Hospitals, red tape may be limiting tubal ligations






NEW YORK (Reuters Health) – Women in California and Texas have varying access to “getting their tubes tied” immediately after giving birth, according to a new study, but the reasons are still unclear researchers say.


Analyzing the records of nearly 890,000 mothers across 499 hospitals in both states, they found that more women in Texas got the voluntary sterilization procedure after delivery in 2009 than did women in California.






But the differences were not clearly linked to obvious factors – such as cost or religiously affiliated hospitals that refuse to do the surgery. Further, sterilization rates ranged from zero to 15 percent in California hospitals and between zero and 30 percent in Texas hospitals.


“This huge variation we’re seeing both between the two states and within facilities raises a red flag,” said study author Dr. Daniel Grossman, senior associate at Ibis Reproductive Health. “Our paper raises more questions than it answers,” he told Reuters Health.


Differences in federal funding could explain some of the discrepancies. Federal funds through Title X and Medicaid programs reach more women in California than Texas, Grossman said.


In his team’s report, published in the journal Obstetrics & Gynecology, the researchers suggest that Texas women have fewer low-cost family planning options, which may act as an incentive to get their tubes tied for contraceptive purposes.


Conversely, the more generous family planning funding in California might mean that women have access to low-cost options beyond sterilization after delivery.


Nonetheless, surgical sterilization remains very popular in the U.S. and nearly a third of women with children use it for family planning purposes, according to some estimates.


A 2011 study from the Centers for Disease Control and Prevention, for example, found that tubal sterilization was performed following every one in 13 births in the U.S. between 2001 and 2008, while insertion of a contraceptive IUD was done after one in every 37,000 births. (See Reuters Health story of August 26, 2011.)


In the new study, Grossman and his colleagues found that in California, one in every 15 women had her tubes tied after delivery, compared with Texas where one in 10 women was sterilized after delivery.


They looked at several factors that might explain the variation in rates, but none stood out as a clear cause. Variation was similar among private versus publicly insured patients and among mothers who delivered by cesarean section – a procedure that might make it easier to have elective sterilization right after delivery.


The age of the mothers also did not explain the disparities. The data did not include the number of previous children the women had.


Differences in accessibility might arise from several other sources, the researchers suggested. Catholic hospitals ban sterilization, but non-Catholic hospitals could also have policies that limit tube tying.


“It doesn’t matter if it’s at an institutional level or a state level, it’s always the least mobile, the poorest (women) who don’t have the choice,” said Dr. Cori Baill, a physician at The Menopause Center in Orlando, who has counseled mothers in family planning issues.


Baill, who was not involved in the current study, said poor women who lack prenatal care will not have sterilization as an option since Medicaid requires expectant mothers to sign consent forms 30 days before delivery. “It’s ridiculous that Medicaid rule still exists,” Baill told Reuters Health.


Night and weekend staffing could also affect the variation in tube tying since doctors may not be around to perform the elective surgery, Baill added.


Though the current study did not examine how many mothers requested their tubes tied after delivery, Grossman and colleagues are examining the demand for sterilization in an ongoing pilot study in El Paso, Texas.


“Women across the country should be able to access the form of contraception that they want,” Grossman said. “We need more information to determine what accounts for this variability.”


SOURCE: http://bit.ly/Uqx8hQ Obstetrics & Gynecology, online December 20, 2012.


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Reasons to Be Scared of Microsoft Stock






The early days of January are typically a time of unbridled optimism. This will be the year we lose 10 pounds and learn to speak French; Japan will turn itself around; Microsoft (MSFT) stock will pull itself out of a decade of doldrums.


Most analysts are betting that the Redmond computer company’s time has come. The company’s fiscal-year revenue has nearly tripled to $ 74 billion in the last 10 years. At $ 27, the shares trade right at their 10-year average and yield more than it costs the company to issue debt. Redmond has Skunk-Worked an exciting new tablet and operating system it’s eager to showcase. It’s all backed by ridiculous amounts of free cash and a fortress-like balance sheet. The 12-month price target on the stock forecasts a 25 percent gain.






