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 aids 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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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 aids 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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Gadgetwise Blog: Tip of the Week: Have Your Phone Take a Memo

A voice recorder app for your smartphone is one way to quickly capture sudden thoughts on a device you are likely to have with you when inspiration strikes. Some phones have built-in recorders; the Voice Memos app in Apple’s iOS system for the iPhone lets you record, edit and e-mail your dictated thoughts as sound clips. If your phone does not include a voice or sound recorder with the operating system, you can find several third-party programs (like Evernote, which may include more features than a default system app) in your phone’s app store.
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Cease-Fire Between Israel and Hamas Takes Effect





CAIRO — Israel and Hamas agreed to a cease-fire on Wednesday, the eighth day of lethal fighting over the Gaza Strip, the United States and Egypt said after intensive negotiations in Cairo.




The cease-fire, which took effect at 9 p.m. local time (2 p.m. E.S.T.), was formally announced by Secretary of State Hillary Rodham Clinton and Foreign Minister Mohamed Amr of Egypt at a news conference here. The agreement was aimed at quieting an escalating aerial battle between Palestinians and Israelis that had threatened to turn into an Israeli ground invasion of Gaza.


Whether the cease-fire could hold was uncertain at best, and even in the minutes leading up to the effective start time, both sides were firing at each other. But the sound of celebratory gunshots could be heard in Gaza after the agreement took effect, and Gazans ventured outside as the roar of Israeli warplanes and thud of bombs that had punctuated the past week was gone.


“This is a critical moment for the region,” Mrs. Clinton, who rushed to the Middle East late Tuesday in an intensified effort to halt the hostilities, told reporters in Cairo. She thanked Egypt’s president, Mohamed Morsi, who played a pivotal role in the negotiations, for “assuming the leadership that has long made this country a cornerstone of regional stability and peace.”


Mrs. Clinton also pledged to work “with our partners across the region to consolidate this progress, improve conditions for the people of Gaza, provide security for the people of Israel.”


Mr. Amr said Egypt’s role in reaching the agreement reflected its “historical commitment to the Palestinian cause” and Egypt’s efforts to “bring together the gap between the Palestinian factions.”


The negotiators reached an agreement after days of nearly nonstop Israeli aerial assaults on Gaza, the Mediterranean enclave run by Hamas, the militant Islamist group, and the firing of hundreds of rockets into Israel from an arsenal Hamas had been amassing in the aftermath of the three-week Israeli invasion four years ago.


Under the terms distributed after the news conference, Israel agreed to stop all land, sea and air hostilities in Gaza, including the “targeting of individuals” — a reference to militants of Hamas and its affiliates who have been killed. The cease-fire also calls on the Palestinian factions in Gaza to stop all hostilities against Israel, including rocket attacks and attacks along the border.


The agreement came despite a bus bombing in Tel Aviv earlier in the day, which Hamas and other Palestinian militant groups had applauded. Also complicating the path to the cease-fire were Israeli strikes overnight on Gaza.


It was unclear how the agreement would be enforced, but the terms stated that “each party shall commit itself not to perform any acts that would breach this understanding.”


Prime Minister Benjamin Netanyahu of Israel, who had been threatening to start another ground invasion if the Gaza rockets did not stop, said in a statement that he was satisfied, for the moment, with the outcome. But he left open the possibility of more military action.


The statement issued by his office said Mr. Netanyahu had spoken with President Obama and “responded positively to his recommendation to give a chance to the Egyptian proposal for a cease-fire and to allow an opportunity to stabilize the situation and to calm it down before there is a need to use much greater force.”


An agreement had been on the verge of completion on Tuesday, but was delayed over a number of issues, including Hamas’s demands for unfettered access to Gaza via the Rafah crossing into Egypt and other steps that would ease Israel’s economic and border control over other aspects of life for the more than one million Palestinian residents of Gaza, which Israel vacated in 2005 after 38 years of occupation.


