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Looking beyond the polls in this year’s election

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Supporters of U.S. Democratic presidential candidate Hillary Clinton and Republican presidential Donald Trump cheer outside a campaign event in Williamson, West Virginia, United States, May 2, 2016.     REUTERS/Jim Young  - RTX2CIFI

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Read the full transcript below.

ALISON STEWART, PBS NEWSHOUR WEEKEND ANCHOR: With 57 days until Election Day, Democratic presidential candidate Hillary Clinton maintains a lead over Republican Donald Trump in most national opinion polls. An ABC News-“Washington Post” poll out this weekend shows Clinton favored by 46 percent of likely voters and Trump, 41 percent.

Statewide polls have also shown Clinton with a significant advantage in the Electoral College map that determines who wins the White House. But this election season has been unpredictable and there are more to these polls than just the status of the frontrunners.

To dig a bit deeper, we are joined by “NewsHour Weekend’s” special correspondent, Jeff Greenfield.

Jeff, we can get caught up in the horserace of it all but there’s something more to talk about in these polls.

JEFF GREENFIELD, NEWSHOUR WEEKEND SPECIAL CORRESPONDENT: For me, one of the most interesting numbers is the relatively high percentage of voters who are either undecided at this point or leaning towards one of the third or fourth party candidates, Gary Johnson or Jill Stein.

This is — for this time in the cycle, that’s unusually high. And I suspect this is because these are two historically unpopular party nominees. The other interesting thing is that, you’d understand why Jill Stein would be taking most votes away from Hillary Clinton, she’s on the left, but you’d expect that a Libertarian like Gary Johnson would be drawing more from the right but if you match these numbers up, he seems to be marginally hurting her more.

And again, I can’t prove this but my notion is, these are people who really don’t want to vote for Trump but cannot or have not yet been persuaded to move to Hillary Clinton. And most significant part of Johnson’s numbers is, in some states, he’s in double digits. If he gets somehow, unlikely it’s going to be, to 15 percent, he gets into the debates.

STEWART: That’s a game changer, right?

GREENFIELD: A phrase I’ve never heard before.

STEWART:
Yes.

GREENFIELD:
It is indeed, because the one thing we know about third party candidates is both the presidential level with Ross Perot, back in ’92 and it’s statewide level is, you put an independent candidate in those debates and automatically he or she stands as an equal to major party candidates. That to me is one of the most significant things to watch before the presidential commission has to figure this out.

STEWART: What do you think of the imbalance in the resources between the two campaigns? When you look at the numbers the Clinton campaign has, 6 to 1 in some cases in terms of what they’re spending, why is that, would Trump ever try match that?

GREENFIELD:
He’s now in the point last cycle, last couple of weeks, where he’s only down two to one. I’ve talked to any number of people and said, well, how come that disparity hasn’t shown up in the polls which in fact have tightened?

There are all kinds of explanations. One is that free media, what people see every night and on the news and get on their devices overwhelms paid media. Second is, well, maybe it did have an impact in increasing Trump’s unfavorable ratings. Some people have complained that Clinton’s messages isn’t positive enough and then there are people who say, you know what, a lot of what spent in advertising may just be wasted.

We’re not going to know the end of this campaign, what impact that had. But it’s worth pointing out that in the primaries, Trump spent a tiny fraction of what his opponents spent on ads and get out the vote operations and won.

STEWART: Let’s talk about the economy, let’s talk about the GDP, are those things going to end up being the most important thing ultimately?

GREENFIELD: You know, there is a whole cottage industry in academia that say if you look — if you understand the right numbers, and they don’t agree on the right numbers but they’re basically economic, gross domestic product, is what happens in inflation or unemployment, some people throwing the incumbent president’s approval ratings, but whatever the mix is, they will tell you that months in advance they have a pretty good idea who’s going to win. And most of the time, if you go back and look, those pre-election year forecasts have looked good.

The problem is, this year, I’ve looked at five different forecast, two of whom said the Democrats will win, two of whom said the Republicans should have an edge, one says, I don’t know. The point about that is, if the so-called fundamentals are marginals, come out like one or two point spread, then there’s other stuff, ads get out the votes, the data analytics that we did a piece on some months ago, that Trump completely has not used.

That can make a difference and the stuff that academics often think doesn’t matter that much, that we focus on the gaffes of what happens in a specific debate, even something like today’s health episode that involved Hillary Clinton, they ordinarily say that has marginal impact. In the race where the fundamentals tell you this is going to be a close election, they may matter more than in the past.

STEWART: Jeff Greenfield, thanks so much.

GREENFIELD: Nice to be here.

The post Looking beyond the polls in this year’s election appeared first on PBS NewsHour.


After 9/11, Americans ‘summoned strength to carry on,’ Obama says

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U.S. President Barack Obama places a wreath during a ceremony marking the 15th anniversary of the 9/11 attacks at the Pentagon in Washington, U.S., September 11, 2016.      REUTERS/Joshua Roberts - RTSN88Y

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ALISON STEWART: The ceremony in New York marked the moment when the first plane hit the trade center’s north tower. Jerry D’Amadeo’s father, Vincent, worked on the 103rd floor for the brokerage firm Cantor Fitzgerald, which lost 658 people that day.

JERRY D’AMADEO: Today, I’m proud to be here to memorialize my father. This is the place that gives me the chance to think about beautiful memories.

ALISON STEWART: Family members led the reading of the nearly 3,000 names inscribed on the national memorial to all 9/11 victims — office workers, plane passengers, emergency responders, members of the military.

When the second plane hit the south tower 17 minutes after the first, Howard Kestenbaum was working inside for Aon insurance. His wife remembered him today.

GRAVILETTE KESTENBAUM: Those of us who’ve lost our loved ones to violence form a kind of group. We know the shock and grief and anger that follows, the heartache that won’t heal.

ALISON STEWART: A half hour after the trade center attack, 230 miles south of New York City, a third plane hit the pentagon — killing 59 people on the plane and 125 people inside the building. President Obama spoke to survivors and victims’ families there.

PRESIDENT OBAMA: Even as you’ve mourned, you’ve summoned the strength to carry on. And in your grief and grace you have reminded us that together there is nothing we Americans cannot overcome.

ALISON STEWART: After the trade center’s south tower fell…Four minutes later, a fourth plane crashed in the western Pennsylvania town of Shanskville. Today, loved ones remembered the bravery of the 40 passengers and crew of united Flight 93, who fought back and thwarted hijackers’ from reaching the u-s capitol in Washington.

The massive twin towers fell in under two hours. A striking image of today’s ceremony was the teenagers reading the names of their parents. Parents who missed out on their childhood.

FAMILY MEMBER OF VICTIM: I love you, Papi, and we miss you, and I know you’re watching over us.

Dad, the whole family misses you. It’s been 15 years. This year, I’m applying to college, and I know I’ll make you proud

ALISON STEWART: After his brother was killed on 9/11, Joe Quinn joined the army and served in Afghanistan and Iraq.

JOE QUINN: Looking back, it was hard to get through those weeks following 9/11, but an important part of me misses those days, because as a country, we were never more united, we were never more inspired. I know in our current political environment, it may feel that we’re divided. Don’t believe it.”

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FDA weighs crackdown that could shut hundreds of stem cell clinics

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A scientific researcher extracts the RNA from embryonic stem cells in a laboratory. Photo by Getty Images

A scientific researcher extracts the RNA from embryonic stem cells in a laboratory. Photo by Getty Images

Scientists on Monday will urge the Food and Drug Administration to crack down on rogue clinics across the country that market stem cell treatments for a dizzying array of ailments from autism to paralysis to erectile dysfunction.

But the move comes at an awkward time — because research on stem cell treatments is just starting to bear fruit.

Tantalizing results from a series of small studies suggest injections with certain types of stem cells may be effective treatments for conditions such as stroke and multiple sclerosis. The results have energized patients and doctors, who are expected to bombard the FDA with pleas to leave commercial stem cell clinics alone, in the name of speeding research and giving desperate patients hope.

Academic researchers will be left to walk a delicate line: Acknowledge the progress they’ve made in developing stem cell therapies — and then make the case that such treatments aren’t yet ready for prime time, and especially not in for-profit clinics.

There are now more than 500 stem cell clinics in the United States. Many charge $5,000 to $20,000 for injections of “stem cell” solutions that may not contain the same kind of stem cells used in controlled experiments — and indeed may not contain stem cells at all.

Because they generally use cells they’ve isolated from a patient’s own fat, and because those cells are considered only “minimally manipulated,” the FDA has not regulated the treatments as it would a traditional pharmaceutical. But safety concerns have spiked — some patients have gone blind after treatment, and others have developed tumors — so the FDA is now proposing to regulate the cells as drugs, meaning clinics would have to go through a costly and rigorous approval process before treating patients.

“It would put an end to any cell therapy now being offered in the US,” said Dr. Leslie Miller, a cardiologist from Tampa, Fla., who has studied stem cells for the past decade.

Miller argues that such a stern crackdown would hinder research progress: “We need an approach that’s more pragmatic.”

Patients who want immediate treatment for their conditions — and clinic owners who want to sell those treatments — say the FDA is being pressured into taking a tough line by academics and pharmaceutical giants who want to control, and profit from, the stem cell industry.

“The problem is, if we do well, it hurts their business plan,” said Dr. Mark Berman, a plastic surgeon in Beverly Hills, Calif., who is scheduled to testify.

Back in 2002, Berman cofounded a chain of clinics called the Cell Surgical Network. He says he and other physicians in the network have conducted some 5,000 stem cell treatments — including on himself and his wife — for conditions such as arthritis and hip, back and joint pain. He called the draft regulations arbitrary and hypocritical.

A ‘hype machine’ in overdrive

The fight over regulation comes at a time when leading stem cell researchers, after years of disappointing results, are increasingly excited about new studies showing the cells appear to be safe and may be effective in treating a variety of crippling diseases, including macular degeneration and Parkinson’s.