Still, the company has attracted at least one major detractor with a big megaphone: Barry Ritholtz, an asset manager who runs a quantitative research firm and founder of the well-trafficked blog The Big Picture. He considers the company a “classic value trap,” not unlike what its customers Dell (DELL) and Hewlett Packard (HPQ) were at the start of this annus horribilis. The problem, he says, is Microsoft Chief Executive Officer Steve Ballmer. “As long as he is running the show—he has missed every major trend in tech over the past decade—I have no confidence in the company.”


He has company. Activist investor David Einhorn has wanted Ballmer out for more than a year and was long the shares in hopes that such an ouster would boost Microsoft’s returns. The stock is up 3 percent this year, compared with the S&P 500’s 14 percent gain. The 13 years since Ballmer became CEO have included the Vista debacle, a thankfully thwarted bid to overpay for Yahoo! (YHOO), the ceding of search supremacy to Google (GOOG), and Apple’s (AAPL) envisioning and dominating much of the smartphone and tablet markets. Meanwhile, where’s that “Skype Phone” in every palm?


‘Value trap’ is a funny term, says Bill Koefoed, Microsoft’s general manager of investor relations. Microsoft, he says, is trading in line with the big-cap technology sector, which has recently been out of favor with investors.


“Enterprise tech hasn’t been as sexy to the press. But our relevance to the enterprise has grown in a huge way. Our database business is growing faster than Oracle’s (ORCL) and IBM’s (IBM).”


Koefoed says people focus on Windows, which provides a quarter of Microsoft’s overall revenue, but not on the comparable 25 percent contribution from the company’s servers and tools division, which he emphasizes that Ballmer has grown, from a $ 3 billion business, to a $ 19 billion enterprise over the past decade. ”Over time, the stock price works itself out. We’re doing a whole bunch of things to be shareholder-friendly. Over time, that will be reflected in our share price.”


Meanwhile, Koefoed says, it was under Ballmer that the company initiated and consistently increased its dividend—with Microsoft shareholders overwhelmingly backing the CEO last month.


Ritholtz is unpersuaded “Think of the difference between what is revealed by a single snapshot of Microsoft today vs. an extended video. Yes, you can see the current situation of lots of cash, a low price-earnings multiple, name recognition, enterprise usage. But what about the trajectory and changes to the underlying market for their goods and services?”


He says that other than Kinnect for Xbox 360, “it’s hard to see what Microsoft gets for its billions of [research and development] dollars.”


“The competitive landscape has been moving against Microsoft,” wrote N. Landell-Mills of Indigo Equity Research after Microsoft’s “uninspiring” latest quarterly report, which involved the company raising its dividend 15 percent. The analyst called the organization “un-innovative and complex” and “a digital dinosaur.”


The full rollout of Windows 8 could, of course, change that state of affairs. Not that early signs are promising.


With the PC replacement cycle stretched out and assailed by competition that Microsoft failed to oppose, Ritholtz has taken to comparing its fate to that of Maytag (WHR). “It was,” he says, “once hugely successful and innovative and created lots of products and markets. Now you replace your dishwasher every 10 years; that’s the only time you ever think of Maytag.”


Businessweek.com — Top News





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2 arrested after Guinea treasury chief killed






CONAKRY, Guinea (AP) — Officials in the West African nation of Guinea say they’ve arrested two suspects in the case of the killing of the country’s treasury chief, who was shot to death nearly two months ago.


Authorities paraded the pair in front of journalists Friday. Aissatou Boiro was killed as she was driving home. She had launched an investigation into the loss of 13 million francs ($ 1.8 million) which went missing from the state coffers.






The government says the suspects were found with Boiro‘s computer memory stick and mobile telephone.


The men denied any involvement in her slaying and said a friend had given them the items.


Boiro’s colleagues say she had zero tolerance for corruption and was intent on putting an end to the mismanagement of state funds.


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iOS apps see Christmas sales spike shrink in 2012






Distimo just released its statistics on Christmas Day app downloads and revenue growth… and the download spike is far smaller than it was last year. Back in 2011, Christmas Day iOS app download volume spiked 230% above the December average. This year, the increase was just 87% — far below industry expectations. The revenue spike came in at 70%.


