Many States Say Cuts Would Burden Fragile Recovery

States are increasingly alarmed that they could become collateral damage in Washington’s latest fiscal battle, fearing that the impasse could saddle them with across-the-board spending cuts that threaten to slow their fragile recoveries or thrust them back into recession.

Some states, like Maryland and Virginia, are vulnerable because their economies are heavily dependent on federal workers, federal contracts and military spending, which will face steep reductions if Congress allows the automatic cuts, known as sequestration, to begin next Friday. Others, including Illinois and South Dakota, are at risk because of their reliance on the types of federal grants that are scheduled to be cut. And many states simply fear that a heavy dose of federal austerity could weaken their economies, costing them jobs and much-needed tax revenue.

So as state officials begin to draw up their budgets for next year, some say that the biggest risk they see is not the weak housing market or the troubled European economy but the federal government. While the threat of big federal cuts to states has become something of a semiannual occurrence in recent years, state officials said in interviews that they fear that this time the federal government might not be crying wolf — and their hopes are dimming that a deal will be struck in Washington in time to avert the cuts.

The impact would be widespread as the cuts ripple across the nation over the next year.

Texas expects to see its education aid slashed hundreds of millions of dollars, which could force local school districts to fire teachers, if the cuts are not averted. Michigan officials say they are in no position to replace the lost federal dollars with state dollars, but worry about cuts to federal programs like the one that helps people heat their homes. Maryland is bracing not only for a blow to its economy, which depends on federal workers and contractors and the many private businesses that support them, but also for cuts in federal aid for schools, Head Start programs, a nutrition program for pregnant women, mothers and children, and job training programs, among others.

Gov. Bob McDonnell of Virginia, a Republican, warned in a letter to President Obama on Monday that the automatic spending cuts would have a “potentially devastating impact” and could force Virginia and other states into a recession, noting that the planned cuts to military spending would be especially damaging to areas like Hampton Roads that have a big Navy presence. And he noted that the whole idea of the proposed cuts was that they were supposed to be so unpalatable that they would force officials in Washington to come up with a compromise.

“As we all know, the defense, and other, cuts in the sequester were designed to be a hammer, not a real policy,” Mr. McDonnell wrote. “Unfortunately, inaction by you and Congress now leaves states and localities to adjust to the looming threat of this haphazard idea.”

The looming cuts come just as many states feel they are turning the corner after the prolonged slump caused by the recession. Gov. Martin O’Malley of Maryland, a Democrat, said he was moving to increase the state’s cash reserves and rainy day funds as a hedge against federal cuts.

“I’d rather be spending those dollars on things that improve our business climate, that accelerate our recovery, that get more people back to work, or on needed infrastructure — transportation, roads, bridges and the like,” he said, adding that Maryland has eliminated 5,600 positions in recent years and that its government was smaller, on a per capita basis, than it had been in four decades. “But I can’t do that. I can’t responsibly do that as long as I have this hara-kiri Congress threatening to drive a long knife through our recovery.”

Federal spending on salaries, wages and procurement makes up close to 20 percent of the economies of Maryland and Virginia, according to an analysis by the Pew Center on the States.

But states are in a delicate position. While they fear the impact of the automatic cuts, they also fear that any deal to avert them might be even worse for their bottom lines. That is because many of the planned cuts would go to military spending and not just domestic programs, and some of the most important federal programs for states, including Medicaid and federal highway funds, would be exempt from the cuts.

States will see a reduction of $5.8 billion this year in the federal grant programs subject to the automatic cuts, according to an analysis by Federal Funds Information for States, a group created by the National Governors Association and the National Conference of State Legislatures that tracks the impact of federal actions on states. California, New York and Texas stand to lose the most money from the automatic cuts, and Puerto Rico, which is already facing serious fiscal distress, is threatened with the loss of more than $126 million in federal grant money, the analysis found.

Even with the automatic cuts, the analysis found, states are still expected to get more federal aid over all this year than they did last year, because of growth in some of the biggest programs that are exempt from the cuts, including Medicaid.

But the cuts still pose a real risk to states, officials said. State budget officials from around the country held a conference call last week to discuss the threatened cuts. “In almost every case the folks at the state level, the budget offices, are pretty much telling the agencies and departments that they’re not going to backfill — they’re not going to make up for the budget cuts,” said Scott D. Pattison, the executive director of the National Association of State Budget Officers, which arranged the call. “They don’t have enough state funds to make up for federal cuts.”

The cuts would not hit all states equally, the Pew Center on the States found. While the federal grants subject to the cuts make up more than 10 percent of South Dakota’s revenue, it found, they make up less than 5 percent of Delaware’s revenue.

Many state officials find themselves frustrated year after year by the uncertainty of what they can expect from Washington, which provides states with roughly a third of their revenues. There were threats of cuts when Congress balked at raising the debt limit in 2011, when a so-called super-committee tried and failed to reach a budget deal, and late last year when the nation faced the “fiscal cliff.”

John E. Nixon, the director of Michigan’s budget office, said that all the uncertainty made the state’s planning more difficult. “If it’s going to happen,” he said, “at some point we need to rip off the Band-Aid.”

Fernanda Santos contributed reporting.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Read More..

In a Slight Shift, North Korea Widens Internet Access, but Just for Visitors

HONG KONG — North Korea will finally allow Internet searches on mobile devices. But if you’re a North Korean, you’re out of luck — only foreigners will get this privilege.

