Iraq President’s Health Is Improving, Doctor Says

KIRKUK, Iraq (Reuters) - Iraqi President Jalal Talabani is now able to talk, his doctor said, adding he was hopeful the Kurdish statesman would soon be fit to return to Iraq from Germany, where he has been receiving medical treatment for a stroke.

A peace-maker who often mediated among Iraq's Shi'ite, Sunni and Kurdish factions, 79-year-old Talabani was flown abroad in December in critical condition.

"I am in continuous contact with the German team treating President Talabani," said Najmaldin Karim, who is also governor of the city of Kirkuk.

"He can talk now with the people around him and started to think in a good way. I and the German team are optimistic that he will get much better and can return back to Iraq soon."

During Talabani's absence, Iraq's political crisis has intensified, with thousands of Sunni Muslims taking to the streets in protest against the Shi'ite-led government

The veteran politician often worked to ease tensions in the country's fragile power-sharing government and negotiated between Baghdad and the autonomous Kurdistan region, which are locked in feud over land and oil rights.

(Writing by Isabel Coles; Editing by Nick Macfie)

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Adele, 'Les Miserables' cast sing on Oscar stage

LOS ANGELES (AP) — It was an extra starry, musical day at the Dolby Theatre.

Adele took the stage first Friday, followed by the cast of "Les Miserables," singing together of the first time.

Oscar nominees Hugh Jackman and Anne Hathaway, along with co-stars Russell Crowe, Amanda Seyfried, Helena Bonham-Carter, Sasha Baron-Cohen, Eddie Redmayne, Aaron Tveit and Samantha Barks rehearsed their performances on the Oscar stage. They were backed by members of the musical's stage productions from London and Broadway.

"Les Miserables" director Tom Hooper sat in the front row of the theater as his cast sang.

Moments earlier, Adele dazzled the tiny audience of show workers with her performance of the James Bond theme "Skyfall."

"I need a lot more reverb on me," she said after her first run. "You might need to get a new reverb machine."

The 24-year-old multiple Grammy winner arrived wearing a black tunic, black leggings and flats, with no makeup and her hair in a ponytail.

"I'm going to have very high heels on the night, guys," she announced from the microphone, sipping tea between verses.

"Do you need the dresses?" she asked, and a team of stylists brought out the gowns Adele is considering for her Oscar performance.

The dress producers favored? "It's very heavy — I mean I struggle to stand in it," Adele said. "Come and feel how heavy it is, so you don't think I'm a wimp!"

She performed her Oscar-nominated song five times before leaving the theater. "It's been good, yeah?" she asked producer Neil Meron, who nodded in approval.

Just after Adele wrapped, the star-studded "Les Miserables" cast took the stage. Hathaway chatted with Bonham-Carter as Jackman sang a capella. Then Hathaway checked her microphone with a quick verse.

"Ooh, that was flat," she said.

The entire cast assembled for a final run-through when Jackman spontaneously began singing "My Bonny Lies over the Ocean."

"My bonny lies over my daddy," the ensemble responded, breaking into laughter.

Other stars rehearsing Friday included Jennifer Hudson, who is set to perform a song from "Dreamgirls" at Sunday's ceremony.

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Drone Pilots Found to Get Stress Disorders Much as Those in Combat Do

U.S. Air Force/Master Sgt. Steve Horton

Capt. Richard Koll, left, and Airman First Class Mike Eulo monitored a drone aircraft after launching it in Iraq.

The study affirms a growing body of research finding health hazards even for those piloting machines from bases far from actual combat zones.

“Though it might be thousands of miles from the battlefield, this work still involves tough stressors and has tough consequences for those crews,” said Peter W. Singer, a scholar at the Brookings Institution who has written extensively about drones. He was not involved in the new research.

That study, by the Armed Forces Health Surveillance Center, which analyzes health trends among military personnel, did not try to explain the sources of mental health problems among drone pilots.

But Air Force officials and independent experts have suggested several potential causes, among them witnessing combat violence on live video feeds, working in isolation or under inflexible shift hours, juggling the simultaneous demands of home life with combat operations and dealing with intense stress because of crew shortages.

“Remotely piloted aircraft pilots may stare at the same piece of ground for days,” said Jean Lin Otto, an epidemiologist who was a co-author of the study. “They witness the carnage. Manned aircraft pilots don’t do that. They get out of there as soon as possible.”

Dr. Otto said she had begun the study expecting that drone pilots would actually have a higher rate of mental health problems because of the unique pressures of their job.

Since 2008, the number of pilots of remotely piloted aircraft — the Air Force’s preferred term for drones — has grown fourfold, to nearly 1,300. The Air Force is now training more pilots for its drones than for its fighter jets and bombers combined. And by 2015, it expects to have more drone pilots than bomber pilots, although fighter pilots will remain a larger group.

Those figures do not include drones operated by the C.I.A. in counterterrorism operations over Pakistan, Yemen and other countries.

The Pentagon has begun taking steps to keep pace with the rapid expansion of drone operations. It recently created a new medal to honor troops involved in both drone warfare and cyberwarfare. And the Air Force has expanded access to chaplains and therapists for drone operators, said Col. William M. Tart, who commanded remotely piloted aircraft crews at Creech Air Force Base in Nevada.

The Air Force has also conducted research into the health issues of drone crew members. In a 2011 survey of nearly 840 drone operators, it found that 46 percent of Reaper and Predator pilots, and 48 percent of Global Hawk sensor operators, reported “high operational stress.” Those crews cited long hours and frequent shift changes as major causes.

That study found the stress among drone operators to be much higher than that reported by Air Force members in logistics or support jobs. But it did not compare the stress levels of the drone operators with those of traditional pilots.

The new study looked at the electronic health records of 709 drone pilots and 5,256 manned aircraft pilots between October 2003 and December 2011. Those records included information about clinical diagnoses by medical professionals and not just self-reported symptoms.

After analyzing diagnosis and treatment records, the researchers initially found that the drone pilots had higher incidence rates for 12 conditions, including anxiety disorder, depressive disorder, post-traumatic stress disorder, substance abuse and suicidal ideation.

But after the data were adjusted for age, number of deployments, time in service and history of previous mental health problems, the rates were similar, said Dr. Otto, who was scheduled to present her findings in Arizona on Saturday at a conference of the American College of Preventive Medicine.

The study also found that the incidence rates of mental heath problems among drone pilots spiked in 2009. Dr. Otto speculated that the increase might have been the result of intense pressure on pilots during the Iraq surge in the preceding years.

The study found that pilots of both manned and unmanned aircraft had lower rates of mental health problems than other Air Force personnel. But Dr. Otto conceded that her study might underestimate problems among both manned and unmanned aircraft pilots, who may feel pressure not to report mental health symptoms to doctors out of fears that they will be grounded.

She said she planned to conduct two follow-up studies: one that tries to compensate for possible underreporting of mental health problems by pilots and another that analyzes mental health issues among sensor operators, who control drone cameras while sitting next to the pilots.

“The increasing use of remotely piloted aircraft for war fighting as well as humanitarian relief should prompt increased surveillance,” she said.

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Magistrate Grants Bail for Pistorius

Mike Hutchings/Reuters

Oscar Pistorius in court on Friday.

PRETORIA, South Africa — After four days of combative hearings, a South African magistrate on Friday granted bail for Oscar Pistorius, the double amputee track star accused of murdering his girlfriend, in a case that has horrified and fascinated the nation.

Magistrate Desmond Nair announced the decision after hearing impassioned final arguments from the defense and the prosecution in Courtroom C of the Pretoria Magistrates Court in the presence of an emotional Mr. Pistorius, who has testified that he mistook his girlfriend, Reeva Steenkamp, for an intruder and never intended to kill her.

Magistrate Nair said Mr. Pistorius did not represent a flight risk and was not likely to interfere with state witnesses.

”The accused has made a case to be released on bail,” the magistrate concluded. Pistorius family members in the packed courtroom shouted, “Yes!”

The magistrate set bail at 1 million rand, or about $112,000.

Before announcing his ruling, the magistrate reprised the four days of conflicting arguments by defense and prosecution lawyers. Mr. Pistorius’s shoulders shook with emotion and tears fell from his eyes as, at one point, Magistrate Nair said, “The deceased died in his arms.”

Magistrate Nair said bail was not a matter of guilt and innocence but about determining whether justice would be served by holding a defendant in custody.

But he took issue with the testimony and actions of the prosecution’s lead investigator, Detective Warrant Officer Hilton Botha, who has since been removed from the case, saying the officer committed “several errors and concessions” and “blundered” in gathering evidence.

“It is his evidence that may have been tarnished by cross-examination, not the state case,” he said. At the same time, the state case was not so “strong and watertight” that Mr. Pistorius “must come to the conclusion that he has to flee.”

In a two-hour summary of the case and of the laws governing bail, the magistrate also read a series of character references from friends of the athlete, who described his relationship with Ms. Steenkamp, a 29-year-old model and law school graduate, as loving and happy.

