Recipes for Health: Spinach and Turkey Salad — Recipes for Health


Andrew Scrivani for The New York Times







Turkey or chicken transforms this classic spinach salad (minus the bacon) into a light main dish, welcome after Thanksgiving and before the rest of the holiday season feasting begins.




2 cups (12 ounces) shredded cooked turkey, chicken breast or chicken breast tenders


1 6-ounce bag baby spinach


6 white or cremini mushrooms, thinly sliced


1 cup cooked wild rice


2 tablespoons chopped walnuts


1 to 2 hard boiled eggs (to taste), finely chopped (optional)


2 tablespoons chopped chives


1 to 2 tablespoons chopped fresh herbs such as parsley, tarragon or marjoram


For the dressing:


2 tablespoons fresh lemon juice


1 tablespoon red wine vinegar, tarragon vinegar or sherry vinegar


1 teaspoon Dijon mustard


Salt and freshly ground pepper


1 small garlic clove, pureed


1/3 cup extra virgin olive oil


2 tablespoons plain low-fat yogurt


1. Combine all of the salad ingredients in a large salad bowl. Whisk together the lemon juice, vinegar, Dijon mustard, salt, pepper, garlic, olive oil and yogurt. Toss with the salad just before serving.


Yield: Serves 4 as a main dish


Advance preparation: The salad can be assembled and the dressing mixed several hours before serving. Refrigerate and toss together when ready to serve.


Variation: Add 1 ripe but firm persimmon, peeled, cored and sliced, to the mixture.


Nutritional information per serving: 375 calories; 25 grams fat; 4 grams saturated fat; 5 grams polyunsaturated fat; 15 grams monounsaturated fat; 53 milligrams cholesterol; 14 grams carbohydrates; 2 grams dietary fiber; 119 milligrams sodium (does not include salt to taste); 26 grams protein


Martha Rose Shulman is the author of “The Very Best of Recipes for Health.”


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Facebook Gift Store Urges Users to Shop While They Share





SAN FRANCISCO — Facebook is already privy to its users’ e-mail addresses, wedding pictures and political beliefs. Now the company is nudging them to share a bit more: credit card numbers and offline addresses.







James Best Jr./The New York Times

Facebook Gifts is a service that prompts users to buy things for friends on the social network.






Sharing Even More




What do you think about Facebook’s plan to have users buy gifts for their friends through the site using their credit cards?







A screenshot of Facebook Gifts.






The nudge comes from a new Facebook service called Gifts. It allows Facebook users — only in the United States for now — to buy presents for their friends on the social network. On offer are items as varied as spices from Dean & DeLuca, pajamas from BabyGap and subscriptions to Hulu Plus, the video service. This week Facebook added iTunes gift cards.


The gift service is part of an aggressive moneymaking push aimed at pleasing Facebook’s investors after the company’s dismal stock market debut. Facebook has stepped up mobile advertising and is starting to customize the marketing messages it shows to users based on their Web browsing outside Facebook.


Those efforts seem to have brought some relief to Wall Street. Analysts issued more bullish projections for the company in recent days, and the stock was up 49 percent from its lowest point, closing Tuesday at $26.15, although that is still well below the initial offering price of $38. The share price has been buoyed in part by the fact that a wave of insider lockup periods expired without a flood of shares hitting the market.


To power the Gifts service, Facebook rented a warehouse in South Dakota and created its own software to track inventory and shipping. It will not say how much it earns from each purchase made through Gifts, though merchants that have a similar arrangement with Amazon.com give it a roughly 15 percent cut of sales.


If it catches on, the service would give Facebook a toehold in the more than $200 billion e-commerce market. Much more important, it would let the company accumulate a new stream of valuable personal data and use it to refine targeted advertisements, its bread and butter. The company said it did not now use data collected through Gifts for advertising purposes, but could not rule it out in the future.


“The hard part for Facebook was aggregating a billion users. Now it’s more about how to monetize those users without scaring them away,” said Colin Sebastian, an analyst with Robert W. Baird.


He added: “Gifts should also contribute more to Facebook’s treasure trove of user data, which has the benefit of a virtuous cycle, driving more personalization of the site, leading to better and more targeted ads, which improves overall monetization.”


Facebook already collects credit card information from users who play social games on its site. But they are a limited constituency, and a wider audience may be persuaded to buy a gift when Facebook reminds them that a friend is expecting a baby or a cousin is approaching her 40th birthday.


The Gifts service, which grew out of Facebook’s acquisition of a mobile application called Karma, was introduced in September and expanded earlier this month on the eve of the holiday shopping season.


Magnolia Bakery, based in New York, was among Facebook’s early partners for Gifts. Its vice president for public relations, Sara Gramling, said the company had sold roughly 200 packages of treats since then. She counted it as a marketing success. The bakery, which gained fame thanks to “Sex and the City,” had only recently begun shipping its goods. “It was a great opportunity to expand our network,” she said.