The Hamas Health Ministry in Gaza said the Palestinian death toll after a week of fighting stood at 140 at noon. At least a third of those killed are believed to have been militants. On the Israeli side, five Israelis have been killed, including one soldier.


Around noon on Wednesday in the Gaza Strip, according to the Hamas government media office, a bomb hit the house of Issam Da’alis, an adviser to Ismail Haniya, the Hamas prime minister. The house had been evacuated. Earlier, a predawn airstrike near a mosque in the Jabaliya refugee camp killed a 30-year-old militant, a spokesman said, and F-16 bombs destroyed two houses in the central Gaza Strip.


David D. Kirkpatrick reported from Cairo, Ethan Bronner from Jerusalem and Rick Gladstone from New York. Reporting was contributed by Jodi Rudoren and Fares Akram from Gaza, Isabel Kershner from Jerusalem, Alan Cowell from London, Andrea Bruce from Rafah and Christine Hauser from New York.



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DealBook: Hewlett-Packard Takes $8.8 Billion Charge

Hewlett-Packard said on Tuesday that it had taken an $8.8 billion accounting charge, after discovering “serious accounting improprieties” and “outright misrepresentations” at Autonomy, a British software maker that it bought for $10 billion last year.

It is a major setback for H.P., which has been struggling to turn around its operations and remake its business.

The charge essentially wiped out its profit. In the latest quarter, H.P. reported a net loss of $6.9 billion, compared with a $200 million profit in the period a year earlier. The company said the improprieties and misrepresentations took place just before the acquisition, and accounted for the majority of the charges in the quarter, more than $5 billion.

Shares in H.P. plummeted nearly 11 percent in early afternoon trading on Tuesday, to less than $12.

Hewlett-Packard bought Autonomy in the summer of 2011 in an attempt to bolster its presence in the enterprise software market and catch up with rivals like I.B.M. The takeover was the brainchild of Léo Apotheker, H.P.’s chief executive at the time, and was criticized within Silicon Valley as a hugely expensive blunder.

Mr. Apotheker resigned a month later. The management shake-up came about one year after Mark Hurd was forced to step down as the head of H.P. after questions were raised about his relationship with a female contract employee.

“I’m both stunned and disappointed to learn of Autonomy’s alleged accounting improprieties,” Mr. Apotheker said in a statement. “The developments are a shock to the many who believed in the company, myself included. ”

Since then, H.P. has tried to revive the company and to move past the controversies. Last year, Meg Whitman, a former head of eBay, took over as chief executive and began rethinking the product lineup and global marketing strategy.

But the efforts have been slow to take hold.

In the previous fiscal quarter, the company announced that it would take an $8 billion charge related to its 2008 acquisition of Electronic Data Systems, as well as added costs related to layoffs. Then Ms. Whitman told Wall Street analysts in October that revenue and profit would be significantly lower, adding that it would take several years to complete a turnaround.

“We have much more work to do,” Ms. Whitman said at the time.

Hewlett-Packard continues to face weakness in its core businesses. Revenue for the full fiscal year dropped 5 percent, to $120.4 billion, with the personal computer, printing, enterprise and service businesses all losing ground. Earnings dropped 23 percent, to $8 billion, over the same period.

“As we discussed during our securities analyst meeting last month, fiscal 2012 was the first year in a multiyear journey to turn H.P. around,” Ms. Whitman said in a statement. “We’re starting to see progress in key areas, such as new product releases and customer wins.”

The strategic troubles have weighed on the stock. Shares of H.P. have dropped to less than $12 from nearly $30 at their high this year.

The latest developments could present another setback for Ms. Whitman’s efforts.

When the company assessed Autonomy before the acquisitions, the financial results appeared to pass muster. Ms. Whitman said H.P.’s board at the time – which remains the same now, except for the addition of the activist investor Ralph V. Whitworth – relied on Deloitte’s auditing of Autonomy’s financial statements. As part of the due diligence process for the deal, H.P. also hired KPMG to audit Deloitte’s work.

