Beijing’s S. China Sea rivals protest passport map

TAIPEI, Taiwan (AP) — China has enraged several neighbors with a few dashes on a map, printed in its newly revised passports that show it staking its claim on the entire South China Sea and even Taiwan.

Inside the passports, an outline of China printed in the upper left corner includes Taiwan and the sea, hemmed in by the dashes. The change highlights China’s longstanding claim on the South China Sea in its entirety, though parts of the waters also are claimed by the Philippines, Vietnam, Taiwan, Brunei and Malaysia.

China’s official maps have long included Taiwan and the South China Sea as Chinese territory, but the act of including them in its passports could be seen as a provocation since it would require other nations to tacitly endorse those claims by affixing their official seals to the documents.

Ruling party and opposition lawmakers alike condemned the map in Taiwan, a self-governed island that split from China after a civil war in 1949. They said it could harm the warming ties the historic rivals have enjoyed since Ma Ying-jeou became president 4 1/2 years ago.

“This is total ignorance of reality and only provokes disputes,” said Taiwan’s Mainland Affairs Council, the Cabinet-level body responsible for ties with Beijing. The council said the government cannot accept the map.

Philippine Foreign Secretary Albert del Rosario told reporters in Manila that he sent a note to the Chinese Embassy that his country “strongly protests” the image. He said China’s claims include an area that is “clearly part of the Philippines’ territory and maritime domain.”

The Vietnamese government said it had also sent a diplomatic note to the Chinese Embassy in Hanoi, demanding that Beijing remove the “erroneous content” printed in the passport.

In Beijing, the Foreign Ministry said the new passport was issued based on international standards. China began issuing new versions of its passports to include electronic chips on May 15, though criticism cropped up only this week.

“The design of this type of passports is not directed against any particular country,” Chinese Foreign Ministry spokeswoman Hua Chunying said at a daily media briefing Friday. “We hope the relevant countries can calmly treat it with rationality and restraint so that the normal visits by the Chinese and foreigners will not be unnecessarily interfered with.”

It’s unclear whether China’s South China Sea neighbors will respond in any way beyond protesting to Beijing. China, in a territorial dispute with India, once stapled visas into passports to avoid stamping them.

“Vietnam reserves the right to carry out necessary measures suitable to Vietnamese law, international law and practices toward such passports,” Vietnamese foreign ministry spokesman Luong Thanh Nghi said.

Taiwan does not recognize China’s passports in any case; Chinese visitors to the island have special travel documents.

China maintains it has ancient claims to all of the South China Sea, despite much of it being within the exclusive economic zones of Southeast Asian neighbors. The islands and waters are potentially rich in oil and gas.

There are concerns that the disputes could escalate into violence. China and the Philippines had a tense maritime standoff at a shoal west of the main Philippine island of Luzon early this year.

The United States, which has said it takes no sides in the territorial spats but that it considers ensuring safe maritime traffic in the waters to be in its national interest, has backed a call for a “code of conduct” to prevent clashes in the disputed territories. But it remains unclear if and when China will sit down with rival claimants to draft such a legally binding nonaggression pact.

The Philippines, Brunei, Malaysia and Vietnam are scheduled to meet Dec. 12 to discuss claims in the South China Sea and the role of China.

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Associated Press writers Oliver Teves in Manila, Philippines, Chris Brummitt in Hanoi, Vietnam, and researcher Zhao Liang in Beijing contributed to this report.

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Rejected Beatles audition tape appears at auction

LONDON (Reuters) – The Beatles audition tape rejected by a record label executive in arguably the biggest blunder in pop history has resurfaced and will go on sale at a London auction next week.

Ted Owen of The Fame Bureau, an auction house specializing in pop memorabilia, said the 10-song tape was recorded on New Year’s Day, 1962, at label Decca‘s studios in north London.

Paul McCartney, John Lennon, George Harrison and Pete Best – who would later be replaced on drums by Ringo Starr – performed up to 15 songs at the session, 10 of which appear on the tape to be sold on November 27.

The band members had been driven from Liverpool to London the night before, and, despite getting lost on the way managed to get to the studios in time for the infamous session paid for by their manager Brian Epstein.

Decca’s senior A&R (artists and repertoire) representative Dick Rowe, who later became known as “the man who turned down the Beatles“, decided against signing them in favor of Brian Poole & The Tremeloes who also auditioned that day.