Magnolia Bakery isn’t exactly catering to the masses. A half-dozen cupcakes cost $35, plus about $12 for shipping. Facebook, Ms. Gramling said, takes care of the billing. The bakery is eyeing Facebook’s global reach, too, as it opens outlets internationally, especially in the Middle East.


One of the appeals of Facebook Gifts is the ease of making a purchase. Facebook users are nudged to buy a gift (a gift-box icon pops up) for Facebook friends on their birthdays. They are offered a vast menu to choose from: beer glasses, cake pops, quilts, marshmallows, magazine subscriptions and donations to charity. They are asked to choose a greeting card. Then they are asked for credit card details. Facebook says it stores that credit card information, unless users remove it after making a purchase.


Facebook has declined to say how many users have bought gifts, only that among those who have, the average purchase is $25.


David Streitfeld contributed reporting.



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Egypt’s President Said to Limit Scope of Judicial Decree


Tara Todras-Whitehill for The New York Times


Egyptians at a burned-out school in Cairo on Monday before the funeral of an activist who was injured in a clash and died Sunday.







CAIRO — With public pressure mounting, President Mohamed Morsi appeared to pull back Monday from his attempt to assert an authority beyond the reach of any court. His allies in the Muslim Brotherhood canceled plans for a large demonstration in his support, signaling a chance to calm an escalating battle that has paralyzed a divided nation.




After Mr. Morsi met for hours with the judges of Egypt’s Supreme Judicial Council, his spokesman read an “explanation” on television that appeared to backtrack from a presidential decree placing Mr. Morsi’s official edicts above judicial scrutiny — even while saying the president had not actually changed a word of the statement.


Though details of the talks remained hazy, and it was not clear whether the opposition or the court would accept his position, Mr. Morsi’s gesture was another demonstration that Egyptians would no longer allow their rulers to operate above the law. But there appeared little chance that the gesture alone would be enough to quell the crisis set off by his perceived power grab.


Protesters remained camped in Tahrir Square, and the opposition was moving ahead with plans for a major demonstration on Tuesday.


The presidential spokesman, Yasser Ali, said for the first time that Mr. Morsi had sought only to assert pre-existing powers already approved by the courts under previous precedents, not to free himself from judicial oversight.


He said that the president meant all along to follow an established Egyptian legal doctrine suspending judicial scrutiny of presidential “acts of sovereignty” that work “to protect the main institutions of the state.” The judicial council had said Sunday that it could bless aspects of the decree deemed to qualify under the doctrine.


Mr. Morsi had maintained from the start that his purpose was to empower himself to prevent judges appointed by former President Hosni Mubarak from dissolving the constituent assembly, which is led by his fellow Islamists of the Muslim Brotherhood’s Freedom and Justice Party. The courts have already dissolved the Islamist-led Parliament and an earlier constituent assembly, and the Supreme Constitutional Court was widely expected to rule against this one next week.


But the text of the original decree had exempted all presidential edicts from judicial review until the ratification of a constitution, not just those edicts related to the assembly or justified as “acts of sovereignty.”


Legal experts said that the spokesman’s explanations of the president’s intentions, if put into effect, would amount to a revision of the decree Mr. Morsi issued last Thursday. But lawyers said that the verbal statements alone carried little legal weight.


How the courts would apply the doctrine remained hard to predict. And Mr. Morsi’s opposition indicated it was holding out for far greater concessions, including the breakup of the whole constituent assembly.


Speaking at a news conference while Mr. Morsi was meeting with the judges, the opposition activist and intellectual Abdel Haleem Qandeil called for “a long-term battle,” declaring that withdrawal of Mr. Morsi’s new powers was only the first step toward the opposition’s goal of “the withdrawal of the legitimacy of Morsi’s presence in the presidential palace.” Completely withdrawing the edict would be “a minimum,” he said.


Khaled Ali, a human rights lawyer and former presidential candidate, pointed to the growing crowd of protesters camped out in Tahrir Square for a fourth night. “The one who did the action has to take it back,” Mr. Ali said.


Moataz Abdel Fattah, a political scientist at Cairo University, said Mr. Morsi was saving face during a strategic retreat. “He is trying to simply say, ‘I am not a new pharaoh; I am just trying to stabilize the institutions that we already have,’ ” he said. “But for the liberals, this is now their moment, and for sure they are not going to waste it, because he has given them an excellent opportunity to score.”


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Newton leads Panthers past Eagles 30-22

PHILADELPHIA (AP) — They were two words on a sponsor's banner draped behind the Philadelphia Eagles' postgame podium: Imagine. Change.

For disgusted Eagles fans, that's all they can do, especially with coach Andy Reid still running the show. They won't have to imagine much longer.

After 14 seasons, one Super Bowl appearance, and, now a dreadful losing streak, the countdown to the end of Reid's tenure is hitting high gear in Philadelphia. Owner Jeffrey Lurie already has said that an 8-8 record would be "unacceptable" this year.

The Eagles would have to finish 5-0 just to get there after Cam Newton threw for two touchdowns and ran for two more to lead the Carolina Panthers to a 30-22 victory over the Philadelphia Eagles on Monday night.