“It’s a very exciting time,” said Sally Temple, a stem cell researcher at the Neural Stem Cell Institute in Rensselaer, N.Y. “We’re going to see many treatments for diseases that are currently untreatable.”

The results researchers are so excited about are only possible because of decades of tedious work to establish safety protocols, test concepts and learn how to grow, produce, and manipulate stem cells, she said.

“It’s hard to have people understand how long this whole process takes,” said Temple, who also serves as president of the International Society of Stem Cell Research. “You would not believe what we have to do in my lab to prepare cells properly.”

Researchers in favor of an FDA crackdown warn that the new crop of studies are small — one involves just a single patient — and far from definitive. Some have not yet been published. They also note that some experimental treatments have highly toxic side effects.

And they worry that if the FDA does not act, more and more patients who hear about the promising but very preliminary study results will seek care at unregulated, for-profit clinics, which may not have the expertise to properly prepare and administer stem cell treatments, or which may not even be using actual stem cells in their injections.

“Academics and stem cell researchers are part of the problem,” said Leigh Turner, a bioethicist at the University of Minnesota who has been urging the FDA for years to shut down private stem cell clinics. “They give sober talks on the spread of red-flag clinics — but whether they like it or not, they are part of the stem cell hype machine.”

“You see scientists issuing press releases describing patients getting out of wheelchairs and walking. They sound just like the clinic operators,” he said.

The FDA has shut down a handful of the more than 550 commercial stem cell clinics in the US, mostly over concerns about sterility, but many critics say that’s just a drop in the bucket.

“The clinics are doing an unapproved and for-profit gigantic human experiment,” said Paul Knoepfler, a stem cell researcher at the University of California, Davis who has extensively and repeatedly chastised the FDA for non-action on his blog The Niche.

Tantalizing hints of the promise of stem cells

Stem cells can be extracted from a number of different tissues. They’re highly flexible and can turn into other kinds of cells — heart cells, say, or retinal cells. That ability lets them act as a kind of internal repair system.

Stem cells extracted from bone marrow have long been used to treat cancer, and blood and immune disorders. Now a variety of types of stem cells are being tested in a slew of other applications.

For example, a team at Stanford and the University of Pittsburgh announced in June in the journal Stroke that they had restored mobility in some stroke patients by injecting a particular kind of modified stem cell directly into their brains. Most stroke patients don’t improve much after six months, but some who received the treatment gained mobility a year or more after their strokes. Some who had been confined to wheelchairs even began to walk.

Dr. Gary Steinberg, a neurosurgeon at Stanford and the study’s lead author, said he thought the cells might be helping by secreting factors that led to the regeneration or reactivation of patient’s cells. “We didn’t imagine we could restore neurologic function in these chronic stroke patients with severe disability,” said Steinberg.

But the study involved just 18 patients; Steinberg is recruiting 156 more for additional study.

In another promising effort, a team from the University of Southern California this week announced they had restored some mobility in a 21-year-old man, Kris Boesen, who had become paralyzed from the neck down after a car accident this spring.

The team, led by USC neurosurgeon and bioengineer Dr. Charles Liu, injected 10 million specialized cells created from embryonic stem cells directly into the patient’s spine.

To be sure, it’s unclear whether, or how much, the treatment helped; the patient may also have recovered spontaneously. But whatever the mechanism, the improvement was dramatic: Three months after the treatment, the patient was feeding himself, hugging his family, and using his cell phone.

“The first thing he did when he could use his hands was text his girlfriend,” Liu said.

This patient was one of five enrolled in a multicenter clinical trial using cells that support nervous system functioning created from embryonic cells by Asterias Biotherapeutics, which plans to release results from several other patients Wednesday at an International Spinal Cord Society meeting in Vienna.

“If it bears out, it’s going to be huge,” Liu said. “This was the difference between someone using his hands or not.”

‘I got my life back, 100 percent’

In what may be the most dramatic of recent results, a study of 24 patients published in Lancet in June showed that stem cell transplants arrested the progress of multiple sclerosis, a disease marked by damage to the myelin that coats nerve fibers.

Patients were followed for four to 13 years. Seventy percent of them did not see any progression in their disability and 40 percent showed sustained improvement. In all cases, damage to the nerve fibers was halted. There was no control group; study leaders said it would have been unethical to enroll patients and not offer them a therapy.

One of the patients, Jennifer Molson, was in assisted living and unable to feed or dress herself when she received the stem cell transplant in 2002. Molson, who’s now 41, recovered so well she was able to walk down the aisle when she married a year later and now downhill-skis and kayaks.

“I got my life back, 100 percent,” she said. “I wasn’t supposed to get better, but I did.”

She did despite the devastating treatment, which included far more than stem cells. First, she had to take a powerful combination of chemotherapy drugs to wipe out her immune system — which was attacking her nervous system. She was then injected with stem cells harvested from her own blood to create a new immune system with no memory of the previous one.

“There’s no sugarcoating it, the treatment was awful,” she said. “I didn’t know you could throw up your own feeding tube.”

The treatment was so toxic that one patient in the trial died of liver failure and another required intensive care. And it’s only suitable for about 5 percent of MS patients — those with an early and aggressive form of the disease who haven’t suffered too much nerve damage already.

But the treatment appears to be so effective in stopping the progression of MS it is now offered with a less toxic dose of chemo as a treatment (for those with Canadian insurance) at Ottawa Hospital, where it was pioneered. Researchers in other countries are working on similar therapies.

Dr. Harold Atkins, a hematologist at Ottawa Hospital who conducted the study with neurologist Dr. Mark Freedman said he’s extremely excited about the results. But he’s concerned about MS patients who might seek stem cell injections at commercial clinics that can’t carry out the stringent and complex procedures he uses in Ottawa.

“It’s frustrating that what some patients are looking at doing doesn’t make sense biologically or medically,” he said. “You tell them that, but they’re desperate and they don’t listen.”

A flood of public comments

The FDA hearing on the draft regulation was originally scheduled to be held in April, but the agency was flooded with public comments.

With hundreds of people clamoring to be heard, the FDA is now holding the hearings over two days — Monday and Tuesday — with a long list of speakers allotted five minutes each. The agency also held a workshop on the subject this week.

The agency has not said when it will make a final decision on the regulations.

Critics fear that even if FDA does classify stem cells as drugs, it will be difficult for the chronically understaffed agency to force the closure of hundreds of clinics. Turner said the FDA should have issued these rules a few years ago, when there were only a handful of stem cell clinics operating.

Some clinic owners are pushing for a middle ground: They’re urging the FDA to let them continue to treat patients, but to set up a registry for them to report safety and efficacy data. The idea would be to encourage commercial clinics to effectively carry out the bigger clinical trials that academics and even biotech startups often can’t afford to do.

Knoepfler says this plan is patently ridiculous. For-profit clinics have no motivation to report results of therapies that don’t work, he said, and wouldn’t have any incentive to compare those who got treatment against a control group that did not.

“They have a vested interest in not testing their ‘treatments’ scientifically because of the risk of showing it is not real,” he said.

This article is reproduced with permission from STAT. It was first published on Sept. 9, 2016. Find the original story here.

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Hillary Clinton, and what you need to know about pneumonia

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U.S. Democratic presidential candidate Hillary Clinton arrives for ceremonies to mark the 15th anniversary of the September 11 attacks at the National 9/11 Memorial in New York, New York, United States September 11, 2016.  Photo by Brian Snyder/REUTERS

U.S. Democratic presidential candidate Hillary Clinton arrives for ceremonies to mark the 15th anniversary of the September 11 attacks at the National 9/11 Memorial in New York, New York, United States September 11, 2016. Photo by Brian Snyder/REUTERS

Hillary Clinton’s wobbly early departure from a Sept. 11 memorial ceremony on Sunday came as she was suffering from pneumonia, according to her physician, Dr. Lisa R. Bardack.

Here’s what you need to know about pneumonia:

What is it?

Pneumonia is an infection of the lungs. That infection can be relatively mild, but it can also be severe.

In some cases it can be fatal. Just last week, obituaries for transgender performer The Lady Chablis — made famous in the book “Midnight in the Garden of Good and Evil” — noted that she died from pneumonia.

But pneumonia is most dangerous in young children and the frail elderly; fatalities are rare in healthy adults. It does take time to recover from, however. “It’s going to be very hard for [Clinton] for the next month, probably, to maintain the kind of schedule that she was planning to maintain,” said Dr. Allison McGeer, an infectious diseases expert at Mount Sinai Hospital in Toronto.

What causes it?

A variety of pathogens can cause pneumonia: bacteria, viruses, even fungi.

Pneumonia that is caused by a bacteria — something like Streptococcus pneumoniae, for instance — is treatable with antibiotics.

Bardack said Clinton was started on antibiotics on Friday, which might suggest the cause of her infection was bacterial. But physicians will often start a patient on antibiotics as a precaution, rather than waiting for test results that might take some time to come back.

We don’t know what testing was done — a chest X-ray? rapid diagnostics? — to determine that Clinton actually has pneumonia or its likely cause.

Viral infections like influenza and respiratory syncytial virus can also lead to pneumonia. But it is off-season for both of these now, according to Dr. Trish Perl, chief of infectious diseases at University of Texas Southwestern Medical Center in Dallas.

Viruses aren’t quelled by antibiotics. Rest and hydration — and medical monitoring — would be the prescription here. “Viral infections get better by themselves in healthy people. It just takes time,” McGeer said.

Read More: Smears over a candidate’s personal health can work. Just ask Michael Dukakis

Pneumonia is spread just like colds and the flu. Infected people cough around other people. Or they cough on their hands, and those hands touch things. Uninfected hands may touch the same things — picking up the bugs in the process.

The Centers for Disease Control and Prevention suggest washing your hands a lot to avoid pneumonia.

