Euro Watch: Euro Zone Unemployment Rose to New Record in February

PARIS — The unemployment rate in the euro zone edged up in January to a new record, official data showed Friday, as the ailing European economy continued to weigh on the job market.

Unemployment in the 17-nation euro zone stood at 11.9 percent in January, up from 11.8 percent in December, and from 10.8 percent in January 2012, Eurostat, the statistical office of the European Union, reported from Luxembourg.

For the 27 nations of the European Union, the January jobless rate stood at 10.8 percent, up from 10.7 percent in December. All of the figures were seasonally adjusted.

A separate Eurostat report showed price pressures easing in February. In the euro zone, the annual inflation rate came in at 1.8 percent, down from 2.0 percent in January, and below the European Central Bank’s 2 percent target.

The jobless data “suggest that wage growth is set to weaken from already low rates” and further depress consumer spending, which has already been damped by government austerity measures, Jennifer McKeown, an economist at Capital Economics in London, wrote in a research note.

Ms. McKeown noted that the low inflation numbers and high joblessness “should leave the E.C.B.’s policy options open,” and she said it was possible the central bank “might discuss an interest rate cut or other unconventional policies” when its governing council meets on Thursday.

There was a small bit of bright news Friday. A survey of European purchasing managers by Markit, a data and research firm, showed German manufacturing output growing in February for second straight month, as new business levels improved. The composite German purchasing managers’ index improved to 50.3 in February — just above the level that signals growth — from 49.8 in January.

“German industry is clearly rebounding and taking advantage from better external traction,” Gilles Moëc, an economist at Deutsche Bank in London, wrote.

Employment is sometimes seen as a lagging indicator of economic growth, since companies try to avoid adding to their costs until they are convinced that a rebound is at hand. Despite the green sprouts in German industry, there are few signs that recovery is certain. Markit’s overall euro zone purchasing managers’ index was unchanged in February, at 47.9, a level that signals continued contraction.

European unemployment bottomed in early 2008, just as the financial crisis was getting in motion, and has been on a rising trend ever since. The January numbers were the highest since the creation of the euro.

In absolute terms, Eurostat estimated Friday, 19 million people in the euro zone and more than 26 million people in the overall European Union. were unemployed.

Spain’s unemployment rate in January was 26.2 percent, and Portugal’s was 17.6 percent. Austria, at just 4.9 percent, had the lowest rate, followed by Germany and Luxembourg, both of which stood at 5.3 percent.

Greece’s unemployment rate in November, the latest month for which Eurostat has figures for the country, was 27 percent.

France, the second-largest euro-zone economy after Germany, had a 10.6 percent jobless rate in January. In Britain, not a euro member, the jobless rate stood at 7.7 percent.

Those numbers compare with the United States, where the January unemployment rate stood at 7.9 percent. In Japan, 4.2 percent of the work force was counted as unemployed in December.

This article has been revised to reflect the following correction:

Correction: March 1, 2013

An earlier version of this article carried a headline that misstated the month of the data. The report was for January, not February.

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Lindsay Lohan driving case returns to LA court

LOS ANGELES (AP) — Lindsay Lohan's attorney returns to court Friday for a hearing in the actress's latest criminal case, as discussions continue about a possible plea deal before trial.

The 26-year-old isn't required to attend the hearing.

The hearing is intended to take care of any issues before a March 18 trial on misdemeanor charges that Lohan lied to police about a June car crash and was driving recklessly.

Attorney Mark Heller also plans to meet with prosecutors Friday to try to negotiate a plea deal. He wants to delay the case so Lohan can pursue psychotherapy and perform community service.

Lohan was on probation at the time of the accident and she faces jail time if a judge determines she violated her sentence in a 2011 theft case.

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The New Old Age Blog: Why Can’t I Live With People Like Me?

“Aging in place” is the mantra of long-term care. Whether looking at reams of survey data, talking to friends or wishing on a star, who among us wouldn’t rather spend the final years — golden or less so — at home, surrounded by our cherished possessions, in our own bed, no cranky old coot as a roommate, no institutional smells or sounds, no lukewarm meals on a schedule of someone else’s making?