Newton, who hadn't played up to his sensational rookie season, showed no signs of a sophomore slump against Philadelphia's porous pass defense. He finished 18 of 28 for 306 yards and had a passer rating of 125 in a matchup of teams with the worst records in the NFC.

Newton was only the latest player to shine against an Eagles (3-8) team about all out of hope. The Eagles haven't won since beating the defending Super Bowl champion New York Giants to go 3-1, a skid that has put Reid's job in real jeopardy. Unless Lurie has an implausible change of heart, Reid's run is about over, an inglorious end for the coach who led the Eagles to five conference championship games.

Lurie ducked out of a pregame press conference for the team's Hall of Fame before he could take questions from reporters. Reid said he hasn't discussed his job status with his boss.

"I'm not worried about all of the other things," Reid said. "I'm worried about winning football games and making sure I get my players coached up to where we do a better job with that."

As Philadelphia's seventh straight loss came to a close, some fed-up fans held up a banner that read, "Jeff This Is On You."

While Lurie surely joins Reid in taking a share of the blame for this ugly season, the players have been awful.

"I feel bad for Andy because he's in a horrible situation in a town that is critical, and rightly so," tight end Brent Celek said. "If I was the fans, I'd be mad, too. I don't see Andy as the problem. I see it as us."

Their latest problem was an inability to solve Newton.

Newton, the No, 1 overall pick in 2011, lived up to the hype by throwing for 4,051 yards with 21 TD passes and 14 TDs on the ground in his first year. He entered this game with only nine TD passes and four TDs rushing, a major disappointment for Panthers fans.

But Newton outshined rookie seventh-round pick Nick Foles in his Monday night debut.

Newton had a 24-yard TD toss over the middle to a wide-open Gary Barnidge for a 7-3 lead. He connected with Brandon LaFell on a 43-yard pass to make it 14-3 later in the first quarter. LaFell was wide open on the play, taking advantage of another breakdown in coverage in the secondary.

Newton led a 95-yard drive to open the third quarter, finishing it off with a 1-yard leap to give the Panthers a 21-15 lead. Newton hit Louis Murphy for a 55-yard gain on a second-and-11 from Carolina's 16.

"I think my best game is still to come," Newton said. "I'm still focused on getting better each and every week."

Carolina (3-8) went ahead 24-22 early in the fourth quarter on Graham Gano's 23-yard field goal.

"It's been a long time in coming," Panthers coach Ron Rivera said. "Lots of people contributed and made plays. Real proud of what we did and the things we did to give ourselves a chance to win."

Bryce Brown set an Eagles' rookie record with 178 yards rushing, including TD runs of 65 and 5 yards. Brown, filling in for injured running back LeSean McCoy, surpassed Correll Buckhalter's rookie mark of 134 yards rushing in his first start since his senior year at Wichita East High School in 2008. Brown also lost two fumbles, including one in Panthers' territory.

Foles was so-so in his second straight start for Michael Vick, who sat out with a concussion. Foles was 16 of 21 for 119 yards.

"The most important thing for me was for us to get the win and that didn't happen tonight," Brown said. "I felt like a lot of that had to do with my two turnovers. It really, really cost us."

After Gano's field goal put them up for good, the Panthers finally stopped Brown when it mattered most, stuffing him on a fourth-and-1 to take over on downs at their 40. Newton led them downfield, running in from the 2 to make it 30-22. Gano, signed last week, missed the extra point. But Brandon Boykin fumbled after a 44-yard kickoff return, the Panthers recovered and held the ball the final 4:29.

The Panthers have shown they're better than their record. They have lost six games by less than a touchdown, including a 2-point loss at Atlanta and a 1-point loss at Chicago.

"It's a huge stage, Monday Night Football, on the road," tackle Jordan Gross said. "It was just big for us and big for the guys on the team who haven't experienced something like this."

For the Eagles, it was simply the latest loss in a season stuffed with them. The Linc was quiet and empty except for some boos when busted coverage led to another Carolina TD. They fled for the exits once the Panthers took over for the final time.

Dwindling fan support is one thing. Losing it from Lurie is quite another for Reid.

"He's as competitive as anybody and he wants to win games," Reid said. "That's what he's in this business for."

NOTES: Neither Vick nor McCoy has been cleared to return to practice. The injury-depleted Eagles lost wide receiver DeSean Jackson (sternum) and defensive tackle Fletcher Cox (tail bone) in the first half. ... The Eagles inducted five-time Pro Bowl cornerback Troy Vincent and longtime front office executive Leo Carlin into the team's Hall of Fame at halftime. ... Brown's 65-yard TD run was the longest for the Eagles since McCoy's 66-yard TD vs NYG on Nov. 1, 2009. ... Buckhalter had 134 yards rushing vs. Arizona on Oct. 7, 2001. ... Newton led the Panthers with 52 yards rushing.