But candidates for president shake a lot of hands. And there are likely long stretches between the rows of outstretched hands and the next available sink.

Why might pneumonia have made Clinton so weak?

Pneumonia impedes the ability of the lungs to take in oxygen; with low oxygen levels, a person’s energy levels can plummet. But McGeer said if Clinton had low oxygen levels, she probably would have been hospitalized.

Even without low oxygen levels, however, pneumonia can just sap your strength. Bardack noted in her statement that she had advised Clinton to “rest and modify her schedule” after diagnosing the pneumonia on Friday.

“It is surprising how much energy fever and infection take out of you,” McGeer said, noting that she is speaking from first-hand experience, having had pneumonia.

Perl said a few things probably contributed to Clinton’s incident.

“She probably wasn’t drinking. She was outside and it was hot. She had a little bit of a fever. Everything all combined and it was a perfect storm, as they say,” she said.

Read More: A conspiracy-free, facts-only guide to the health of Clinton and Trump

If Clinton has pneumonia, how has she been campaigning? Wouldn’t she be home in bed?

There is something euphemistically called “walking pneumonia.”

STAT is not suggesting that’s what Clinton has; we don’t know. But both McGeer and Perl raised that possibility. “It’s totally plausible,” Perl said.

It’s caused by a bacterium called Mycoplasma pneumoniae. The CDC says somewhere between 2 and 20 percent of U.S. pneumonia cases that aren’t caught in the hospital are caused by this bacterium.

It’s more common in kids and school-aged children, but can infect people at any stage in life.

McGeer said this form of pneumonia has a gradual onset that could easily be confused with seasonal allergies — which is what both Clinton and her doctor said she’s had by way of explaining recent coughing fits.

This article is reproduced with permission from STAT. It was first published on Sept. 11, 2016. Find the original story here.

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13 percent of U.S. reports household hunger. How do teens cope?

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New government data says 13 percent of Americans report household hunger. A new report explores how when faced with hunger, teens often assume the responsibility of earning extra money to help other family members.  REUTERS/David McNew

New government data says 13 percent of Americans report household hunger. A new report explores how when faced with hunger, teens often assume the responsibility of earning extra money to help other family members. REUTERS/David McNew

Teenagers as young as 13 all too often play an active role in feeding their families, many taking jobs when they can or selling their possessions to help raise money for food, researchers found in a detailed look at hunger among adolescents. In extreme cases, teens resorted to crime and sexual favors in exchange for nourishment.

Yet, according to the research, many cringed at the thought of using a local food bank.

“I will go without a meal if that’s the case,” said one girl in Chicago. “As long as my two young siblings is good, that’s all that really matters to me.”

The report, published Monday, is from the Urban Institute, an economic and social policy research group, and Feeding America, a national network of food banks. It is based on interviews of 193 teenagers in 20 focus groups across the country. Although child hunger continues to attract national support, the study seeks to pinpoint the struggles teenagers face when grappling with the issue.

Many teens shrink from seeking help for fear of being stigmatized.”

Researchers asked teens how they cope with hunger in their communities and the barriers preventing them from accessing food assistance programs. They discovered many teens shrink from seeking help for fear of being stigmatized.

Susan Popkin, senior fellow at the Urban Institute and co-author of the report, said teens engaging in risky behavior are often treated with disdain instead of being recognized as victims of sexual exploitation and the larger cycle of hunger.

“We need to be thinking about getting assistance to families with teens,” she said. “We need to stop thinking about teens as the problem and start helping them.”

“We need to be thinking about getting assistance to families with teens. We need to stop thinking about teens as the problem and start helping them.”

The federal Department of Agriculture last week released the latest government estimate of household hunger, finding 13 million children and 29 million adults did not have sufficient food at some point in 2015. That is nearly 13 percent of the U.S. population.

Caught between the throes of adolescence and the responsibility of feeding a household, teens turned to alternative strategies to earn cash for food, according to the new report on adolescents. In 13 of the 20 focus groups, participants mentioned “selling their body” or “sex for money” as a viable strategy. While participants in nearly every focus group preferred finding a job to make ends meet, high unemployment rates and school commitments make working more difficult, the teens noted.

Others simply go hungry so their siblings can eat.

Despite their ingenuity, a participant from Oregon said he doesn’t feel welcome in local food pantries. “People don’t trust teenagers,” he said. “People might not believe teens actually need the help.”

Food insecurity in the U.S. garnered mainstream national attention after the Great Recession left millions of families in financial straits. The USDA found the number of households facing hunger shot up to nearly 15 percent in 2008, a 3.5 percentage point increase from the year before. Nearly 17 million children went hungry in 2008.

Congress sought to tackle child hunger in 2010 by passing the Healthy, Hunger Free Kids Act, which provides additional federal funding to states for school meal programs and summer food assistance.

The law also created the community eligibility program, an initiative that enables schools serving in high-poverty areas to serve meals to every student for free without requiring each student to provide family income details to qualify.

Five years later, the law appears to have helped. In 2015, the rate of households facing food insecurity dipped below 14 percent for the first time since the economic downturn. More than 2 million children who faced food insecurity in 2014 obtained reliable access to food last year.

Despite the federal government’s success, teens in the report said existing Supplemental Nutrition Assistance Program benefits — federal food assistance —do not provide enough food for the month. A participant from rural North Carolina commented on how his peers’ actions change as food becomes scarce.

“By the end of the month you can tell by how the kids act. The kids might be aggravated,” he said. “You can tell, they’re depressed. You just know.”

The report also found teens don’t know many of the resources available to them. In addition to stigma, some participants perceived local food pantries as inaccessible and believed summer programs targeted small children, not adolescents.
Crystal FitzSimons, director of school and out-of-school time programs at the Food Research & Action Center, a nonprofit advocacy group based in Washington, D.C., says several programs already in place are successfully engaging teens in meal assistance while maintaining discretion about individuals’ food insecurities.

The Grab ‘N’ Go breakfast initiative being used in many secondary schools around the country allows students to pick up a bag of breakfast foods in the morning and eat while in class, providing a meal for teens without the hassle of arriving early to school.

FitzSimons credits the 2010 federal law with providing a strong buffer against hunger in schools, but she still notes the gap in programming for teens.

“We do have like a solid nutritional safety net, but we do need to do more work to make sure kids are accessing the meals that are available through it,” FitzSimons said.

“We do have like a solid nutritional safety net, but we do need to do more work to make sure kids are accessing the meals that are available through it.”

Participants in the Urban study echoed her sentiment. Pairing summer food assistance with enrichment programs like job training can reduce stigma and increase engagement, they told researchers. Teens also noted the need for more inclusiveness in food pantries and children’s programs.

The authors also suggested more research is needed to better understand how food insecurity affects adolescent development. According to a 2015 study, teens facing hunger typically exercise less and eat more poorly. A separate study published in 2012 discovered teens facing hunger are at a higher risk for anxiety, depression and substance abuse.

Emily Engelhard, managing director of research and evaluation at Feeding America, said more research now to address food insecurity can protect teens from suffering in the future.

“It’s much easier to solve hunger than to deal with the consequences of a person who suffered an impairment,” Engelhard said.

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Lawsuits from Sept. 11 families could strain U.S. relations, Gulf nations say

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A person touches the south reflecting pool at the National September 11 Memorial and Museum on the 15th anniversary of the 9/11 attacks in Manhattan, New York, U.S., September 11, 2016.  REUTERS/Andrew Kelly - RTSNABH

A person touches the south reflecting pool at the National September 11 Memorial and Museum on the 15th anniversary of the 9/11 attacks in Manhattan, New York, U.S., September 11, 2016. REUTERS/Andrew Kelly – RTSNABH

DUBAI, United Arab Emirates — A group of six Gulf Arab countries expressed “deep concern” Monday over a bill passed by the U.S. Congress that would allow families of Sept. 11 victims to sue the government of Saudi Arabia over the attacks.

The head of the Saudi-dominated Gulf Cooperation Council, Abdullatif al-Zayani, said in a statement that the legislation runs against the principles of international law and sets a dangerous precedent for foreign relations.

The U.S. House of Representatives approved the legislation last Friday, following earlier passage by the Senate. The White House has signaled President Barack Obama would veto the proposed law over concerns that it could open the U.S. up to similar lawsuits from other countries.

The legislation could also further strain relations between Washington and oil-rich Saudi Arabia, which is wary of the Obama administration’s outreach to its regional rival, Iran.

Fifteen of the 19 hijackers on the planes that killed nearly 3,000 people in New York, the Washington, D.C. area and Pennsylvania were Saudi nationals. Sunday marked the 15th anniversary of the attack.

Congress in July released 28 declassified pages from a congressional report into 9/11 that rekindled speculation that some of the hijackers had ties to Saudi government officials. Later U.S. investigations into the attacks were unable to substantiate the allegations.

Saudi Arabia welcomed the release of the declassified files, saying they contained no surprises and should end speculation of official Saudi involvement. But the kingdom has strongly objected to the proposed legislation allowing 9/11 lawsuits, which would give victims’ families the right to sue Saudi Arabia in U.S. courts over any role that the Saudi government may have played in the 2001 attacks.

The United Arab Emirates, which has the second-largest economy in the GCC after Saudi Arabia, issued its own statement echoing the Gulf bloc’s concerns Monday.

“This law is not equal with the foundations and principles of relations among states, and represents a clear violation given its negative repercussions and dangerous precedents,” said Sheikh Abdullah bin Zayed Al Nahyan, the federation’s foreign minister.

The seven-state Emirates federation is one of Washington’s closest Arab allies. Two of the 9/11 hijackers were Emirati.

Besides Saudi Arabia and the UAE, the GCC includes Bahrain, Kuwait, Oman and Qatar.

In its own statement, Qatar said the 9/11 legislation “violates international law, particularly the principle of sovereign equality between states.” The head of the Arab League, Ahmed Aboul-Gheit, added his criticism too, saying the law would contradict “established norms of the international law,” according to Egypt’s state news agency MENA.