Neither Deloitte nor KPMG caught the accounting discrepancies. Deloitte said in a statement that it could not comment on the matter, citing client confidentiality. “We will cooperate with the relevant authorities with any investigations into these allegations,” the accounting firm said.

Hewlett-Packard said it first began looking into potential accounting problems in the spring, after a senior Autonomy executive came forward. H.P. then hired a third-party forensic accounting firm, PricewaterhouseCoopers, to conduct an investigation covering Autonomy sales between the third quarter 2009 and the second quarter 2011, just before the acquisition.

The company said it discovered several accounting irregularities, which disguised Autonomy’s actual costs and the nature of the its products. Autonomy makes software that finds patterns, data that is used by companies and governments.

H.P. said that Autonomy, in some instances, sold hardware like servers, which has higher associated costs. But the company booked these as software sales. It had the effect of underplaying the company’s expenses and inflating the margins.

“They used low-end hardware sales, but put out that it was a pure software company,” said John Schultz, the general counsel of H.P. Computer hardware typically has a much smaller profit margin than software. “They put this into their growth calculation.”

An H.P. official, who spoke on background because of ongoing inquiries by regulators, said the hardware was sold at a 10 percent loss. The loss was disguised as a marketing expense, and the amount registered as a marketing expense appeared to increase over time, the official said.

H.P. also contends that Autonomy relied on value-added resellers, middlemen who sold software on behalf of the company. Those middlemen reported sales to customers that didn’t actually exist, according to H.P.

H.P. also claims that that Autonomy was taking licensing revenue upfront, before receiving the money. That improper assignment of sales inflated the company’s gross profit margins.pfront, before receiving the money. It had the effect, the company said, of significantly bolstering Autonomy’s gross margin.

Hewlett Packard turned over its findings to Securities and Exchange Commission in the United States and the Serious Fraud Office in Britain with the last week. In a conference call with analysts, Ms. Whitman said the company might consider legal actions against several parties.

The former management team of Autonomy, which includes the company’s founder Mike Lynch, rejected H.P. claims about the accounting issues.

“H.P. has made a series of allegations against some unspecified former members of Autonomy Corporation PLC’s senior management team. The former management team of Autonomy was shocked to see this statement today, and flatly rejects these allegations, which are false,” the group said in a statement. “It took 10 years to build Autonomy’s industry-leading technology and it is sad to see how it has been mismanaged since its acquisition by H.P.”

While Mr. Schultz would not detail H.P.’s future legal strategy, he said “we intend to be aggressive in recovering value for our shareholders.” In addition to Mr. Lynch, the company indicated this could include other individuals, including perhaps former senior executives of H.P. who missed the bad accounting. “We’re not limiting it to Autonomy,” Mr. Shulz said.

H.P. also underscored the importance of Autonomy to the broader strategy, emphasized the quality of the products. “This is a very healthy company with good products that exist,” said Mr. Shultz. “At its core, these are very good products.”

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Ecstasy Treatment for Post-Traumatic Stress Shows Promise


Gretchen Ertl for The New York Times


ALTERNATIVE TREATMENT Rick Doblin of the Multidisciplinary Association for Psychedelic Studies, which is financing research into the drug Ecstasy.







Hundreds of Iraq and Afghanistan veterans with post-traumatic stress have recently contacted a husband-and-wife team who work in suburban South Carolina to seek help. Many are desperate, pleading for treatment and willing to travel to get it.




The soldiers have no interest in traditional talking cures or prescription drugs that have given them little relief. They are lining up to try an alternative: MDMA, better known as Ecstasy, a party drug that surfaced in the 1980s and ’90s that can induce pulses of euphoria and a radiating affection. Government regulators criminalized the drug in 1985, placing it on a list of prohibited substances that includes heroin and LSD. But in recent years, regulators have licensed a small number of labs to produce MDMA for research purposes.