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Follow Dan Gelston on Twitter: https://twitter.com/APGelston

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Online: http://pro32.ap.org/poll and http://twitter.com/AP_NFL

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Recipes for Health: Quinoa Salad With Avocado and Kalamata Olives — Recipes for Health


Andrew Scrivani for The New York Times







This is inspired by a salad I recently enjoyed in a small vegetarian restaurant called Siggy’s on Henry Street in Brooklyn Heights. They called it a quinoa Greek salad, but really the only thing that was Greek about it was the kalamata olives. No matter, it was still delicious.




3/4 cup quinoa


1 1/4 cups water


Salt to taste


1 small cucumber, cut in half lengthwise, seeded and sliced, or 1 Persian cucumber, sliced; or 1/2 cup sliced or diced celery (from the inner heart)


1/4 cup kalamata olives, pitted and halved (about 12__ olives)


1 ripe avocado, diced


1 tablespoon slivered fresh mint leaves


2 tablespoons chopped fresh parsley


1 1/2 ounces feta cheese, crumbled (1/3 cup, optional)


1 6-ounce bag mixed spring salad greens, baby spinach, arugula, or a combination


For the dressing:


1 tablespoon freshly squeezed lemon juice


1 tablespoon sherry vinegar


1 teaspoon Dijon mustard


1 small garlic clove, pureed


Salt to taste


2 tablespoons extra virgin olive oil


1/3 cup buttermilk or plain low-fat yogurt


Freshly ground pepper


1. Place the quinoa in a strainer and rinse several times with cold water. Place in a medium saucepan with 1 1/4 cups water and salt to taste. Bring to a boil, cover and simmer 15 minutes, until the grains display a thread-like spiral and the water is absorbed. Remove from the heat, remove the lid and place a dish towel over the pan, then return the lid to the pan and let sit for 10 minutes or longer undisturbed. Transfer to a salad bowl and fluff with forks. Allow to cool.


2. Add the remaining salad ingredients except the salad greens to the bowl. Whisk together the dressing ingredients. If using yogurt, thin out if desired with a tablespoon of water.


3. Just before serving toss the lettuces with 3 tablespoons of the dressing. Toss the quinoa mixture with the rest of the dressing. Line a salad bowl or platter with the greens, top with the quinoa, and serve. Or if preferred, toss together the greens and quinoa mixture before serving.


Yield: Serves 4 to 6


Advance preparation: You can assemble the salad up to a day ahead but do not toss with the dressing until shortly before serving.


Nutritional information per serving (4 servings): 340 calories; 21 grams fat; 4 grams saturated fat; 3 grams polyunsaturated fat; 13 grams monounsaturated fat; 10 milligrams cholesterol; 30 grams carbohydrates; 7 grams dietary fiber; 347 milligrams sodium (does not include salt to taste); 9 grams protein


Nutritional information per serving (6 servings): 226 calories; 14 grams fat; 3 grams saturated fat; 2 grams polyunsaturated fat; 9 grams monounsaturated fat; 7 milligrams cholesterol; 20 grams carbohydrates; 5 grams dietary fiber; 231 milligrams sodium (does not include salt to taste); 6 grams protein


Martha Rose Shulman is the author of “The Very Best of Recipes for Health.”


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Puerto Rico Races to Rescue Its Pension Fund





Puerto Rico is fighting to stay afloat in a rising sea of debt.




Its economy is sputtering. Its population is shrinking. Its recent election is disputed. Its public pension fund is perilously low on cash. The American territory has just been through a brutal five-year recession, something not experienced in the United States as a whole since the 1930s.


Desperate to raise cash, Puerto Rican officials have been selling off anything they can: two toll roads and the main airport so far.


To bring in tax revenue, they are trying to lure people out of the underground economy. Coffee shops, hairdressers, even outdoor market stalls are being required to issue printed receipts with every sale. The receipts carry a lottery number, with a chance to win cars or cash, as an incentive to get shoppers to pay the island’s 7 percent sales tax.


Though many of Puerto Rico’s problems are reminiscent of Greece’s — tax noncompliance, a stagnant economy, years of issuing long-term debt to cover short-term payments — investors have had a nearly insatiable appetite for its bonds.


But now their support is dwindling. Some big investors are pruning their holdings. That is beginning to widen the cost of borrowing for Puerto Rico relative to other states and municipalities, which are benefiting from a big decline in borrowing costs. The interest rate its 30-year bonds now pay is about 2.5 percentage points higher than other municipal borrowers’, up from a difference of just 1.5 percentage points at the beginning of 2012, according to Municipal Market Data.


The possibility of a credit downgrade also hangs in the air, something that could lead to more selling.


“There is no specific event looming on the horizon,” said Alan Schankel, a managing director at Janney Capital Markets in Philadelphia. “But it’s a problem of immense magnitude, and it’s very challenging to sit here and see how they work their way out of it.”


Puerto Rico needs to be able to issue bonds at attractive rates to cover its short-term financing needs. Perhaps more important, it has to figure out how to salvage its retirement funds. After shortchanging them for years, it now has the weakest major public pension system in America.


The main fund, which serves about 250,000 government workers, past and present, is only 6 percent funded — a small percentage of what is considered the minimum needed for a marginally healthy pension plan — and could run out of money as soon as 2014. Another fund, for about 80,000 teachers, which is 20 percent funded, will last just a few years longer if nothing is done. Police officers and teachers in Puerto Rico have opted out of Social Security and rely entirely on their pensions.


