The New Old Age Blog: Patience, Consciousness and White Lies

My wife and I are blessed with having three “semi-independent” parents in their mid-80s living within a few blocks of us. Our children grew up knowing their grandparents as integral parts of our nuclear family, within walking distance for most of their childhoods. But now that our nest is empty, we find ourselves reliving many of the parenting issues we faced when our children were little — now in geriatric versions, at close range. As it turns out, parenting was good practice for the issues we face with our own parents.

What exactly does semi-independence mean as applied to elderly parents? Among our three, we have two canes, five walkers, one wheelchair (for long walks), four artificial joints, a pacemaker, four hearing aides and a knee brace. The list of medical conditions is long, and the list of medications even longer, requiring different color pill box organizers for morning, afternoon and evening.

Our parents all live in the same homes they have been in for many years. Keeping them safe and healthy there, as well as when they leave the house, has become a big part of our day-to-day work these days. Therein the yin and yang of parenting has returned — independence versus helicoptering.

Children’s yearning for independence begins in toddlerhood: “I can do it myself!” It escalates through childhood, accelerates with the driver’s license, and crescendos, with pomp and circumstance, at high school graduation.

The urge for independence is seen in all animal species, but relinquishing independence and accepting assistance in old age is unique to humans. For most elderly, it comes with a struggle, reflecting how hardwired our brains are for independence. The thought of getting in-home help is antithetical to our parents’ sense of self worth, exceeded only by the dread of leaving their homes for assisted living facilities. So, as tasks that were once mundane and automatic have become onerous and stressful for them, we attempt to foster autonomy while protecting them from harm, as we did with our children just a few short years ago.

Childproofing – Our home has again become hazardous, as have theirs. Furniture must be rearranged, booster seats placed on chairs to ease standing up, slippery rugs removed, lighting improved, bathrooms accessorized with handles and rails.

Dressing – Body shapes change in childhood and in old age. Our parents’ wardrobes, like those of our children’s before them, need frequent attention to preserve self-esteem. Their unwillingness to part with old clothes turns us into tailors. And, once again, we shop for slip-on sneakers with Velcro ties.

Driving – For our teens, driving was the symbolic liberation from childhood to young adulthood. For our parents, driving is the symbolic resistance to infirmity and old age. Our attempt to wean them from their cars, in precisely the reverse order we used to phase our teens into driving, has been torture for our parents and for us.

Toys – We have filled our parents’ shelves with new toys to help them with everything from opening cartons of milk (I would like a word with whoever designed those plastic pull loops) and zipping their clothes, to opening jars and removing the protective seals from over-the-counter medicines. A “picker-upper” device helps them avoid bending too low, and a key turner gives them leverage to open their door. Large digital clock faces, easy-to-read telephone keypads, and magnifying glasses keep them in touch with the world, and an e-mail printer keeps them in touch with their grandchildren.

Medicating – Filling those plastic pill box organizers with a week’s worth of medicines has become a personal barometer of competence for our parents, yet, as with our children when they were young, we feel compelled to oversee the dosing.

Mobility – Despite numerous falls, it was only with much teeth gnashing (or denture gnashing, as the case may be) that our mothers consented to use canes; more gnashing when canes gave way to walkers. For long walks, we hide the wheelchair half way there and back so the neighbors don’t see.

The more we do for our parents, the more frail and guilty they feel. Our efforts are sometimes resented. Helping them get in and out of the car, or bracing them under the arm as they negotiate a bumpy sidewalk, can be an affront. “I can do it myself!”

Can I ride my bike to tennis practice if I’m really careful crossing Holly Street? Why can’t I take a cab home from the seniors program at the community center? Can I walk to grandma’s by myself this time? Can I take the bus to the supermarket today? Everyone is hanging out at the park after school, can I go? I’ll just walk down the block to the neighbor’s house this afternoon, O.K.?

What wisdom did we gain the first time around to help us now? Patience, consciousness and white lies.

Patience to wait for them to come to the same conclusions we did. Mom, do you think Rosalind would have fallen and broken both wrists if she had been using a walker?

Consciousness about their need for independence as ballast to our need for their well-being. Why don’t you just let us drive you at night for now?

And white lies: I’m going to the supermarket anyway, we can shop together.

The longer we can protect our parents from harm, the more we can share our lives with them and the more joy they can have from their grandchildren. The trick is doing it without hurting them in other ways.

We have been through this before. It was worth it then, and it is worth it now.

Dr. Harley A. Rotbart is professor and vice chairman of pediatrics at the University of Colorado School of Medicine and the author of “No Regrets Parenting.”

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Blue Laws Curb Consumerism Where Pilgrims Gave Thanks


Charlie Mahoney for The New York Times


The annual Thanksgiving celebration in Plymouth, Mass., is held the weekend before the holiday, so as not to interfere.