Cracking the door open slightly to wider Internet use, the government will allow a company called Koryolink to give foreigners access to 3G mobile Internet service by next Friday, according to The Associated Press, which has a bureau in the North.

The North Korean police state is famously cloistered, a means for the government to keep news of the world from its impoverished people. Only the most elite North Koreans have been allowed access to the Internet, and even they are watched. And although many North Koreans are allowed to have cellphones, sanctioned phones cannot call outside the country.

Foreigners were only recently allowed to use cellphones in the country. Previously, most had to surrender their phones with customs agents.

But it is unlikely that the small opening will compromise the North’s tight control of its people; the relatively few foreigners who travel to North Korea — a group that includes tourists and occasional journalists — are assigned government minders.

The decision, announced Friday, to allow foreigners Internet access comes a month after Google’s chairman, Eric E. Schmidt, visited Pyongyang, the North’s capital. While there he prodded officials on allowing Internet access, noting how easy it would be to set up through the expanding 3G network of Koryolink, a joint venture of North Korean and Egyptian telecommunications corporations. Presumably, Mr. Schmidt’s appeal was directed at giving North Koreans such capability.

“As the world becomes increasingly connected, their decision to be virtually isolated is very much going to affect their physical world, their economic growth and so forth,” Mr. Schmidt told reporters following his visit. “We made that alternative very, very clear.”

North Koreans will get some benefit from the 3G service, as they will be allowed to text and make video calls, The Associated Press said. They can also view newspaper reports — but the news service mentioned only one source: Rodong Sinmun, the North’s main Communist Party newspaper.

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India Ink: In Hyderabad, Anger and Frustration

Srinivas Mahesh, 28, was snacking outside his hostel near the Konark Theater in Dishknagar, his usual hangout in Hyderabad, when he heard a loud explosion Thursday evening. Not long after, he saw smoke filling up the air. Once he realized it was a bomb blast, instead of rushing back to his hostel he resolved to helping the injured.

“I saw disfigured bodies for the first time in my life,” he said. He helped three severely injured people into ambulances and took another injured man by auto to Osmania Hospital.

Mr. Mahesh, who is originally from Kurnool, came to Hyderabad two years ago to do a graduation in engineering from Ashok Institute in Dilsukhnagar. After yesterday’s blasts though, he might have to return home.

“My parents were visiting Hyderabad in 2007, when there were blasts. They had a tough time then,” he said. “After yesterday, they are convinced that this city is cursed and want me home.”

More than 24 hours after two bombs went off near the ever-crowded Dilsukhnagar bus stand, there is palpable frustration and anger in the area. N.Pradeep Reddy, 29, a chartered accountant who lives in Dilsukhnagar, heard the first blast and came to the balcony of his house. Then he saw the second explosion. Aghast, he couldn’t move for several seconds, he said.

Mr. Reddy’s family has been in Hyderabad for 10 years now, but now he is disillusioned with the charm of the city, he said. “No one cares for our lives here – not the politicians, not the media not the police,” he added.

Hyderabad has been the site of numerous explosions in recent years, including two in 2007 attacks that killed dozens of people.

Soon after Thursday’s blasts, the road in front of the Dilsukhnagar bus stand had a median dividing it into two. While traffic was allowed on one side, the other side of the road was cordoned off by the police.

“This is obstructing traffic and adding to the commotion,” said P. Sadanandam, who commutes through the road regularly. “They are not doing this for security, it is just so that the VIPs can visit the blast site and have a photo-op,” he said angrily.

Andhra Pradesh Director General of Police and other senior police officers visited the at blast site today to look for evidence.

All the shops on a two kilometer stretch on the Dilsukhnagar main road were shuttered down all day today. Some security men outside the shops said that this was not due to the bandh, or shutdown, that the Bharatiya Janata Party had called, but because the shop owners were sure that there would be no customers today. They might open on Monday, they said.

Narsing Vennala, 25, sells flowers on the main road. He is one of the only three flower vendors who reopened their shops today. A temple next door needs flowers, he said, and therefore he had to come to work.

His 18-year-old sister is so paranoid about his coming to work a day after the blasts that she keeps calling him every half-an-hour to check if he is alright.  Mr Vennala walks home at 11 p.m. every night, and he plans to do the same even today.

“Whatever had to happen, happened,” he said. “Now how long can we stay hungry and not earn because of that?”

“Bharat mata ki jai,” (Victory for mother India) was loudly shouted by a bunch of residents. They said that was their answer to those that were against peace in the country.  There was also some anti-Pakistan sloganeering.

One resident estimated that there were 500 to 600 educational institutions in Dilsukhnagar. They have offerings ranging from short-term computer courses to three-year degrees. Thousands of students, from smaller towns and neighboring districts, live in hostels around their respective institutions. Many of them were on the streets yesterday to help the injured.

While some students don’t see any option but to stay in the city, others, like Mr. Mahesh, are packing their bags.

“I have to go home, even if I don’t like to,” he said “My family will be worried every day I stay in Hyderabad.”

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DealBook: In Dell’s Waning Cash Flows, Signs of Concern

The proposed Dell buyout may be motivated more by fear than greed.

Dell’s founder, Michael S. Dell, and the investment firm Silver Lake are offering to take the company private in a $24.4 billion deal. One interpretation of the offer is that savvy investors, using cheap loans, see a nice opportunity to unlock the value from a company that has fallen out of favor with stock investors. The fact that large shareholders are opposed to the deal, thinking it is priced too low, supports the idea that Dell is a diamond in the rough.