“For now, I’m not totally shaken about the possibility of the fund going broke,” said Jorge Ramón Román, a 78-year-old retired instructor for the island’s Civil Air Patrol. “But I do fear for the future, when I’ll be an even older person, more infirm and with less of a pension.”


Héctor M. Mayol Kauffman, the executive director of the pension system, said it would be impossible to cut the benefits of people who are already retired, citing court precedent.


Puerto Rican officials were racing this fall to put together a rescue plan for the pension fund. Voters, though, pushed out Gov. Luis Fortuño, who had tried austerity measures that included cutting tens of thousands of government workers along with a revamping of the fund.


They elected Alejandro García Padilla, who promised to create 50,000 new jobs in the next 18 months. But the margin was razor-thin and Mr. Fortuño has requested a recount. Mr. García Padilla’s party had dropped out of the retirement overhaul effort, but the governor-elect says he will deal with the looming pension crisis with “diligence and promptness” and has put together a task force of economists and financial advisers.


“We will not leave retired government workers stranded at a bus stop in their older years,” he said.


Since the election, yields on the island’s 30-year bonds have continued to widen.


“I don’t think that there’s a default that’s about to happen, but a default isn’t the only bad thing that can happen when you’ve got bonds,” Mr. Schankel said. Puerto Rico’s bonds are just a notch or two above junk status. If they fall to that level, at least some institutions would be forced to sell, potentially setting off a chain reaction. And individual investors could get a jolt if they saw the value of their holdings fall. Many people own Puerto Rican debt without knowing it, through their mutual funds.


“The concern is that Puerto Rico is a systemic risk to the municipal bond market because it’s so widely held,” said Robert Donahue, a managing director with Municipal Market Advisors.


Rafael Matos contributed reporting from San Juan, P.R.



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As Rebels Gain, Congo Again Slips Into Chaos





GOMA, Democratic Republic of Congo — The lights are out in most of Goma. There is little water. The prison is an empty, garbage-strewn wasteland with its rusty front gate swinging wide open and a three-foot hole punched through the back wall, letting loose 1,200 killers, rapists, rogue soldiers and other criminals.




Now, rebel fighters are going house to house arresting people, many of whom have not been seen again by their families.


“You say the littlest thing and they disappear you,” said an unemployed man named Luke.


In the past week, the rebels have been unstoppable, steamrolling through one town after another, seizing this provincial capital, and eviscerating a chaotic Congolese Army whose drunken soldiers stumble around with rocket-propelled grenades and whose chief of staff was suspended for selling crates of ammunition to elephant poachers.


Riots are exploding across the country — in Bukavu, Butembo, Bunia, Kisangani and Kinshasa, the capital, a thousand miles away. Mobs are pouring into streets, burning down government buildings and demanding the ouster of Congo’s weak and widely despised president, Joseph Kabila.


Once again, chaos is courting Congo. And one pressing question is, why — after all the billions of dollars spent on peacekeepers, the recent legislation passed on Capitol Hill to cut the link between the illicit mineral trade and insurrection, and all the aid money and diplomatic capital — is this vast nation in the heart of Africa descending to where it was more than 10 years ago when foreign armies and marauding rebels carved it into fiefs?


“We haven’t really touched the root cause,” said Aloys Tegera, a director for the Pole Institute, a research institute in Goma.


He said Congo’s chronic instability is rooted in very local tensions over land, power and identity, especially along the Rwandan and Ugandan borders. “But no one wants to touch this because it’s too complicated,” he added.


The most realistic solution, said another Congo analyst, is not a formal peace process driven by diplomats but “a peace among all the dons, like Don Corleone imposed in New York.”


Congo’s problems have been festering for years, wounds that never quite scabbed over.


But last week there was new urgency after hundreds of rebel fighters, wearing rubber swamp boots and with belt-fed machine guns slung across their backs, marched into Goma, the capital of North Kivu Province and one of the country’s most important cities.


The rebels, called the M23, are a heavily armed paradox. On one hand, they are ruthless. Human rights groups have documented how they have slaughtered civilians, pulling confused villagers out of their huts in the middle of the night and shooting them in the head.


On the other hand, the M23 are able administrators — seemingly far better than the Congolese government, evidenced by a visit in recent days to their stronghold, Rutshuru, a small town about 45 miles from Goma.


In Rutshuru, there are none of those ubiquitous plastic bags twisted in the trees, like in so many other parts of Congo. The gravel roads have been swept clean and the government offices are spotless. Hand-painted signs read: “M23 Stop Corruption.” The rebels even have green thumbs, planting thousands of trees in recent months to fight soil erosion.


“We are not a rebellion,” said Benjamin Mbonimpa, an electrical engineer, a bush fighter and now a top rebel administrator. “We are a revolution.”


Their aims, he said, were to overthrow the government and set up a more equitable, decentralized political system. This is why the rebels have balked at negotiating with Mr. Kabila, though this weekend several rebels said that the pressure was increasing on them to compromise, especially coming from Western countries.