PLYMOUTH, Mass. — Here in the birthplace of Thanksgiving, where the Pilgrims first gave thanks in 1621 for their harvest and their survival, some residents are giving thanks this year for something else: the Colonial-era blue laws that prevent retailers from opening their doors on the fourth Thursday of November.








Charlie Mahoney for The New York Times

Participants in Saturday's town parade.






While shoppers in the rest of the country will skip out on Thanksgiving to go to Walmart or Kmart or other big-box stores, William Wrestling Brewster, whose ancestors arrived on the Mayflower and participated in that first Thanksgiving, will limit his activities to enjoying a traditional meal here with his extended family at his parents’ house.


“Thanksgiving is supposed to be about giving thanks for all you have,” said Mr. Brewster, 47, who runs a computer repair business. “I cringe to think what society is doing to itself,” he said of the mercantile mania that threatens one of the least commercial holidays.


Some of the nation’s biggest retailers — Sears, Target and Toys “R” Us among them — announced this month that they would be moving up their predawn Black Friday door-buster sales to Thanksgiving Day or moving up their existing Thanksgiving sales even earlier on Thursday. Walmart, which has already been open on Thanksgiving for many years, is advancing its bargain specials to 8 p.m. Thursday from 10 p.m.


But in Maine, Massachusetts and Rhode Island, the stores will sit dark until the wee hours of Friday. Even Walmart will not open in Maine until just after midnight Friday or in Massachusetts or Rhode Island until 1 a.m.


New England’s blue laws were put down by early settlers to enforce proper behavior on Sundays. (The origin of the term is unclear. Some have said the laws were printed on blue paper, while others have said the word “blue” was meant to disparage those like the “blue noses” who imposed rigid moral codes on others.)


Over decades, many of those laws — which banned commerce, entertainment and the sale of alcohol, among other things — were tossed aside or ignored, or exemptions were granted. In some cases, the statutes were extended to holidays and barred retailers specifically from operating on Thanksgiving or Christmas.


Maine granted an exception to L. L. Bean, whose store in Freeport is open around the clock every day, including Christmas. When the blue laws, which had faded, were revived in the 1950s, the store in Freeport was already operating 24/7, said Carolyn Beem, a spokeswoman. She said that the store, which originally catered to hunters and fishermen who shopped at odd hours, was grandfathered in and allowed to stay open on the holidays.


Nationwide, a protest is developing against Thanksgiving Day sales. Workers at some stores have threatened to strike, saying the holiday openings were disrupting their family time. Online petitions have drawn hundreds of thousands of signatures protesting the move. The stores say that many of their workers have volunteered to work on the holiday, when they will get extra pay, and that consumers wanted to shop early. It is not yet clear what effect the protests might have.


At the same time, this corner of New England is serving as something of a bulwark against the forces of commercialism.


Even the Retailers Association of Massachusetts is treading gently on the notion of Thanksgiving sales.


“There hasn’t been any outcry from our members over the years pushing this,” said Bill Rennie, vice president of the association.


But, as Thanksgiving shopping becomes more common, he said, “it may be time to have a discussion about it.”


Blue laws seem anachronistic when people can shop anytime online, he said.


There is also the case of simple economics. These states are already at risk of losing sales to stores in New Hampshire, which has no sales tax. Now, Mr. Rennie pointed out, they could lose even more in the holiday bargain rush when stores in New Hampshire are open and stores here are closed.


Still, Barry Finegold, a Massachusetts state senator whose district abuts New Hampshire, said that so far, none of the retailers in his district had asked for a change in the law.


This article has been revised to reflect the following correction:

Correction: November 20, 2012

An earlier version of this article misstated William Wrestling Brewster’s occupation. He runs a computer repair business, not a computer store.



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Clinton to Visit Middle East in Effort to Defuse Gaza Conflict





PHNOM PENH, Cambodia — President Obama sent Secretary of State Hillary Rodham Clinton to the Middle East on Tuesday to try to defuse the conflict in Gaza, the White House announced.




Mrs. Clinton, who accompanied Mr. Obama on his three-country Asia trip, left on her own plane immediately for the region, where she will stop first in Jerusalem to meet with Prime Minister Benjamin Netanyahu of Israel, then head to the West Bank to meet with Palestinian leaders and finally to Cairo to consult with Egyptian officials.


The decision to dispatch Mrs. Clinton dramatically deepens the American involvement in the crisis. Mr. Obama made a number of late-night phone calls from his Asian tour to the Middle East on Monday night that contributed to his conclusion that he had to become more engaged and that Mrs. Clinton might be able to accomplish something.


With Ban Ki-moon, the United Nations secretary general, also scheduled to arrive in Israel on Tuesday, a senior official in the prime minister’s office said Israel decided to give more time to diplomacy before launching a ground invasion into Gaza. But Israel has not withdrawn other options.