[More from BGR: Google names 12 best Android apps of 2012]






Interestingly, iPad downloads increased by 140% this Christmas, implying that the iPhone download bounce was really modest.


[More from BGR: New purported BlackBerry Z10 specs emerge: 1.5GHz processor, 2GB RAM, 8MP camera]


A few weeks ago, AppAnnie released statistics showing that iOS app revenue growth had stalled over the summer of 2012, whereas Android app revenue growth was relatively strong at 48% over a five month period. Both Distimo and Appannie are respected companies and their analytics are closely followed by app industry professionals. Could it be that the pace of iPhone app revenue growth has slowed down sharply from 2011 levels, even if Distimo and AppAnnie numbers aren’t entirely accurate?


This article was originally published by BGR


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“Rescue Me” singer Fontella Bass dies aged 72






(Reuters) – American soul singer Fontella Bass, who topped the R&B chart in 1965 with the song “Rescue Me,” died in St. Louis. She was 72.


Bass died in hospice care on Wednesday night from complications of a heart attack she suffered three weeks ago, her daughter, Neuka Mitchell, told Reuters. Bass had also suffered from strokes in recent years.






“She’s going to be missed,” Mitchell said. “Her big personality. Her love for family. Her big, giving heart and her cooking.”


She was known as the “queen of soul food” to her family, Mitchell said.


Bass was born into a singing family in St. Louis. Her mother, Martha Bass, was a singer in the Clara Ward Singers gospel group. Her brother, the late R&B singer David Peaston, scored a handful of hits in the 1980s and 1990s.


Bass first achieved success dueting with Bobby McClure in 1965 on songs such as “Don’t Mess Up A Good Thing” and “You’ll Miss Me (When I’m Gone),” both of which were hits on the pop and R&B charts.


Bass’ biggest hit came with “Rescue Me,” which shot up the Billboard pop charts in the fall of 1965, becoming one of the most popular soul hits of all time.


“It held a special place in her heart,” Mitchell said of the song. “She sang it every time she performed.”


The song has been covered and sampled numerous times over the years, including by pop stars Linda Ronstadt and Cher, and more recently in 2000 by UK group Nu Generation, who remixed the song into a dance track.


Nu Generation’s remix, “In Your Arms (Rescue Me)” hit the top 10 of the UK singles chart.


Bass had moderate success in later years with a gospel album in the 1990s, but was unable to emulate the popularity set by “Rescue Me.”


She was married to jazz trumpeter and composer Lester Bowie. The two spent time living in Europe in the late 1960s and early 1970s before moving back to the United States.


Funeral arrangements for Bass have not been finalized. The singer is survived by her four children.


(Reporting by Eric Kelsey and Piya Sinha-Roy; Editing by Doina Chiacu)


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Senator McConnell says still time to avert “fiscal cliff”






WASHINGTON (Reuters) – The top Republican in the U.S. Senate, Mitch McConnell, on Thursday said that there is still time to avert the “fiscal cliff” and a “wholly preventable economic crisis.”


In a speech on the Senate floor McConnell warned, however, that Senate Republicans “aren’t about to write a blank check for anything Senate Democrats put forward just because we find ourselves at the edge of the cliff.”






Lawmakers and President Barack Obama are up against a December 31 deadline for finding a way to stop $ 600 billion in potentially harmful tax hikes and spending cuts from taking effect with an alternative deficit-reduction formula.


(Reporting By Richard Cowan and David Lawder; Editing by Sandra Maler)


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Factbox: “Fiscal cliff” tax, budget provisions in detail






WASHINGTON (Reuters) – The “fiscal cliff” is only days away and efforts to avert it are making little progress, with some U.S. lawmakers predicting the tax increases and federal spending cuts involved will start taking hold in January, unless a deal comes together very quickly.


If these jolts to the economy are allowed to occur, a recession could follow, economists have forecast.






Consumer spending power suddenly would be reduced if the nation tumbles over the “cliff.” The U.S. government’s annual tax take would rise by $ 500 billion, significantly lowering the federal budget deficit, but at a high economic price.


On average, each U.S. household’s tax bill would rise by $ 3,500; for middle-income households, by almost $ 2,000, according to the Tax Policy Center, a non-partisan think tank.