On Sunday, rebel forces and government troops were still squared off, just a few miles apart, down the road from Goma.


The M23 rebels are widely believed to be covertly supported by Rwanda, which has a long history of meddling in Congo, its neighbor blessed with gold, diamonds and other glittering mineral riches. The Rwandan government strenuously denies supplying weapons to the M23 or trying to annex eastern Congo. Rwanda has often denied any clandestine involvement in this country, only to have the denials later exposed as lies.


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Agency Investigates Deaths and Injuries Associated With Bed Rails


Thomas Patterson for The New York Times


Gloria Black’s mother died in her bed at a care facility.







In November 2006, when Clara Marshall began suffering from the effects of dementia, her family moved her into the Waterford at Fairway Village, an assisted living home in Vancouver, Wash. The facility offered round-the-clock care for Ms. Marshall, who had wandered away from home several times. Her husband Dan, 80 years old at the time, felt he could no longer care for her alone.








Thomas Patterson for The New York Times

Gloria Black, visiting her mother’s grave in Portland, Ore. She has documented hundreds of deaths associated with bed rails and said families should be informed of their possible risks.






But just five months into her stay, Ms. Marshall, 81, was found dead in her room apparently strangled after getting her neck caught in side rails used to prevent her from rolling out of bed.


After Ms. Marshall’s death, her daughter Gloria Black, who lives in Portland, Ore., began writing to the Consumer Product Safety Commission and the Food and Drug Administration. What she discovered was that both agencies had known for more than a decade about deaths from bed rails but had done little to crack down on the companies that make them. Ms. Black conducted her own research and exchanged letters with local and state officials. Finally, a letter she wrote in 2010 to the federal consumer safety commission helped prompt a review of bed rail deaths.


Ms. Black applauds the decision to study the issue. “But I wish it was done years ago,” she said. “Maybe my mother would still be alive.” Now the government is studying a problem it has known about for years.


Data compiled by the consumer agency from death certificates and hospital emergency room visits from 2003 through May 2012 shows that 150 mostly older adults died after they became trapped in bed rails. Over nearly the same time period, 36,000 mostly older adults — about 4,000 a year — were treated in emergency rooms with bed rail injuries. Officials at the F.D.A. and the commission said the data probably understated the problem since bed rails are not always listed as a cause of death by nursing homes and coroners, or as a cause of injury by emergency room doctors.


Experts who have studied the deaths say they are avoidable. While the F.D.A. issued safety warnings about the devices in 1995, it shied away from requiring manufacturers to put safety labels on them because of industry resistance and because the mood in Congress then was for less regulation. Instead only “voluntary guidelines” were adopted in 2006.


More warnings are needed, experts say, but there is a technical question over which regulator is responsible for some bed rails. Are they medical devices under the purview of the F.D.A., or are they consumer products regulated by the commission?


“This is an entirely preventable problem,” said Dr. Steven Miles, a professor at the Center for Bioethics at the University of Minnesota, who first alerted federal regulators to deaths involving bed rails in 1995. The government at the time declined to recall any bed rails and opted instead for a safety alert to nursing homes and home health care agencies.


Forcing the industry to improve designs and replace older models could have potentially cost bed rail makers and health care facilities hundreds of million of dollars, said Larry Kessler, a former F.D.A. official who headed its medical device office. “Quite frankly, none of the bed rails in use at that time would have passed the suggested design standards in the guidelines if we had made them mandatory,” he said. No analysis has been done to determine how much it would cost the manufacturers to reduce the hazards.


Bed rails are metal bars used on hospital beds and in home care to assist patients in pulling themselves up or helping them out of bed. They can also prevent people from rolling out of bed. But sometimes patients — particularly those suffering from Alzheimer’s — can get confused and trapped between a bed rail and a mattress, which can lead to serious injury or even death.


While the use of the devices by hospitals and nursing homes has declined as professional caregivers have grown aware of the dangers, experts say dozens of older adults continue to die each year as more rails are used in home care and many health care facilities continue to use older rail models.


Since those first warnings in 1995, about 550 bed rail-related deaths have occurred, a review by The New York Times of F.D.A. data, lawsuits, state nursing home inspection reports and interviews, found. Last year alone, the F.D.A. data shows, 27 people died.


As deaths continued after the F.D.A. warning, a working group put together in 1999 and made up of medical device makers, researchers, patient advocates and F.D.A. officials considered requiring bed rail makers to add warning labels.


But the F.D.A. decided against it after manufacturers resisted, citing legal issues. The agency said added cost to small manufacturers and difficulties of getting regulations through layers of government approval, were factors against tougher standards, according to a meeting log of the group in 2000 and interviews.


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Oprah Winfrey Seeks a Younger Audience to Bolster a Flagging Empire


Stephanie Diani for The New York Times


Oprah Winfrey spoke last month at a convention held by O, The Oprah Magazine, in Los Angeles.







LOS ANGELES — It’s not easy to find a fresh way to photograph Oprah Winfrey.