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Worsening highway traffic slows down paid express lanes

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Americans are driving more miles than ever before, which means express lanes have become too popular, according to Pew Stateline. REUTERS/Mike Segar

Americans are driving more miles than ever before, which means express lanes have become too popular, according to Pew Stateline. REUTERS/Mike Segar

Highway express lanes provide a faster trip for carpoolers, people who drive low-emission cars, and solo travelers who are willing to pay more.

That’s the idea, anyway.

But as Americans drive more miles than ever before, express lanes are facing a challenge: they are too popular. So many drivers of all kinds are using the lanes that it is increasingly difficult for transportation officials to keep them speedy.

For solo drivers, the tolls in express lanes typically vary based on demand. In some places, drivers pay more during peak travel times, and in others prices go up as more cars enter the lane. Either way, the idea is to charge enough so that the lane is never overcrowded.

But in Atlanta, for example, the average number of weekday trips has increased from 7,300 in 2011 to nearly 29,000, even as the maximum toll price has gone from $5.55 in 2011 to $13.95 this year.

In South Florida, tolls have risen from $6 in 2009 to $10.50. But last year, during evening rush hour, Florida drivers going northbound on Interstate 95 only traveled faster than 45 mph — the federal standard for express lanes — 65 percent of the time.

Average speeds are now below 45 mph on nearly half of the San Francisco Bay Area’s carpool lanes. As a result, drivers of electric vehicles who have a state-issued tag to drive on express lanes are now barred from some Bay Area lanes during peak congestion times, up to an hour each morning. Transportation officials say similar restrictions may be put in place on other Bay Area highways.

Meanwhile, California legislators last week declined to raise the current 85,000 cap on the number of hybrid vehicles allowed to ride on California’s HOV lanes for free. Over the past several years, lawmakers had raised the cap by 15,000 on three separate occasions.

John Goodwin, of the Metropolitan Transportation Commission in San Francisco, said his agency opposed another increase in the number of hybrid vehicles allowed to use the express lane, because they were clogging it up for carpoolers.

“We do want people to use the HOT [high-occupancy toll] lanes, but there’s already ample encouragement to drive electric cars,” Goodwin said. “The idea behind free carpool access is to maximize groups of people on the road, not the number of vehicles on the road.”

In Los Angeles County, express lanes are restricted to carpoolers when the lanes get too congested, a feature common to many programs. In 2013, the express lanes on Interstate 110 switched into high-occupancy vehicle (HOV) mode for 1,983 minutes. The number tripled in 2014, to 6,336, and nearly doubled in 2015, to 11,476.

Kathy McCune, deputy director of Los Angeles County’s Metropolitan Transportation Authority, said the region’s express lanes are so congested it may become necessary to require hybrid and electric vehicles to pay at least a partial toll.

“If the lanes are congested, you’ve got to do something.”

“If the lanes are congested, you’ve got to do something,” said Mark Burris, a researcher at the Texas A&M Transportation Institute. “You’ve got to raise the price or say we’re not going to have hybrid and low-emission vehicles.”

Hitting the Road
After a dip during the recession, Americans have returned to their cars in force: There were more cars on U.S. roads in 2015 than ever before. Americans lost nearly 7 billion hours to traffic delays last year — more than three times the amount lost in 1982, according to researchers at Texas A&M. During the same period, the amount of wasted fuel resulting from stalled traffic rose from 500 million to 3.1 billion gallons.

At the same time, the percentage of commuters who carpool has been falling since the U.S. Census Bureau began tracking numbers in 1980. Back then, 20 percent of commuters carpooled to work. The carpooling percentage declined to 13 percent in 1990 and 12 percent in 2000. Today it is only 9 percent.

The plunge occurred despite city and state efforts to encourage carpooling by introducing more high-occupancy lanes restricted to cars with two or more passengers. As those HOV lanes fell into disuse, more cities and states have transformed them into express lanes open to solo drivers of low-emission vehicles or those willing to pay for the privilege.

At least twenty cities, from Los Angeles and Houston to Miami and Washington, D.C., now have express lanes where tolls change based on demand or the time of day.

To Chris Tomlinson, who heads Georgia’s State Road and Tollway Authority, it’s obvious what makes the express lanes appealing to solo drivers.

“They have a more consistent trip. It’s still congested, but they can predict their time better than in the regular lanes,” he said. “Even though they pay a price to use the lane, it tends to travel better than general-purpose lanes next to them.”

In Georgia, the express lanes have proven so popular — 365,000 people have purchased transponders, up from about 100,000 when the program started in 2011 — that the state has already reached the $13.95 limit (the toll for driving the full 16 miles) it vowed not to exceed when the program started.

Only about 14 percent of express-lane travelers in Atlanta are carpoolers who use the lanes for free. Tomlinson now has his eyes on getting more people to use the buses that run in the express lanes.

Last year, Georgia experimented with allowing people to earn toll credits for riding the bus — up to $60 in six months — to save them money on the days they choose to drive. The state is considering expanding the program to more drivers if it can find the money for it.

The region also plans to add express lanes near “park and ride” lots. The idea is to make it easier for people to be express-lane bus passengers rather than car drivers.

“We recognize, in a congested metro area like Atlanta, having some segments of the population choose to use transit could make a big difference,” Tomlinson said.

What Are They Paying For?
As tolls have climbed around the country, researchers have noticed an interesting phenomenon: Rather than deterring drivers, as they are supposed to, higher prices tend to attract them.

David Levinson, a researcher at the University of Minnesota, said that when express tolls rise, many drivers take it as a sign that regular lanes are congested, rather than realizing that it means that the express lanes are especially crowded.

Levinson said people aren’t good at estimating how much time they’re saving by taking the express lane, and assume they are saving a lot because they are passing other cars. In fact, they may end up paying a high price for just a few minutes.

Even so, Levinson views the overwhelming popularity of express lanes as a positive development.

“If people are willingly paying lots of money voluntarily for this service it must be a valuable service,” he said. “That’s a success not a failure.”

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WATCH: Trump says Clinton holds contempt for American voters

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Republican presidential nominee Donald Trump speaks at a campaign rally in Phoenix, Arizona, U.S., August 31, 2016.   REUTERS/Carlo Allegri

Republican presidential nominee Donald Trump speaks at a campaign rally in Phoenix, Arizona, U.S., August 31, 2016. REUTERS/Carlo Allegri

Republican presidential nominee Donald Trump addressed the National Guard Association of the United States in Baltimore at Monday, the Baltimore Sun reported.

Trump said Democratic presidential nominee Hillary Clinton called “deplorable,” “irredeemable” and “unamerican,” and said Nobody’s heard anything like this.”

Trump pressed on, saying these his supporters are not Islamophobic and said Clinton was bullying voters.

“You cannot run for president if you have such contempt in your heart for the American voter. And she does,” he said.

Trump went on to accuse Clinton of lying and hiding her emails.

“It’s going to be four more years of Barack Obama, only worse.”

He then went on to promise better equipment for the National Guard if he is elected president as well as a “direct line to the Oval Office.”

Later in the day, he will travel to Asheville, N.C., to address a rally there.

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Mosque of Pulse nightclub shooter Omar Mateen set on fire

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A view of the Islamic Center of Fort Pierce, a center attended by Omar Mateen who attacked Pulse nightclub in Orlando, in Fort Pierce, Florida, U.S. on June 17, 2016. REUTERS/Mike Brown/File Photo

A view of the Islamic Center of Fort Pierce, a center attended by Omar Mateen who attacked Pulse nightclub in Orlando, in Fort Pierce, Florida, U.S. on June 17, 2016. REUTERS/Mike Brown/File Photo

The mosque attended by Omar Mateen, the Orlando nightclub shooter, was intentionally set on fire Monday in an arson attack, according to law enforcement authorities.

The fire was extinguished at about 5 a.m. with no injuries.

“A fire at any place of worship is alarming, regardless of the circumstances,” the St. Lucie County Sheriff’s Office said in a statement. “Video captured at the Fort Pierce Islamic Center shows an individual approached the east side of the building just moments before a flash is seen and the fire starts.”

Two callers driving in the area reported seeing flames from the roof of the building, the St. Lucie County Sheriff’s Office said. Local law enforcement responded to the fire at 12:31 a.m.

The sheriff’s office said the individual in the video was a white or Hispanic male who arrived at the mosque on a motorcycle and was “carrying paper and a bottle of some type of liquid.”

When asked about the motive of the arson attack, Major David Thompson told reporters he did not want to speculate, but “we all know the implications of the date and the time of year that this is – the 9/11 anniversary. Is that related? I would not want to speculate, but certainly that is in the back of our minds.”

The arson attack also coincides with the beginning of Eid al-Adha, the Islamic holiday known as the Feast of Sacrifice.

“This is a horrible tragedy, not only for the Islamic Center, but for our community,” Maj. Thompson told reporters.

In a Facebook post, the Islamic Center of Fort Pierce asked people to “please keep us in your Du’as and prayers.”

Authorities are working to identify the individual in the surveillance video and have asked the public to call the sheriff’s office with tips. The St. Lucie County Sheriff’s Office has also released the 9-1-1 calls and mosque surveillance footage.

Mateen committed the deadliest mass shooting in modern U.S. history when he murdered 49 people and wounded 53 at the Pulse nightclub in Orlando before being killed by law enforcement.

The Washington Post reports Mateen occasionally attended the Islamic Center of Fort Pierce for prayers. His sisters were also active volunteers there.

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The shortage of non-white professors is a self-perpetuating problem

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The biggest problem for colleges looking to diversity is finding nonwhite faculty. Photo by Sam Edwards/Getty Images

This story was produced by The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education. Read more about higher education.

Felecia Commodore came into her job search armed with a University of Pennsylvania doctorate in higher education and published research papers. But after a year of looking, she still didn’t have a job.