Here are the key tax increases, spending cuts and other issues that have come to be known as the “fiscal cliff”:


TAX MEASURES


* Income tax rates. On December 31, low ordinary income tax rates enacted on a “temporary” basis in 2001 under former Republican President George W. Bush are set to expire.


President Barack Obama, his fellow Democrats and Republicans in Congress agreed at the end of 2010 to extend these rates for two years, but only a few days remain on that timetable.


If Congress and Obama do nothing by December 31, taxes will rise for most Americans. Rates will go up to 15, 28, 31, 36 and 39.6 percent from the present 10, 15, 25, 28, 33 and 35 percent.


Obama and the Democrats want to prevent this by extending the Bush tax rates again, but only for income below $ 200,000 per individual, or $ 250,000 per family. For income above that level, they seek a return to the higher, pre-Bush tax rates.


Republicans are divided. Some who oppose tax increases of any kind want the Bush tax rates to be extended at all income levels. Others, including House of Representatives Speaker John Boehner, have supported letting rates rise, but only on incomes above $ 1 million – a much higher level than Democrats support.


Obama proposed a compromise level of $ 400,000, but this was spurned by Republicans. Boehner spent several days last week trying to pass a measure in the House, which he leads, with the $ 1-million threshold. But he lacked the votes and gave up.


Afterward, Boehner said Obama and the Democratic-controlled Senate must work out a compromise. The Senate has returned from its holiday break. The Republican-controlled House has not but is expected to return late on Sunday.


* Investment income tax rates. Bush and Congress in 2003 cut taxes on capital gains and dividends, most of which go to high-income taxpayers. These cuts are set to expire at year-end too.


If no action is taken, the long-term capital gains tax rate will rise to 20 percent from 15 percent for the top four tax brackets. At the bottom, they will rise to 10 percent from zero.


Obama wants to let the capital gains rate rise to 20 percent from 15 percent for income above the $ 200,000/$ 250,000 level. Taxes on gains below that would still top out at 15 percent.


Without action from Congress, the dividend tax rate will rise to the ordinary income tax rates for each tax bracket. That would be as high as 39.6 percent for top earners, up from 15 percent now for dividends on qualified, long-term investments.


Obama wants to keep the 15 percent qualified dividend rate cap for most people, but let it rise on income above the $ 200,000/$ 250,000 threshold, to 36 percent or 39.6 percent.


* Personal exemption phase-out and itemized deduction limit. These caps on personal exemptions and itemized deductions will return in 2013 if Congress does not intervene. Both apply to upper-income taxpayers and would limit their ability to lower their tax bills. The caps were eliminated in stages by Bush. But the expiration of his tax cuts means the caps would come back.


* Obama healthcare tax. Regardless of what happens with the fiscal cliff, investment income above $ 200,000/$ 250,000 will be subject to a new 3.8 percent tax under Obama’s healthcare law.


* Alternative minimum tax. The AMT – which prevents upper income taxpayers from slashing their tax bills too much through tax breaks – expired at the end of 2011. That has not had an impact yet because 2012 tax returns have not been filed. The tax is not indexed for inflation. So it is routinely “patched” to prevent tens of millions of upper-middle-class taxpayers from having to start paying it. Both Republicans and Democrats support doing another patch, but have not approved one. The Internal Revenue Service has warned that as many as 100 million taxpayers could face refund delays without an AMT fix.


* Tax breaks. Dozens of individual and business tax breaks expired at the end of 2011, including the research and development credit. There is wide support for extending them again, but businesses will be watching for any faltering.


* Payroll tax. A cut in the payroll tax was extended earlier this year, in an effort to boost the economy. The current 4.2 percent rate paid by about 160 million workers, down from the previous 6.2 percent rate, expires on December 31. Some Democrats, including Obama, back extending the tax cut. The powerful AARP seniors’ lobby opposes renewing the cut, fearing the Social Security system that it helps fund will be undermined.


* Estate tax. The estate tax, which applies to assets passed onto heirs, currently stands at 35 percent, after an exemption level of $ 5 million. With no action, the tax will rise to 55 percent, after excluding the first $ 1 million of value. Obama wants to raise the tax to 45 percent, with a $ 3.5 million exemption, but some high-profile Democrats have come out in support of keeping the current tax and exemption levels. Many Republicans want a repeal of what they call the “death tax.”