But there is an opposite interpretation: The buyout is a last-ditch effort to revive the company. To some, taking Dell private is what’s necessary to implement the sort of bold measures that could prevent the steady decline of a company that has been left behind in many of its markets. And like many acts of desperation, the risks are high that going private will fail.

This viewpoint starts with Dell’s cash flows. How much actual money a company makes each quarter is always an important metric. It’s especially critical at firms that go private in leveraged buyout deals. Once private, Dell would have a lot more debt – and it would need divert more cash to service it.

Going private may allow the company to slash costs, which preserves cash. But management may also feel liberated to spend more on initiatives it feels enthusiastic about, which would use up cash initially. In a botched buyout, management’s plans fail to produce results and a dangerous cash crunch occurs.

And there are some signs that Dell’s cash flows are weakening going into the deal.

The cash flow metric that matters is called free cash flow, which takes the money generated by Dell’s operations and then subtracts what the company spends on capital expenditures. Through the end of its latest fiscal year, which ended in February, Dell’s free cash flows were $2.77 billion. That is well below the $4.85 billion reported in the prior fiscal year. And the recent cash flows may have gotten a boost from financial moves that might be hard to repeat. In the most recent quarter, Dell generated a lot of cash from taking longer to pay its suppliers.

It’s easy to paint a grim picture from these numbers. A privately held Dell might have an extra $700 million to $1 billion of extra interest a year, which could in theory take annual free cash flows below $2 billion. That provides little margin for safety if Dell’s operations run into serious trouble, even if the company does decide to dip into its large pool of overseas cash.

But there are some reasons to believe this analysis is overly pessimistic.

First, the cash flow numbers probably don’t fully factor in how much cash can be generated by Dell’s recent acquisitions. Just as a couple of items helped bolster cash flows in recent quarters, others used up a lot cash, and may not do so in the future. For instance, Dell had a $450 million cash drain in the last fiscal year just from the “deferred income taxes” line. That could be the result of a one-off action rather than a recurring trend.

With all its acquisitions contributing, optimists might contend that Dell can produce $3.5 billion of free cash flow a year. If investors paid seven times that, the company would be valued at the $24 billion, which is where it is valued today on the stock market. Other shareholders think Dell is worth a lot more than $24 billion, and has the cash flows to justify it.

But right now, Dell’s cash flows are weakening. And if they continue to wane, Mr. Dell may soon have a tough job ahead of him. He may already know that — looking at those cash flows.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Gadgetwise Blog: Q&A: Moving the Mac’s Dock

It’s easy to move the Taskbar to a different edge of the screen on a Windows machine, but how do you move the Mac’s row of program icons from the bottom of the screen?

The Windows Taskbar — that row of program icons and open files that typically appears along the bottom edge of the screen — can be moved to the top or sides of the desktop by dragging it with the mouse, or in some later versions of Windows, by unlocking it first before dragging. The Dock, the Mac’s rough equivalent of the Taskbar, can also be moved to other edges of the screen in a few ways.

One method is to click the Mac’s Apple menu up in the top-left corner of the screen, select Dock and slide over to the submenu with the commands to position the dock on the left or right sides of the desktop. This same sub-menu holds options for automatically hiding the Dock on the screen until you pass the mouse cursor nearby, as well as the option for magnifying the icons stocked in the Dock when you pass the cursor over.

The Apple menu can take you right to the Dock’s settings in the Mac’s System Preferences if you want to fine-tune things further. You can also get to these settings by clicking the System Preferences icon in the Dock itself and clicking the Dock icon. In addition to the controls for positioning the Dock on the desktop, the preferences box contains settings for changing the overall size of it, adjusting the magnification size of the icons and other visual aspects of the Dock.

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India Ink: What They Said: Could the Hyderabad Explosions Have Been Prevented?

As more information emerges about the most recent bombs in Hyderabad, many in India have begun to question the role of state and central government authorities, intelligence agencies and local police, asking whether they could have done more to prevent the attacks.

Less than two days before the two explosions in Hyderabad on Thursday evening, which killed at least 15 people and injured more than 100, the central government warned state officials of the possibility of a terror attack. In the days before the bombs exploded, CCTV cameras in the area had been disabled but were not repaired.

India Ink talked to intelligence experts Friday about the bombings and the difficulty of preventing terrorism attacks, even when there is some warning. Government officials also spoke publicly about the explosions.

J. N. Rai, former additional director of the Intelligence Bureau, India’s internal intelligence-gathering agency, in a telephone interview:

All alerts in intelligence are of a general nature. If you have specific information, you will arrest the guys and prevent the event.

Alerts that include a specific place, specific time or specific operation are next to impossible to provide. Even the guys who are planting the explosives may not know until the very last minute where they are going to plant them. Or someone is told to go park a cycle in one place, and they don’t know what’s on the cycle.

These alerts are so routine that you cannot act upon them. With more use of technology and online communication, it has become more difficult. The terrorist modules use code language. So it has become more difficult to detect.

At times we get information that some members of networks visited a particular town, so we send an alert to that town. But that is not of much use. At times we learn that a particular module is collecting explosives and arms and giving training, so we interpret that they are gearing up for a big operation.

One guy was arrested, and he said that he did a recce at Dilsukh Nagar in 2011. You cannot make much out of that.

Ajit Doval, former director of the Intelligence Bureau, in a telephone interview:

If you do not have any information, it is an intelligence failure. But if you have some information, and even then you cannot prevent the event, then it is the failure of the government.