That works best, experts tell us, in dense cities, where we can hail a cab at curbside, call the superintendent when something breaks and have our food delivered from Fresh Direct or countless takeout restaurants. We’d have neighbors in the apartment above us, below us, just on the other side of the wall. Hearing their toilets flush and their children ride tricycles on uncarpeted floors is a small inconvenience compared to the security of knowing they are so close by in an emergency.

Urban planners, mindful that most Americans live in sprawling, car-reliant suburbs, are designing more elder-friendly, walkable communities, far from “real” cities. Houses and apartments are built around village greens, with pockets of commerce instead of distant strip malls. Some have community centers for congregate meals and activities; others share gardens, where people can get their hands in the warm spring dirt long after they can push a lawn mower.

All of this is a step in the right direction, despite the Potemkin-village look of so many of them. But it doesn’t take into account those who are too infirm to stay at home, even in cities or more manageable suburban environments. Some are alone, others with a loving spouse who by comparison is “well” but may not be for long, given the rigors of care-taking. It doesn’t take into account people who can’t afford a home health aide, who don’t qualify for a visiting nurse, who have no adult children to help them or whose children live far away.

But by now, aging in place, unrealistic for some, scary or unsafe for others and potentially very isolating, has become so entrenched as the right way to live out one’s life that not being able to pull it off seems a failure, yet another defeat at a time when defeats are all too plentiful. Are we making people feel guilty if they can’t stay at home, or don’t want to? Are we discouraging an array of other solutions by investing so much, program-wise and emotionally, in this sine qua non?

Regular readers of The New Old Age know that I am single, childless and terrified of falling off a ladder while replacing a light bulb, breaking a hip and lying on the floor, unattended, until my dog wails so loudly a neighbor comes by to complain. A MedicAlert pendant is not something that appeals to me at 65, but even if I give in to that, say at 75, I’m not sure my life will be richer for digging my heels in and insisting home is where I should be.

So I spend a lot of time thinking about the alternatives. I know enough to distinguish between naturally-occurring-retirement communities, or NORCs (some of which work better than others); age-restricted housing complexes (with no services); assisted living (which works fine when you don’t really need it and not so fine when you do); and continuing care retirement communities (which require big upfront payments and extensive due diligence to be sure the place doesn’t go belly up after you get there).

What I find so unappealing about all these choices is that each means growing old among people with whom I share no history. In these congregate settings, for the most part, people are guaranteed only two things in common: age and infirmity. Which brings us to what is known in the trade as “affinity” or “niche” communities,” long studied by Andrew J. Carle at the College of Health and Human Services at George Mason University in Fairfax, Va.

Mr. Carle, who trains future administrators of senior housing complexes, was a media darling a few years back, before the recession, with the first baby boomers approaching 65 and niche communities that included services for the elderly — not merely warm-weather developments adjacent to golf courses — expected to explode. In newspaper interviews as recently as 2011, Mr. Carle said there were “about 100 of them in existence or on the drawing board,” not counting the large number of military old-age communities.

Mr. Carle still believes that better economic times, when they come, will reinvigorate this sector of senior housing, after the failure of some in the planning stages and others in operation. In an e-mail exchange, Mr. Carle said there were now about 70 in operation, with perhaps 50 of those that he has defined as University Based Retirement Communities, adjacent to campuses and popular with alumni, as well as non-alumni, who enjoy proximity to the intellectual and athletic activities. Among the most popular are those near Dartmouth, Oberlin, the University of Alabama, Penn State, Notre Dame, Stanford and Cornell.

At the height of the “affinity” boom, L.G.B.T.-assisted living communities and nursing homes were all the rage, seen as a solution to the shoddy treatment that those of different sexual orientations in the pre-Stonewall generation experienced in generic facilities. A few failed, most never got built and, by all accounts, the only one to survive is the pricy Rainbow Vision community in Sante Fe, N.M.