The prosecution had opposed the sprinter’s application to be released on bail until a full trial, arguing that he might flee. It said Mr. Pistorius, 26, murdered Ms. Steenkamp when he fired four shots through a locked bathroom door at his home in a gated community in Pretoria on Feb. 14 while she was on the other side.

The sprinter, who underwent double amputation as an infant after being born without fibula bones and uses prostheses, has said he believed that the person in the bathroom was an intruder.

Magistrate Nair said that while the prosecution case rested on “nothing more than circumstantial evidence,” there were “improbabilities that need to be explored” in Mr. Pistorius’s account of events.

“The only person who knows what happened there is the accused,” he said. But “I cannot find that it has been established that the accused is a flight risk.”

He cited legal requirements that the defense must establish “exceptional circumstances” to qualify for bail in cases of premeditated murder.

Premeditated murder is the most serious murder charge under South African criminal law and carries a mandatory life sentence, with parole in 25 years at the latest.

Mr. Pistorius’s lawyer, Barry Roux, said Friday that if he were prosecuting the case, the charge would be culpable homicide — a less serious charge implying either negligence or a lack of intention to kill. Prosecutors say judges decide the sentence for culpable homicide depending on the circumstances.

With his head bowed as he entered the court on Friday in advance of the ruling, Mr. Pistorius appeared to be struggling to hold back tears, his jaw clenched, as the prosecutor described Ms. Steenkamp’s plight on Feb. 14.

Lydia Polgreen reported from Pretoria, and Alan Cowell from London.

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Tyler, Perry lead Songwriters Hall of Fame class

NASHVILLE, Tenn. (AP) — The Songwriters Hall of Fame is saluting 1970s and '80s rock 'n' roll with its 2013 induction class.

Joe Perry and Steven Tyler of Aerosmith and Mick Jones and Lou Gramm of Foreigner will join the hall of fame this year along with the writers of iconic rock hits "Love Is a Battlefield" and "Heartache Tonight." The ceremony will be held June 13 in New York.

Aerosmith and Foreigner will get the attention here, but inductees Holly Knight, JD Souther and Tony Hatch also have distinguished careers that helped define the sound of rock 'n' roll.

Knight wrote anthemic hits "Love Is a Battlefield" and "Invincible" for Pat Benatar and "The Warrior" for Patty Smyth. She also wrote several songs for Tina Turner, including "The Best" and "Better Be Good to Me," that became standards for the star.

Souther, who has a role on the music-inspired television show "Nashville," had a partnership with The Eagles that spawned several hits, including "Heartache Tonight," ''Victim of Love," ''New Kid in Town" and "Best of My Love."

Hatch made his mark during the British invasion, teaming with Petula Clark on hits like "Downtown" and "My Love" that helped shaped the future of pop music.

Perry and Tyler have survived a sometimes contentious relationship to become one of rock's most successful songwriting teams over the last 40 years. The Rock and Roll Hall of Famers, staples of classic rock radio and pop culture icons, are known for hits like "Sweet Emotion," ''Dream On" and "Livin' on the Edge," and released their 15th studio album last year.

Jones and Gramm are contemporaries of Perry and Tyler who also ruled radio for a time, but they sometimes came at it from a different angle. They could lay down a straight-up rocker like "Jukebox Hero" or "Feels Like the First Time." But they also could slow it down with hits like "I Wanna Know What Love Is" and "Cold as Ice" that helped foreshadow the ballad-driven rock of the late '80s.

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The New Old Age Blog: For Traumatized Caregivers, Therapy Helps

I recently wrote about caregivers who experienced symptoms of traumatic-like stress, and readers responded with heart-rending stories. Many described being haunted by distress long after a relative died.

Especially painful, readers said, was witnessing a loved one’s suffering and feeling helpless to do anything about it.

The therapists I spoke with said they often encountered symptoms among caregivers similar to those shown by people with post-traumatic stress — intrusive thoughts, disabling anxiety, hyper-vigilance, avoidance behaviors and more — even though research documenting this reaction is scarce. Improvement with treatment is possible, they say, although a sense of loss may never disappear completely.

I asked these professionals for stories about patients to illustrate the therapeutic process. Read them below and you’ll notice common themes. Recovery depends on unearthing the source of psychological distress and facing it directly rather than pushing it away. Learning new ways of thinking can change the tenor of caregiving, in real time or in retrospect, and help someone recover a sense of emotional balance.

Barry Jacobs, a clinical psychologist and author of “The Emotional Survival Guide for Caregivers” (Guilford Press, 2006), was careful to distinguish normal grief associated with caregiving from a traumatic-style response.

“Nightmares, lingering bereavement or the mild re-experiencing of events that doesn’t send a person into a panic every time is normal” and often resolves with time, he said.

Contrast that with one of his patients, a Greek-American woman who assisted her elderly parents daily until her father, a retired firefighter, went to the hospital for what doctors thought would be a minor procedure and died there of a heart attack in the middle of the night.

Every night afterward, at exactly 3 a.m., this patient awoke in a panic from a dream in which a phone was ringing. Unable to go back to sleep for hours, she agonized about her father dying alone at that hour.

The guilt was so overwhelming, the woman couldn’t bear to see her mother, talk with her sisters or concentrate at work or at home. Sleep deprived and troubled by anxiety, she went to see her doctor, who works in the same clinic as Dr. Jacobs and referred her to therapy.

The first thing Dr. Jacobs did was to “identify what happened to this patient as traumatic, and tell her acute anxiety was an understandable response.” Then he asked her to “grieve her father’s death” by reaching out to her siblings and her mother and openly expressing her sadness.

Dr. Jacobs also suggested that this patient set aside a time every day to think about her father — not just the end of his life, but also all the things she had loved about him and the good times they’d had together as a family.

Don’t expect your night time awakenings to go away immediately, the psychologist told his patient. Instead, plan for how you’re going to respond when these occur.

Seven months later, the patient reported her panic at a “3 or 4” level instead of a “10” (the highest possible number), Dr. Jacobs said.

“She’ll say, ‘oh, there’s the nightmare again,’ and she can now go back to sleep fairly quickly,” he continued. “Research about anxiety tells us that the more we face what we fear, the quicker we are to extinguish our fear response and the better able we are to tolerate it.”

Sara Qualls, a professor of psychology at the University of Colorado in Colorado Springs, said it’s natural for caregivers to be disgusted by some of what they have to do — toileting a loved one, for instance — and to be profoundly conflicted when they try to reconcile this feeling with a feeling of devotion. In some circumstances, traumatic-like responses can result.

Her work entails naming the emotion the caregiver is experiencing, letting the person know it’s normal, and trying to identify the trigger.

For instance, an older man may come in saying he’s failed his wife with dementia by not doing enough for her. Addressing this man’s guilt, Dr. Qualls may find that he can’t stand being exposed to urine or feces but has to help his wife go to the bathroom. Instead of facing his true feelings, he’s beating up on himself psychologically — a diversion.

Once a conflict of this kind is identified, Dr. Qualls said she can help a person deal with the trigger by using relaxation exercises and problem-solving techniques, or by arranging for someone else to do a task that he or she simply can’t tolerate.

Asked for an example, Dr. Qualls described a woman who traveled to another state to see her mother, only to find her in a profound disheveled, chaotic state. Her mother said that she didn’t want help, and her brother responded with disbelief. Soon, the woman’s blood pressure rose, and she began having nightmares.

In therapy, Dr. Qualls reassured the patient that her fear for her mother’s safety was reasonable and guided her toward practical solutions. Gradually, she was able to enlist her brother’s help and change her mother’s living situation, and her sense of isolation and helplessness dissipated.

“I think that a piece of the trauma reaction that is so devastating is the intense privacy of it,” Dr. Qualls said. “Our work helps people moderate their emotional reactivity through human contact, sharing and learning strategies to manage their responsiveness.”

Dolores Gallagher-Thompson, a professor of psychiatry at Stanford University School of Medicine in California, noted that stress can accumulate during caregiving and reach a tipping point where someone’s ability to cope is overwhelmed.

She tells of a vibrant, active woman in her 60s caring for an older husband who declined rapidly from dementia. “She’d get used to one set of losses, and then a new loss would occur,” Dr. Gallagher-Thompson said.

The tipping point came when the husband began running away from home and was picked up by the police several times. The woman dropped everything else and became vigilant, feeling as if she had to watch her husband day and night. Still, he would sneak away and became more and more difficult.

Both husband and wife had come from Jewish families caught up in the Holocaust during World War II, and the feeling of “complete and utter helplessness and hopelessness” that descended on this older woman was intolerable, Dr. Gallagher-Thompson said.

Therapy was targeted toward helping the patient articulate thoughts and feelings that weren’t immediately at the surface of her consciousness, like, for example, her terror at the prospect of abandonment. “I’d ask her ‘what are you afraid of? If you visualize your husband in a nursing home or assisted living, what do you see?’” Dr. Gallagher-Thompson said.