READ MORE: Rethinking College

Commodore, who is black, couldn’t help but wonder whether race played a part as she was rejected from one college teaching job after another. So she toned down racial references in her cover letter — using the term “cultural communities” rather than “African-American communities,” for instance, to refer to one of her areas of study — and things took a turn for the better.

The experience left her conflicted.

“I wondered whether I wanted to be in a field, academia, where you have to whitewash yourself,” said Commodore, who is starting this fall as an assistant professor of education, a tenure track position, at Virginia’s Old Dominion University. “In hindsight, you need a job and you do what you need to do to get a job.”

For all of their assurances that they’ll add more non-white faculty in response to last year’s student protests demanding more diversity on campuses, colleges and universities largely haven’t been doing that over the last few years.

While many want to live up to their promises of hiring more non-white professors over the next few years, the small number of nonwhites in the doctoral pipeline will make that difficult.

While many want to live up to their promises of hiring more non-white professors over the next few years, the small number of nonwhites in the doctoral pipeline will make that difficult.

Only 6.4 percent of U.S. citizen or permanent resident research doctoral recipients in 2014 were black and 6.5 percent were Hispanic, according to the National Science Foundation. That’s the most recent year for which the doctoral recipient figures are available, and a much smaller proportion of both groups than their shares of the American population, which were 13.3 percent and 17.6 percent, respectively.

Although 13.3 percent of education doctorates are awarded to blacks, they receive just 3.5 percent of doctorates in the physical sciences. Hispanic or Latino students meanwhile receive 7.2 percent of doctorates in both the humanities and social sciences, but just 5.4 percent in the physical sciences.

And even those minorities completing their doctorates aren’t getting hired by some top colleges and universities as easily as their white counterparts.

The Massachusetts Institute of Technology, for example, added 539 instructional staff members in 2014, more than any other higher-education institution. But only seven of those hires, or 1.3 percent, were black, according to federal Department of Education data. Sixteen — or 2.9 percent of the total — were Hispanic.

At the University of Michigan, just 3.3 percent of its 478 new instructional hires were black, and 3.5 percent Hispanic. And at the University of California at Berkeley, new hires were 1.3 percent black and 2.4 percent Hispanic.

 6.4%:  The number of research doctoral recipients who are black. Just 6.5% are Hispanic.

A new study from the TIAA Institute, the research arm of the financial services company, finds that faculty diversity has barely improved in the last 20 years. Few of the black, Hispanic and Native American faculty who have been hired are on the prestigious tenure track, and more are part-time.

Related: What happens when a college recruits black students others consider too risky?

“I don’t think people are serious about recruiting faculty of color,” said Marybeth Gasman, a University of Pennsylvania higher-education professor who studies institutions with high minority enrollment. “People like to hire people like themselves. I’ve heard faculty members say that.”

Some schools have done better. At Texas A&M International, just a few miles from the Mexican border, about 38 percent of 2014 instructional hires were Hispanic. And nearly 70 percent of new instructors were black at Florida A&M University, a historically black institution in Tallahassee.

But the hiring problem in general is self-perpetuating, Gasman said. Non-white students who see few or no non-white faculty may feel unsupported on their way to even associate or bachelor’s degrees, never mind decide to go into university teaching.

“People like to hire people like themselves. I’ve heard faculty members say that.” — Marybeth Gasman, University of Pennsylvania

“If you’re white, you’ve had white role models all around you,” Gasman said. “Imagine if you did not see people who looked like you held up as examples. You could be Latino and not be taught by anyone Latino.”

Commodore, for example, had never come across a black tenure-track professor in her discipline until she was working on her master’s degree at the University of Maryland.

RELATED: Some religious colleges forgo federal funding, staying free of civil rights rules

“That was the first time I thought I could be a professor,” she said. “It’s important to find that connection, to find that mentorship in your field. It’s one thing to navigate your field, but it’s another thing to learn to navigate it in your own body.”

A few universities have added diversity offices in doctoral programs, recruit from historically black colleges and offer special summer sessions and mentoring groups to minority students. Duke, for instance, does this in biomedicine. The University of California, Berkeley, aggressively recruits non-white graduate students in math, science and engineering. So does the University of Maryland system.

In response to campus protests, Yale has promised to spend $50 million over the next five years to try to eliminate bias in faculty searches, bolster the number of minorities headed into university teaching and recruit scholars who “would enrich diversity.”

But a study of 21 major university science, engineering and math doctoral programs by the Council of Graduate Schools found that only 45 percent actively recruited non-whites, barely a third offered peer mentoring, and fewer than one in 10 had clubs for minority students.

Without such support, among other reasons, minority men end up 40 percent less likely and minority women 54 percent less likely to be interested in teaching at research universities than their white classmates, according to another University of Maryland survey of 1,500 students.

RELATED: Consumers get more information about a purchase they once made on trust: college

Among those who do begin doctoral programs, blacks and Hispanics are less likely to ultimately earn degrees than whites, the Council of Graduate Schools reports.

Those minorities who ultimately beat these odds and end up employed on college campuses still face other problems. Although a handful of schools have tried to help new professors feel comfortable by hiring clusters of minority instructors, faculty who are the first non-whites in their departments can nonetheless feel alone, said University of Illinois professor James Anderson, who is black and talks frequently with other non-white professors around the country.

Minorities who ultimately beat these odds and end up employed on college campuses still face other problems.

Nationally, 6 percent of university faculty are black and r percent Hispanic, according to the National Center for Education Statistics. Those figures have barely changed since 2009, federal data shows.

The same data shows that tenure-track hiring has slowed dramatically since 2009 as colleges have grappled with budget challenges, with most schools relying on part-time and adjunct faculty to take up the slack.

Anderson said he was lucky to have supportive white colleagues when he was hired as one of the first minority faculty members at the University of Indiana 40 years ago.

Although schools have improved hiring practices somewhat, Anderson said many academic departments still seem confused about how to make non-white instructors feel comfortable, and he said he is troubled by how quickly minority professors change jobs because of dissatisfaction. He says the majority of young, non-white professors seem unhappy .

Related: In spite of rising tuition, one country manages to shepherd poor kids into college

“When I talk to young faculty across the country, I’m surprised by the number of people who say it’s not going well,”Anderson said, who now heads his university’s department of education policy, organization, and leadership. “It reminds us that we’re still in a place where underrepresented minority faculty feel isolated.”

That isolation is made worse when schools treat minority professors as token hires. A black math professor, for example, can become a de facto diversity officer — a sounding board for anything on campus that’s race-related — Anderson said.

A big reason for the shortage of non-white professors is that colleges are not preparing doctoral students of any race for careers in academia, said Ansley Abraham, who directs a Southern Regional Education Board initiative to produce more minority doctorates. Some with high minority enrollment don’t do enough to steer students toward post-doctoral programs that could bolster their candidacies for faculty jobs, Abraham said.

In many cases, non-white, female and LGBTQ doctoral students have to make an extra effort to prepare for the job market, said James Alvarez-Mourey, a Hispanic business professor at Chicago’s DePaul University. He considers himself lucky to have had a professor who took time to talk to him about Ph.D. programs when he was an undergraduate.

Too many universities are still more focused on research than graduates’ jobs, he said.

“I don’t know if we do good service for students in terms of laying out the career path in front of them,” said Alvarez-Mourey, who was supported during his own doctoral work at the University of Michigan by a national program for minority students. “I think we should incentivize professors for taking an active interest in students’ career success.”

Job searches often eliminate minority candidates because they didn’t attend top-ranked schools, she said, and hiring committees are too often devoid of minority professors. Yet the nation’s demographics are changing rapidly. In 2014,  non-whites made up more than half of U.S. children under five for the first time, according to the U.S. Census Bureau.

“People don’t understand what they’re losing by not having faculty of color,” Gasman said. “And our institutions aren’t remotely prepared for the influx of students of color they’re going to see.”

This story was produced by The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education. Read more about higher education.

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How banks target less savvy borrowers with visual distractions and hidden fees

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You may have thought you signed up for a free trial , but did you read the fine print? By REUTERS/Jim Bourg

Photo by Jim Bourg/Reuters

Making Sense/NBER logo

Each month, the NBER Digest summarizes several recent NBER working papers. These papers have not been peer-reviewed, but are circulated by their authors for comment and discussion. With the NBER’s blessing, Making Sen$e is pleased to feature these summaries regularly on our page.

The following summary was written by the NBER and doesn’t necessarily reflect the views of Making Sen$e.


There are substantial differences in the credit card offers that banks extend to different potential customers. Less sophisticated borrowers receive offers with more back-loaded and hidden features, as well as more upfront rewards, visual distractions and fine print at the end of the offer letter, according to Hong Ru and Antoinette Schoar in their new study, “Do Credit Card Companies Screen for Behavioral Biases?” Banks also ratchet up these hidden features when their cost of funding increases and when the credit risk of consumers is lower, which reduces the risk for the banks that customers default once they are hit with the unexpected charges. In addition, hidden fees go up when state unemployment insurance benefits become more generous.

Less sophisticated borrowers receive credit card offers with more back-loaded and hidden features.

Lenders can only charge late fees if borrowers miss payments. Prior research on credit card use suggests that the borrowers most likely to miss payments — less educated or “unsophisticated” consumers who are less adept at predicting their future financial needs and behavior — are the least likely to read fine print and fully understand the terms of the credit agreements they take on. These consumers are also most readily attracted by colorful pictures and typographical gymnastics.