“I prefer a diplomatic solution,” Mr. Netanyahu said in a statement at the start of a meeting in Jerusalem with the German foreign minister, Guido Westerwelle. “I hope that we can get one but if not, we have every right to defend ourselves with other means and we shall use them.” “As you know, we seek a diplomatic unwinding to this, through the discussions of cease-fire,” Mr. Netanyahu added. “But if the firing continues, we will have to take broader action and we won’t hesitate to do so.”


About three hours before Mr. Ban was scheduled to meet Mr. Netanyahu in Jerusalem, sirens sounded across the city in the early afternoon announcing an incoming rocket from Gaza. The military wing of Hamas said it had fired at the city. The rocket fell short, landing harmlessly in the West Bank just south of Jerusalem, and the military said it landed on open ground near a Palestinian village.


The rocket attack on the city, which is holy to Jews, Muslims and Christians, was the second in less than a week. The earlier rocket on Friday landed in a similar location, the police said.


The Israeli military said that in the course of the morning its air force had struck at 11 Palestinian squads involved in planting explosives and firing rockets, as well as underground rocket launchers and a store of weapons and ammunition. The military said it had also used tank shells and artillery fire against unspecified targets in Gaza.  


The Health Ministry in Gaza said the Palestinian death toll had climbed by late Tuesday morning to 112, roughly half of the dead civilians, including children. Three Israelis died in a rocket attack last week.


After an Asian summit dinner in Phnom Penh on Monday night, Mr. Obama called President Mohamed Morsi of Egypt to discuss the situation, then spoke with Mr. Netanyahu and called Mr. Morsi back. He was up until 2:30 a.m. on the phone, the White House said. He consulted with Mrs. Clinton repeatedly on the sidelines of the Asian summit meetings on Tuesday.


“This morning, Secretary Clinton and the president spoke again about the situation in Gaza, and they agreed that it makes sense for the secretary to travel to the region so Secretary Clinton will depart today,” said Benjamin Rhodes, a deputy national security adviser to Mr. Obama. “Her visits will build on the engagement that we’ve undertaken in the last several days.”


Mr. Rhodes said, “Any resolution to this has to include an end to that rocket fire” by Hamas militants on Israeli communities but “the best way to solve this is through diplomacy.”


He added, “It’s in nobody’s interest to see an escalation of the military conflict.”


Mrs. Clinton will not meet with Hamas representatives on her trip, but with the Palestinian leadership in the West Bank, which is at odds with the Hamas rulers of the Gaza Strip. “We do not engage directly with Hamas,” Mr. Rhodes said.


Instead, Mr. Obama is focused on leveraging Egypt’s influence with Hamas to press for a halt to the rocket attacks. “We believe Egypt can and should be a partner in achieving that outcome,” Mr. Rhodes said.


Mr. Rhodes reaffirmed that the United States supports Israel’s right to defend itself and said Mr. Obama did not ask Mr. Netanyahu to hold off a ground incursion into Gaza.


In Jerusalem, an official in the prime minister’s office said the country’s top nine ministers, who make up the inner security cabinet, held discussions late into the night on the state of the diplomatic efforts and Israel’s military operation in Gaza. The goal of the operation, Israel says, is to end years of rocket fire by Gaza militants against southern Israel.


Peter Baker reported from Phnom Penh, Cambodia, and Isabel Kershner from Jerusalem. Jodi Rudoren contributed reporting from Gaza City.



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N.Y. police officer says not guilty of plan to cook, eat women
















NEW YORK (Reuters) – A New York City police officer pleaded not guilty on Monday to conspiring to kidnap, torture, cook and eat women.


Gilberto Valle, 28, of Forest Hills, Queens, was charged and arrested in October with conspiring to cross state lines to kidnap the women and with illegally accessing a federal database.













Prosecutors said some of the women were acquaintances of Valle but it was not clear if he knew or had met all of them. Valle, who an official said had no prior criminal record, was not charged with carrying out any of his suspected plans.


At a brief hearing Monday in U.S. District Court in Manhattan, Valle’s attorney, Julia Gatto, told the judge she would again seek to have her client freed on bail after two other judges previously denied her request.


Investigators uncovered a file on Valle’s computer containing the names and pictures of at least 100 women, and the addresses and physical descriptions of some of them, according to the criminal complaint. It said he had undertaken surveillance of some of the women at their places of employment and their homes.


Gatto argues that Valle, a 6-1/2 year NYPD veteran, was all talk and should be released on bail.


The charges carry a maximum sentence of life in prison.


The case is U.S. v. Gilberto Valle, U.S. District Court for the Southern District of New York, No. 12-cr-847.


(Reporting by Basil Katz; Editing by Cynthia Osterman)


Internet News Headlines – Yahoo! News



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'Trapped' on Broadway? R. Kelly is working on it

NEW YORK (AP) — Is Broadway ready for Twan, Sylvester, Pimp Lucius and "the package"? R. Kelly thinks so — and says he's working to bring the wacky characters and plotlines in his even wackier "Trapped in the Closet" series to the Great White Way.