All the intelligence inputs are of a generic nature. It is up to the government agencies to develop those generic inputs into actionable inputs. You need to do lots of followup on the ground. It can be done by hard work. However nebulous or generic the intelligence input is, it is to be followed by ground work by the state police.

S. A. Huda, director general of Andhra Pradesh state police, in a telephone interview:

It is too early and too premature. We’re getting back to the scene. We’ll not do ball and ball commentary.

The moment we give some information, the terrorists get an alert. It’s happened so many times before.

There have been no arrests as yet. It’s painstaking work. We don’t want to jump the gun.

Sushma Swaraj, leader of opposition in the Lok Sabha, or lower house of Parliament, during the Parliament session on Friday:

This is a very unfortunate, painful and shameful act. These events are not an opportunity for the blame game; they are an opportunity to fight terrorism together with determination. But that we can do only if we have a common thinking. I feel sorry that a common thinking to fight terrorism is not emerging in our country.

On many occasions we advocate for the human rights of terrorists and advocate to deal with them softly.

On many occasions, the central government gives an input to the state government and thinks that their job is over. In this case, this has happened. The home minister said that the input was shared with the state government.

If you have the input and even after that the incident takes place, then the failure is doubled. What was the central government doing, what was the state government doing? These are the questions which come up after every terrorist incident.

We all understand that terrorism is not to seen in religious terms or in any color. A terrorist is a terrorist. If the whole country starts fighting terrorism with this spirit, if the whole country gets together and political parties get together, we will be able to defeat terrorism.

Sushil Kumar Shinde, Home Affairs Minister, during the Parliament session on Friday:

I extend my heartfelt condolences for the bereaved families who lost their near and dear ones in the blasts. The Government is committed to combat such cowardly terror attack and it shall make all possible efforts to apprehend the perpetrators and masterminds behind the blasts and ensure that they are punished as per the law. (Read his full statement.)

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DealBook: Linn Energy to Buy Berry Petroleum for $2.5 Billion

Deal-making in the oil patch continued on Thursday, as Linn Energy agreed to buy the Berry Petroleum Company for about $2.5 billion, expanding its presence in oil-rich shale formations.

Under the terms of the deal, an affiliate of Linn, LinnCo L.L.C., will issue 1.25 million new common shares for each Berry share. That amounts to $46.24 a share, a premium of roughly 20 percent to Berry’s closing price on Wednesday.

LinnCo will then transfer Berry’s assets to Linn in exchange for additional ownership units in its sibling, which is structured as a master limited partnership. Including the assumption of debt, the deal is valued at $4.3 billion.

By purchasing Berry, Linn will significantly bolster its oil production and increase its holdings in California and the Permian Basin in western Texas. The company estimates that its newest acquisition will increase its proven reserves by 34 percent and its production capabilities by 30 percent. And Berry’s reserves are estimated to be about 75 percent oil and liquids, considered to be significantly more valuable than natural gas, given current prices.

Linn cited the growth promised by the deal in announcing an increase in its quarterly distributions to unit holders, to 77 cents a unit from 72.5 cents.

“Berry’s assets are an excellent fit for Linn, and we believe this transaction generates significant accretion to our distributable cash flow per unit,” Mark E. Ellis, Linn’s chief executive, said in a statement. “We have great respect for what the Berry management team has accomplished and consider the Berry employees to be an important part of this transaction.”

To help defray the tax consequences LinnCo will take on in the deal, Linn will pay its affiliate $6 million a year through 2015.

LinnCo was advised by Citigroup, while a conflicts committee of its board was advised by Evercore Partners and the law firm Locke Lord. A conflicts committee of Linn’s board was advised by Greenhill & Company and Akin Gump Strauss Hauer & Feld.

Latham & Watkins served as legal counsel to both Linn and LinnCo. Berry was advised by Credit Suisse and the law firm Wachtell, Lipton, Rosen & Katz.

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In Reversal, Florida to Take Health Law’s Medicaid Expansion

MIAMI — Gov. Rick Scott of Florida reversed himself on Wednesday and announced that he would expand his state’s Medicaid program to cover the poor, becoming the latest — and, perhaps, most prominent — Republican critic of President Obama’s health care law to decide to put it into effect.

It was an about-face for Mr. Scott, a former businessman who entered politics as a critic of Mr. Obama’s health care proposals. Florida was one of the states that sued to try to block the law. After the Supreme Court ruled last year that though the law was constitutional, states could choose not to expand their Medicaid programs to cover the poor, Mr. Scott said that Florida would not expand its programs.

Mr. Scott said Wednesday that he now supported a three-year expansion of Medicaid, through the period that the federal government has agreed to pay the full cost of the expansion, and before some of the costs are shifted to the states.

“While the federal government is committed to paying 100 percent of the cost, I cannot in good conscience deny Floridians that needed access to health care,” Mr. Scott said at a news conference. “We will support a three-year expansion of the Medicaid program under the new health care law as long as the federal government meets their commitment to pay 100 percent of the cost during that time.”

He said there were “no perfect options” when it came to the Medicaid expansion. “To be clear: our options are either having Floridians pay to fund this program in other states while denying health care to our citizens,” he said, “or using federal funding to help some of the poorest in our state with the Medicaid program as we explore other health care reforms.”

Mr. Scott said the state would not create its own insurance exchange to comply with another provision of the law.