“I feel survivor’s guilt, both for coming back from Iraq alive and now for having had a chance to do this therapy,” said Anthony, a 25-year-old living near Charleston, S.C., who asked that his last name not be used because of the stigma of taking the drug. “I’m a different person because of it.”


In a paper posted online Tuesday by the Journal of Psychopharmacology, Michael and Ann Mithoefer, the husband-and-wife team offering the treatment — which combines psychotherapy with a dose of MDMA — write that they found 15 of 21 people who recovered from severe post-traumatic stress in the therapy in the early 2000s reported minor to virtually no symptoms today. Many said they have received other kinds of therapy since then, but not with MDMA.


The Mithoefers — he is a psychiatrist and she is a nurse — collaborated on the study with researchers at the Medical University of South Carolina and the nonprofit Multidisciplinary Association for Psychedelic Studies.


The patients in this group included mostly rape victims, and experts familiar with the work cautioned that it was preliminary, based on small numbers, and its applicability to war trauma entirely unknown. A spokeswoman for the Department of Defense said the military was not involved in any research of MDMA.


But given the scarcity of good treatments for post-traumatic stress, “there is a tremendous need to study novel medications,” including MDMA, said Dr. John H. Krystal, chairman of psychiatry at the Yale School of Medicine.


The study is the first long-term test to suggest that psychiatrists’ tentative interest in hallucinogens and other recreational drugs — which have been taboo since the 1960s — could pay off. And news that the Mithoefers are beginning to test the drug in veterans is out, in the military press and on veterans’ blogs. “We’ve had more than 250 vets call us,” Dr. Mithoefer said. “There’s a long waiting list, we wish we could enroll them all.”


The couple, working with other researchers, will treat no more than 24 veterans with the therapy, following Food and Drug Administration protocols for testing an experimental drug; MDMA is not approved for any medical uses.


A handful of similar experiments using MDMA, LSD or marijuana are now in the works in Switzerland, Israel and Britain, as well as in this country. Both military and civilian researchers are watching closely. So far, the research has been largely supported by nonprofit groups.


“When it comes to the health and well-being of those who serve, we should leave our politics at the door and not be afraid to follow the data,” said Brig. Gen. Loree Sutton, a psychiatrist who recently retired from the Army. “There’s now an evidence base for this MDMA therapy and a plausible story about what may be going on in the brain to account for the effects.”


In interviews, two people who have had the therapy — one, Anthony, currently in the veterans study, and another who received the therapy independently — said that MDMA produced a mental sweet spot that allowed them to feel and talk about their trauma without being overwhelmed by it.


“It changed my perspective on the entire experience of working at ground zero,” said Patrick, a 46-year-old living in San Francisco, who worked long hours in the rubble after the Sept. 11, 2001, attacks searching in vain for survivors, as desperate family members of the victims looked on, pleading for information. “At times I had this beautiful, peaceful feeling down in the pit, that I had a purpose, that I was doing what I needed to be doing. And I began in therapy to identify with that,” rather than the guilt and sadness.


This article has been revised to reflect the following correction:

Correction: November 20, 2012

An earlier version of this article described incorrectly the office arrangement the Mithoefers use to conduct therapy sessions using MDMA. They hold the sessions in an office in a converted house, but they do not conduct the sessions in their home office.



Read More..

Ecstasy Treatment for Post-Traumatic Stress Shows Promise


Gretchen Ertl for The New York Times


ALTERNATIVE TREATMENT Rick Doblin of the Multidisciplinary Association for Psychedelic Studies, which is financing research into the drug Ecstasy.







Hundreds of Iraq and Afghanistan veterans with post-traumatic stress have recently contacted a husband-and-wife team who work in suburban South Carolina to seek help. Many are desperate, pleading for treatment and willing to travel to get it.