A handful of nudist elder communities, and ones for old hippies, also fell by the wayside, perhaps too free-spirited for the task. According to Mr. Carle, despite the odds, at least one group of RV enthusiasts has added an assisted-living component to what began as collections of transient elderly, looking only for a parking spot and necessary water and power hook-ups for their trailers. Native Americans have made a go of an assisted-living community in Montana, and Asians have done the same in Northern California.

But professional affinity communities, which I find most appealing, are few and far between.

The storied Motion Picture & Television Country House and Hospital, a sliding-scale institution in the San Fernando Valley since 1940, survived near-closure in 2009 as a result of litigation, activism by the Screen Actors Guild and the local chapter of the Teamsters, and news media pressure. Among film legends who died there — along with cameramen, back-lot security guards and extras — were Mary Astor, Joel McCrea, Yvonne De Carlo and Stepin Fetchit.

New York State’s volunteer firefighters are all welcome to a refurbished facility in the Catskill region that offers far more in the way of care and activities, including a state-of-the-art gym, than when I visited there five years ago. At that time, the residents amused themselves by activating the fire alarm to summon the local hook and ladder company, which didn’t mind a bit.

Then there is Nalcrest, the retirement home for unionized letter carriers. Even as post offices nationwide are preparing to eliminate Saturday service, and snail mail becomes an artifact, the National Association of Letter Carriers holds monthly fees around the $500 mark, is located in central Florida so its members no longer have to brave rain and sleet to complete their appointed rounds, and bans dogs, the bane of their existence.

So why not aged journalists? We surely have war stories to embroider as we rock on the porch. Perhaps a mimeograph machine to produce an old-fashioned, dead-tree newspaper, which some of us will miss once it has given way to Web sites like this one. Pneumatic tubes, one colleague suggested, to whisk our belongings upstairs when we can no longer carry them. Other colleagues wondered about welcoming both editors and reporters. How can these two groups, which some consider natural adversaries, complain about each others’ tin ears or missed deadlines if we’re not segregated?

I disagree. The joy of this profession is its collaboration. We did the impossible day after day when young. We belong together when old.

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Off the Charts: Globalization, as Measured by Investment, Takes a Step Backward

A FEW years ago, capital was flying around the globe faster than it ever had. The world economy became more tightly integrated and technology contributed to making it easier for banks and investors to deploy their money on the other side of the world if prospects looked more attractive there.

Then came the financial crisis, which, the McKinsey Global Institute noted in a report issued this week, “upended many of the world’s assumptions about the inevitability of growth and globalization.”

Last year, the report estimated, world capital flows were 13 percent below the levels of the previous year. And while they were higher than during the depths of the credit crisis, they are still 61 percent below the peak levels of 2007.

“Some of the shifts under way represent a healthy correction of the excesses of the bubble years,” the report stated, but there is a risk the reversal of globalization will be overdone.

“If we move to a system where the global financial system is more balkanized, that will raise the cost of capital for more borrowers and perhaps slow economic growth,” said Susan Lund, a principal of McKinsey Global Institute and the primary author of the report.

The accompanying charts show the institute’s estimates of global capital flows, which totaled $4.6 trillion in 2012, down from $11.8 trillion in 2007. Of the 2007 total, $10.2 trillion went to developed countries, and $1.6 trillion went to developing countries. Last year, capital flows were $3.1 trillion, a decline of 69 percent, for the developed countries, and $1.5 trillion, a decline of 10 percent, for the others.

The charts break out the flows into four types. The most stable is foreign direct investment, in which a company either builds a business or acquires at least 10 percent of an existing business. By far the least stable is loans, which are often short term and can be withdrawn on short notice, creating havoc. The others are bonds and equity, meaning stock market investments.

The Asian currency crisis of the late 1990s taught developing countries the potential hazards of loans that can be here today and gone tomorrow — a lesson that some European countries ignored to their regret. The institute calculated that in 2006 and 2007, the amount of capital flowing into Ireland was more than twice as large as the country’s gross domestic product. Moreover, most of that was in loans and bonds, debt instruments that in many cases could not be repaid.