The superstar announced Monday night that he's had an offer to bring the cult classic to the stage, and he may even be in some performances.

"To transform it into a Broadway version, that's what I'm working on," he told a packed house at the Sunshine Theater, where he unveiled the latest chapters in "Trapped in the Closet," which will debut on the IFC channel on Friday.

Kelly gave no other details about a possible Broadway adaptation of the wildly popular video opera. It got its start from a stirring series of songs Kelly debuted in 2005, which ended with a cliffhanger. The songs captured so much attention that Kelly made an over-the-top video series about it that just got crazier and crazier as he added more chapters.

Kelly has often referred to "Trapped" as an alien, and on Monday, he said: "I'm glad to be one of the astronauts to take this thing to the unknown."

He thanked the enthusiastic crowd for accepting the series, and admitted that he always wanted to act: "Somehow, I landed 'Trapped in the Closet' from being silly."

He also joked about the ridiculous nature of the series.

"I'm just having a lot of fun. I don't have a job, so I sit in the studio all day and think of stuff to do and this is just something stupid I've done that's been successful for me," he said. "I'm having a lot of fun with it."

The latest chapters introduce a few new faces, and like the others series, ends with a cliffhanger. While it's taken Kelly five years to add these latest chapters, Kelly says he won't take as long to produce more.

"I want everybody to know I've got 85 chapters of 'Trapped in the Closet' waiting in the studio for y'all," he said. "The chapters that are coming — the show, we call it — is going to exceed every chapter that you have ever seen."

Kelly capped off the evening with a rendition of one of his biggest hits, "I Believe I Can Fly," for the audience.

___

Online:

http://www.r-kelly.com

http://www.ifc.com

___

Nekesa Mumbi Moody is the AP's Global Entertainment & Lifestyles Editor. Follow her at http://www.twitter.com/nekesamumbi

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Responding to Illnesses Manifesting Amid Recovery From Storm


Nicole Bengiveno/The New York Times


Dr. Aaron Gardener, center, attended to a patient at an ad hoc medical unit in Long Beach, N.Y. Many people have coughs, rashes and other ailments.







Day and night, victims of Hurricane Sandy have been streaming into ad hoc emergency rooms and relief centers, like the MASH-type medical unit on an athletic field in Long Beach, and the warming tent in the Rockaways the size of a small high school gym.




They complain of rashes, asthma and coughing. They need tetanus shots because — house-proud and armed with survivalist instincts — they have been ripping out waterlogged boards and getting poked by rusty nails. Those with back pain from sifting through debris receive muscle relaxants; those with chest pain from overexertion are hooked up to cardiac monitors.


“I’ve been coughing,” said Gabriel McAuley, 46, who has been working 16-hour days gutting homes and hauling debris in the Rockaways since the storm hit. “I’ve never felt a cough like that before. It’s deeper down.”


It is impossible to say how many people have been sickened by what Hurricane Sandy left behind: mold from damp drywall; spills from oil tanks; sewage from floodwater and unflushable toilets; tons upon tons of debris and dust. But interviews with hurricane victims, recovery workers, health officials and medical experts over the last week reveal that some of the illnesses that they feared would occur, based on the toxic substances unleashed by the storm and the experience of other disasters, notably Hurricane Katrina, have begun to manifest themselves.


Emergency rooms and poison control centers have reported cases of carbon monoxide exposure — and in New Jersey, several deaths have been attributed to it — from the misuse of generators to provide power and stoves to provide heat.


In Livingston, N.J., the Burn Center at St. Barnabas Medical Center had 16 burn cases over about six days, three times as many as usual, from people trying to dispel the cold and darkness with boiling water, gasoline, candles and lighter fluid.


Raw sewage spilled into homes in Baldwin and East Rockaway, in Nassau County, when a sewage plant shut down because of the surge and the system could not handle the backup. Sewage also spilled from a huge plant in Newark. “We tried to limit our presence in the house because the stink was horrible,” said Jennifer Ayres, 34, of Baldwin, who has been staying temporarily in West Hempstead. She said that she felt ill for several days, that her son had a scratchy throat, and that her mother, who lives in the house, had difficulty breathing, all problems she attributed to the two days they spent inside their house cleaning up last week. “I had stomach problems. I felt itchy beyond itchy on my face.”


Coughing — locally known as the Rockaway cough — is a common symptom that health officials said could come from mold, or from the haze of dust and sand kicked up by the storm and demolitions. The air in the Rockaways is so full of particles that the traffic police wear masks — though many recovery workers do not, worrying people who recall the fallout of another disaster.


“It’s just like 9/11,” said Kathy Smilardi, sitting inside the skeleton of her gutted home in Broad Channel, wrapped in a white puffy jacket, her breath visible in the afternoon cold. “Everyone runs in to clean up, and they’re not wearing masks. Are we going to wait 20 years to figure out that people are dying?”