Drawing upon a dataset gathered by Compremedia of almost 1 million credit card offers mailed to U.S. households between 1999 and 2011, the researchers extracted “hard” information about the offers, such as annual percentage rates (APRs), fees and reward programs, as well as “soft” information, such as use of photos, color, font size and whether information about an offer was provided at the beginning or the end of the letter. They investigated the correlations between these features of the offers and recipients’ educational attainment and income.

creditcards NBER

They find that less educated households were offered higher late fees, overlimit fees and default penalty rates, as well as more upfront inducements, such as low introductory APRs, cash back and waivers of annual fees. In contrast, more highly educated households were offered cards with front-loaded features such as stable regular purchasing APRs and low late fees and overlimit fees. Back-loaded characteristics tended to be bundled together and to be paired with rewards programs such as low introductory APRs, cash back or points. Sophisticated customers were offered these rewards less often; instead, they tended to be offered participation in airline miles programs.

They find that less educated households were offered higher late fees, overlimit fees and default penalty rates, as well as more upfront inducements, such as low introductory APRs, cash back and waivers of annual fees.

The researchers also found that when the federal funds rate — the bank’s cost of funding — rose, the late and overlimit fees in unsophisticated customers’ offers also rose, suggesting that banks were using these features to pass funding costs to these customers. In offers to sophisticated customers, federal funds rate increases were associated with increases in regular APRs and annual fees and with decreases in late fees and overlimit fees.

Not surprisingly, banks appear to monitor the likelihood that unsophisticated customers will default on their debts and incorporate these probabilities into their card offers. The researchers found that when a state’s unemployment insurance benefits increased, providing borrowers with smoother cash flow in the event of job loss, banks issued potential borrowers within that state more offers with reward programs, late fees and default penalties, and they increased the number of colors in offer letters and moved the back-loaded features to the end of the letter. “Taken together, these results suggest that credit card companies realize that there is an inherent trade-off in the use of back-loaded features in credit card offers: They might induce customers to take on more (expensive) credit, but at the same time, they expose the lender to greater risk if those consumers do not anticipate the true cost of credit.” In other words, card companies seem to weigh the amount of fees they can extract from less sophisticated borrowers without increasing their likelihood of default.

— Deborah Kreuze, National Bureau of Economic Research

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Where do the presidential candidates stand on child care and pay equity?

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Democratic presidential candidate Hillary Clinton greets a child during a campaign stop at the Mug-N-Muffin restaurant in Stone Ridge, Virginia. Photo by Kevin Lamarque/Reuters

Democratic presidential candidate Hillary Clinton greets a child during a campaign stop at the Mug-N-Muffin restaurant in Stone Ridge, Virginia. Photo by Kevin Lamarque/Reuters


WASHINGTON — In much of the United States, families spend more on child care for two kids than on housing. And if you’re a woman, it’s likely you earn less than your male colleagues even though 1 in 4 households with kids relies on mom as the sole or primary breadwinner. That’s according to the latest research that suggests while the U.S. economy has improved, women and their families are still struggling to make the numbers work.

It’s already illegal to pay women less for the same job or deny them a raise because of their sex, and the pay gap has narrowed dramatically in recent decades. Republicans say tougher regulation would only hurt U.S. businesses — costing Americans jobs — while new taxpayer programs would drive up the deficit.

Democrats say it’s still too easy for employers to hide or deny wage disparities because workers rarely perform identical jobs. And with paid leave scarce and expensive, women and their families are losing out on wages that could be reinvested back into the economy and keep struggling families off government aid.

WHERE THEY STAND

Hillary Clinton calls for 12 weeks of government-paid family leave to care for a new child or seriously ill family member, which she says would be paid with higher taxes on the rich. She also backs legislation that would force private businesses to disclose gender pay data to the government for analysis; the bill would allow women to seek punitive damages for discrimination.

Donald Trump has said he thinks the pay gap isn’t an issue. He’s called for allowing parents to deduct the “average” cost of child care from their taxable income if the parents earn under a certain, unspecified amount. But what about the 40 percent of Americans who don’t earn enough to pay federal income taxes? Trump’s campaign says lower-income workers would be able to exclude childcare expenses from half of their payroll taxes.

WHY IT MATTERS

This issue isn’t going away. According to the Bureau of Labor Statistics, women are about 57 percent of the labor force and many are mothers of young children. More than half of mothers with an infant under age 1 have paid jobs, for example. And that number climbs to 74 percent among moms with children under age 17.

Yet the bureau says women in 2014 working full time earned 83 cents on average for every dollar a man makes. Why? The Pew Research Center says women are much more likely than men to take time off work or reduce hours to care for family members.

But remove those factors and the pay gap persists. The American Association of University Women found that female engineering majors earned 88 percent of what male graduates did one year after school. Another study, by the University of California, San Francisco, found that male nurses out-earned female nurses by as much as $5,000 a year, even when taking into account years of experience, location and specialty.

Aggravating wage disparities is the steep cost of child care. Families in 2011 paid on average $143 per week for child care — up from $84 a week in 1985 (in constant 2011 dollars). According to the National Conference of State Legislatures, child care costs for two kids are higher than the median rent payment in every state. And only 12 percent of private industry workers last year had access to paid family leave, despite strong public support for it and concerns in some states that struggling parents are turning to low-quality, unlicensed daycares because they are cheaper.

For Clinton’s anti-discrimination proposals to work, she’ll need Congress and state legislatures to jump on board — no easy task politically. U.S. businesses have already staved off legislation by warning that a new law would expose them to frivolous lawsuits.

Meanwhile, Trump’s child care proposal does nothing to address the pay gap.

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How much health data should candidates disclose?

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Merkel

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JUDY WOODRUFF: Now a closer look at just how much the public has a right to know about the health of the American president or a presidential candidate, and what earlier presidents have and have not disclosed about their personal health histories.

For that, we turn to Dr. Howard Markel. He’s director of the Center for the History of Medicine at the University of Michigan. He’s also author of a number of books on health and infectious diseases.

Dr. Markel, welcome.

Hillary Clinton’s campaign says that her pneumonia is not severe. Just how serious can pneumonia be?

DR. HOWARD MARKEL, University of Michigan: Well, pneumonia can be quite serious.

People can die of it. They used to call it the old man’s friend in the years before antibiotics. But now with taking antibiotics, taking care of yourself and resting, it is quite an easy thing to treat.

JUDY WOODRUFF: We saw — I guess it was just reported this afternoon on Politico that Hillary Clinton’s staff is saying she doesn’t prefer to drink water often. Could that have contributed to what happened yesterday?

DR. HOWARD MARKEL: Absolutely.

Think about it. You’re tired, you’re sick, you’re out in the sun, which dehydrates us all, whether we’re aware of it or not. And that could very well have been what caused that wobbly step that everyone has seen and talked about today.

JUDY WOODRUFF: Well, let me ask you, both of these campaigns, both Trump and Clinton are now saying, in the next few days, they are going to be releasing fuller medical histories, we’re going to know more about their medical story.

What do the American voters have a right to know? What should people know in order to know whether these two individuals are healthy or not?

DR. HOWARD MARKEL: Well, I think it’s very important.

And I think American voters do have the right to know about the health of the people who are running for the most powerful job in the world. It is very easy to present one’s health history, and yet it’s become very tangled and diffuse, just like people’s tax returns.

But I think both these pieces of information are valid for people to ask about.

JUDY WOODRUFF: And so what are some aspects of their health that you think should be disclosed when they do put these histories out?

DR. HOWARD MARKEL: Well, I think just the basic top-to-bottom physical examination, mental health examination, a recording of the medications they may or may not take, past illnesses, illnesses that may run in their family, a general medical history.

Now, remember, this hasn’t really been done all that much since 1992. And it was Paul Tsongas who didn’t tell the American people precisely about his non-Hodgkin’s lymphoma. He said he was cured. He wasn’t. Had he won the rest of the campaign and run for president, he probably would have been quite ill during his presidency.

So these things do matter. And I think it’s one more piece of information that we as voters have a right to know about.

JUDY WOODRUFF: And, of course, there are other examples as well. People think of John F. Kennedy, Addison’s disease.

DR. HOWARD MARKEL: That’s right.

JUDY WOODRUFF: And a number of other presidents.

DR. HOWARD MARKEL: Yes. And really back to Kennedy, or Roosevelt or even Woodrow Wilson’s health, these were an era where medicine could not do all that much for these serious diseases.

Today, more and more people are living full and healthy lives with chronic illnesses. And I have got to tell you, having turned 50 myself quite a few years ago, the warranty on your body runs out at that point, and we all have problems with our bodies.

And so Mrs. Clinton’s pneumonia is community-acquired. It’s a very normal thing to do to contract, particularly when you’re shaking hands, and working a grueling campaign, and flying on airplanes and stuff. And I have to tell you that most doctors would give the advice, why don’t you take a break from this grueling campaign for a day or so and rest, like any human being whose body gets sick?

JUDY WOODRUFF: Well, you mentioned age.

Hillary Clinton is 68. Donald Trump is 70. How much is age a factor in this, as you describe, grueling job they both want to take on?

DR. HOWARD MARKEL: Well, it’s hard to say with each 70-year-old. One 70-year-old may be quite fatigued by this type of a schedule. Other people — and it seems Mr. Trump and Mrs. Clinton are those types — are energized by it.

So, it really is a case-by-case person — case-by-case situation. But, you know, most people over 65 should get a pneumonia shot and also should get a flu shot every year. So that’s something you can do.

But it’s hard to say. These sounds like extremely energetic people. They sound like very healthy people. I’m a little puzzled why they just don’t tell us what’s going on.

JUDY WOODRUFF: Well, again, as we prepare to see whatever these campaigns release, how will we know we’re getting the full story?

DR. HOWARD MARKEL: That is difficult, and we don’t know.

And particularly the briefer the report is, there may be stuff that you’re not seeing, or you could get a data dump, like John McCain did a few years back where he released thousands of pages of his medical history and gave journalists only about three or four hours to review them.

I’m a medical professor, and I couldn’t do it in that time. So there’s different ways that people can be somewhat shifty or less than transparent with their health data. I think it’s high time in this modern era of great medicine and great health prevention that our presidential candidates just tell us what is going on in their bodies. And we can make those decisions one way or the other.