International loans and bond issuances have particularly declined in Western Europe, where the euro crisis led many to withdraw funds and caused banks to concentrate on local markets. During four years in the middle of the last decade, more than $1 trillion in Western European bonds were purchased by foreigners each year. In each of the last two years, more bonds were sold back to the issuing country than were newly sold internationally.

For a number of years, China was the largest recipient of foreign direct investment, and that continues, with as estimated $260 billion flowing in last year. But it also sent $120 billion in such investment to other countries, about the same as Japan and more than was sent by any other country except the United States, according to the estimates.

Floyd Norris comments on finance and the economy at nytimes.com/economix.

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U.S. Economy Barely Grew in Fourth Quarter, Revision Shows

Breathe a tiny sigh of relief, if not exactly contentment: the American economy grew just barely in the last quarter of 2012.

Output expanded at an annual rate of just 0.1 percent, which is basically indistinguishable from having no growth at all and is far below the growth needed to get unemployment back to normal. But at least the economy did not shrink, as the Commerce Department had originally estimated last month, when the first report suggested that output contracted by an annual rate of 0.1 percent.

The department’s latest estimate for economic output, released Thursday, showed that growth was depressed by declines in military spending (possibly in anticipation of the across-the-board spending cuts set to begin Friday) and the amount that companies restored their stockroom shelves.

“The good news with business inventories is that what they take away in one quarter they tend to add to the next,” said Paul Ashworth, senior United States economist at Capital Economics, referring to the measure of this restocking process. “So there’s a good chance that first-quarter numbers will be better than originally thought.”

The output growth number was revised upward from the original estimate partly thanks to updated, and improved, data on business investment and net trade. Imports were lower than previously reported and exports were higher.

Economists expect that government spending will continue to drag on the economy this year, especially if Congress does not avert the spending cuts, which would shave around 0.6 percentage point off growth. Many are hoping that even if the cuts go through, Congress will reverse them in short order.

“They can always change their minds when they have to renew the continuing budget resolution at the end of this month or in April or May,” said Mr. Ashworth. “My expectation is that at most the cuts stay a month or two, and in most departments, with a wink or a nod, they won’t do anything crazy.”

Even if government does lop off $85 billion in the so-called sequester, as current law states, the private sector will offset most of this drag, thanks to the housing recovery and other sources of strength. Forecasts for the first quarter are for annual growth around 2.4 percent to 3 percent.

Monetary stimulus from the Federal Reserve, while under fire from some Republicans, is also helping offset the fiscal contraction.

“With monetary policy working with a lag and still being eased, the boost to the economy is probably still growing,” said Jim O’Sullivan, chief United States economist at High Frequency Economics.

The combination of monetary expansion and fiscal tightening has helped lead to a painfully slow drawdown in the unemployment rate. The jobless rate stood at 7.9 percent in January. The recent end of the payroll tax holiday is also expected to hold back consumer spending, and so job growth as well.

“I think it’s largely steady as she goes for employment,” said Jay Feldman, an economist at Credit Suisse, of the indications from the latest growth report. “I still think we’re in kind of a 175,000-jobs-a-month clip for a while, but with some downside risks later in the year from the sequester.”

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Donald Trump returns to the 'Apprentice' boardroom

NEW YORK (AP) — There is something Donald Trump says he doesn't know.

Trump has welcomed a reporter to his 26th-floor corner office in Trump Tower to talk about "All-Star Celebrity Apprentice." And here in person, this one-of-a-kind TV star, billionaire businessman, ubiquitous brand mogul and media maestro strikes a softer pose than he has typically practiced in his decades on public display.

Relaxed behind a broad desk whose mirror sheen is mostly hidden by stacks of paper that suggest work is actually done there, Trump is pleasant, even chummy, with a my-time-is-your-time easiness greeting his guest.

He even contradicts his status as a legendary know-it-all with this surprising admission: There's a corner of the universe he doesn't understand.