The soldiers have no interest in traditional talking cures or prescription drugs that have given them little relief. They are lining up to try an alternative: MDMA, better known as Ecstasy, a party drug that surfaced in the 1980s and ’90s that can induce pulses of euphoria and a radiating affection. Government regulators criminalized the drug in 1985, placing it on a list of prohibited substances that includes heroin and LSD. But in recent years, regulators have licensed a small number of labs to produce MDMA for research purposes.


“I feel survivor’s guilt, both for coming back from Iraq alive and now for having had a chance to do this therapy,” said Anthony, a 25-year-old living near Charleston, S.C., who asked that his last name not be used because of the stigma of taking the drug. “I’m a different person because of it.”


In a paper posted online Tuesday by the Journal of Psychopharmacology, Michael and Ann Mithoefer, the husband-and-wife team offering the treatment — which combines psychotherapy with a dose of MDMA — write that they found 15 of 21 people who recovered from severe post-traumatic stress in the therapy in the early 2000s reported minor to virtually no symptoms today. Many said they have received other kinds of therapy since then, but not with MDMA.


The Mithoefers — he is a psychiatrist and she is a nurse — collaborated on the study with researchers at the Medical University of South Carolina and the nonprofit Multidisciplinary Association for Psychedelic Studies.


The patients in this group included mostly rape victims, and experts familiar with the work cautioned that it was preliminary, based on small numbers, and its applicability to war trauma entirely unknown. A spokeswoman for the Department of Defense said the military was not involved in any research of MDMA.


But given the scarcity of good treatments for post-traumatic stress, “there is a tremendous need to study novel medications,” including MDMA, said Dr. John H. Krystal, chairman of psychiatry at the Yale School of Medicine.


The study is the first long-term test to suggest that psychiatrists’ tentative interest in hallucinogens and other recreational drugs — which have been taboo since the 1960s — could pay off. And news that the Mithoefers are beginning to test the drug in veterans is out, in the military press and on veterans’ blogs. “We’ve had more than 250 vets call us,” Dr. Mithoefer said. “There’s a long waiting list, we wish we could enroll them all.”


The couple, working with other researchers, will treat no more than 24 veterans with the therapy, following Food and Drug Administration protocols for testing an experimental drug; MDMA is not approved for any medical uses.


A handful of similar experiments using MDMA, LSD or marijuana are now in the works in Switzerland, Israel and Britain, as well as in this country. Both military and civilian researchers are watching closely. So far, the research has been largely supported by nonprofit groups.


“When it comes to the health and well-being of those who serve, we should leave our politics at the door and not be afraid to follow the data,” said Brig. Gen. Loree Sutton, a psychiatrist who recently retired from the Army. “There’s now an evidence base for this MDMA therapy and a plausible story about what may be going on in the brain to account for the effects.”


In interviews, two people who have had the therapy — one, Anthony, currently in the veterans study, and another who received the therapy independently — said that MDMA produced a mental sweet spot that allowed them to feel and talk about their trauma without being overwhelmed by it.


“It changed my perspective on the entire experience of working at ground zero,” said Patrick, a 46-year-old living in San Francisco, who worked long hours in the rubble after the Sept. 11, 2001, attacks searching in vain for survivors, as desperate family members of the victims looked on, pleading for information. “At times I had this beautiful, peaceful feeling down in the pit, that I had a purpose, that I was doing what I needed to be doing. And I began in therapy to identify with that,” rather than the guilt and sadness.


This article has been revised to reflect the following correction:

Correction: November 20, 2012

An earlier version of this article described incorrectly the office arrangement the Mithoefers use to conduct therapy sessions using MDMA. They hold the sessions in an office in a converted house, but they do not conduct the sessions in their home office.



Read More..

Virtual U.: Colleges Turn to Crowd-Sourcing Courses


Ozier Muhammad/The New York Times


Prof. Mitchell Duneier of Princeton is adapting his classroom teaching style for an online audience of tens of thousands.