His reversal sent ripples through the nation, especially given the change in tone and substance since the summer, when he said he would not create an exchange or expand Medicaid.

“Floridians are interested in jobs and economic growth, a quality education for their children, and keeping the cost of living low,” Mr. Scott said in a statement at the time. “Neither of these major provisions in Obamacare will achieve those goals, and since Florida is legally allowed to opt out, that’s the right decision for our citizens.”

Mr. Scott now joins the Republican governors of Arizona, Michigan, Nevada, New Mexico, North Dakota and Ohio, who have decided to join the Medicaid expansion. Some, like Gov. Jan Brewer of Arizona, were also staunch opponents of Mr. Obama’s overall health care law.

Shortly before his announcement, the governor received word from the federal government that it planned to grant Florida the final waiver needed to privatize Medicaid, a process the state initially undertook as a pilot project. Mr. Scott, who is running for re-election next year, has heavily lobbied for the waiver, arguing that Florida could not expand Medicaid without it.

Mr. Scott’s support of Medicaid expansion is significant, but is far from the last word. The program requires approval from Florida’s Republican-dominated Legislature, which has been averse to expanding Medicaid under the health care law. The Legislature’s two top Republican leaders said that before making a decision they would consider recommendations from a select committee, which has been asked to review the state’s options.

“The Florida Legislature will make the ultimate decision,” Will Weatherford, the state House speaker, said. “I am personally skeptical that this inflexible law will improve the quality of health care in our state and ensure our long-term financial stability.”

Medicaid, which covers three million people in Florida, costs the state $21 billion a year. The expansion would extend coverage to one million more people.

Mr. Scott’s reversal is sure to anger his original conservative supporters.

The governor “was elected because of his principled conservative leadership against Obamacare’s overreach,” said Slade O’Brien, state director for Americans for Prosperity, an influential conservative advocacy organization. “Hopefully our legislative leaders will not follow in Governor Scott’s footsteps, and will reject expansion.”

During his announcement on Wednesday, Mr. Scott said his mother’s recent death and her lifetime struggle to raise five children “with very little money” played a role in his decision.

“Losing someone so close to you puts everything in a new perspective, especially the big decisions,” he said.

Michael Cooper contributed reporting from New York.

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In Reversal, Florida to Take Health Law’s Medicaid Expansion

MIAMI — Gov. Rick Scott of Florida reversed himself on Wednesday and announced that he would expand his state’s Medicaid program to cover the poor, becoming the latest — and, perhaps, most prominent — Republican critic of President Obama’s health care law to decide to put it into effect.

It was an about-face for Mr. Scott, a former businessman who entered politics as a critic of Mr. Obama’s health care proposals. Florida was one of the states that sued to try to block the law. After the Supreme Court ruled last year that though the law was constitutional, states could choose not to expand their Medicaid programs to cover the poor, Mr. Scott said that Florida would not expand its programs.

Mr. Scott said Wednesday that he now supported a three-year expansion of Medicaid, through the period that the federal government has agreed to pay the full cost of the expansion, and before some of the costs are shifted to the states.

“While the federal government is committed to paying 100 percent of the cost, I cannot in good conscience deny Floridians that needed access to health care,” Mr. Scott said at a news conference. “We will support a three-year expansion of the Medicaid program under the new health care law as long as the federal government meets their commitment to pay 100 percent of the cost during that time.”

He said there were “no perfect options” when it came to the Medicaid expansion. “To be clear: our options are either having Floridians pay to fund this program in other states while denying health care to our citizens,” he said, “or using federal funding to help some of the poorest in our state with the Medicaid program as we explore other health care reforms.”

Mr. Scott said the state would not create its own insurance exchange to comply with another provision of the law.

His reversal sent ripples through the nation, especially given the change in tone and substance since the summer, when he said he would not create an exchange or expand Medicaid.

“Floridians are interested in jobs and economic growth, a quality education for their children, and keeping the cost of living low,” Mr. Scott said in a statement at the time. “Neither of these major provisions in Obamacare will achieve those goals, and since Florida is legally allowed to opt out, that’s the right decision for our citizens.”

Mr. Scott now joins the Republican governors of Arizona, Michigan, Nevada, New Mexico, North Dakota and Ohio, who have decided to join the Medicaid expansion. Some, like Gov. Jan Brewer of Arizona, were also staunch opponents of Mr. Obama’s overall health care law.

Shortly before his announcement, the governor received word from the federal government that it planned to grant Florida the final waiver needed to privatize Medicaid, a process the state initially undertook as a pilot project. Mr. Scott, who is running for re-election next year, has heavily lobbied for the waiver, arguing that Florida could not expand Medicaid without it.

Mr. Scott’s support of Medicaid expansion is significant, but is far from the last word. The program requires approval from Florida’s Republican-dominated Legislature, which has been averse to expanding Medicaid under the health care law. The Legislature’s two top Republican leaders said that before making a decision they would consider recommendations from a select committee, which has been asked to review the state’s options.

“The Florida Legislature will make the ultimate decision,” Will Weatherford, the state House speaker, said. “I am personally skeptical that this inflexible law will improve the quality of health care in our state and ensure our long-term financial stability.”

Medicaid, which covers three million people in Florida, costs the state $21 billion a year. The expansion would extend coverage to one million more people.

Mr. Scott’s reversal is sure to anger his original conservative supporters.

The governor “was elected because of his principled conservative leadership against Obamacare’s overreach,” said Slade O’Brien, state director for Americans for Prosperity, an influential conservative advocacy organization. “Hopefully our legislative leaders will not follow in Governor Scott’s footsteps, and will reject expansion.”