The ratings woes of NBC, which airs his show, are on Trump's mind at the moment, and as he hastens to voice confidence in the network's powers-that-be ("They will absolutely get it right"), he marvels at the mysteries of the entertainment world.

"If I buy a great piece of real estate and do the right building, I'm really gonna have a success," he says. "It may be MORE successful or LESS successful, but you can sort of predict how it's gonna do. But show business is like trial and error! It's amazing!"

He loves to recall the iffy prospects for "The Apprentice" when it debuted in January 2004. With show biz, he declares, "You NEVER know what's gonna happen."

Except, of course, when you do.

"I do have an instinct," he confides. "Oftentimes, I'll see shows go on and I'll say, 'That show will never make it,' and I'm always right. And I understand talent. Does anybody ask me? No. But if they did, I would be doing them a big service. I know what people want."

So maybe he does know it all. In any case, lots of people wanted "The Apprentice." In its first season, it averaged nearly 21 million viewers each week.

And it gave Trump a signature TV platform that clinched his image as corporate royalty. He presided in a mood-lit stagecraft boardroom where celebrity subjects addressed him as "Mr. Trump" and shrank at that dismissive flick of his wrist and dreaded catchphrase, "You're fired."

The two-hour premiere of "All-Star Celebrity Apprentice" (Sunday at 9 p.m. EST) starts by rallying its 14 veteran contenders in the even more evocative setting of the 2,000-year-old Egyptian Temple of Dendur at the Metropolitan Museum of Art.

There, grandly, Trump receives such returning players as Gary Busey, Stephen Baldwin, LaToya Jackson and reality mean queen Omarosa.

Soon, teammates are chosen by team leaders Bret Michaels and Trace Adkins. Their first assignment: concoct a winning recipe for meatballs, then sell more of them than the rival team.

This is the 13th edition of the "Apprentice" franchise, which has now slipped to less than one-third its original viewership, according to Nielsen Co. figures. But even an audience matching last season's 6.26 million viewers would be pleasant news for NBC, which has recently fallen to fifth place in prime time, behind even Spanish-language Univision.

"I could probably do another show when I don't enjoy 'The Apprentice' anymore," says the 66-year-old Trump, mulling his TV future. "I have been asked by virtually every network on television to do a show for them. But there's something to sticking with what you have: This is a good formula. It works."

Years before "The Apprentice," Trump had hit on a winning formula for himself: Supercharge his business success with relentless self-promotion, putting a human face — his! — on the capitalist system, and embedding his persona in a feedback loop of performance and fame.

Since then, he has ruled as America's larger-than-life tycoon and its patron saint of material success. Which raises the question: Does he play a souped-up version of himself for his audience as Donald Trump, a character bigger and broader than its real-life inspiration?

He laughs, flashing something like a you-got-me smile.

"Perhaps," he replies. "Not consciously. But perhaps I do. Perhaps I do."

It began as early as 1987, when his first book, "Trump: The Art of the Deal," became a huge best-seller.

And even without a regular showcase, he was no stranger to TV. For instance, in the span of just 10 days in May 1997, Trump not only was seen on his "Miss Universe Pageant" telecast on CBS, but also made sitcom cameo appearances as himself on NBC's "Suddenly Susan" and ABC's "Drew Carey Show."

Meanwhile, as a frequent talk-show guest then (as now), he publicized his projects and pushed his brand.

"I'll be on that show for 20 or 30 or 60 minutes, and it costs me nothing," he notes. "When you have an opportunity for promotion, take it! It's free."

No one has ever accused Trump of hiding his light under a bushel. But his promotional drive (or naked craving for attention) has taken him to extremes that conventional wisdom warns against: saying and doing things that might hurt your bottom line.

Item: Trump's noisy, even race-baiting challenge to President Barack Obama to prove his American citizenship. This crusade has earned Trump the title from one editorialist as "birther blowhard."

For an industrialist and entertainer, where's the profit in voicing political views that could tick off a segment of your market or your audience?