Then the conversation would turn to the choices the older woman had. Go and look at some long-term care places and see what you think, her psychologist suggested. You can decide how often you want to visit. “This isn’t an either-or — either you’re miserable 24/7 or you don’t love him,” she advised.

The older man went to assisted living, where he died not long afterward of pneumonia that wasn’t diagnosed right away. The wife fell into a depression, preoccupied with the thought that it was all her fault.

Another six months of therapy convinced her that she had done what she could for her husband. Today she works closely with her local Alzheimer’s Association chapter, “helping other caregivers learn how to deal with these kinds of issues in support groups,” Dr. Gallagher-Thompson said.

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Wall Street Edges Ahead

Stocks rose on Wall Street Friday, bolstered by better-than-expected earnings from Hewlett-Packard.

The Standard & Poor’s 500-stock index climbed 0.4 percent, the Dow Jones industrial average rose 0.3 percent, and the Nasdaq composite index added 0.4 percent.

The S.&P. 500 has dropped 1.9 percent over the last two sessions, its worst two-day drop since early November, putting the benchmark index on pace for its first weekly decline of the year. The retreat was triggered by minutes from the Federal Reserve’s January meeting, released earlier in the week, that suggested stimulus measures may end earlier than thought.

Still, the index was up more than 5 percent for the year and has held above the 1,500-point level.

“When you get a move like that, you are bound to see a pause, and the Fed minutes is a good enough reason to at least reassess,” said Michael Marrale, head of research, sales and trading at ITG in New York.

But, he added, “ultimately, we are going to see rates go higher and, ultimately, that will take money out of bonds and into equities.”

Hewlett-Packard, the maker of personal computers and printers, climbed 5.1 percent after the company’s quarterly revenue and forecasts beat analysts’ expectations as it continued to cut costs.

Abercrombie & Fitch, the clothing retailer, dipped 1 percent after it reported a drop in fourth-quarter comparable sales, even as the latest quarterly earnings topped estimates.

The insurer American International Group posted fourth-quarter results that beat analysts’ expectations. Shares advanced 4.4 percent.

Marvell Technology Group, a chip maker, rose 5.8 percent after the company gained market share in the hard-disk drive and flash-storage businesses.

The European Commission forecast on Friday that growth in the 27-nation European Union would rise only 0.3 percent this year, while growth in the 17 members that use the euro would fall 0.1 percent for a second year of recession. Stock markets in Europe were mostly ahead in afternoon trading after a sharp pullback on Thursday.

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Gen. Philip M. Breedlove Likely Candidate for Top NATO Post

BRUSSELS — Senior NATO officials said on Thursday that Gen. Philip M. Breedlove, currently the commander of American Air Force units in Europe and Africa, was emerging as the likely candidate to be nominated by President Obama to be the alliance’s supreme military commander.

An opening to serve as NATO’s next military commander surfaced this week as the previous nominee, Gen. John R. Allen of the Marine Corps, announced that he was retiring.

General Allen, who served until earlier this month as the top commander in Afghanistan, said he was retiring to focus on family health issues. He had been caught up in the scandal that led to the resignation of David H. Petraeus as the director of the Central Intelligence Agency. Last month, the Pentagon officially cleared him of any misconduct after an investigation into his exchange of e-mails with Jill Kelley, a Tampa, Fla. socialite.

General Breedlove at present holds several positions. He is the Air Force’s top officer for both the European Command and for the Africa Command.

He was commissioned into the Air Force in 1977 from the R.O.T.C. program at George Tech. According to his official biography, he has commanded a fighter squadron, an operations group and three fighter wings.

Before his current command position, General Breedlove also served as vice chief of staff of the Air Force.

Senior NATO officials described General Breedlove as the leading candidate for the top alliance military post, but spoke on condition of anonymity because it has not yet been announced by Mr. Obama.

The disclosure on the likely personnel decision came as Defense Secretary Leon E. Panetta joined other defense ministers from the alliance for a two-day session. The future of the mission in Afghanistan was on the agenda for the defense ministers' meeting, the first since Mr. Obama ordered American forces in Afghanistan to be reduced by 34,000 troops within a year.

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Rapper Ja Rule set to leave NY prison in gun case

ALBANY, N.Y. (AP) — Platinum-selling rapper Ja Rule was set to leave an upstate prison on Thursday after serving most of his two-year sentence for illegal gun possession but head straight into federal custody in a tax case.

The rapper, who had been in protective custody at the Mid-State Correctional Facility because of his celebrity, has some time remaining on a 28-month sentence for tax evasion, correction officials said. His sentences were expected to run concurrently.

Ja Rule may have less than six months left and may be eligible for a halfway house, defense attorney Stacey Richman said. An order to pay $1.1 million in back taxes is one of the main reasons he wants to get back to work, she said.

"Many people are looking forward to experiencing his talent again," Richman said.

Ja Rule scored a Grammy Award nomination in 2002 for the best rap album with "Pain is Love." He also has appeared in movies, including "The Fast and the Furious" in 2001 and "Scary Movie 3" in 2003.

Ja Rule, who went to the prison in Marcy in June 2011, is getting out at his earliest release date, state correction spokeswoman Linda Foglia said. He had two misbehavior reports for unauthorized phone calls in February 2012 and had work assignments on lawn and grounds crews and participated in education programs, she said.

In the gun case, New York City police said they found a loaded .40-caliber semiautomatic gun in a rear door of Ja Rule's $250,000 luxury car after it was stopped for speeding, and he pleaded guilty in 2010.

He admitted in March 2011 in federal court that he failed to pay taxes on more than $3 million he earned between 2004 and 2006 while he lived in Saddle River, N.J.

"I in no way attempted to deceive the government or do anything illegal," he told the judge. "I was a young man who made a lot of money — I'm getting a little choked up — I didn't know how to deal with these finances, and I didn't have people to guide me, so I made mistakes."

Richman said the 36-year-old rapper, whose real name is Jeffrey Atkins, is looking forward to his daughter's graduation.

"He's a devoted father," she said.

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Personal Best: When to Retire a Running Shoe

Fitness Tracker

Marathon, half-marathon, 10k and 5K training plans to get you race ready.

Ryan Hall, one of the world’s best distance runners, used to pride himself on wearing his running shoes into nubs. No more. Now he assiduously replaces his shoes after running about 200 miles in them. He goes through two pairs a month.

“I know that my shoes could probably handle a couple of hundred more miles before they are worn out, but my health is so important to me that I like to always make sure my equipment is fresh,” he said.

Of course Mr. Hall, sponsored by Asics, does not have to pay for his shoes. Most of the rest of us do, and at around $100 a pair they aren’t cheap. Yet we are warned constantly to replace them often, because running in threadbare shoes may lead to injuries that can take months to heal.

So here’s a simple question: How do you know when your shoes are ready for those discard bins in gyms? And if you do get injured, is it fair to blame your shoes?

My friend Jen Davis runs more than 100 miles a week, like Mr. Hall, but has a different set of criteria for getting rid of shoes. One is that if they smell bad even after she washes them in her washing machine, it’s time for a new pair. She estimates she puts 500 miles on each pair of shoes.

Henry Klugh, a running coach and manager of The Inside Track, a running store in Harrisburg, Pa., says he goes as far as 2,000 miles in some shoes. He often runs on dirt roads, he said, which are easier on shoes than asphalt is and do not compress and beat up the midsole as much.

My coach, Tom Fleming, has his own method. Put one hand in your shoe, and press on the sole with your other hand. If you can feel your fingers pressing through, those shoes are worn out — the cushioning totally compressed or the outer sole worn thin.

As for me, my practice has been to keep track of the miles I run with each pair and replace them after 300 miles. Who is right? Maybe none of us. According to Rodger Kram, a biomechanics researcher at the University of Colorado, the theory is that you must change shoes before the ethylene vinyl acetate, or E.V.A., that lines most running shoe insoles breaks down.

“Think of a piece of Wonder Bread, kind of fluffy out of the bag,” he said. “But smoosh it down with the heel of your palm, and it is flat with no rebound.”

A moderate amount of cushioning improves running efficiency, he has found. But as to whether cushioning prevents injuries, he said, “I doubt that there are good data.”

Dr. Jacob Schelde of Odense University Hospital in Denmark, has looked for clinical trials that address the cushioning and injury question — and has found none. He’s applying for funds to do one himself, a 15-month study with 600 runners.

Dr. Schelde did find a study on injury rates among runners, published in 2003, that had some relevant data even though it was not a randomized clinical trial and shoe age was not its main focus. The study was large and regularly tested runners in a 13-week training program. The researchers failed to find any clear relationship between how long running shoes were worn and a runner’s risk of injury.

It also is difficult to find good data on how long E.V.A. insoles last. But one exhaustive study, led by Ewald Max Hennig of the biomechanics laboratory at University of Duisburg-Essen in Germany, involved 18 years of shoe testing from 1991 to 2009. The researchers measured the performance of 156 shoe models worn by runners. Dr. Hennig and his colleagues wrote that the sort of mechanical testing that shoe manufacturers do to evaluate cushioning materials does not reflect what happens when people actually run.