Health officials and experts say the risks are real, but are cautioning against hysteria. Some coughing could be due to cold, damp weather. Lasting health effects from mold, dust and other environmental hazards generally require long-term, continuous exposure, they said. And the short-term effects can be mitigated by taking precautions like wearing masks, gloves and boots and removing mold-infested wallboard. “The reality is that cleaning up both muck and sewage and spills and removing walls and reconstruction and dealing with debris all do in fact pose concerns,” Daniel Kass, New York City’s deputy commissioner for environmental health, said Friday. “Are they vast or uncontrollable? No. But they depend on people doing work correctly and taking basic precautions.”


The Katrina cough was found to be temporary, said Roy J. Rando, a professor at Tulane’s School of Public Health and Tropical Medicine. Felicia Rabito, an epidemiologist at the school, said that healthy children exposed to mold after Hurricane Katrina showed no lasting respiratory symptoms when they moved back to new or renovated homes.


Immediately after Hurricane Katrina, lead levels in New Orleans’s soil dropped after the top layers of dirt, where lead from paint and gasoline can accumulate, were washed away. But in the two years afterward, soil testing found extremely high lead levels, Dr. Rabito said, which she theorized came from renovating old homes. “That’s a cautionary tale,” she said. Lead in soil can be tracked into homes and pose a health hazard to children playing inside or outside.


Though at least one outbreak of norovirus, a contagious gastrointestinal virus, occurred in a Brooklyn high school that was used as a shelter, New York and New Jersey health officials said they had not seen any significant spike in respiratory or gastrointestinal diseases related to the storm.


In Broad Channel, most homes on Noel Road, where Ms. Smilardi lives, have outdoor oil tanks that were overturned by the storm. The innards of many homes, built when asbestos was used, lie spilled among major and minor roads.


Ominous red spots covered both sides of Paul Nowinski’s burly torso. After the storm, Mr. Nowinski, a musician, waded into the basement of his childhood home on Beach 146th Street in the Rockaways to try to salvage records, books and instruments. He was up to his chest in water, which he thinks might have been contaminated with sewage. He said that he did not know the cause of the red marks; and that he had been too busy “schlepping” to go to the doctor.


Angela Macropoulos contributed reporting.



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Tax Talks Raise Bar for Richest Americans


By most measures, the personal finances of Anne Zimmerman, a small-business owner in Cincinnati, have little in common with those of Oracle’s chief executive, Lawrence J. Ellison.


Ms. Zimmerman runs an accounting business and a cloud-based Internet service company with combined annual profit of $250,000 to $500,000 in recent years. Mr. Ellison made nearly $15 million in salary, bonuses and perks in 2011, even without the $62 million he received in stock options from Oracle.


In the deficit reduction debate now consuming Washington, however, both Mr. Ellison and Ms. Zimmerman are grouped in the same, sprawling category: wealthy Americans targeted for tax increases.


President Obama has focused efforts on raising revenue from the wealthiest 2 percent of taxpayers — individuals earning more than $200,000 a year and families with adjusted gross incomes above $250,000 — calling them “millionaires and billionaires who can afford to pay a little more.” Republicans have thus far resisted those efforts, countering that the high earners are job creators and that increasing their taxes would discourage hiring.


But for all the broad brush rhetoric of political debate, the rate increases and limits on deductions now being discussed by the president and Congressional Republicans are calibrated to take the biggest bite out of the highest earners. They would lead to a smaller increase for those who earn less than $500,000 a year. The figures are all adjusted gross incomes, and since some deductions would be preserved, a household would probably have more than $250,000 in total income, perhaps $300,000, before it would fall into the wealthy definition used by the president.


If all Mr. Obama’s tax proposals for wealthy Americans were enacted, they would raise $1.6 trillion over the next decade. And an analysis by the Tax Policy Center, a nonpartisan research firm, found that the increases would be heavily weighted toward the wealthiest. Taxpayers with adjusted gross incomes over $1 million would see average increases of $184,504, the study found, with higher taxes on the ultrawealthy bloating that average. Those with adjusted gross incomes from $200,000 to $500,000 would face a tax increase averaging $4,446, with people toward the lower end having only a modest increase and people on the higher end paying several times more.


A married couple with two children earning $300,000 would see its effective tax rate increase to 21.1 percent from 16.5 percent, according to an analysis by the Tax Policy Center. A married couple with two children earning $2 million would see its effective federal income tax rate rise to 26.8 percent from 21.6 percent.


To Ms. Zimmerman, the Cincinnati businesswoman, that amount sounds reasonable.


“I’m not going to change my business decision-making process based on a few percentage points of tax increases,” she said. “If it helps get the country on a better path, well, we’re all in this together.”