"It's a great question, and a hard question to answer, because you happen to be right," Trump begins. "The fact is, some people love me, and some people the-opposite-of-love me, because of what I do and because of what I say. But I'm a very truthful person. By speaking out, it's probably not a good thing for me personally, but I feel I have an obligation to do it."

But isn't he being divisive with some of his pronouncements?

"I think 'divisive' would be a fair word in some cases, not in all cases," he replies. "But I think 'truthful' is another word."

The publicity he got from his political activism reached a fever pitch during his months-long, media-blitzed flirtation with running for president that seemed conveniently to dovetail with the Spring 2011 season of his TV show.

That May, he announced he would not run. For some, it was the final scene of nothing more than political theatrics.

"They weren't," Trump says quietly. "I was very seriously considering running. It was a race that the Republicans should have won. I made a mistake in not running, because I think I would have won."

He says he has no designs on this year's race for mayor of New York. But his politicizing continues apace. In his Twitter feed, with 2 million followers, he continues to bash China and rant about Washington. He phones in to Fox News Channel's "Fox & Friends" each Monday morning to vent his spleen.

"I believe in speaking my mind," he says, "and I don't mind controversy, as you probably noticed. I think sometimes controversy is a good thing, not a bad thing."

Last summer saw the opening in Aberdeen, Scotland, of Trump International Golf Links after a bitter, yearslong fight waged by environmentalists and local residents against government leaders and, of course, Trump.

A man for whom it seems no publicity is bad publicity, Trump insists the controversy helped the project.

"If there wasn't controversy surrounding it, I don't think anybody would even know it exists," he says, laying out the alternative: "I could take an ad: 'Golf course opening.'"

Trump even seems to profit from the harsh attention focused on his hair.

"I get killed on my hair!" he says, with no trace of remorse. But he wants everyone to know, "It's not a wig!" Nor is it an elaborately engineered coif to hide a hairline in retreat, as many Trump-watchers imagine.

To prove it, Trump does a remarkable thing: He lifts the flaxen locks that flop above his forehead to reveal, plain as day, a normal hairline.

"I wash my hair, I comb it, I set it and I spray it," he says. "That's it. I could comb it back and I'd look OK. But I've combed it this way for my whole life. It's become almost a trademark. And I think NBC would be very unhappy if I combed it back, 'cause — you know what? — maybe I wouldn't get as high a rating."

___

Online:

www.nbc.com

___

Frazier Moore is a national television columnist for The Associated Press. He can be reached at fmoore(at)ap.org and at http://www.twitter.com/tvfrazier

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The New Old Age Blog: For the Elderly, Lists of Tests to Avoid

The Choosing Wisely campaign, an initiative by the American Board of Internal Medicine Foundation in partnership with Consumer Reports, kicked off last spring. It is an attempt to alert both doctors and patients to problematic and commonly overused medical tests, procedures and treatments.

It took an elegantly simple approach: By working through professional organizations representing medical specialties, Choosing Wisely asked doctors to identify “Five Things Physicians and Patients Should Question.”

The idea was that doctors and their patients could agree on tests and treatments that are supported by evidence, that don’t duplicate what others do, that are “truly necessary” and “free from harm” — and avoid the rest.

Among the 18 new lists released last week are recommendations from geriatricians and palliative care specialists, which may be of particular interest to New Old Age readers. I’ve previously written about a number of these warnings, but it’s helpful to have them in single, strongly worded documents.

The winners — or perhaps, losers?

Both the American Geriatrics Society and the American Academy of Hospice and Palliative Medicine agreed on one major “don’t.” Topping both lists was an admonition against feeding tubes for people with advanced dementia.

“This is not news; the data’s been out for at least 15 years,” said Sei Lee, a geriatrician at the University of California, San Francisco, and a member of the working group that narrowed more than 100 recommendations down to five. Feeding tubes don’t prevent aspiration pneumonia or prolong dementia patients’ lives, the research shows, but they do exacerbate bedsores and cause such distress that people often try to pull them out and wind up in restraints. The doctors recommended hand-feeding dementia patients instead.