Over the years, running shoe quality steadily improved, the researchers reported. The shoes also changed as running fads waxed and waned. Shock attenuation, for example, diminished starting around 2000, when there was talk of shoes providing too much cushioning.

Then, when cushioning became fashionable again, it returned. But so did minimalist shoes designed for the barefoot running fad, which have almost no cushioning.

In Europe, the researchers reported, people typically wear shoes for about 600 miles. But their studies indicated that shoes could last much longer.

Most shoemakers, of course, would prefer to see us trade in sooner. Kira Harrison, a spokeswoman for Brooks, said shoes should last for 400 to 500 miles. The very light models last about 300 miles, she said.

Biomechanical studies have shown that after those distances the shoes lose their bounce, she said: “Everyone in the industry knows that standard.”

Gavin Thomas, a Nike spokesman, said a shoe’s life span depended on the type of shoe — lightweight or more heavily cushioned — and on the runner’s weight and running style. Those who are light on their feet can wear shoes longer than those who pound the ground. Those who run on soft surfaces can keep their shoes longer.

After 300 or 400 miles, Mr. Thomas said, a typical shoe worn by a typical runner will not feel the way it used to, a sign it is worn out.

But Golden Harper, developer of Altra running shoes and founder of the company, said any advice on mileage was “a lot of malarkey.” Mr. Harper, a distance runner, said most runners could feel when their shoes need to be replaced. “You get a sense for it,” he said. “Nothing hurts, but it is going to soon.”

So when should you retire those faithful running shoes, and what happens if you don’t? Despite the doomsday warnings, no one really knows. And with so many variables — type of shoe, runner’s weight, running surfaces, running style — there may never be a simple answer.

But we can take comfort in Dr. Hennig’s work. Even people like Henry Klugh, who put in many more miles than most guidelines suggest may still be fine. Their shoes may still be performing.

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In Montana’s Kalispell, Guns Are a Matter of Life

Making Guns in Montana:
Kalispell, Mont., has become the center of a growing firearms industry, particularly for high-end rifles and industrial rifle parts.

BIGFORK, Mont. — Jerry Fisher’s big and careful arms cradled a polished cutout of English walnut, which was aging in his workroom like a fine wine. The slight tapering along one edge gave a ghostly hint of its future as the stock of a handmade hunting rifle.

His eyebrows lifted as he explained the properties of this piece of walnut. “This wood will assume the moisture content of the atmosphere you store it in,” he said. “It takes five or six years to dry it.”

Mr. Fisher, 82, is a gunsmith whose exquisite firearms, decorated with designs by fine artists, have attracted customers from around the world. He built on the work of older gunsmiths here, just as younger ones hope to learn from him. He epitomizes the values of the Flathead Valley of northwestern Montana, where people grow up with, relax with and live around guns.

Since the 19th century, hunting has been a pastime in the forests that climb up the tiara of rocky peaks around Flathead Lake. Members of the growing group of high-end gunsmiths say it is the mountains, the air and the game that draw them, not the presence of other artisans. But the area’s reputation for this kind of gunsmithing has also made it a growing destination for more prosaic manufacturing of gun parts and guns — including high-end semiautomatic rifles and military weapons.

In Kalispell, the Flathead County seat, 250 people earn a living making guns or gun parts, a tenfold increase since 2005. That growth helped mitigate the effects of the recession, which was a body blow to construction, a major local employer. Another longtime industry, logging, has also withered.

Clint Walker’s company, New Evolution Military Ordnance, became one of the newest entrants in the business within the last couple of years, joining a roster of companies that included Montana Rifle, McGowen Precision Barrels and SI Defense.

Mr. Walker, who had been an editor of trade magazines covering video equipment, said Montana Rifle was “doing literally tens of thousands of barrels” for large gunmaking companies back East. “They have to slow down and stop what they are doing to help us out,” he said. “And they’ve done that. They said: ‘You guys are local. You’re family.'”

“That is a large part of the success of this area,” Mr. Walker added.

To provide trained hands for companies like these, Flathead Valley Community College started a course in gunsmithing last summer. Students learn everything from hollowing out a barrel to checkering a stock – carving fine crosshatched indentations behind the trigger both for decoration and to create a solid grip.

Jane A. Karas, a former New Yorker who is the school’s president, said the program “focuses on craftsmanship that maintains the historic values” of the area. Her colleague Susan Burch, who worked with a transplanted Oklahoma gunsmith, Brandon Miller, to teach the course, added, “You’re looking at the intersection of art and the outdoors.”

Homicides with guns are relatively rare in the area. There have been six murders in Kalispell (population 20,000) in the past 12 years, said Roger Nasset, the local police chief. His officers are never surprised to find a gun inside a car they stop for a traffic violation – and seldom bother to discuss it, much less confiscate it. Montana’s laws on gun possession are among the least restrictive in the nation.

Guns are not permitted in schoolrooms, but have been used to raise money for them. Last fall, the Stillwater Christian School earned more than $20,000 when its parent-teacher organization held a raffle for a locally made semiautomatic AR-15 assault rifle donated by Mr. Walker, a parent of two young students there.

“When we did the fund-raiser, it didn’t cross my mind, ‘Wow, we’re donating an assault rifle to a school for a fund-raiser,'” he said. It was just, ‘This is one of the No. 1-selling rifles in America.'”

Butch Hurlbert, whose daughter and teenage granddaughter were murdered with a gun near Kalispell on Christmas Day in 2010, blames the killer — his daughter’s former boyfriend — and the police, not the gun. Having a gun, he said, “is pretty much just a normal thing.”

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Robin Roberts returns to 'Good Morning America'

NEW YORK (AP) — Five months after undergoing a bone marrow transplant, Robin Roberts is back on television in the morning.

Roberts said Wednesday she'd been waiting 174 days "to say this, good morning America."

The morning-show host is recovering from MDS, a blood and bone marrow disease. She looked thin with close-cropped hair but was smiling broadly, back at work on "Good Morning America" at ABC's studio in New York.

Roberts was welcomed back in a taped message from President Barack Obama and his wife, Michelle, former ESPN colleagues and Magic Johnson.

ABC announced Roberts will interview the first lady later this week, to be shown next Tuesday.

ABC News President Ben Sherwood came into the studio to give fist bumps to the anchors at the 7:25 a.m. EST break. He said Roberts' health will be closely monitored to make sure she doesn't overdo it at the beginning.

"This was up to Robin, her doctors and God," Sherwood said. "It's a day that we all rejoice."

ABC didn't miss a beat with her absence, continuing in first place in the ratings after first overcoming NBC's "Today" show last spring. Sherwood said the success with Roberts' absence surprised him.

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The New Old Age Blog: The Reluctant Caregiver

Now and then, I refer to the people that caregivers tend to as “loved ones.” And whenever I do, a woman in Southern California tells me, I set her teeth on edge.

She visits her mother-in-law, runs errands, helps with the paperwork — all tasks she has shouldered with a grim sense of duty.  She doesn’t have much affection for this increasingly frail 90something or enjoy her company; her efforts bring no emotional reward. Her husband, an only child, feels nearly as detached. His mother wasn’t abusive, a completely different scenario, but they were never very close.

Ms. A., as I’ll call her because her mother-in-law reads The Times on her computer, feels miserable about this. “She says she appreciates us, she’s counting on us. She thanks us,” Ms. A. said of her non-loved one. “It makes me feel worse, because I feel guilty.”

She has performed many services for her mother-in-law, who lives in a retirement community, “but I really didn’t want to. I know how grudging it was.”

Call her the Reluctant Caregiver. She and her husband didn’t invite his parents to follow them to the small city where they settled to take jobs. The elders did anyway, and as long as they stayed healthy and active, both couples maintained their own lives. Now that her mother-in-law is widowed and needy, Ms. A feels trapped.

Ashamed, too. She knows lots of adult children work much harder at caregiving yet see it as a privilege. For her, it is mere drudgery. “I don’t feel there’s anybody I can say that to,” she told me — except a friend in Phoenix and, anonymously, to us.

The friend, therapist Randy Weiss, has served as both a reluctant caregiver to her mother, who died very recently at 86, and a willing caregiver to her childless aunt, living in an assisted living dementia unit at 82. Spending time with each of them made Ms. Weiss conscious of the distinction.

Her visits involved many of the same activities, “but it feels very different,” she said. “I feel the appreciation from my aunt, even if she’s much less able to verbalize it.” A cherished confidante since adolescence, her aunt breaks into smiles when Ms. Weiss arrives and exclaims over every small gift, even a doughnut. She worked in the music industry for decades and, despite her memory loss, happily sings along with the jazz CDs Ms. Weiss brings.