JUDY WOODRUFF: Well, we will be looking for what each campaign has to say in the coming days.

Dr. Howard Markel, we thank you.

DR. HOWARD MARKEL: Thank you.

JUDY WOODRUFF: And on our Web site, you can find a guide to pneumonia, what causes it and what makes it a potentially dangerous illness. That’s at PBS.org/NewsHour.

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News Wrap: As cease-fire starts, Assad insists he means to retain control

Clinton campaign pledges more health information after pneumonia diagnosis


Trump seeks 5-week delay in Trump University trial

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In 2005, Donald Trump holds a media conference announcing the establishment of Trump University in New York City. Photo by Thos Robinson/Getty Images

In 2005, Donald Trump holds a media conference announcing the establishment of Trump University in New York City. Photo by Thos Robinson/Getty Images

SAN DIEGO — Republican presidential nominee Donald Trump wants a five-week delay in a trial over whether the now-defunct Trump University defrauded customers because his lead attorney has a scheduling conflict.

Trump attorney Daniel Petrocelli asked a federal judge in San Diego to move the trial from Nov. 28 to Jan. 2. Both dates fall between the presidential election and inauguration.

The judge didn’t immediately make a decision.

Petrocelli said in a court filing Monday that he represents Sirius XM Radio Inc. in a trial scheduled for Nov. 15. The judge in that case denied a delay.

A 6-year-old, class-action lawsuit alleges Trump University fleeced customers with unfilled promises to teach success in real estate. Trump has strongly criticized the judge, Gonzalo Curiel, noting his Mexican heritage.

Plaintiffs say they oppose the delay.

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Column: How an uplifting story about refugees in Sardinia quickly unraveled

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A field on the Italian island of Sardinia is purported to be a farm worked by migrants. Image by Malcolm Brabant

A field on the Italian island of Sardinia is purported to be a farm worked by migrants. Image by Malcolm Brabant

Eighteen months into Europe’s migrant crisis, it’s become something of a challenge to find stories that shed a new or unusual light on this historic movement of people.

My interest was piqued a couple of months back by an item on ANSA, the respected Italian News Agency, about some derelict land on the Italian island of Sardinia that had been handed over to a group of 50 African farmers so they could become independent of government assistance, and learn new techniques that they could take back home, should conditions ever permit.

My Rome-based colleague Alessandra Maggiorani phoned the main spokesman for the African cooperative, a Senegalese man called Cheikh Diankha, and everything seemed to stand up; filming the project sounded very straightforward.

We were just waiting for an opportunity to put it in the can.

And that turned out to be on a trip to Italy earlier this month, where our main aim was to shoot a feature about how 80 percent of Nigerian women who make it across the Mediterranean are forced into prostitution. The Sardinia farm story would be the second of our assignment.

We were on a train heading for Milan Central Station when Alessandra called Diankha to confirm we were on our way. She told him we wanted to shoot some scenes at dawn on Friday, Sept. 2. He said Friday morning would be impossible because the farmers were doing something else but assured us that filming toward dusk on Friday and over the weekend would be achievable.

So we boarded a flight to the Northern Sardinian town of Alghero, confident that we would soon have a fairly simple and possibly uplifting story in the bag.

We couldn’t have been more wrong.

The assignment turned out to be one of the most opaque of my professional life.

More than 10 days after we landed in Sardinia, I’m still not sure what the true story is.

What I am certain of though, is that somehow we kicked a hornet’s nest and in the process got an interesting look at the underbelly of a country that’s struggling to cope with the impact of mass migration as well as some of the people who’re making money out of it.

If Cheikh Diankha had just fobbed us off and had told us he couldn’t help, we’d have perhaps shrugged our shoulders and not traveled to Sardinia.

Somehow we kicked a hornet’s nest and in the process got an interesting look at the underbelly of a country that’s struggling to cope with the impact of mass migration.

But he stopped taking our calls when we got there, as did a man called Luca Pintus, who was named as the owner of the land given to the African farmers.

So we started digging into the project and its main partners.

On the days we visited the land in Platamona, in Northern Sardinia, there was nobody working. Workers in neighboring vineyards had seen and heard nothing. And they had a clear view of the land. One of them was a policeman who passed the entrance every single day.

The consistent theme of these conversations was that Sardinian agriculture was struggling and many farmers were wary of migrants taking over their jobs by undercutting wages. So any Africans in the fields would have raised eyebrows, if not more.

Cheikh Diankha ran a refugee center, and seemed to be the go-to man on Sardinia in terms of migrant issues. He was linked to a number of integration initiatives including teaching newcomers the Italian language.

Luca Pintus’ reputation on the island was not particularly savory. We consulted senior police officers, neighbors, old family employees, council officials and other institutions. The least-worst character assessment was offered by a farmer. He described Pintus as the black sheep of a wealthy family who was always trying to make a fast buck.

We tracked down Pintus to his mother’s cafe in the main square of Sassari, a Northern Sardinian town. He put aside his plate of lasagna and assured us that the project was aboveboard; we could see all the paperwork, and he would arrange a facility with a talented migrant fashion designer who had allegedly attracted the attention of Giorgio Armani. When his mother was out of earshot, he gave us another phone number that we could use to contact him. He didn’t want his mother to hear the number and check up on him.

Giovanni Rossi tells us to stop filming. Image by Malcolm Brabant

Giovanni Rossi tells us to stop filming. Image by Malcolm Brabant

On Monday, Sept. 5, we went to an address in a trendy building not far from the cafe, to a meeting that Pintus had set up. He was supposed to be there, along with the migrant designer, and a fellow director of Cheikh Diankha’s company. When we got there, the only person present was Diankha’s colleague, Giovanni Rossi, who described himself as an accountant. To cut a long story short, he didn’t want to do a televised interview. We did. And he took a swing at my camera, while failing to answer questions about whether the African farmers existed.

During our earlier conversation, Pintus had named the local farmers union, the Coldiretti, and a psychologist as having supported the farmers project.

We talked to a senior Coldiretti official who said they were approached informally, and liked the idea as it would provide food for local schools and markets. But they were not presented with any documents and they did not become involved.

Cheikh Diankha and Luca Pintus attend a Coldiretti farmers union event. Photo provided by Luca Pintus

Cheikh Diankha and Luca Pintus attend a Coldiretti farmers union event. Photo provided by Luca Pintus

Pintus sent us some photos showing him and Diankha at a Coldiretti event. The farmers’ association moved very quickly to distance itself from the project once we started asking questions.

As for the psychologist, she was named as a supporting professional in a scheme for Alzheimer’s patients that was closed down because of deception and physical abuse.

So was this farmer’s scheme a case of fraud?

We don’t know, because we never managed to discover which authority had approved it. Despite Pintus’ promises, the paperwork was never forthcoming.

We went to see Cheikh Diankha at his office in a former disco once known as the “Kiss Kiss,” which in its earlier days was closed down in a prostitution racket.

The Kiss Kiss is now a reception center, holding about 100 mainly African migrants.

To say that Diankha was surprised to see us would be an understatement. And he started shaking like a leaf when I asked if the farmers’ project was a scam.

His answers and those of Luca Pintus were inconsistent. Diankha claimed the cooperative had not started work. Yet, there had been a report on local television. Also, he insisted, they had yet to receive a penny. Pintus claimed the last time his land had farmers on it was 15 days previously.

Diankha ushered us out of the Kiss Kiss, saying I shouldn’t even think about filming.

The company Janas International has a "reception center" to house refugees. Image by Malcolm Brabant

The company Janas International has a “reception center” to house refugees. Image by Malcolm Brabant

Like other businesses running reception centers, his company, Janas International, which specializes in “facilities and hospitality,” receives about 32 euros or $36 a day per migrant. The money is supposed to pay for food and clothing. The potential daily income for his company at the Kiss Kiss is $3,600 a day. In a year, that’s about $1.3 million.

Pintus, ever talkative, told us that Diankha and Giovanni Rossi were planning to open up another reception center.

So what were they all trying to hide, if anything?

I’m truly puzzled. But surely it had nothing to do with concerns from local residents that the center was being used as a base for prostitution?

There are literally hundreds of millions of dollars in public funds being thrown at the migrant crisis and the opportunities for fraud are enormous.

It’s entirely possible that some of the migrants living in the center are among the 80 percent of Nigerian women who make it to Italy and are forced into the sex trade to pay for their crossing.

That doesn’t mean that Diankha and his hospitality company are involved. But he and his partner are certainly profiting from the migrant crisis. There are literally hundreds of millions of dollars in public funds being thrown at the migrant crisis and the opportunities for fraud are enormous.

In June, we reported from Sicily that the Italian Finance Police had cracked a massive fraud by the Mafia in which migrant reception centers were used as a vehicle to defraud the state of billions.

The European Union is so concerned about its coffers being emptied by criminals, that it’s set up a special task force in conjunction with the Italian state. We know from our inquiries that several institutions in Sardinia are now examining the activities of the gentlemen we encountered.

But this being Italy, I can’t tell you anything official.

Watch Malcolm Brabant’s report on Tuesday’s PBS NewsHour.

The post Column: How an uplifting story about refugees in Sardinia quickly unraveled appeared first on PBS NewsHour.

Russian hackers target Simone Biles, Serena Williams in medical data leak

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U.S. gymnast Simone Biles was one of four athletes that were targeted in a medical data leak by a Russian hacking group. Photo by Mike Blake/Reuters

U.S. gymnast Simone Biles was one of four athletes that were targeted in a medical data leak by a Russian hacking group. Photo by Mike Blake/Reuters


The World Anti-Doping Agency has confirmed a “Russian cyber espionage group” illegally gained access to its confidential medical database.

The Russian hackers, known collectively as “Fancy Bear” or “Tsar Team,” published private medical records of four Team USA stars: Olympic gold medalist and gymnast Simone Biles, tennis giants Serena and Venus Williams and basketball MVP Elena Delle Donne.