Teaching Introduction to Sociology is almost second nature to Mitchell Duneier, a professor at Princeton: he has taught it 30 times, and a textbook he co-wrote is in its eighth edition. But last summer, as he transformed the class into a free online course, he had to grapple with some brand-new questions: Where should he focus his gaze while a camera recorded the lectures? How could the 40,000 students who enrolled online share their ideas? And how would he know what they were learning?




In many ways, the arc of Professor Duneier’s evolution, from professor in a lecture hall to online instructor of tens of thousands, reflects a larger movement, one with the potential to transform higher education. Already, a handful of companies are offering elite college-level instruction — once available to only a select few, on campus, at great cost — free, to anyone with an Internet connection.


Moreover, these massive open online courses, or MOOCs, harness the power of their huge enrollments to teach in new ways, applying crowd-sourcing technology to discussion forums and grading and enabling professors to use online lectures and reserve on-campus class time for interaction with students.


The spread of MOOCs is likely to have wide fallout. Lower-tier colleges, already facing resistance over high tuition, may have trouble convincing students that their courses are worth the price. And some experts voice reservations about how online learning can be assessed and warn of the potential for cheating.


MOOCs first landed in the spotlight last year, when Sebastian Thrun, a Stanford professor, offered a free artificial-intelligence course, attracting 160,000 students in 190 nations. The resulting storm of publicity galvanized elite research universities across the country to begin to open higher education to everyone — with the hope of perhaps, eventually, making money doing so.


The expansion has been dizzying. Millions of students are now enrolled in hundreds of online courses, including those offered by Udacity, Mr. Thrun’s spinoff company; edX, a joint venture of Harvard and the Massachusetts Institute of Technology; and Coursera, a Stanford spinoff that is offering Professor Duneier’s course and 200 others.


No one knows just how these massive courses will evolve, but their appeal to a broad audience is unquestioned: retirees in Indiana see them as a route to lifelong learning, students in India as their only lifeline to college-level work.


The professors involved face new challenges. “It was really intimidating at the beginning to do these lectures with no live audience, no sense of who was listening and how they were reacting,” Professor Duneier said. “I talk about things like racial differences in I.Q., Abu Ghraib and public bathrooms, and I worried that my lectures might come across as examples of American ethnocentrism.”


Feedback came quickly. When his first lecture went online, students wrote hundreds, then thousands, of comments and questions in online discussion forums — far too many for Professor Duneier to keep up with. But crowd-sourcing technology helped: every student reading the forum could vote questions and comments up or down, allowing him to spot important topics and tailor his lectures to respond.


Bigger Audiences


Top universities with courses like Professor Duneier’s stand to gain, both in prestige and in their ability to refine their pedagogy; few seem worried about diluting their brand-name appeal. The risks are greater for lesser colleges, which may be tempted to drop some of their own introductory courses — and some professors who teach them — and substitute cheaper online instruction from big-name professors.


“We’ve reached the tipping point where every major university is thinking about what they will do online,” said Peter McPherson, the president of the Association of Public and Land-Grant Universities. “In a way, the most important thing about these MOOCs from the top universities is that they provide cover, so other universities don’t need to apologize about putting courses online.”


In the rush to keep up, elite universities are lining up to join forces with a MOOC provider. Coursera, which began with Princeton, the University of Pennsylvania, Stanford and the University of Michigan in April, currently leads the field with 33 university partners. But edX, too, is expanding rapidly — the University of California, Berkeley, has joined, and the University of Texas announced that it would use edX courses for credit. Already, students in one Udacity class can get credit through the Global Campus of Colorado State University. Most MOOC providers are making plans to offer credit — and charge fees for certificates and proctored exams.


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Truce in Gaza Is Close, Egyptian Officials Say





JERUSALEM — Diplomatic efforts accelerated on Tuesday to end the deadly confrontation between Israel and Palestinian militants in Gaza, as the United States sent Secretary of State Hillary Rodham Clinton to the Middle East and Egypt’s president and his senior aides expressed confidence that a cease-fire was close.