Because she had no such connection with her mother, whom Ms. Weiss described as distant and critical, “it’s harder to do what I have to do,” she said. (We spoke before her mother’s death.) “One is an obligation I fulfill out of duty. One is done with love.”

Unlike her friend Ms. A, “I don’t feel guilty that I don’t feel warmly towards my mother,” Ms. Weiss said. “I’ve made my peace.”

Let’s acknowledge that at times almost every caregiver knows exhaustion, anger and resentment.  But to me, reluctant caregivers probably deserve more credit than most. They are not getting any of the good stuff back, no warmth or laughter, little tenderness, sometimes not even gratitude.

Yet they are doing this tough work anyway, usually because no one else can or will. Maybe an early death or a divorce means that the person who would ordinarily have provided care can’t. Or maybe the reluctant caregiver is simply the one who can’t walk away.

“It’s important to acknowledge that every relationship doesn’t come from ‘The Cosby Show,’” said Barbara Moscowitz when I called to ask her about reluctance. Ms. Moscowitz, a senior geriatric social worker at Massachusetts General Hospital, has heard many such tales from caregivers in her clinical practice and support groups.

“We need to allow people to be reluctant,” she said. “It means they’re dutiful; they’re responsible. Those are admirable qualities.”

Yet, she recognizes, “they feel oppressed by the platitudes. ‘Your mother is so lucky to have you!’” Such praise just makes people like Ms. A. squirm.

Ms. Moscowitz also worries about reluctant caregivers, and urges them to find support groups where they can say the supposedly unsay-able, and to sign up early for community services — hotlines, senior centers, day programs, meals on wheels — that can help lighten the load.

“Caregiving only goes one way – it gets harder, more complex,” she said. “Support groups and community resources are like having a first aid kit. It’s going to feel like even more of a burden, and you need to be armed.”

I wonder, too, if reluctant caregivers have a romanticized view of what the task is like for everyone else. Elder care can be a wonderful experience, satisfying and meaningful, but guilt and resentment are also standard parts of the job description, at least occasionally.

For a reluctant caregiver, “the satisfaction is, you haven’t turned your back,” Ms. Moscowitz said. “You can take pride in that.”

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Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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DealBook: Office Depot and OfficeMax Announce Plans to Merge, After Erroneous Release

9:40 a.m. | Updated

Office Depot and OfficeMax announced their plans to merge on Wednesday, just hours after an erroneous release about the deal briefly surfaced.

Under the terms of the deal, Office Depot said it would issue 2.69 new shares of common stock for each share of OfficeMax. At that level, the transaction would value OfficeMax at $13.50, or roughly $1.19 billion, a premium of more than 25 percent to the company’s closing price last week.

The deal has been anticipated, as the companies face an increasingly difficult competitive environment. Both companies, which are burdened with big real estate footprints, have struggled against lower-priced rivals like Amazon.com and Costco. By uniting, the two companies should be able to cut costs and better negotiate prices.

“In the past decade, with the growth of the internet, our industry has changed dramatically,” Neil Austrian, chairman and chief executive officer of Office Depot, said in a statement. “Combining our two companies will enhance our ability to serve customers around the world, offer new opportunities for our employees, make us a more attractive partner to our vendors, and increase stockholder value.”

While the deal has been years in the making, it was initially announced prematurely. A news release announcing the merger of the two office supply retailers was posted early Wednesday morning on Office Depot’s Web site, but it quickly disappeared.

Several news organizations reported the terms disclosed in the errant news release for Office Depot’s earnings. The details were buried on page four of the release under the header “Other Matters.”

As the details filtered through the market, shares of the companies jumped. In premarket trading, Office Depot’s stock rose more than 7 percent, while OfficeMax shares were up more than 8 percent.

The episode is reminiscent of other times that companies’ earnings releases were published prematurely. Last fall, Google’s third-quarter earnings were published three hours early, which the technology giant blamed on a mistake by R.R. Donnelley & Sons, the company’s printer.

Representatives for Office Depot and OfficeMax were not immediately available for comment on the erroneous release.

Strategically, the deal makes sense, as the companies deal with a changing competitive environment.

Combined, the companies reported about $4.4 billion in revenue for their third quarter of 2012; in comparison, Staples disclosed $6.4 billion in revenue for the same period.

Office Depot has also been under pressure from an activist hedge fund, Starboard Value, which sent a letter to the retailer’s board last fall. In it, Starboard called for more cost cuts and a greater focus on higher-margin businesses like copy and print services. With a 14.8 percent stake, Starboard is the company’s biggest investor.

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Obama to Turn Up Pressure for Deal on Budget Cuts

WASHINGTON — President Obama, back from his three-day golf getaway, on Monday morning will make use of his bully pulpit, while Congress remains out all week, to turn up the pressure for a bipartisan agreement to avoid indiscriminate across-the-board budget cuts that will otherwise hit March 1.

In the morning, Mr. Obama will speak at a White House auditorium, where he will be joined by first responders to illustrate the sorts of Americans whose jobs are threatened if the cuts take effect. According to the White House, the Federal Emergency Management Agency would not be able to provide grants to states and local governments that currently support hiring for firefighters and other local emergency personnel.

Some Republicans in Congress have proposed alternative savings that would spare any cuts in military spending but not in domestic accounts. Mr. Obama and Congressional Democrats are calling for a mix of spending cuts and additional tax revenues by closing some tax breaks for wealthy investors and corporations.

A White House statement announcing the president’s scheduled remarks summarized the political frame that Mr. Obama has devised to try to corner the Republicans into compromising: “The president will challenge Republicans to make a very simple choice: do they protect investments in education, health care and national defense or do they continue to prioritize and protect tax loopholes that benefit the very few at the expense of middle- and working-class Americans?”

The president’s latest deficit reduction push comes as the heads of his 2010 deficit reduction commission — former Senator Alan K. Simpson and Erskine B. Bowles, a former chief of staff to President Bill Clinton — unveil a new plan that would reduce the deficit by $2.4 trillion through a series of spending cuts and an overhaul of the tax system.

When Congress returns from a winter recess next week, just days remain before the deadline for the so-called sequester of spending cuts, a deadline that already was moved once — at the start of the year — to allow more time for the two parties to negotiate.

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McCready's death renews questions for Dr. Drew

NASHVILLE, Tenn. (AP) — The criticism of Dr. Drew Pinsky spread on the Internet almost as quickly as news of Mindy McCready's death.

The country singer with the tumultuous personal life became the fifth cast member of his "Celebrity Rehab" series to die since appearing on the show and the third from Season 3. The previous deaths stirred up rumors of a curse and a debate about the show's helpfulness. McCready's apparent suicide upped the pitch of the reaction, however.

Singer Richard Marx on Twitter compared Pinsky to Dr. Jack Kevorkian, the so-called suicide doctor: "Same results."

Marx backed off later Monday, saying the crack went too far. But he restated his thoughts in a way that summed up much of the reaction in the first 24 hours since the 37-year-old McCready's death Sunday afternoon in Heber Springs, Ark.

"It is, however, my opinion that what Dr. D does is exploitation and his TV track record is not good," Marx wrote.

VH1's "Celebrity Rehab with Dr. Drew" is not currently on the air. Pinsky switched his focus to non-celebrities in Season 6 last fall and changed the title to "Rehab." The show spawned two spinoffs, "Sober House" and "Sex Rehab."

Season 3, shot in 2009, featured McCready, former NBA star Dennis Rodman, actors Tom Sizemore and Mackenzie Phillips, former Hollywood madam Heidi Fleiss and a handful of lesser known celebrity types.

McCready was a sympathetic character on the show and appeared to be far less damaged than her fellow cast members, some of whom experienced fairly graphic symptoms of opiate withdrawal in front of the cameras. McCready suffered a seizure while on the show, further endearing her to Pinsky and the others.

She said in a 2010 interview with The Associated Press that she initially turned Pinsky down.

"But Dr. Drew said something to me that just mowed me over literally, just floored me," she said. "He said, 'You've been being treated for the symptoms of what's wrong with you, not the problem. And you're going to have to put your family aside for a moment, put their feelings aside for a moment and worry about you because if you don't get better, it doesn't matter what your family thinks. You're not going to be there anymore.'"

Pinsky diagnosed her with "love addiction" during the series' run and called her an "angel" in the finale. In an interview with The Associated Press several months later, he said McCready had a good shot at recovery if she remained in treatment.

"Like with anybody I treat, it's really up to them," Pinsky said. "I never know. If they do the work they're supposed to do, yes (there can be success). If she does the work it will be great. It's up to her how much of that she does, how much she feels she needs to do. It seems like she's doing rather well right now so I hope she continues to do so."

Three years later, she's dead of an apparent self-inflicted gunshot to the head. McCready walked away from treatment several days ago after her father asked a judge to intervene. Her body was found on the front porch of a home she shared with David Wilson, the longtime boyfriend and father of her youngest son who appears to have killed himself in the same spot last month.

Pinsky wasn't available for comment, his publicist said, but he issued a statement Sunday night that noted he'd spoken with McCready recently.