The geriatricians’ list goes on to warn against the routine prescribing of antipsychotic medications for dementia patients who become aggressive or disruptive. Though drugs like Haldol, Risperdal and Zyprexa remain widely used, “all of these have been shown to increase the risk of stroke and cardiovascular death,” Dr. Lee said. They should be last resorts, after behavioral interventions.

The other questionable tests and treatments:

No. 3: Prescribing medications to achieve “tight glycemic control” (defined as below 7.5 on the A1c test) in elderly diabetics, who need to control their blood sugar, but not as strictly as younger patients.

No. 4: Turning to sleeping pills as the first choice for older people who suffer from agitation, delirium or insomnia. Xanax, Ativan, Valium, Ambien, Lunesta — “they don’t magically disappear from your body when you wake up in the morning,” Dr. Lee said. They continue to slow reaction times, resulting in falls and auto accidents. Other sleep therapies are preferable.

No. 5: Prescribing antibiotics when tests indicate a urinary tract infection, but the patient has no discomfort or other symptoms. Many older people have bacteria in their bladders but don’t suffer ill effects; repeated use of antibiotics just causes drug resistance, leaving them vulnerable to more dangerous infections. “Treat the patient, not the lab test,” Dr. Lee said.

The palliative care doctors’ Five Things list cautions against delaying palliative care, which can relieve pain and control symptoms even as patients pursue treatments for their diseases.

It also urges discussion about deactivating implantable cardioverter-defibrillators, or ICDs, in patients with irreversible diseases. “Being shocked is like being kicked in the chest by a mule,” said Eric Widera, a palliative care specialist at the San Francisco V.A. Medical Center who served on the American Academy of Hospice and Palliative Medicine working group. “As someone gets close to the end of life, these ICDs can’t prolong life and they cause a lot of pain.”

Turning the devices off — an option many patients don’t realize they have — requires simple computer reprogramming or a magnet, not the surgery that installed them in the first place.

The palliative care doctors also pointed out that patients suffering pain as cancer spreads to their bones get as much relief, the evidence shows, from a single dose of radiation than from 10 daily doses that require travel to hospitals or treatment centers.

Finally, their list warned that topical gels widely used by hospice staffs to control nausea do not work because they aren’t absorbed through the skin. “We have lots of other ways to give anti-nausea drugs,” Dr. Widera said.

You can read all the Five Things lists (more are coming later this year), and the Consumer Reports publications that do a good job of translating them, on the Choosing Wisely Web site.

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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: As Losses Mount, R.B.S. Unveils Plan to Sell Assets

LONDON – The Royal Bank of Scotland, hammered by losses, announced plans on Thursday to sell assets and pare back its investment banking business, in an effort to appease regulators and its biggest shareholder, the British government.

R.B.S. said it planned to sell a stake in the Citizens Financial Group, the American lender it bought in 1988, through an initial public offering in two years. The bank will also continue to reduce its investment banking operations, with plans to cut risky assets and eliminate jobs.

The moves are designed to help bolster the bank’s capital levels and refocus its operations, part of a multiyear turnaround effort initiated by its chief executive, Stephen Hester. In the end, R.B.S. will emerge a much smaller bank, largely focused on Britain.

“R.B.S. is four years into its recovery plan,” Mr. Hester said in a statement, “and good progress has been made. We are a much smaller, more focused and stronger bank. Our target is for 2013 to be the last big year of restructuring.”

Like many rivals, R.B.S. is struggling with the legacy of the financial crisis and a spate of legal issues. On Thursday, it reported a bigger-than-expected loss, in part tied to its legal troubles.

The bank, in which the British government holds an 82 percent stake after a bailout in 2008, posted a net loss of £5.97 billion ($9 billion) in 2012, much larger than the £2 billion loss recorded in 2011. Analysts had been expecting a loss of £5.1 billion. For the last quarter of 2012, R.B.S. reported a £2.6 billion loss, up from a £1.8 billion loss in the period a year earlier.