That’s why the editors of O, The Oprah Magazine, recently tried to create a shot that recalled the glory days of Ms. Winfrey’s syndicated talk show. They arranged to photograph her for its April 2013 issue as she stepped onstage to speak to 5,000 attendees at the magazine’s annual conference, a New Age slumber party of sorts for women held at the convention center here last month. When Ms. Winfrey confidently strode out dressed in a sea foam green V-neck dress and a pair of perilously tall ruby red stilettos, the audience collectively leapt to its feet and shrieked at the sight of her.


“I love you, Oprah,” some women shouted, while other fans brushed away tears. “I love you back,” she responded in her signature commanding voice. “It’s no small thing to get the dough to come here.”


Ms. Winfrey, who used to receive this kind of applause from fans five days a week, has had fewer such receptions since the talk show she hosted for 25 years ended 18 months ago. The cable network OWN, which she started with Discovery Communications, is emerging from low ratings and management shake-ups. And without a regular presence on daytime network television, she cannot steer traffic to her other products as easily as in the past. Her magazine, in particular, has experienced a decline in advertising revenue and newsstand sales since the talk show finished.


“She’s still Oprah. But she’s still struggling,” said Janice Peck, an associate professor of journalism and mass communication at the University of Colorado who wrote the 2008 book “The Age of Oprah.” “I think she’s scared, even though she’s very, very rich and she’s always going to be very, very rich. The possibility of failure, it’s quite scary.”


Ms. Winfrey, 58, has shown some signs of strain. She arrived at the conference with faint shadows under her eyes and announced to her best friend, Gayle King, and the audience simultaneously that she had a breast cancer scare the week before. (It was ultimately a false alarm.) When Ms. King grew visibly upset, one woman chided Ms. Winfrey for not telling her friend ahead of time and ordered her to apologize to Ms. King — all before an audience. Ms. Winfrey also did not hide her dissatisfaction with the criticism she had faced. She told the audience, “the press tried to cut me off at the knees” in its coverage of OWN, and bristled at questions about the challenges her magazine confronted.


“I don’t care what the form is,” Ms. Winfrey said with the conviction of a preacher. “I care about what the message is.”


With signs of progress at OWN, Ms. Winfrey now has more time to devote to other media platforms — her magazine, her radio channel on XM Satellite Radio, her Facebook page, which has 7.8 million subscribers, her Twitter account, which has nearly 15 million followers, and her latest content channel on The Huffington Post.


“It’s all an opportunity to speak to people,” Ms. Winfrey said as she sat for an interview during the conference, a pair of glittery gold stilettos slung in her hand and a couple of handlers in the corner quietly tapping away at smartphones. She pushed aside a bottle of sparkling water, a glass with a silver straw and a delicate orchid placed before her and spoke frankly about her plans.


“Ultimately, you have to make money because you are a business. I let other people worry about that. I worry about the message. I am always, always, always about holding true to the vision and the message, and when you are true to that, then people respond.”


When it comes to the magazine, Ms. Winfrey said her staff prepared her to expect a 25 percent decline in newsstand sales after the talk show ended. (It has been closer to 22 percent.) And while she acknowledged that she enjoyed “holding the magazine in my hand,” she was pragmatic about print’s future and said she would stop publishing a print magazine if it were not profitable.


“Obviously, the show was helping in ways that you know I hadn’t accounted for,” Ms. Winfrey said. “I’m not interested, you know, in bleeding money.”


Ms. Winfrey, who spoke in a conference room over the roars of an expectant crowd in the convention space below, said she knew that her brand’s strength stemmed from how she resonated with a breadth of viewers.


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White House Presses for Drone Rule Book





WASHINGTON — Facing the possibility that President Obama might not win a second term, his administration accelerated work in the weeks before the election to develop explicit rules for the targeted killing of terrorists by unmanned drones, so that a new president would inherit clear standards and procedures, according to two administration officials.




The matter may have lost some urgency after Nov. 6. But with more than 300 drone strikes and some 2,500 people killed by the Central Intelligence Agency and the military since Mr. Obama first took office, the administration is still pushing to make the rules formal and resolve internal uncertainty and disagreement about exactly when lethal action is justified.


Mr. Obama and his advisers are still debating whether remote-control killing should be a measure of last resort against imminent threats to the United States, or a more flexible tool, available to help allied governments attack their enemies or to prevent militants from controlling territory.


Though publicly the administration presents a united front on the use of drones, behind the scenes there is longstanding tension. The Defense Department and the C.I.A. continue to press for greater latitude to carry out strikes; Justice Department and State Department officials, and the president’s counterterrorism adviser, John O. Brennan, have argued for restraint, officials involved in the discussions say.


More broadly, the administration’s legal reasoning has not persuaded many other countries that the strikes are acceptable under international law. For years before the Sept. 11, 2001, attacks, the United States routinely condemned targeted killings of suspected terrorists by Israel, and most countries still object to such measures.


But since the first targeted killing by the United States in 2002, two administrations have taken the position that the United States is at war with Al Qaeda and its allies and can legally defend itself by striking its enemies wherever they are found.