"She is a lovely woman who will be missed by many," the statement said. "Although I have not treated her for a few years, I had reached out to her recently upon hearing about the apparent suicide of her boyfriend and father of her younger (child). She was devastated. Although she was fearful of stigma and ridicule she agreed with me that she needed to make her health and safety a priority. Unfortunately it seems that Mindy did not sustain her treatment."

A lack of continued treatment also appears to have led to the deaths of McCready's Season 3 castmates Mike Starr, bassist for Alice in Chains, and Joey Kovar, a "Real World" participant. Los Angeles riots spark Rodney King and actor Jeff Conaway also have passed away. Starr and Kovar overdosed and King was found dead in his pool with alcohol and marijuana in his system. Conaway was initially thought to have overdosed, but died of pneumonia and an infection.

Bob Forrest, a chemical dependency counselor who appeared on Season 3 of "Celebrity Rehab" and continues to work with Pinsky, said a discussion about mental health and substance abuse issues is important. But attacking Pinsky has only distracted from the real issues.

"Regardless of your feelings about how we do it with the TV show, calling Dr. Drew 'Dr. Kevorkian,' what kind of dialogue is that?" he said. "It's a good headline. We're going through a growth spurt in regards to who we are as a country. I really feel there's something going on in America beyond Mindy McCready's death."

The most recent figures from the Centers for Disease Control and Prevention show there were 38,364 suicides in the U.S. in 2010 — an average of 105 a day. Thirty-three percent of suicides tested positive for alcohol in 2009 and 20 percent for opiates, including heroin and prescription painkillers.

There were no immediate numbers available for suicides or overdoses post-rehab, but a patient with substance abuse problems is a higher risk for an attempt.

Dr. Sharon Hirsch, an associate professor in the University of Chicago's Department of Psychiatry and Behavioral Neuroscience, says patients can get trapped in the yin and yang of addiction. She was not familiar with McCready's case, but noted people abusing alcohol or drugs have a lower impulse control. And their lows when they're off drugs become more difficult to overcome, also lowering their resolve.

Dealing with loss, as McCready was, also increases risk, especially around anniversaries.

Hirsch said mental health and addiction issues have to be taken as seriously as a heart attack.

"Depression and substance dependence are all very malignant disorders and I think people forget that," Hirsch said. "They think of cancer, strokes and heart attacks killing people, but depression, substance abuse and eating disorders, too, all kill people. There are very, very high rates of deaths in those illnesses."

Pinsky's shows drew attention to the struggle. But did they help patients? Pinsky has taken an interest in cast members after the shows end and referred them to continuing treatment. But ultimately Hirsch wonders who was on call the last time McCready pondered killing herself.

"One of the key components of any treatment is to talk confidentially with your treatment provider about every aspect of what is going on with you, to be able to get the best care you can," she said. "I just don't know how that could occur in the context of an internationally televised show. And so it would be difficult for me to envision it as a complete treatment program. ... It just really strikes me as entertainment and not as treatment."

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Follow AP Music Writer Chris Talbott: http://twitter.com/Chris_Talbott.

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National Briefing | South: Abortion Curbs Clear Senate in Arkansas

The State Senate voted 25 to 7 on Monday to ban most abortions 20 weeks into a pregnancy. The measure goes back to the House to consider an amendment that added exceptions for rape and incest. The legislation is based on the belief that fetuses can feel pain 20 weeks into a pregnancy, and is similar to bans in several other states. Opponents say it would require mothers to deliver babies with fatal conditions. Gov. Mike Beebe has said he has constitutional concerns about the proposal but has not said whether he will veto it.

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Wall St. Shares Inch Ahead

Shares on Wall Street inched higher in early trading on Tuesday, putting the Standard & Poor’s 500-stock index on track to extend its seven-week winning streak.

Shortly after the opening bell, the S.&P. 500 was up 0.3 percent, while the Dow Jones industrial average was up 0.1 percent. The Nasdaq composite rose 0.2 percent.

The strong start to the year has been helped by legislators in Washington, who temporarily averted a series of automatic spending cuts and tax increases, as well as by better-than-expected earnings and economic data. The Federal Reserve’s stimulus policy has also been a major factor.

But further gains for the benchmark S.&P. index have been a struggle as investors look for new catalysts to lift the index, which hovers near five-year highs.

The compromise by lawmakers on across-the-board spending cuts, known as sequestration, only postponed until March 1 a resolution to the Congressional budget fight.

The faster pace in merger-and-acquisition activity, a sign of optimism about the outlook on Wall Street, has resulted in more than $158 billion in deals announced so far in 2013.

“The firm market tone continues," said Andre Bakhos, director of market analytics at Lek Securities in New York, "fueled by a lack of negative surprises as well as an increase in M.&A. activity, adding confidence to market valuations.”

“The market has been able to shrug off minor negatives as it looks ahead to a potential bigger hurdle in the sequestration,” he said. “Until then, the situation looks stable.”

The No. 2 office supply retailer in the United States, Office Depot, surged 24 percent. The company is said to be in merger talks with a smaller rival, OfficeMax. OfficeMax shares jumped 30 percent.

The computer maker Dell reports fourth-quarter results on Tuesday, and it is expected to show earnings per share fall to 39 cents from 51 cents a year earlier. Analysts will have their first chance to question management on a buyout deal struck earlier this month by its chief executive, Michael Dell, private equity firm Silver Lake and Microsoft.

According to the Thomson Reuters data through Friday, of the 388 companies in the S.&P. 500 that have reported results, 69.8 percent have exceeded analysts’ expectations, compared with a 62 percent average since 1994 and 65 percent over the last four quarters.

Fourth-quarter earnings for S.&P. 500 companies are estimated to have risen 5.6 percent, according to the data, above a 1.9 percent forecast at the start of the earnings season.

European shares rose on Tuesday, lifted by gains at food group Danone and fresh signs of a German economic recovery, although broader market sentiment remained cautious ahead of Italian elections this weekend.

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Tech Industry Sets Its Sights on Gambling

Jim Wilson/The New York Times

Cesar Miranda, left, and his brother, Edgar, working on their claw crane game in San Jose, Calif.

SAN FRANCISCO — Look out Las Vegas, here comes FarmVille.

Silicon Valley is betting that online gambling is its next billion-dollar business, with developers across the industry turning casual games into occasions for adults to wager.

At the moment these games are aimed overseas, where attitudes toward gambling are more relaxed and online betting is generally legal, and extremely lucrative. But game companies, from small teams to Facebook and Zynga, have their eye on the ultimate prize: the rich American market, where most types of real-money online wagers have been cleared by the Justice Department.

Two states, Nevada and Delaware, are already laying the groundwork for virtual gambling. Within months they will most likely be joined by New Jersey.

Bills have also been introduced in Mississippi, Iowa, California and other states, driven by the realization that online gambling could bring in streams of tax revenue. In Iowa alone, online gambling proponents estimated that 150,000 residents were playing poker illegally.

Legislative progress, though, is slow. Opponents include an influential casino industry wary of competition and the traditional antigambling factions, who oppose it on moral grounds.

Silicon Valley is hardly discouraged. Companies here believe that online gambling will soon become as simple as buying an e-book or streaming a movie, and that the convenience of being able to bet from your couch, surrounded by virtual friends, will offset the lack of glittering ambience found in a real-world casino. Think you can get a field of corn in FarmVille, the popular Facebook game, to grow faster than your brother-in-law’s? Five bucks says you cannot.

“Gambling in the U.S. is controlled by a few land-based casinos and some powerful Indian casinos,” said Chris Griffin, chief executive of Betable, a London gambling start-up that handles the gaming licenses and betting mechanics of the business for developers. “What potentially becomes an interesting counterweight is all of a sudden thousands of developers in Silicon Valley making money overseas and wanting to turn their efforts inward and make money in the U.S.”

Betable has set up shop in San Francisco, where 15 studios are now using its back-end platform. “This is the next evolution in games, and kind of ground zero for the developer community,” Mr. Griffin said.

Overseas, online betting is generating an estimated $32 billion in annual revenue — nearly the size of the United States casino market. Juniper Research estimates that betting on mobile devices alone will be a $100 billion worldwide industry by 2017.

“Everyone is really anticipating this becoming a huge business,” said Chris DeWolfe, a co-founder of the pioneering social site Myspace, who is throwing his energies into a gaming studio with a gambling component backed by, among others, the personal investment funds of Jeff Bezos, Amazon’s founder, and Eric E. Schmidt, Google’s executive chairman.

As companies eagerly wait for the American market to open up, they are introducing betting games in Britain, where Apple has tweaked the iPhone software to accommodate them. Facebook began allowing online gambling for British users last summer with Jackpotjoy, a bingo site; deals with other developers followed in December and this month.

Zynga, the company that developed FarmVille, Mafia Wars, Words With Friends and many other popular casual games, is advertising the imminent release of its first betting games in Britain. “All your favorite Zynga game characters will be there, except this time they’ll have real money prizes to offer you,” an ad says. “Play online casino games for pennies and live the dream!”