BUDGET MEASURES


* Automatic spending cuts. In a deal last year to raise the U.S. debt ceiling, Obama and Congress agreed to $ 1.2 trillion in across-the-board spending cuts if lawmakers failed to reach a deficit-cutting deal by January 2. They failed. Now lawmakers fear the cuts, known as a “sequester,” could harm the economy. Obama has proposed delaying the cuts for a year.


* Unemployment benefits. Millions of people have been exhausting their government jobless benefits during the economic downturn. Congress has extended the benefits several times. Another deadline comes at year-end. Many Republicans want the extensions to stop, saying they discourage job-hunting. Obama has proposed extending the benefits.


* “Doc fix.” Because of an outdated formula in the law, government payments to doctors who treat patients on Medicare, the U.S. health program for the elderly and disabled, are routinely underestimated. If Congress doesn’t fix the situation by the end of the year, the doctors face a double-digit cut to their payments, which could lead them to drop Medicare patients.


DEBT CEILING


The Treasury Department on December 26 announced the first in a series of measures to delay by two months or so the day when the government will exceed its legal borrowing authority. Without action, Treasury said the $ 16.4 trillion debt ceiling would be reached on December 31. Obama wants it raised under a deal to avoid the cliff and he wants new power to raise it himself.


(Additional reporting by Richard Cowan, David Lawder, Tom Ferraro, Rachelle Younglai; Editing by Howard Goller and Cynthia Osterman)


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China tightening controls on Internet






BEIJING (AP) — China‘s new communist leaders are increasing already tight controls on Internet use and electronic publishing following a spate of embarrassing online reports about official abuses.


The measures suggest China’s new leader, Xi Jinping, and others who took power in November share their predecessors’ anxiety about the Internet’s potential to spread opposition to one-party rule and their insistence on controlling information despite promises of more economic reforms.






“They are still very paranoid about the potentially destabilizing effect of the Internet,” said Willy Lam, a politics specialist at the Chinese University of Hong Kong. “They are on the point of losing a monopoly on information, but they still are very eager to control the dissemination of views.”


This week, China’s legislature took up a measure to require Internet users to register their real names, a move that would curtail the Web’s status as a freewheeling forum to complain, often anonymously, about corruption and official abuses. The legislature scheduled a news conference Friday to discuss the measure, suggesting it was expected to be approved.


That comes amid reports Beijing might be disrupting use of software that allows Web surfers to see sites abroad that are blocked by its extensive Internet filters. At the same time, regulators have proposed rules that would bar foreign companies from distributing books, news, music and other material online in China.


Beijing promotes Internet use for business and education but bans material deemed subversive or obscene and blocks access to foreign websites run by human rights and Tibet activists and some news outlets. Controls were tightened after social media played a role in protests that brought down governments in Egypt and Tunisia.


In a reminder of the Web’s role as a political forum, a group of 70 prominent Chinese scholars and lawyers circulated an online petition this week appealing for free speech, independent courts and for the ruling party to encourage private enterprise.


Xi and others on the party’s ruling seven-member Standing Committee have tried to promote an image of themselves as men of the people who care about China’s poor majority. They have promised to press ahead with market-oriented reforms and to support entrepreneurs but have given no sign of support for political reform.


Communist leaders who see the Internet as a source of economic growth and better-paid jobs were slow to enforce the same level of control they impose on movies, books and other media, apparently for fear of hurting fledgling entertainment, shopping and other online businesses.


Until recently, Web surfers could post comments online or on microblog services without leaving their names.


That gave ordinary Chinese a unique opportunity to express themselves to a public audience in a society where newspapers, television and other media are state-controlled. The most popular microblog services say they have more than 300 million users and some users have millions of followers reading their comments.


The Internet also has given the public an unusual opportunity to publicize accusations of official misconduct.


A local party official in China’s southwest was fired in November after scenes from a videotape of him having sex with a young woman spread quickly on the Internet. Screenshots were uploaded by a former journalist in Beijing, Zhu Ruifeng, to his Hong Kong website, an online clearing house for corruption allegations.