During his announcement on Wednesday, Mr. Scott said his mother’s recent death and her lifetime struggle to raise five children “with very little money” played a role in his decision.

“Losing someone so close to you puts everything in a new perspective, especially the big decisions,” he said.

Michael Cooper contributed reporting from New York.

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Gadgetwise Blog: Tip of the Week: Search the Text on a Web Page

Search engines help find the Web pages you are looking for, but when it comes down to locating your keywords on the actual page, your browser can help. Most browser programs use the Control-F (Command-F on the Mac) to open a search box for finding certain words within the page itself, and most highlight the instances of the word (and number of time it appears). Google Chrome also displays yellow markers vertically along the scroll bar on the right side of the page so you can quickly see all the places the word or phrase appears.

Back and forward buttons in the search box let you click through the page for each occurrence of the word. Depending on the browser, you may be able to fine-tune your search results within the page. Internet Explorer includes an Options button that can match the whole word only or just the typographical case; Firefox can also match the word’s case, making it easier to locate proper nouns and names within a page.

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Car Bomb In Syrian Capital Kills At Least 31, Opposition Says

Sana/European Pressphoto Agency

An injured man was carried near the site of a car bomb explosion in Damascus on Thursday.

In renewed violence reaching the center of the Syrian capital, a car bomb exploded in Damascus on Thursday near the headquarters of President Bashar al-Assad’s ruling party, killing more than two dozen people, mainly civilians but also some security forces, according to opposition sources.

The violence coincided with renewed talks among Mr. Assad’s adversaries who met in Cairo on Thursday to discuss the terms on which the opposition Syrian National Coalition is prepared to talk about a negotiated settlement to the conflict.

Reuters quoted a draft communiqué under discussion by the group as saying it was prepared to negotiate, but Mr. Assad and his security force commanders were “not part of any political solution in Syria.”

The Syrian Observatory for Human Rights, an anti-Assad group based in Britain that has a network of contacts in Syria, reported that at least 31 people were killed by the bomb which exploded in the neighborhood of Mazraa.

Syrian state television said two children were wounded, while Al Ikhbariya, a pro-government television channel, showed footage of two dead bodies and body parts in a park.

The area where the bomb exploded was near the headquarters of Mr. Assad’s ruling Baath Party and the Russian Embassy. State television and the Syrian Observatory also said that mortar shells exploded near the Syrian Army General Command in the center of the capital, but there were no reported casualties.

The strikes were the latest to extend to the heart of the Syrian capital.

Reports this week appeared to show that rebel shells have reached new areas in Damascus.

State media and opposition activists reported on Wednesday that mortar rounds had hit the Tishreen sports stadium in the downtown neighborhood of Baramkeh. The state news agency, SANA, said the explosion killed an athlete from the Homs-based soccer team Al Wathba as he was practicing.

Government forces hit a rebel command center in a suburb east of the capital on Wednesday, injuring a founder of the Liwaa al-Islam brigade, Sheik Zahran Alloush, the brigade said in a statement.

On Tuesday, activists reported that up to seven mortar rounds had been fired by fighters of the Free Syrian Army toward Mr. Assad’s Tishreen Palace in Damascus.

There were no immediate reports of casualties, and it was not known whether Mr. Assad was there at the time. The palace, surrounded by a park, is in a wealthy area that has largely been insulated from the insurgency and it lies less than a mile from the main presidential palace.

Syrian rebels are entrenched in suburbs south and east of the capital, but they have been unable to push far into the center, although they strike the area with occasional mortars and increasingly frequent car bombs.

Such indiscriminate attacks, however, risk killing passers-by, exposing the rebels to charges that they are careless with civilian life and property. Many Damascus residents are undecided in the civil war and fear their ancient city will be ravaged like Aleppo and other urban centers to the north.

At the same time, the government has decimated pro-rebel suburbs with airstrikes and artillery, leaving vast areas depopulated or terrorized.

Fighting continued also for control of the main civilian airport in Aleppo on Wednesday.

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DealBook: Office Depot's Deal for OfficeMax Said to Have Been Announced Prematurely

A merger between Office Depot and OfficeMax has been years in the making. But it appears the deal may have been announced too hastily.

A press release announcing the merger of the two office supply retailers briefly surfaced Wednesday on Office Depot’s Web site. Since then, the announcement has disappeared.

The deal negotiations are ongoing, according to two people with knowledge of the matter. As of Wednesday morning, the company’s bankers and lawyers were still attempting to finalize an agreement.

Several news organizations quickly reported the terms disclosed in the apparently errant press release for Office Depot’s earnings. Buried on page four of the release, the company outlined details of the merger.

The release noted that Office Depot would issue $2.69 new shares of common stock for each share of OfficeMax. That would value OfficeMax at $13.50, or roughly $1.19 billion, a more than 25 percent premium to the company’s closing price last week.

The two people said that the press release — that was published and then taken down — was a draft. The described terms were not final, they added.

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

Representatives for Office Depot and OfficeMax were not immediately available for comment.

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The New Old Age Blog: The Reluctant Caregiver

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The New Old Age Blog: The Reluctant Caregiver

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Bits Blog: Marissa Mayer Puts Her Stamp on Yahoo.com

8:39 a.m. | Updated On Wednesday, Yahoo introduced a fresh new home page with Marissa Mayer’s stamp all over it.