Mr. DeWolfe’s studio, SGN, is also on the verge of starting its first real-money games in Britain. “Those companies that have a critical mass of users that are interested in playing real-money games are going to be incredibly valuable,” he said.

Mark Pincus, the chief executive of Zynga, said the company was just following the market. “There is no question there is great interest from all kinds of people in games of chance, whether it is for real money or virtual rewards,” he said. Zynga, which has missed revenue expectations in the last year, is making gambling a centerpiece of its new strategy. It has just applied to Nevada for a gambling license.

Casual gaming first blossomed on Facebook’s Web site, where players could readily corral friends into their games. It is now being rethought for mobile devices, so people can play in brief snippets as they wait for a bus or a sandwich.

Some games mimic the slots and poker found in casinos; others emphasize considerably more creativity. The vast majority of casual game players play at no charge. A small number buy virtual objects in the game to speed their play or increase their status.

Tech executives expect an equally small number to play for real money but believe they will bet heavily, making them much more valuable to the gaming companies. By Betable’s estimate, the lifetime value of a casual player is $2 versus $1,800 for a real-money player.

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Singer Mindy McCready dies in apparent suicide

HEBER SPRINGS, Ark. (AP) — Perhaps there was one heartbreak too many for Mindy McCready.

The former country star apparently took her own life Sunday afternoon in Heber Springs, Ark. Authorities say McCready died of a suspected self-inflicted gunshot to the head and an autopsy is planned. She was 37, the mother of two young sons.

McCready has had at least three suicide attempts since 2005 among a series of tumultuous public events that marked much of the singer's adult life.

Speaking to The Associated Press in 2010, McCready smiled wryly while talking about the string of issues she'd dealt with over the last half-decade.

"It is a giant whirlwind of chaos all the time," she said of her life. "I call my life a beautiful mess and organized chaos. It's just always been like that. My entire life things have been attracted to me and vice versa that turn into chaotic nightmares or I create the chaos myself. I think that's really the life of a celebrity, of a big, huge, giant personality."

This time it seems the whirlwind overwhelmed McCready.

Her death comes a month after that of David Wilson, her longtime boyfriend and the father of her youngest son. He is believed to have shot himself on the same porch of the home they shared in the small wooded community of large lakefront houses about 65 miles north of Little Rock, Ark., and his death also was investigated as a suicide.

It was the most difficult moment in a life full of them. McCready issued a statement last month lamenting his death. And she called him her soul mate and a caregiver to her sons in an interview with NBC's "Today" show.

"I just keep telling myself that the more suffering that I go through, the greater character I'll have," she said, according to a transcript of the interview.

Like so many times before, McCready showed a little toughness in the midst of a personal storm, again endearing herself to her fans. But as usual, the brave face for the camera hid a much more complicated internal struggle that surfaced publicly time and again over the last 10 years.

This time, along with her remembrances of finding Wilson as he lay dying, she also answered questions about whether they'd argued earlier that evening about an affair and if she'd shot him.

"Oh, my God," the "Today" transcript reads. "No. Oh, my God. No. He was my life. We were each other's life."

It's unclear what circumstances led to McCready taking her own life, but it appears she was struggling again with twin issues that have persisted for years — substance abuse and the custody of her children. She checked into court-ordered rehab and gave her children up to foster care earlier this month after her father asked a judge to intervene, saying she'd stopped taking care of herself and her sons and was abusing alcohol and prescription drugs.

It's not clear where her sons, 6-year-old Zander and infant Zayne, were Sunday.

A deputy stationed outside McCready's home Sunday night referred questions to the Cleburne County sheriff, who was unavailable. Yellow crime-scene tape cordoned off the front yard and a dark-colored pickup truck sat in the driveway.

News of McCready's death spread quickly Sunday night on Twitter, with major country stars paying their respects to the onetime Nashville darling.

"Too much tragedy to overcome. R.I.P Mindy McCready," wrote Natalie Maines of The Dixie Chicks.

And Carrie Underwood added: "I grew up listening to Mindy McCready...so sad for her family tonight. Many prayers are going out to them..."

Melinda Gayle McCready arrived in Nashville in 1994 still in her teens with tapes of her karaoke vocals and earned a recording contract with BNA Records. She had a few memorable moments professionally, scoring her first No. 1 hit almost immediately.

"Guys Do It All the Time," a self-assured dig at male chauvinism, endeared her to female fans in 1996. She also scored a hit with "Ten Thousand Angels," and her album of that title sold 2 million copies.

Beyond that, though, she's mostly remembered for a string of dramatic moments as she spent the next 15 years chasing another huge hit. Her problems included a custody battle with her mother over one of her sons, arrests, overdoses and discord in her love life.

She made headlines in April 2008 when she claimed a longtime relationship with baseball great Roger Clemens. Published reports at the time said she met the pitcher at a Florida karaoke bar when she was 15 and he was 28 and married. Clemens denied the relationship. A decade earlier she was engaged to actor Dean Cain, but the two never married.

She also had a turbulent relationship with Billy McKnight, a country singer who is the father of her oldest son. McKnight was arrested in 2005 on charges of attempted murder after authorities say he beat and choked her.

During this period she also pleaded guilty to obtaining the painkiller OxyContin fraudulently at a pharmacy and got probation. She violated the probation with a drunken driving arrest in May 2005, a few days before McKnight was arrested. And in July 2007, she was arrested in her hometown of Fort Myers, Fla., on misdemeanor charges of scratching her mother, Gayle Inge, on the face during a scuffle and resisting sheriff's deputies.

Less than a year later, McCready was arrested and charged with violating her probation by falsifying her community service records relating to the 2004 drug charge. A month later, she entered an extended care facility for undisclosed treatment, and followed that with a 60-day jail sentence. Inge took custody of Zander.

There were at least three suicide attempts between July 2005 and December 2008.

She tried to get help in an unusual way, joining the cast of "Celebrity Rehab 3" with Dr. Drew Pinsky. McCready came off as a sympathetic figure during the show's run. Pinsky called her an "angel" and in an interview in 2010 said it appeared McCready was doing "rather well."

Pinsky helped treat McCready for love addiction on the show and said he'd referred her to professionals who could continue to help her afterward.

"A love addict basically is somebody that really didn't have a good model for intimacy in their childhood, often times traumatized in one way or another, thereby intimacy becomes a risk place, becomes an intolerable place," Pinsky said. "And so what they tend to do is attach themselves to idealized, bigger than life, unavailable others, specifically go after some public figure that's married or go after some rock star who is himself a sex addict and not interested in a relationship, and then idealize that person and actively pursue them to the point of obsession."

McCready suffered a seizure in one of the show's scarier moments. Tests showed she has suffered brain damage, something she attributed to her abusive relationship with McKnight.

McCready is the fifth celebrity to pass away since appearing on Pinsky's show and the third from Season 3. Alice in Chains bassist Mike Starr and "Real World" participant Joey Kovar both died of overdoses.

In the months after her stint, McCready said she found some peace, telling The Associated Press in early 2010 that she hoped to get her career restarted, write a book about her experiences and begin production on a reality show with her brothers. She'd just met Wilson and talked openly about their relationship, although the producer and musician declined to speak on the record.

With a publicist, reporters, cameras, makeup artists and musicians swirling around her during a press day for her last album, "I'm Still Here," McCready fended off questions about a sex tape and said she and Wilson started out as friends.

"And I've never had a relationship like that before where we started completely as friends," she said. "It turned into friends really caring about each other and then it turned into love and I've never had that happen before."

At the time, Pinsky thought the relationship was on the right track: "She's an easy person to like and to care about and we hope she does well," Pinsky said. "So far so good as far as I can tell."

McCready said her main goal in 2010 was to pull her family back together: "I would like my son back with me and for my brothers and I and he to be able to go and do this (TV reality show), and I think after that I will be a pretty happy girl."

The new album debuted at No. 71 and failed to gain radio airplay. McCready's plans never materialized and she soon was in legal trouble again, this time fighting for custody.

McCready took her older son from her mother, the boy's legal guardian, in late 2011. She fled to Arkansas without permission over what she called child abuse fears. Authorities eventually found McCready hiding in a home without permission and took the boy into custody.

She and Wilson had their son in April 2012.

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Music Writer Chris Talbott reported from Nashville, Tenn. Associated Press writer Tamara Lush contributed to this report from Tampa, Fla.

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Well: Health Effects of Smoking for Women

The title of a recent report on smoking and health might well have paraphrased the popular ad campaign for Virginia Slims, introduced in 1968 by Philip Morris and aimed at young professional women: “You’ve come a long way, baby.”

Today that slogan should include: “…toward a shorter life.” Ten years shorter, in fact.