But some conservatives and business advocates warn that the proposed increases could stall the sluggish economic recovery.


“There is a price that comes with these tax increases on the very wealthiest because that is where the capital is concentrated,” said William McBride, chief economist at the Tax Foundation, a conservative research firm. “That price is economic growth and hiring.”


About four million of the 114 million American households face a possible tax increase. And while they are a narrow slice of the overall population, they are nonetheless a swath of well-to-do Americans so varied that they defy easy categorization. Census data indicates that they cut across a broad range of occupations: doctors, auto dealers and dilettantes, professional athletes and financial planners, family farmers, entrepreneurs, two-income couples, corporate executives and hedge fund managers.


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Gaza Clash Escalates With Deadliest Israeli Strike


Bernat Armangue/Associated Press


Smoke rose over Gaza City on Sunday, as Israel widened its range of targets to include buildings used by the news media.







CAIRO — Emboldened by the rising power of Islamists around the region, the Palestinian militant group Hamas demanded new Israeli concessions to its security and autonomy before it halts its rocket attacks on Israel, even as the conflict took an increasing toll on Sunday.




After five days of punishing Israeli airstrikes on the Hamas-controlled Gaza Strip and no letup in the rocket fire in return, representatives of Israel and Hamas met separately with Egyptian officials in Cairo on Sunday for indirect talks about a truce.


The talks came as an Israeli bomb struck a house in Gaza on Sunday afternoon, killing 11 people, in the deadliest single strike since the conflict between Israel and Hamas escalated on Wednesday. The strike, along with several others that killed civilians across the Gaza Strip, signaled that Israel was broadening its range of targets on the fifth day of the campaign.


By the end of the day, Gaza health officials reported that 70 Palestinians had been killed in airstrikes since Wednesday, including 20 children, and that 600 had been wounded. Three Israelis have been killed and at least 79 wounded by unrelenting rocket fire out of Gaza into southern Israel and as far north as Tel Aviv.


Hamas, badly outgunned on the battlefield, appeared to be trying to exploit its increased political clout with its ideological allies in Egypt’s new Islamist-led government. The group’s leaders, rejecting Israel’s call for an immediate end to the rocket attacks, have instead laid down sweeping demands that would put Hamas in a stronger position than when the conflict began: an end to Israel’s five-year-old embargo of the Gaza Strip, a pledge by Israel not to attack again and multinational guarantees that Israel would abide by its commitments.


Prime Minister Benjamin Netanyahu of Israel stuck to his demand that all rocket fire cease before the air campaign lets up, and Israeli tanks and troops remained lined up outside Gaza on Sunday. Tens of thousands of reserve troops had been called up. “The army is prepared to significantly expand the operation,” Mr. Netanyahu said at the start of a cabinet meeting.


Reda Fahmy, a member of Egypt’s upper house of Parliament and of the nation’s dominant Islamist party, who is following the talks, said Hamas’s position was just as unequivocal. “Hamas has one clear and specific demand: for the siege to be completely lifted from Gaza,” he said. “It’s not reasonable that every now and then Israel decides to level Gaza to the ground, and then we decide to sit down and talk about it after it is done. On the Israeli part, they want to stop the missiles from one side. How is that?”


He added: “If they stop the aircraft from shooting, Hamas will then stop its missiles. But violence couldn’t be stopped from one side.”


Hamas’s aggressive stance in the cease-fire talks is the first test of the group’s belief that the Arab Spring and the rise in Islamist influence around the region have strengthened its political hand, both against Israel and against Hamas’s Palestinian rivals, who now control the West Bank with Western backing.


It also puts intense new pressure on President Mohamed Morsi of Egypt, a former leader of the Muslim Brotherhood who was known for his fiery speeches defending Hamas and denouncing Israel. Mr. Morsi must now balance the conflicting demands of an Egyptian public that is deeply sympathetic to Hamas and the Palestinian cause against Western pleadings to help broker a peace and Egypt’s need for regional stability to help revive its moribund economy.


Indeed, the Egyptian-led cease-fire talks illustrate the diverging paths of the Muslim Brotherhood and Hamas, a Palestinian offshoot of the original Egyptian Islamist group. Hamas has evolved into a more militant insurgency and is labeled a terrorist organization by the United States and Israel, while the Brotherhood has effectively become Egypt’s ruling party. Mr. Fahmy said in an interview in March that the Brotherhood’s new responsibilities required a step back from its ideological cousins in Hamas, and even a new push to persuade the group to compromise.


Reporting was contributed by Ethan Bronner, Irit Pazner Garshowitz and Isabel Kershner from Jerusalem, and Peter Baker from Bangkok.



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Justin Bieber gets love at American Music Awards

Justin Bieber may be Canadian, but he was the all-American boy at Sunday night's American Music Awards.

The pop singer dominated the awards show, winning three trophies, including artist of the year. His mom joined him onstage as he collected the award, beating out Rihanna, Maroon 5, Katy Perry and Drake.