The diplomatic moves to end the nearly week-old crisis came on a day of some of the most intense violence yet, in what appeared to be efforts by the antagonists to get their last attacks done before a cease-fire went into effect.


Israeli aerial forces assaulted several Gaza targets in multiple strikes, including a suspected rocket-launching site near Al Shifa hospital, which killed more than a dozen people, and Israeli naval vessels launched an intensive shelling aimed at the Gaza coastline. A delegation visiting from the Arab League canceled a news conference at the hospital because of the Israeli aerial assaults as wailing ambulances brought victims in, some of them decapitated.


Militants in Gaza fired a barrage of rockets into southern Israel, killing an Israeli soldier — the first military casualty on the Israeli side since the hostilities broke out last week. The Israel Defense Forces said the soldier, identified as Yosef Fartuk, 18, died from a rocket strike that hit an area near Gaza.


Other Palestinian rockets hit the southern Israeli cities of Beersheba and Ashdod, and longer-range rockets were fired at Tel Aviv and Jerusalem, but neither main city was struck and no casualties were reported. One Gaza rocket hit a building in the Israeli city of Rishon Lezion, just south of Tel Aviv, injuring one person and wrecking the top three floors.


Senior Egyptian officials in Cairo said Israel and Hamas, the militant Islamist group that governs Gaza, were “very close” to a cease-fire agreement that could be announced within hours. “We have not received final approval but I hope to receive it any moment,” said Essam el-Haddad, President Mohamed Morsi’s top foreign affairs adviser.


Foreign diplomats who were briefed on the outlines of a tentative agreement said it had been structured in stages — first, an announcement at approximately 10 p.m. local time (3 p.m. E.S.T.) of a cease-fire, followed by its implementation at midnight, for 48 hours. That would allow time for Mrs. Clinton to arrive, and to create a window for negotiators to agree on conditions for a longer-term cessation of hostilities.


Whether Hamas can enforce control over all of the militant Palestinian factions in Gaza to hold their fire during that period remained unclear.


The announcement of Mrs. Clinton’s active role in efforts to defuse the crisis added a strong new dimension to the multinational push to avert a new Middle East war. Israel has amassed thousands of soldiers on the border with Gaza and has threatened to invade the crowded Palestinian enclave for the second time in four years to stop the persistent rockets that have been lobbed at Israel.


Mrs. Clinton, who accompanied President Obama on his three-country Asia trip, left Cambodia on her own plane immediately for the Middle East. She was en route to 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.


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 in Israel on Tuesday, a senior official in Prime Minister Benjamin Netanyahu’s office said Israel had decided to give more time to diplomacy before starting 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.”


Intensifying the pressure on Hamas after a day of heavy rocket fire out of Gaza against southern Israel, the Israeli military said on Tuesday afternoon that it had distributed leaflets over Gaza instructing the Palestinian residents in several areas to evacuate their homes immediately, “for your safety,” and to move toward defined zones in central Gaza City. That seemed intended to signal that plans for a ground operation were imminent should the cease-fire talks fail. 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. On Friday, a rocket landed in a similar location, the police said.


Isabel Kershner reported from Jerusalem; Peter Baker from Phnom Penh, Cambodia; and Rick Gladstone from New York. Reporting was contributed by Jodi Rudoren from Gaza City, David D. Kirkpatrick from Cairo, Ethan Bronner from Jerusalem and David E. Sanger from Washington.



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News Corporation Looks at Potential Acquisitions


Kevork Djansezian/Getty Images


Rupert Murdoch, second from left, with his sons, Lachlan, left, and James, second from right, and Chase Carey, News Corporation’s president and chief operating officer, in July in Sun Valley, Idaho.