“WADA deeply regrets this situation and is very conscious of the threat that it represents to athletes whose confidential information has been divulged through this criminal act,” WADA director General Olivier Niggli said in a statement.

The leak reportedly showed that the athletes were authorized to take prescriptions that were on the list of WADA’s banned substances. Olympic athletes can receive “Therapeutic Use Exemptions” (TUEs) to take substances that might normally be banned, if they are proven to treat certain medical conditions.

“After detailed studying of the hacked WADA databases we figured out that dozens of American athletes had tested positive,” the Fancy Bears’ group said on its website. “The U.S. team played well but not fair.”

For Biles, the hackers published data that showed the gymnast tested positive for d-amphetamine and dexmethylphenidate, which are used to treat attention deficit hyperactivity disorder (ADHD).

USA Gymnastics released a statement today, saying Biles “filed the proper paperwork” for an exemption. As reported by USA Today, the International Olympic Committee condemned the attack, adding that these four athletes didn’t violate anti-doping rules.

WADA officials said the Russian hackers gained access to the athletes’ medical records with a spearphishing attack, which uses targeted emails or phone calls to trick someone into giving out important information.

This breach comes months after WADA released a report exposing a state-sponsored doping program in Russia. Except for one athlete based in the U.S., the country’s track and field team was banned from this year’s Rio Games.

The group said it will disclose more leaked data on other Olympic teams later. Experts believed the same group of Russian hackers breached WADA’s website in August.

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A look at some of the details of the confidential Syria cease-fire deal

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Rebel fighters rest with their weapons in Quneitra countryside, Syria. Photo by Alaa Al-Faqir/Reuters

Rebel fighters rest with their weapons in Quneitra countryside, Syria. Photo by Alaa Al-Faqir/Reuters

WASHINGTON — The new Syria cease-fire is rich in detail on the mechanics of ending violence in Aleppo. It says little about how the United States and Russia will establish a new military partnership that is seen as key to the long-term sustainability of the deal.

Officials familiar with the document outline a highly technical series of requirements for both Syrian President Bashar Assad’s government and opposition forces. These include precise calculations, in meters, on how the sides would pull back from a key artery into Aleppo and where they would have to redeploy weaponry.

The agreement was reached last Friday after a marathon day of negotiations between U.S. Secretary of State John Kerry and Russian Foreign Minister Sergey Lavrov. Underscoring the complexity of the new arrangement, even Kerry stumbled over some of the particulars while speaking shortly after the cease-fire came into effect Monday.

Here are some details of the agreement, according to the U.S. officials. They weren’t authorized to speak publicly about the still-confidential agreement and demanded anonymity.

  • As of Monday, Assad’s government and opposition forces should have ceased all attacks with any weapons, including aerial bombardments, rockets, mortars and anti-tank guided missiles.
  • Sides cannot seek to acquire territory.
  • They should allow rapid, safe, unhindered and sustained humanitarian access to all people in need.
  • In cases when self-defense is required, proportionate force should be used.
  • Two checkpoints will be established on the key Aleppo artery of Castello Road. The Syrian Red Crescent will initially operate the checkpoints, with security of no more than 20 armed personnel. Security will be determined by mutual consent of government and opposition forces. The U.N. will monitor the personnel, physically or remotely.
  • Government forces must withdraw personnel, heavy weapons and other arms to different points away from Castello Road. In some places, tanks, artillery and mortars must be pulled back at least 3.5 kilometers, or just more than 2 miles. Elsewhere, soldiers with lighter weapons have to retreat at least 500 yards from the road. Other requirements concern crew-served machine guns and observation posts.
  • Opposition forces also must withdraw from the road, in many places equidistant or similar to the level of pullback by government forces. East of Castello Road, their withdrawal will depend on the action of Kurdish forces. If the Kurds retreat 500 yards, the opposition forces should do likewise. Other requirements concern heavy weapons, including infantry-fighting vehicles and tanks, and crew-served machine guns.
  • Opposition must make every effort to prevent al-Qaida-linked militants from advancing into demilitarized areas.
  • All Syrians should be able to leave Aleppo on Castello Road, including opposition forces with their weapons. Fighters must coordinate with U.N. officials ahead of time.
  • The U.S. and Russia will address violations of cease-fire.
  • The U.S. and Russia will announce the establishment of their Joint Implementation Center after at least seven straight days of adherence to the cease-fire.
  • Preparatory work for the center should have started Monday, including information-sharing to delineate territories controlled by al-Qaida-linked militants and those controlled by opposition groups. More comprehensive delineation occurs after the center is established.
  • Starting Monday, the U.S. and Russia should have started developing actionable targets against the Islamic State and al-Qaida-linked militants, so that strikes can start immediately after the center is established. Once the first strikes occur, all Syrian military air activities must be halted in agreed areas.
  • The U.S. and Russia can each withdraw from the arrangement.

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Clinton has history of powering through illness — and paying a price

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Democratic presidential candidate Hillary Clinton speaks to reporters after holding a "National Security Working Session" with national security advisers in New York, in September. Photo by Brian Snyder/Reuters

Democratic presidential candidate Hillary Clinton speaks to reporters after holding a “National Security Working Session” with national security advisers in New York, in September. Photo by Brian Snyder/Reuters

WHITE PLAINS, N.Y. — The White House was submerged in scandal. Democrats faced tough midterm elections. And Hillary Clinton, far more popular than her embattled husband, had become a one-woman campaign machine.

But the non-stop travel in 1998 took a toll. Clinton developed a blood clot behind her right knee, prompting the White House doctor to recommend hospitalization and a week of bedrest.

Determined to stay on the campaign trail, Clinton settled on an alternative: A nurse would travel with her to administer the medicine needed to monitor her health. She kept her condition a secret from nearly everyone but her Secret Service detail, alerted only because an injury could have been life-threatening.

“Very few people knew about it at the time,” recalled Dr. Connie Mariano in her autobiography. “Her staff thought she had pulled a muscle exercising.”

Nearly two decades later, Clinton’s desire to work through illness — and penchant for keeping her health secret — has helped cause the most damaging 48-hour period in her presidential campaign and given fresh ammunition to GOP rival Donald Trump. The incident has also stoked long-simmering conservative conspiracy theories about her health and questions about her commitment to openness.

Video of her staggering and stumbling at a 9/11 ceremony on Sunday and her controversial comments about Trump’s supporters at a Friday fundraiser both occurred while she suffered from lingering pneumonia.

At least part of the blame goes to a simple cause: Clinton’s stubborn unwillingness to follow the advice of doctors, family and friends.

“This is just who she is. She is a workhorse. No matter who tells her, her husband can tell her. It doesn’t matter. Chelsea can tell her,” said Virginia Gov. Terry McAuliffe, a Democrat who served as chairman of her 2008 presidential campaign. “You’re not going to change her at this point in her life.”

[Watch Video]

How much should voters know about the presidential candidates’ health? On Sunday, Hillary Clinton left a 9/11 memorial ceremony in lower Manhattan after a stumble. It was later revealed that the Democratic nominee had been diagnosed with pneumonia a few days before. Judy Woodruff speaks with University of Michigan’s Dr. Howard Markel about Clinton’s pneumonia and what voters have a right to know.

After her Friday pneumonia diagnosis, Clinton was determined to “power through,” she told CNN late Monday.

The public and most in her campaign were kept in the dark. Her running mate, Virginia Sen. Tim Kaine, and her campaign manager, Robby Mook, declined to say when they first learned about her condition.

The decision to keep going was one that Clinton, who suffers seasonal allergies that can become a vicious cough, came to regret. The Democrat is now taking a few days off the campaign trail, forced to the sidelines at a critical point in the fall election. Facing criticism about her lack of disclosure, she’s agreed to release more health information soon.

“I probably would have been better off if I’d just pulled down my schedule on Friday,” Clinton said on CNN, adding: “I just didn’t think it was going to be that big a deal.”

Video by CNN

Her supporters now are trying to turn the episode into a badge of honor — and a credential for the White House.

“This is a woman who works 20 hours a day and comes into contact with tens of thousands of people and you pick up germs and viruses and things like that and you get exhausted,” said Democratic Gov. Dannel Malloy of Connecticut. “If you don’t get a cold or a virus or the flu or pneumonia in a campaign, you weren’t working hard enough.”

But the incident follows a long pattern, with Clinton paying a price, both physically and politically.

During the waning days of her time as secretary of state, she sustained a concussion in a fainting episode at her home, which her doctor later attributed to dehydration and a stomach virus she developed during a trip to Europe. In follow-up evaluations, Clinton was found to have a blood clot in a vein in the space between her brain and the skull behind her right ear.

To recover, she spent a few days at a hospital and took a month-long absence from the State Department for treatment. Her physician, Dr. Lisa Bardack, said in 2013 that testing showed “complete resolution” of the concussion’s effects.

But the episode became a central part of a political rumor about her health that has only grown more damaging as her presidential campaign has continued. Trump has seized on those concerns, often questioning Clinton’s stamina and energy.

That infuriates Clinton’s friends and former aides, who cite dozens of stories about her simply refusing to take a sick day.

“I am 20 years younger than Hillary Clinton and there is no single day when I outpaced her ever in my life,” said Neera Tanden, a former Clinton policy aide and president of the liberal Center for American Progress. “I’ve always seen her get up earlier and stay up later.”

Tanden recalled a time when Clinton, then a New York senator, refused to cancel a public service announcement she was scheduled to tape with Sesame Street even though she was sick. Her staff had planned to bring their children in to meet Elmo and Clinton didn’t want to disappoint the kids.

“I felt so badly. She had a throaty voice and you could tell she had a bad cough,” said Tanden, who now has a photo of her then 2-year-old daughter with Clinton and Elmo. “But she was like, ‘It’s fine. I just could not live with these kids crying about missing Elmo.'”

Thomas reported from Washington.

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