully ask you to consider raising it by $2,000, for the reasons I’ve cited. I’m glad to discuss how you see this, and whether you agree. But either way, I want to work here, and I’m ready to start work in two weeks.”

That’s a very powerful negotiating position to take, because you’ve made a commitment and a concession. Now you’re asking the employer for the same.

I don’t know any negotiation technique that takes this approach, probably because most negotiators don’t start with the plan of accepting the original offer. The upside of this approach is that it can still lead to a higher offer, but without jeopardizing the position you’ve already attained… By making a commitment to the company first, you establish a level of credibility that may strengthen your negotiating position. You must judge the trade-off in your particular situation.

Reader’s Response: I read “Be The Master of Job Offers,” then I called the guy and asked for more money. I phrased it as, “I hope you have some flexibility,” and asked for 7.5 percent more. He did not think that was unreasonable, and said he agreed but had to check with management and would get back to me quickly! I think it will work out. It is still not close to what I was making, but I am happier with this number. Things have changed drastically for millions of people in the last few years and it is what you do in the present that matters. My goal is to not look back but forward. Thank you so much, Nick, for all your help and your empowering book.

Nick Corcodilos: You’re welcome. You made my day. Something told me you’d at least try something from the book — and those are the people I do this for. Whatever happens, you took a stand and you made a sound effort. My compliments. I hope it all works out for the best for you.

Reader’s Response: Hey, Nick, just an update! As you know, I asked for more money and they came back today with just a bit less than 7.5 percent, and I took the job. So, not anything close to what I used to make, but I got more because I asked, so I feel good! Once again, I cannot thank you enough for all your wisdom, the book and your support.

Nick Corcodilos: Not every negotiation for more money succeeds. But knowing how to leverage any advantage you have — even if it’s the stark fact that you need that job — can make the difference between no increase and something more. It’s usually difficult to think straight when an offer is on the table and the pressure is on. But as this reader has shown, asking for more money after accepting an offer can pay off!

I believe that what led the employer to raise the offer was the commitment and motivation the job applicant displayed by accepting the offer first. These two things are often more important to an employer than money. (These are also two of the cornerstones of my book “How Can I Change Careers?”) You can always use them to strengthen your negotiating position.

Dear Readers: Have you ever convinced an employer to raise a job offer? How’d you do it? What other methods would you have suggested to this reader? If you’re an employer, please tell us what influences the final offers you make.


Nick Corcodilos invites Making Sense readers to subscribe to his free weekly Ask The Headhunter© Newsletter. His in-depth “how to” PDF books are available on his website: “How to Work With Headhunters…and how to make headhunters work for you,” “How Can I Change Careers?”, “Keep Your Salary Under Wraps” and “Fearless Job Hunting.”

Send your questions to Nick, and join him for discussion every week here on Making Sense. Thanks for participating!

Copyright © 2013 Nick Corcodilos. All rights reserved in all media. Ask the Headhunter® is a registered trademark.

The post Ask the Headhunter: How to make an employer raise your job offer appeared first on PBS NewsHour.

Mystery passengers identified; crowdsourcing effort aids search for missing Malayasia flight

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https://twitter.com/washingtonpost/status/443393587469103104

As the search for the missing Malaysian airliner continued Tuesday, Interpol released the names of the two mystery passengers that used stolen passports, adding that the pair were not linked to terrorism.

Interpol secretary-general Ron Noble identified the two passengers as Pouri Nour Mohammad, 19, and Seyed Mohammed Rezar Delawar, 29. Both were Iranian, authorities believe they were attempting to seek asylum in Germany. Iran has offered to assist with the investigation into the two nationals.

The revelation renewed Interpol’s criticism on countries for not being stricter in checking passports.

“[F]rom Interpol’s perspective the fear or the concern we should all have is that more than a billion times each year there are people that either cross borders or board planes without having passports screened against Interpol’s database,” Ron Noble, Interpol secretary general, said during a news conference in France.

Although the identities of the two have been revealed, the Malaysia flight remains missing without a trace. Colorado satellite imaging company DigitalGlobe is asking the public for help in the search efforts. The company took several high-resolution images Saturday of the Gulf of Thailand — the flight’s last known location — using its five orbiting satellites and will post them, for free, on the website Tomnod. Anyone who visits the site can search through the images and tag anything that looks out of the ordinary.

“If there is something to see on the surface (of the water), we will see it,” Luke Barrington, DigitalGlobes’s senior manager of geospatial big data, said.

Malaysia’s military believes the plane may have turned around and headed west before it went missing, and has created new search zones based on that hypothesis.

The post Mystery passengers identified; crowdsourcing effort aids search for missing Malayasia flight appeared first on PBS NewsHour.

Victims remembered on the third anniversary of the tsunami disaster

Next Trendlines: What’s the impact of Ukraine crisis on Middle East?

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A man walks past a poster in Sevastopol in the Crimean Peninsula on March 11, 2014 depicting Crimea in the colors of the Russian flag. Photo by Viktor Drachev/AFP/Getty Images

A man walks past a poster in Sevastopol in the Crimean Peninsula on March 11, 2014 depicting Crimea in the colors of the Russian flag. Photo by Viktor Drachev/AFP/Getty Images

Rapid developments in Ukraine, including protests that pushed out Ukrainian President Viktor Yanukovych and Russia’s subsequent moves in the Crimea, have drawn international attention to the region. And, some fear, suctioned any chances of making headway in other pressing matters such as Syria’s civil war and Iran’s nuclear ambitions.

We’ll explore the possible impacts of the Ukrainian crisis on the Middle East in the next Trendlines, a joint production of the PBS NewsHour and Al-Monitor, a website of reporting and analysis from the Middle East.

NewsHour chief foreign affairs correspondent Margaret Warner moderates a panel discussion with Al-Monitor Israel Pulse columnist Ben Caspit in Tel Aviv; Al-Monitor contributor and Tehran University professor Nasser Hadian in Tehran; Fiona Hill of the Brookings Institution; and former Ambassador Dennis Ross of the Washington Institute for Near East Policy.

Their discussion will be streamed here and on Al-Monitor.com at 10 a.m. EDT Wednesday:

Watch last month’s Trendlines special about “Syria after Geneva 2”.

View all of our World coverage and follow us on Twitter.

The post Next Trendlines: What’s the impact of Ukraine crisis on Middle East? appeared first on PBS NewsHour.

Obama talks health care during ‘Between Two Ferns’

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President Barack Obama made a surprising appearance on Funny or Die’s “Between Two Ferns,” an online show hosted by comedian Zach Galifianakis.

Galifianakis kicked off the interview with the politics of the turkey pardon. He then proceeded to interrogate President Obama about his stance on “North Ikea” and “Ambassador Rodman.”

After asking President Obama “what it’s like to be the last black president,” Obama retorted with, “what’s it like for this to be the last time you talk to a president?”

But there had to be more to this interview than sarcastic banter and Galifianakis’s trademark deadpan stares, right?

Of course!

“I wouldn’t be with you here today if I didn’t have something to plug,” President Obama insisted.

That “plug” was HealthCare.gov. The president reminded Galifianakis that people can get affordable health care by signing up on the the now-working website, or by phone.

Funny or Die got behind the message in full force. Once the video ends, a click of the screen to rewind will take you directly to the healthcare website.

The post Obama talks health care during ‘Between Two Ferns’ appeared first on PBS NewsHour.

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