"I wanted to thank you for always believing in me," Bieber said, looking to his mom.

The 18-year-old also won the honor in 2010. He said it's "hard growing up with everyone watching me" and asked that people continue to believe in him.

But the teenager who brought his mom as a date also got in some grinding with Nicki Minaj — who shared the stage with him and took home two awards — and a kiss on the neck from presenter Jenny McCarthy.

"Wow. I feel violated right now," he said, laughing.

"I did grab his butt," McCarthy said backstage. "I couldn't help it. He was just so delicious. So little. I wanted to tear his head off and eat it."

Another collaboration was the night's most colorful performance: Korean rapper PSY and MC Hammer. Hammer joined the buzzed-about pop star for his viral hit "Gangnam Style." PSY rocked traditional "Hammer" pants as they danced to his jam and to Hammer's "Too Legit to Quit."

Minaj, who wore three different wigs and four outfits throughout the night, repeated her AMAs wins from last year, picking up trophies for favorite rap/hip-hop artist and album for "Pink Friday: Roman Reloaded." She was in an all-white get-up, including fur coat and pink hair when she performed her new song "Freedom." The scene was ghostly and snowy, as a choir — also in white — joined her onstage. One background singer stole the performance, belting semi-high notes as Minaj looked on.

Usher kicked off the three-hour ABC-televised show with green laser lights beaming onstage as he performed a medley of songs, including "Numb," ''Climax" and "Can't Stop, Won't Stop," which featured a smoky floor and a number of backup dancers, as Usher jammed in all black, with the exception of his red shoes. He won favorite soul/R&B male artist.

His protege Bieber won favorite pop/rock male artist in the first award handed out and gave a shout-out to those who didn't think he would last on the music scene.

"I want to say this is for all the haters who thought I was just here for one or two years. I feel like I'm going to be here for a very long time," he said.

He also won favorite pop/rock album for his platinum-selling third album, "Believe." He gave a stripped down, acoustic performance of "As Long As You Love Me," then transitioned to the dance-heavy "Beauty and a Beat," where Minaj joined him onstage, grinding with the teen for a few seconds.

Swift won her fifth consecutive award for favorite country female artist.

"This is unreal. I want to thank the fans. You guys are the ones who voted on this," she said.

Swift gave a masquerade-themed performance of the pop song "I Knew You Were Trouble." She sang onstage in a light dress while dancers wore mostly black. But then she changed into a red corset and black skirt, matching their dark mood. She even danced and sang on the floor as lights flickered throughout the performance.

Dick Clark, who created the AMAs, was remembered by Ryan Seacrest and an upbeat performance by Stevie Wonder.

"What a producer he was," said Seacrest, as Wonder sang his hits, including "My Cherie Amour."

Carly Rae Jepsen, who performed early in the night, won favorite new artist.

"I am floored. Wow," she said, thanking Bieber and his manager, Scooter Braun.

Party girl Ke$ha was glammed up on the red carpet, rocking long, flowy blonde hair and a light pink dress. She switched to her normal attire when she performed her hit single "Die Young." It was tribal, with shirtless dancers in skin-tight pants, silver hair and skeleton-painted faces, who also played the drums. Ke$ha was pants-less, rocking knee-high boots and rolling on the floor as she finished up the song.

Minaj and Christina Aguilera were blonde bombshells, too: Minaj's hair was busy and full of volume and she sported a neon strapless gown to accept her first award. Aguilera wore a blonde bob in a purple dress that matched her eyeshadow.

Aguilera performed a medley of material from her new album and joined Pitbull onstage.

Kelly Clarkson also hit the stage, making a nod to her "American Idol" roots with a number on her dress and three judges looking on as she sang "Miss Independent." Then she went into "Since U Been Gone," ''Stronger" and "Catch My Breath."

Fellow "Idol" winner Carrie Underwood won best favorite country album and performed, hitting the right notes while singing "Two Black Cadillacs." She talked about singing competition shows backstage.

"These people that go on these shows are so talented, you know? And I would love to see if so many of the other artists that are out there today would go back and try out for these shows, because they might get their behinds kicked by some of the contestants," she said.

Luke Bryan won favorite country male artist and Lady Antebellum favorite country group.

American Music Awards nominees were selected based on sales and airplay, and fans chose the winners by voting online. At this award show, even the stars were fans: Pink said on the red carpet that she'd like to collaborate with Lauryn Hill. Cyndi Lauper said her musical playlist includes Pink and Minaj. Boy band The Wanted said they were excited to see PSY and Colbie Caillat wanted to watch No Doubt.

"What makes the American Music Awards special is the fans choose the winning artists," said Chester Bennington of Linkin Park, who won favorite alternative rock artist and performed "Burn It Down," as Brandy sang along and Gwen Stefani, Usher and Phillip Phillips bobbed their heads.