The new report is one of two rather shocking analyses of the hazards of smoking and the benefits of quitting published last month in The New England Journal of Medicine. The data show that “women who smoke like men die like men who smoke,” Dr. Steven A. Schroeder, a professor of health and health care at the University of California, San Francisco, wrote in an accompanying editorial.

That was not always the case. Half a century ago, the risk of death from lung cancer among men who smoked was five times higher than that among women smokers. But by the first decade of this century, that risk had equalized: for both men and women who smoked, the risk of death from lung cancer was 25 times greater than for nonsmokers, Dr. Michael J. Thun of the American Cancer Society and his colleagues reported.

Today, women who smoke are even more likely than men who smoke to die of lung cancer. According to a second study in the same journal, women smokers face a 17.8 times greater risk of dying of lung cancer than women who do not smoke; men who smoke are at 14.6 times greater risk to die of lung cancer than men who don’t. Women who smoke now face a risk of death from lung cancer that is 50 percent higher than the estimates reported in the 1980s, according to Dr. Prabhat Jha of the Center for Global Health Research in Toronto and his colleagues.

After controlling for age, body weight, education level and alcohol use, the new analysis found something else: men and women who continue to smoke die on average 10 years sooner than those who never smoked.

Dramatic progress has been made in reducing the prevalence of smoking, which has fallen from 42 percent of adults in 1965 (the year after the first surgeon general’s report on smoking and health) to 19 percent in 2010. Yet smoking still results in nearly 200,000 deaths a year among people 35 to 69 years old in the United States. A quarter of all deaths in this age group would not occur if smokers had the same risk of death as nonsmokers.

The risks are even greater among men 55 to 74 and women 60 to 74. More than two-thirds of all deaths among current smokers in these age groups are related to smoking. Over all, the death rate from all causes combined in these age groups “is now at least three times as high among current smokers as among those who have never smoked,” Dr. Thun’s team found.

While lung cancer is the most infamous hazard linked to smoking, the habit also raises the risk of death from heart disease, stroke, pulmonary disease and other cancers, including breast cancer.

Furthermore, changes in how cigarettes are manufactured may have increased the dangers of smoking. The use of perforated filters, tobacco blends that are less irritating, and paper that is more porous made it easier to inhale smoke and encouraged deeper inhalation to achieve satisfying blood levels of nicotine.

The result of deeper inhalation, Dr. Thun’s report suggests, has been an increased risk of chronic obstructive pulmonary disease, or C.O.P.D., and a shift in the kind of lung cancer linked to smoking. Among nonsmokers, the risk of death from C.O.P.D. has declined by 45 percent in men and has remained stable in women, but the death rate has more than doubled among smokers.

But there is good news, too: it’s never too late to reap the benefits of quitting. The younger you are when you stop smoking, the greater your chances of living a long and healthy life, according to the findings of Dr. Jha’s international team.

The team analyzed smoking and smoking-cessation histories of 113,752 women and 88,496 men 25 and older and linked them to causes of deaths in these groups through 2006.

Those who quit smoking by age 34 lived 10 years longer on average than those who continued to smoke, giving them a life expectancy comparable to people who never smoked. Smokers who quit between ages 35 and 44 lived nine years longer, and those who quit between 45 and 54 lived six years longer. Even quitting smoking between ages 55 and 64 resulted in a four-year gain in life expectancy.

The researchers emphasized, however, that the numbers do not mean it is safe to smoke until age 40 and then stop. Former smokers who quit by 40 still experienced a 20 percent greater risk of death than nonsmokers. About one in six former smokers who died before the age of 80 would not have died if he or she had never smoked, they reported.

Dr. Schroeder believes we can do a lot better to reduce the prevalence of smoking with the tools currently in hand if government agencies, medical insurers and the public cooperate.

Unlike the races, ribbons and fund-raisers for breast cancer, “there’s no public face for lung cancer, even though it kills more women than breast cancer does,” Dr. Schroeder said in an interview. Lung cancer is stigmatized as a disease people bring on themselves, even though many older victims were hooked on nicotine in the 1940s and 1950s, when little was known about the hazards of smoking and doctors appeared in ads assuring the public it was safe to smoke.

Raising taxes on cigarettes can help. The states with the highest prevalence of smoking have the lowest tax rates on cigarettes, Dr. Schroeder said. Also helpful would be prohibiting smoking in more public places like parks and beaches. Some states have criminalized smoking in cars when children are present.

More “countermarketing” of cigarettes is needed, he said, including antismoking public service ads on television and dramatic health warnings on cigarette packs, as is now done in Australia. But two American courts have ruled that the proposed label warnings infringed on the tobacco industry’s right to free speech.

Health insurers, both private and government, could broaden their coverage of stop-smoking aids and better publicize telephone quit lines, and doctors “should do more to stimulate quit attempts,” Dr. Schroeder said.

As Nicola Roxon, a former Australian health minister, put it, “We are killing people by not acting.”

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Tech Industry Sets Its Sights on Gambling

Jim Wilson/The New York Times

Cesar Miranda, left, and his brother, Edgar, working on their claw crane game in San Jose, Calif.

SAN FRANCISCO — Look out Las Vegas, here comes FarmVille.

Silicon Valley is betting that online gambling is its next billion-dollar business, with developers across the industry turning casual games into occasions for adults to wager.

At the moment these games are aimed overseas, where attitudes toward gambling are more relaxed and online betting is generally legal, and extremely lucrative. But game companies, from small teams to Facebook and Zynga, have their eye on the ultimate prize: the rich American market, where most types of real-money online wagers have been cleared by the Justice Department.

Two states, Nevada and Delaware, are already laying the groundwork for virtual gambling. Within months they will most likely be joined by New Jersey.

Bills have also been introduced in Mississippi, Iowa, California and other states, driven by the realization that online gambling could bring in streams of tax revenue. In Iowa alone, online gambling proponents estimated that 150,000 residents were playing poker illegally.

Legislative progress, though, is slow. Opponents include an influential casino industry wary of competition and the traditional antigambling factions, who oppose it on moral grounds.

Silicon Valley is hardly discouraged. Companies here believe that online gambling will soon become as simple as buying an e-book or streaming a movie, and that the convenience of being able to bet from your couch, surrounded by virtual friends, will offset the lack of glittering ambience found in a real-world casino. Think you can get a field of corn in FarmVille, the popular Facebook game, to grow faster than your brother-in-law’s? Five bucks says you cannot.

“Gambling in the U.S. is controlled by a few land-based casinos and some powerful Indian casinos,” said Chris Griffin, chief executive of Betable, a London gambling start-up that handles the gaming licenses and betting mechanics of the business for developers. “What potentially becomes an interesting counterweight is all of a sudden thousands of developers in Silicon Valley making money overseas and wanting to turn their efforts inward and make money in the U.S.”

Betable has set up shop in San Francisco, where 15 studios are now using its back-end platform. “This is the next evolution in games, and kind of ground zero for the developer community,” Mr. Griffin said.

Overseas, online betting is generating an estimated $32 billion in annual revenue — nearly the size of the United States casino market. Juniper Research estimates that betting on mobile devices alone will be a $100 billion worldwide industry by 2017.

“Everyone is really anticipating this becoming a huge business,” said Chris DeWolfe, a co-founder of the pioneering social site Myspace, who is throwing his energies into a gaming studio with a gambling component backed by, among others, the personal investment funds of Jeff Bezos, Amazon’s founder, and Eric E. Schmidt, Google’s executive chairman.

As companies eagerly wait for the American market to open up, they are introducing betting games in Britain, where Apple has tweaked the iPhone software to accommodate them. Facebook began allowing online gambling for British users last summer with Jackpotjoy, a bingo site; deals with other developers followed in December and this month.

Zynga, the company that developed FarmVille, Mafia Wars, Words With Friends and many other popular casual games, is advertising the imminent release of its first betting games in Britain. “All your favorite Zynga game characters will be there, except this time they’ll have real money prizes to offer you,” an ad says. “Play online casino games for pennies and live the dream!”

Mr. DeWolfe’s studio, SGN, is also on the verge of starting its first real-money games in Britain. “Those companies that have a critical mass of users that are interested in playing real-money games are going to be incredibly valuable,” he said.

Mark Pincus, the chief executive of Zynga, said the company was just following the market. “There is no question there is great interest from all kinds of people in games of chance, whether it is for real money or virtual rewards,” he said. Zynga, which has missed revenue expectations in the last year, is making gambling a centerpiece of its new strategy. It has just applied to Nevada for a gambling license.

Casual gaming first blossomed on Facebook’s Web site, where players could readily corral friends into their games. It is now being rethought for mobile devices, so people can play in brief snippets as they wait for a bus or a sandwich.

Some games mimic the slots and poker found in casinos; others emphasize considerably more creativity. The vast majority of casual game players play at no charge. A small number buy virtual objects in the game to speed their play or increase their status.

Tech executives expect an equally small number to play for real money but believe they will bet heavily, making them much more valuable to the gaming companies. By Betable’s estimate, the lifetime value of a casual player is $2 versus $1,800 for a real-money player.

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