Partly because United Nations officials know that the United States is setting a legal and ethical precedent for other countries developing armed drones, the U.N. plans to open a unit in Geneva early next year to investigate American drone strikes.


The attempt to write a formal rule book for targeted killing began last summer after news reports on the drone program, started under President George W. Bush and expanded by Mr. Obama, revealed some details of the president’s role in the shifting procedures for compiling “kill lists” and approving strikes. Though national security officials insist that the process is meticulous and lawful, the president and top aides believe it should be institutionalized, a course of action that seemed particularly urgent when it appeared that Mitt Romney might win the presidency.


“There was concern that the levers might no longer be in our hands,” said one official, speaking on condition of anonymity. With a continuing debate about the proper limits of drone strikes, Mr. Obama did not want to leave an “amorphous” program to his successor, the official said. The effort, which would have been rushed to completion by January had Mr. Romney won, will now be finished at a more leisurely pace, the official said.


Mr. Obama himself, in little-noticed remarks, has acknowledged that the legal governance of drone strikes is still a work in progress.


“One of the things we’ve got to do is put a legal architecture in place, and we need Congressional help in order to do that, to make sure that not only am I reined in but any president’s reined in terms of some of the decisions that we’re making,” Mr. Obama told Jon Stewart in an appearance on “The Daily Show” on Oct. 18.


In an interview with Mark Bowden for a new book on the killing of Osama bin Laden, “The Finish,” Mr. Obama said that “creating a legal structure, processes, with oversight checks on how we use unmanned weapons, is going to be a challenge for me and my successors for some time to come.”


The president expressed wariness of the powerful temptation drones pose to policy makers. “There’s a remoteness to it that makes it tempting to think that somehow we can, without any mess on our hands, solve vexing security problems,” he said.


Despite public remarks by Mr. Obama and his aides on the legal basis for targeted killing, the program remains officially classified. In court, fighting lawsuits filed by the American Civil Liberties Union and The New York Times seeking secret legal opinions on targeted killings, the government has refused even to acknowledge the existence of the drone program in Pakistan.


But by many accounts, there has been a significant shift in the nature of the targets. In the early years, most strikes were aimed at ranking leaders of Al Qaeda thought to be plotting to attack the United States. That is the purpose Mr. Obama has emphasized, saying in a CNN interview in September that drones were used to prevent “an operational plot against the United States” and counter “terrorist networks that target the United States.”


But for at least two years in Pakistan, partly because of the C.I.A.’s success in decimating Al Qaeda’s top ranks, most strikes have been directed at militants whose main battle is with the Pakistani authorities or who fight with the Taliban against American troops in Afghanistan.


In Yemen, some strikes apparently launched by the United States killed militants who were preparing to attack Yemeni military forces. Some of those killed were wearing suicide vests, according to Yemeni news reports.


“Unless they were about to get on a flight to New York to conduct an attack, they were not an imminent threat to the United States,” said Micah Zenko, a fellow at the Council on Foreign Relations who is a critic of the strikes. “We don’t say that we’re the counterinsurgency air force of Pakistan, Yemen and Somalia, but we are.”


Then there is the matter of strikes against people whose identities are unknown. In an online video chat in January, Mr. Obama spoke of the strikes in Pakistan as “a targeted, focused effort at people who are on a list of active terrorists.” But for several years, first in Pakistan and later in Yemen, in addition to “personality strikes” against named terrorists, the C.I.A. and the military have carried out “signature strikes” against groups of suspected, unknown militants.


Originally that term was used to suggest the specific “signature” of a known high-level terrorist, such as his vehicle parked at a meeting place. But the word evolved to mean the “signature” of militants in general — for instance, young men toting arms in an area controlled by extremist groups. Such strikes have prompted the greatest conflict inside the Obama administration, with some officials questioning whether killing unidentified fighters is legally justified or worth the local backlash.


Many people inside and outside the government have argued for far greater candor about all of the strikes, saying excessive secrecy has prevented public debate in Congress or a full explanation of their rationale. Experts say the strikes are deeply unpopular both in Pakistan and Yemen, in part because of allegations of large numbers of civilian casualties, which American officials say are exaggerated.


Gregory D. Johnsen, author of “The Last Refuge: Yemen, Al Qaeda and America’s War in Arabia,” argues that the strike strategy is backfiring in Yemen. “In Yemen, Al Qaeda is actually expanding,” Mr. Johnsen said in a recent talk at the Brookings Institution, in part because of the backlash against the strikes.


Shuja Nawaz, a Pakistan-born analyst now at the Atlantic Council in Washington, said the United States should start making public a detailed account of the results of each strike, including any collateral deaths, in part to counter propaganda from jihadist groups. “This is a grand opportunity for the Obama administration to take the drones out of the shadows and to be open about their objectives,” he said.


But the administration appears to be a long way from embracing such openness. The draft rule book for drone strikes that has been passed among agencies over the last several months is so highly classified, officials said, that it is hand-carried from office to office rather than sent by e-mail.


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