David Guetta won the show's first-ever electronic dance music award. Non-televised awards went to Katy Perry for pop/rock female artist, Beyonce for soul/R&B female artist, Adele for adult contemporary artist and Shakira for Latin artist.

Along with Rihanna, Minaj was the top nominee with four nominations.

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ABC is owned by The Walt Disney Co.

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AP Entertainment Writer Sandy Cohen contributed to this report from Los Angeles.

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Follow Mesfin Fekadu on Twitter at http://twitter.com/MusicMesfin

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Teenage Boys, Worried About Body Image, Take Health Risks


Béatrice de Géa for The New York Times


David Abusheikh at a gym in Brooklyn. He goes six days a week and says he uses protein supplements to help build muscle.







It is not just girls these days who are consumed by an unattainable body image.




Take David Abusheikh. At age 15, he started lifting weights for two hours a day, six days a week. Now that he is a senior at Fort Hamilton High School in Brooklyn, he has been adding protein bars and shakes to his diet to put on muscle without gaining fat.


“I didn’t used to be into supplements,” said Mr. Abusheikh, 18, who plans on a career in engineering, “but I wanted something that would help me get bigger a little faster.”


Pediatricians are starting to sound alarm bells about boys who take unhealthy measures to try to achieve Charles Atlas bodies that only genetics can truly confer. Whether it is long hours in the gym, allowances blown on expensive supplements or even risky experiments with illegal steroids, the price American boys are willing to pay for the perfect body appears to be on the rise.


In a study to be published on Monday in the journal Pediatrics, more than 40 percent of boys in middle school and high school said they regularly exercised with the goal of increasing muscle mass. Thirty-eight percent said they used protein supplements, and nearly 6 percent said they had experimented with steroids.


Over all, 90 percent of the 2,800 boys in the survey — who lived in the Minneapolis-St. Paul area, but typify what doctors say is a national phenomenon — said they exercised at least occasionally to add muscle.


“There has been a striking change in attitudes toward male body image in the last 30 years,” said Dr. Harrison Pope, a psychiatry professor at Harvard who studies bodybuilding culture and was not involved in the study. The portrayal of men as fat-free and chiseled “is dramatically more prevalent in society than it was a generation ago,” he said.


While college-age men have long been interested in bodybuilding, pediatricians say they have been surprised to find that now even middle school boys are so absorbed with building muscles. And their youth adds an element of risk.


Just as girls who count every calorie in an effort to be thin may do themselves more harm than good, boys who chase an illusory image of manhood may end up stunting their development, doctors say, particularly when they turn to supplements — or, worse, steroids — to supercharge their results.


“The problem with supplements is they’re not regulated like drugs, so it’s very hard to know what’s in them,” said Dr. Shalender Bhasin, a professor of medicine at Boston Medical Center. Some contain anabolic steroids, and even high-quality protein supplements might be dangerous in large amounts, or if taken to replace meals, he said. “These things just haven’t been studied very well,” he said.


Anabolic steroids pose a special danger to developing bodies, Dr. Bhasin said. Steroids “stop testosterone production in men,” he said, leading to terrible withdrawal problems when still-growing boys try to stop taking them. Still, the constant association of steroids with elite athletes like Lance Armstrong and Barry Bonds perpetuates the notion that they can be managed successfully.


Online, in bodybuilding forums for teenagers, boys barely out of puberty share weight-lifting regimens and body fat percentages, and judge one another’s progress. On Tumblr and Facebook, teenagers post images of ripped athletes under the heading “fitspo” or “fitspiraton,” which are short for “fitness inspiration.” The tags are spinoffs of “thinspo” and “thinspiration” pictures and videos, which have been banned from many sites for promoting anorexia.


“Lifted b4 school today felt good but was weak as hell,” wrote one boy who said he was 15 and from Tallahassee, Fla., on a message board on Bodybuilding.com in September, saying he bench-pressed 245 pounds. “Barely got it.”


Many of these boys probably see themselves in Mike Sorrentino, “The Situation” from the “Jersey Shore” series on MTV, or the Adam Sackler character, on the HBO series “Girls,” who rarely wears a shirt or takes a break from his crunches.


Mr. Abusheikh, for instance, has a Facebook page full of photos of himself shirtless or showing off his six-pack abs. At his high school, participation in the annual bodybuilding competition hit an all-time high of 30 students this year.


“They ask us about everything,” said Peter Rivera, a physical education teacher at Fort Hamilton High School who helps oversee the competition. “How do I lose weight? How do I gain muscle? How many times a week should I work out?” Some boys want to be stronger for sports, Mr. Rivera said, but others “want to change their body type.”


This article has been revised to reflect the following correction:

Correction: November 19, 2012

An earlier version of this article gave an incorrect nationality for the soccer player Cristiano Ronaldo. He is Portuguese, not Brazilian.



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