The rising losses reflect the bank’s regulatory and legal problems.

R.B.S. said on Thursday that it had set aside an additional £1.1 billion to compensate clients to which it improperly sold insurance products, bringing the total provision to £2.2 billion. It also estimated it would have to pay £700 million to compensate small businesses to which it improperly sold some interest-rate hedging products.

The bank agreed this year to pay $612 million to British and American authorities to settle accusations of rate-rigging. Since then, Mr. Hester has promised to tighten controls at the bank to limit the risk of future rate manipulation.

The head of R.B.S.’s investment banking division, John Hourican, resigned at the beginning of February as a result of the scandal related to manipulating the London interbank offered rate, or Libor. The bank plans to pay its fine with money clawed back from bonuses.

‘‘Along with the rest of the banking industry we faced significant reputational challenges,’’ Mr. Hester said in the statement. ‘‘We are determined to overcome the cultural and reputational baggage of precrisis times with the same focus we have applied to the financial cleanup from that era.’’

Eager to get back some of the £45.5 billion it invested in R.B.S., the British government recently increased pressure on the bank’s management to speed up the reorganization.

Some analysts said the government could start selling parts of its investment in the bank, even at a loss, before the next general election, which is set for 2015. R.B.S.’s shares are still trading at about half what the government paid for them in 2008. Some lawmakers said they would favor handing out shares to the public instead of a possible sale of the stake on the open market.

Richard Hunter, head of equities at Hargreaves Lansdown Stockbrokers, said there were signs that Mr. Hester’s efforts to turn around the bank had started to pay off, but that “the ongoing absence of a dividend and overhang of the government stake are negatives which need to be resolved.”

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Clearing a Path for Renewal of Violence Against Women Act

WASHINGTON — Bowing to pressure from within their own party, House Republican leaders last night appeared to clear a path for House passage of the Senate’s broadly bipartisan reauthorization of the Violence Against Women Act.

The House Rules Committee, an arm of leadership, approved a bifurcated process to consider the legislation, which would broaden the landmark 1994 law. The House will vote on a Republican version on Thursday that contains provisions that weaken a Senate version that empowers Native American courts to prosecute non-Indians accused of violence on tribal land. The House version also does not explicitly extend programs to prevent domestic violence and treat its victims to members of same-sex relationships.

If that version fails to win passage, the House will take up the Senate-passed version — at this point the likely outcome. That would ensure a swift White House signing ceremony.

The Senate passed that version earlier this month, 78 to 22, with 23 Republicans voting yes, up from 15 last year.

House conservatives maintain that the Senate provision on tribal courts is a dangerous and unconstitutional expansion of tribal power, and they preferred to keep the bill silent on same-sex couples. But the pressure, especially on the tribal issue, was bipartisan. Republican Representatives Darrell Issa of California and Tom Cole of Oklahoma, himself a Chickasaw, pressed hard to toughen the tribal-courts language. Mr. Cole said on Sunday he would try to bring the House bill down if he did not prevail.

Ultimately, it is likely he will. Democrats are united against the Republican version, and Representative Eric Cantor of Virginia, the House majority leader, has committed to passing a bipartisan version in the House or none at all.

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9/11 victim's mom upset film used son's last words

NEW CANAAN, Conn. (AP) — A Connecticut woman whose son died in the Sept. 11 attacks at the World Trade Center says she's upset the Oscar-winning movie "Zero Dark Thirty" used a recording of his last words without her permission.

Mary Fetchet of New Canaan told CBS News and the Daily News this week that she was shocked the filmmakers didn't ask if they could use the voicemail her son, Bradley Fetchet, left on her phone while he was on the 89th floor of the World Trade Center's south tower.

The movie about the manhunt for Osama bin Laden begins with the voices of 9/11 victims making their last phone calls.

Sony Pictures Entertainment said in a statement that the filmmakers contacted several relatives of 9/11 victims about using the voice recordings.

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