Some industry analysts suggest allowing Web surfers in a controlled setting to vent helps communist leaders stay abreast of public sentiment in their fast-changing society. Still, microblog services and online bulletin boards are required to employ censors to enforce content restrictions. Researchers say they delete millions of postings a day.


The government says the latest Internet regulation before the National People’s Congress is aimed at protecting Web surfers’ personal information and cracking down on abuses such as junk e-mail. It would require users to report their real names to Internet service and telecom providers.


The main ruling party newspaper, People’s Daily, has called in recent weeks for tighter Internet controls, saying rumors spread online have harmed the public. In one case, it said stories about a chemical plant explosion resulted in the deaths of four people in a car accident as they fled the area.


Proposed rules released this month by the General Administration of Press and Publications would bar Chinese-foreign joint ventures from publishing books, music, movies and other material online in China. Publishers would be required to locate their servers in China and have a Chinese citizen as their local legal representative.


That is in line with rules that already bar most foreign access to China’s media market, but the decision to group the restrictions together and publicize them might indicate official attitudes are hardening.


That comes after the party was rattled by foreign news reports about official wealth and misconduct.


In June, Bloomberg News reported that Xi’s extended family has amassed assets totaling $ 376 million, though it said none was traced to Xi. The government has blocked access to Bloomberg’s website since then.


In October, The New York Times reported that Premier Wen Jiabao’s relatives had amassed $ 2.7 billion since he rose to national office in 2002. Access to the Times’ Chinese-language site has been blocked since then.


Previous efforts to tighten controls have struggled with technical challenges in a country with more than 500 million Internet users.


Microblog operators such as Sina Corp. and Tencent Ltd. were ordered in late 2011 to confirm users’ names but have yet to finish the daunting task.


Web surfers can circumvent government filters by using virtual private networks — software that encrypts Web traffic and is used by companies to transfer financial data and other sensitive information. But VPN users say disruptions that began in 2011 are increasing, suggesting Chinese regulators are trying to block encrypted traffic.


Curbs on access to foreign sites have prompted complaints by companies and Chinese scientists and other researchers.


In July, the American Chamber of Commerce in China said 74 percent of companies that responded to a survey said unstable Internet access “impedes their ability to do business.”


Chinese leaders “realize there are detrimental impacts on business, especially foreign business, but they have counted the cost and think it is still worthwhile,” said Lam. “There is no compromise about the political imperative of controlling the Internet.”


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Samsung expects to ship more than half a billion phones in 2013









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Natalie Portman, Kristen Stewart most bankable Hollywood stars






NEW YORK (Reuters) – Actresses Natalie Portman and Kristen Stewart are Hollywood’s most bankable stars and provide studios with the highest average returns for their films, according to Forbes.com.


Academy award winner Portman topped the list of best actors for the buck, providing about $ 42.70 for every dollar she earns.






“Black Swan,” for which she won her best actress Oscar, was produced for an estimated $ 13 million and earned $ 329 million in global box office sales.


“We estimate that for every dollar Portman is paid by the studios, she returns $ 42.70. Compare that to Eddie Murphy, our most overpaid star, who returns $ 2.30 for every dollar he gets paid,” Forbes.com said.


“Twilight” star Stewart was not far behind, bringing in $ 40.60. She also topped the Forbes list of highest-earning actresses with an estimated $ 34.5 million in salary in 2012.


“Stewart was able to earn a ton over the last three years and offer a healthy return thanks to ‘Twilight,’” according to Forbes.com. “Even though she was paid $ 25 million to star in the last two films, she was clearly worth the money.”


Forbes.com analyzed salaries, estimated box office grosses from the actor’s last three films over the previous three years to calculate the studio’s return on investment. The most bankable stars tended to be featured in the most profitable films.


Stewart’s two co-stars in the “Twilight” films were also good investments for the studio. Robert Pattinson came in fourth with a return of $ 31.70 and Taylor Lautner was No. 6, making $ 29.50 for the studio for every dollar he was paid.


(This story was refiled to correct spelling of Kristen)


(Editing by Steve Orlofsky)


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