Yahoo’s home page has long been a sort of sad reflection of the company. A jazzed-up Craigslist of sorts, the site was often cluttered with low-quality ads and irrelevant content and in no way reflected the fact that Yahoo is one of the most visited sites on the Web. With more than 700 million monthly visitors, Yahoo is still a leading source of information for sports, finance and entertainment.

Ms. Mayer took the reins as Yahoo’s chief executive last July. Before that she was a long-time executive at Google, where she was widely credited with the simple look of the Google search page. Now she seeks to apply that same, clean aesthetic to one of the most chaotic sites on the Web.

In an interview Tuesday, Ms. Mayer said she wanted to make Yahoo’s site “fresh and dynamic and add an element of surprise and serendipity.”

Gone are the low-quality ads. She has added an infinite, Twitter-like news feed and a stream of content recommended by users’ Facebook friends. Instead of trying to jam every Yahoo feature onto the site, the new design gives special prominence to Yahoo’s most popular Web properties: Yahoo’s e-mail and news service, Yahoo Finance, Yahoo Sports, its movie listing site and OMG, its popular entertainment site.

Users can now easily share content they see on the home page via e-mail, Twitter or Facebook with one click. They also have limited ability to customize the site to their liking. They can turn off home page features like horoscopes, stock quotes and sports stats. Ms. Mayer pointed out that the more items users switch on and off, the smarter the Yahoo algorithm gets and the more relevant content Yahoo will serve up.

Yahoo’s redesigned home page is the third major aesthetic improvement Ms. Mayer has introduced since joining the company. In December, she redesigned Yahoo’s e-mail service and its once-popular photo-sharing service Flickr.

In the interview, Ms. Mayer said these would be the “first of many releases” and she would turn her focus to a dozen or more Yahoo products. Her next priority for the home page, she said, will be adding content sources. In December, Yahoo signed three deals, with CBS Television, NBC Sports and ABC News. In each case, the media companies will work with Yahoo to promote each other’s content and produce original video content for the Web.

“We’re introducing a new way to welcome people to Yahoo,” Ms. Mayer said.

But it’s more than aesthetics. Ms. Mayer is betting that the renewed focus on Yahoo’s products will turn around the company’s ailing display ad revenue. Yahoo, once the biggest seller of display ads in the United States, went from a leading 15.5 percent share of all digital ad revenues in the United States in 2009, to an 8.4 percent share last year, even as total digital ad spending grew, according to eMarketer. Meanwhile, its competitor, Google, increased its share to 41 percent.

Last month, she told analysts, “More personalized content and increased product innovation will be key to getting us back to the path for display revenue growth.”

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IHT Rendezvous: True or False? The Tussle Over Ping Fu's Memoir

Did Ping Fu, a prominent Chinese-American businesswoman and author of a recent memoir, “Bend, not Break”, make up her horrible experiences during the 1966-76 Cultural Revolution in order to gain United States citizenship? Did they help her become an American by claiming political asylum?

That’s what her critics, many of them fellow Chinese Americans, say. It’s an accusation that can stick. As a recent New York Times investigation showed, claiming persecution has spawned an immigration industry involving lawyers prepping client to make false asylum claims.

As I write in my Letter from China this week, Ms. Fu is being accused of making up a lot of things in her memoir. She’s also a successful entrepreneur: the U.S. government honored the founder of the software company Geomagic (in the process of being sold to 3D Systems) with a “2012 Outstanding American by Choice” award.

Ms. Fu is on the board of the White House’s National Advisory Council on Innovation and Entrepreneurship, and is a member of the National Council on Women in Technology, according to the Web site of the U.S. Citizenship and Immigration Services.

Ms. Fu, who says in her memoir she was “quietly deported” to the U.S. in 1984 for writing about female infanticide while still a college student, denies the accusations. But until now she hadn’t explained in public how she became an American.

In an interview with the International Herald Tribune, she said, apparently for the first time, the reason she kept quiet was she was trying to protect her first husband, an American, whom she does not mention in her memoir. The marriage took place while she was living in California, she said.

“I had a first marriage and that’s how I got my green card,” she said by telephone. She married on Sept. 1, 1986 and divorced three years later. Until now she had kept silent because of a “smear” campaign against her online, mostly by fellow Chinese who accuse her of lying, which extended to real-life harassment, she said: “They smear my name, they try to get my daughter’s name on the Internet, they sent people to Shanghai to surround my family and to Nanjing to harass my neighbors.” She said the accusers, who are “angry” for reasons she doesn’t really understand, contacted U.S. immigration authorities to challenge her award and her citizenship, as well as shareholders of 3D Systems to warn them she was a “liar,” and not to buy Geomagic. Her second husband, Herbert Edelsbrunner, whom she has since divorced, received many “hate emails,” she said. “I just don’t want to hurt innocent people.”

If a first, unpublicized marriage might lay to rest one contentious issue, there are others. Some were the result of exaggeration or unclear communication with her ghost-writer, Los Angeles-based MeiMei Fox, she said.

In the interview, she volunteered an example of an error: a widely criticized account of the ‘‘period police,’’ the authorities who checked a woman’s menstrual cycle to ensure she wasn’t pregnant in the early days of the one-child policy. To stop women substituting others’ sanitary pads for inspection, they were sometimes required to use their own finger to show blood. Through a misunderstanding with Ms. Fox, Ms. Fu said this was portrayed as the use of other people’s fingers – an invasion of the woman’s body.