The media conglomerate, which had been on its heels for more than a year because of the phone hacking scandal in Britain, is looking to make acquisitions again. First on the list could be a 49 percent stake in the Yes Network in New York, a purchase that could become the foundation for a new nationwide sports network to compete with ESPN.


News Corporation’s stock has reached highs as the company prepares to transfer its underperforming publishing assets, including newspapers like The Wall Street Journal and The New York Post, into a separate publicly traded entity.


One of the crucial factors in the decision was that the split would allow Rupert Murdoch, the company’s chairman and chief executive, to buy into the businesses he loves without upsetting investors who are more interested in cable and broadcast. Potential targets include The Los Angeles Times, The Chicago Tribune and more education companies.


“Rupert has his mojo back,” said Todd Juenger, a media analyst at Sanford C. Bernstein. “The stock is up, investors are happy with the company’s recent decisions.”


“He is definitely rubbing his hands together,” a person with knowledge of News Corporation’s deal-making discussions said of Mr. Murdoch.


In the last several weeks, Mr. Murdoch has exuded a satisfaction and sure-footedness that people close to the company said they had not seen since before Mr. Murdoch’s British newspaper unit became embroiled in a phone hacking scandal. That is in part because hacking has been overtaken in the press by an unfolding scandal at the British Broadcasting Corporation.


The BBC, which Mr. Murdoch and his son James have frequently criticized, is accused of canceling a news program’s segment about serial child molesting committed by longtime host Jimmy Savile, and broadcasting false reports of pedophilia about a member of Margaret Thatcher’s administration.


People close to Mr. Murdoch said he considered the BBC scandal karmic justice for months of negative coverage of News Corporation, and he has provided almost daily commentary via Twitter. “BBC getting into deeper mess,” he wrote on Nov. 10. “After Savile scandal, now prominent news program falsely names senior pol as pedophile.”


And the BBC scandal touches another Murdoch rival — The New York Times, whose parent company’s new chief executive, Mark Thompson, served as director general at the BBC. Mr. Thompson’s replacement at the BBC, George Entwistle, resigned on Nov. 11 after just 54 days on the job. “Look to new CEO to shape up NYT unless recalled to BBC to explain latest scandal,” Mr. Murdoch wrote on Twitter last month.


As News Corporation sank into its hacking scandal last year, it delayed new acquisitions. In September, Britain’s Office of Communications, known as Ofcom, said that British Sky Broadcasting, 39.1 percent owned by News Corporation, was “fit and proper” to hold a broadcast license. The decision removed a cloud of uncertainty at News Corporation’s Manhattan headquarters and cleared the company to revisit deals, analysts said.


“The internal narrative at the company is that the boss is in shopping mode,” said one person close to News Corporation who could not discuss Mr. Murdoch’s thinking publicly.


Dropping its $12 billion bid for the portion of BSkyB that it did not already own gave News Corporation ample cash to complete share buybacks and consider other acquisitions. The company had $9.6 billion in cash at the end of its 2012 fiscal year and in September borrowed another $1 billion.


On a recent earnings call, Chase Carey, News Corporation’s president and chief operating officer, said: “We always seem to be the topic of the day when it comes to a rumor of some transaction.” Still, he added: “There are places where we think we should kick the tires on things.”


Last week News Corporation neared a deal with Yankees Global Enterprises to buy a 49 percent stake in the Yes Network, a regional New York sports network, with a valuation of about $3 billion. A stake in Yes would add to News Corporation’s lineup of regional sports channels and contribute to its reported plans to introduce a national cable sports channel that could take on the Walt Disney Company’s ESPN.


“It’s one of the only businesses where there’s no No. 2,” said Michael Nathanson, a media analyst at Nomura Securities. “In our view, sports is the safest asset in media.”


This month the company paid an estimated $250 million for the portion of ESPN Star Sports that it did not already own. ESPN Star Sports, based in Singapore, operates 17 sports networks in five languages around Asia.


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