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.

Read More..

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.

Read More..

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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