Ms. Fox “wrote it wrong,’’ she said. ‘‘I corrected it three times but it didn’t get corrected.’’ Women used their own finger to show blood, she said, but the mistake went into print anyway.

In general, Ms. Fox may have ‘‘just made some searches on the Internet that maybe weren’t correct,’’ said Ms. Fu.

Chiefly the errors involved use of the words ‘‘all, never, any,’’ that generalized unacceptably, Ms. Fu said. And, ‘‘She doesn’t know China’s geography,’’ said Ms. Fu.

At the beginning of her memoir, Ms. Fu writes of being kidnapped by a Vietnamese-American on arrival in the U.S. state of New Mexico and locked in his apartment to care for his very young children, whose mother had left, in a bizarre incident. A spokeswoman at the Albuquerque Police Department’s Records Office, where the alleged kidnapping took place, said she could not locate such an incident in their records. Asked about it, Ms. Fu repeated that she did not press charges as, fresh from China, she was terrified of all police, “So I don’t know how they keep records, if there is no criminal charges or record.”

And in an email to me, she admitted she made mistakes about a magazine she said she helped edit, called Wugou, or “No Hook,” produced in 1979 by students at her college, then called the Jiangsu Teacher’s College (later it changed its name to Suzhou University, she said.) It was not that magazine but another one, “This Generation,” that was taken to a meeting in Beijing of student magazine writers from around the country, she wrote in the email. “A good case that shows everyone’s memory can be wrong,” she wrote.

But bigger questions about the scale of the online vitriol from parts of the Chinese and Chinese-American community remain. “I really haven’t known China for 20-something years, and it didn’t occur to me that what I wrote would generate so much anger,” she said. In the last years, “as China got stronger, nationalistic views got stronger,” she said, making a “civil conversation” about disagreements apparently harder.
Additional reporting by Cindy Hao in Seattle

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Bits Blog: Tech Predictions for 2013: It's All About Mobile

If there is one theme that will be the topic of digital business this year, it is mobile.

ComScore, which tracks Web and mobile usage, published a report about what happened in 2012, and what to expect in 2013.

It shows that the effects of a movement toward mobile are everywhere, from shopping to media to search. According to the report, “2013 could spell a very rocky economic transition,” and businesses will have to scramble to stay ahead of consumers’ changing behavior.

Here are a few interesting tidbits from the 48-page report.

The mobile transition is happening astonishingly quickly. Last year, smartphone penetration crossed 50 percent for the first time, led by Android phones. People spend 63 percent of their time online on desktop computers and 37 percent on mobile devices, including smartphones and tablets, according to comScore.

Just as they compete on computers, Facebook and Google are dominant and at each other’s throats on phones.

Google’s map app for the iPhone, which had been the most used mobile app, lost its No. 1 spot to Facebook after Apple kicked Google’s maps off the iPhone in October. Now, Facebook reaches 76 percent of the smartphone market and accounts for 23 percent of total time spent using apps each month. The next five most used apps are Google’s, which account for 10 percent of time on apps.

As mobile continues to take share from desktop, some industries have been particularly affected, and they are seeing significant declines in desktop use of their products as a result. They are newspapers, search engines, maps, weather, comparison shopping, directories and instant messenger services.

The most visited Web sites are not so surprising: Google, Yahoo, Microsoft, Facebook and Amazon. Facebook continues to take up most of our time online.

But there were a few surprises from younger, smaller Web companies. Tumblr was No. 8 on the list of sites, ordered by time spent on them. And several Web sites were breakout hits last year, as measured by growth and visitor numbers: Spotify (music), Dropbox (online storage), Etsy (shopping), BuzzFeed (news), JustFab (shopping), SoundCloud (music) and BusinessInsider (news).

Search, one of the biggest and most reliable Web industries, is at a crossroads, comScore said. Even though the search market continues to be extraordinarily profitable, there is a desire for it to evolve and offer new services to users.

Here is some evidence: Searches on traditional search engines, dominated by Google, declined 3 percent last year, and the number of searches per searcher declined 7 percent. Yet searches on specialty sites, known as vertical search engines, like Amazon.com or Whitepages.com, climbed 8 percent.

Social search, based on what users’ friends like, has put Facebook and Google on a “collision course,” comScore said, particularly in searches for local businesses like restaurants.

In social networking, the visual Web, as comScore calls it, has transformed the landscape. Pinterest, Tumblr and Instagram, all of which emphasize images, each gained more than 10 million visitors last year.

Last year was also pivotal for online video, comScore said, as viewers increasingly seek the ability to watch video when and where they want. Watching TV shows online helped last year break viewing records, especially during the Olympics.

In the United States, 75 million people a day watch online video and stream 40 billion videos a month, and viewing is driven by YouTube.

There has also been a turning point for video ads. They cost more than typical ads, and have always lagged behind viewership. But in 2012, 23 percent of videos were accompanied by an ad, up from 14 percent the year before. More TV ad dollars are coming to online video, comScore concluded.

Though e-commerce spending grew 13 percent last year, it was a disappointing holiday season online, largely because of economic pressures. Purchasing on mobile phones is beginning to make a dent in e-commerce, comScore said, with mobile shopping accounting for 11 percent of e-commerce in the fourth quarter of 2012, up from 3 percent in the period two years earlier.

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National Briefing | South: Abortion Curbs Clear Senate in Arkansas

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

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National Briefing | South: Abortion Curbs Clear Senate in Arkansas

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

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