“Guitar groups are on their way out, Mr. Epstein,” he is widely quoted as saying.

Rowe did, however, sign the Rolling Stones, who went on to become one of the biggest acts in British rock, and experts dispute whether it was him or a more junior colleague who passed the Beatles over.

There are bootleg versions of the session in existence, but the “safety master”, or back-up tape, on offer at auction is unique, Owen said.

“The most important thing about this is the quality,” he told Reuters. “There are bootlegs out there, horrible bootlegs — some are at the wrong speed, others are crackily and taken from a cassette off an acetate (disc).

“This quality we have never heard.”

Despite its rarity, the tape has been estimated to fetch 18-20,000 pounds ($ 29-32,000), which Owen said had been set by the owner and was a “sensible” starting point.

He added that only a handful of collectors were likely to bid for the piece of pop history, and, given that the Beatles own the copyright through their company, a commercial record release based on the tape was extremely unlikely.

Marked as the “Silver Beatles”, which the “Fab Four” were briefly called, the tape comes with a hand-written track list and black-and-white photograph of the musicians posing in leather jackets that would be been used for the record sleeve.

Also on offer at the Popular Culture auction is a guitar used by Jimi Hendrix to play the bulk of his breakthrough set at the Monterey festival in California in 1967. The black Fender Stratocaster is expected to fetch 120-180,000 pounds.

(Reporting by Mike Collett-White, editing by Paul Casciato)

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Canada meat plant operations halted on food safety concerns

OTTAWA (Reuters) – Canadian food inspectors on Friday said they have suspended operations at a meat-processing plant in Edmonton, Alberta, for failing to properly track its deliveries after detecting the Listeria bacteria on an employee.

The incident comes just a month after a major health scare in Canada over tainted beef at another meat plant in the province.

Capital Packers Inc detected the bacteria Listeria monocytogenes — which can cause fever, nausea and even meningitis in infected people — on a worker’s sleeve and on Monday notified the Canadian Food Inspection Agency (CFIA).

While such a finding is routine and there is no evidence that any food was contaminated, the CFIA suspended the company’s license as a precautionary measure after finding it was unable to properly track the whereabouts of its products.

“The company’s ability to understand the distribution of their products is in question and is an element of concern for us, hence the license suspension,” Paul Mayers, associate vice-president of programs at the CFIA, told reporters on a teleconference.

Initially, the company told the CFIA that the potentially affected products were under its control. The CFIA’s own investigation determined that they may in fact have been delivered to several provinces, Mayers said.

In September, the XL Foods meat plant in Alberta was shut down for about a month after it produced millions of pounds of beef tainted with the E. coli bacteria that sickened at least 16 people in Canada.

Capital Packers makes bacon, sausages, fresh meats and other products and sells them in Western Canada and the Northwest Territories, according to its Web site.

The company has voluntary recalled ham sausages under the brand names Capital and Compliments.

“The ham sausage recall that is underway is not directly related to the suspension, however we are voluntarily recalling this product because there was found to be a positive for listeria on an employee sleeve working on a packaging equipment line,” the company said in a statement.

“We are working closely with the CFIA to rectify this situation in a timely manner.”

CFIA officials said the plant would be closed until they were satisfied Capital Packers has improved its record-keeping and that additional products could be added to the recall as the investigation continues.

(Reporting by Louise Egan; Editing by Bob Burgdorfer)

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Sandy victims cheered by NYC's Thanksgiving parade

NEW YORK (AP) — Victims of Superstorm Sandy in New York and elsewhere in the Northeast were comforted Thursday by kinder weather, free holiday meals and — for some — front row seats to the annual Macy's Thanksgiving Day Parade.

"It means a lot," said Karen Panetta, of the hard-hit Broad Channel section of Queens, as she sat in a special viewing section set aside for New Yorkers displaced by the storm.

"We're thankful to be here and actually be a family and to feel like life's a little normal today," she said.

The popular Macy's parade, attended by more than 3 million people and watched by 50 million on TV, included such giant balloons as Elf on a Shelf and Papa Smurf, a new version of Hello Kitty, Buzz Lightyear, Sailor Mickey Mouse and the Pillsbury Doughboy. Real-life stars included singer Carly Rae Jepsen and Rachel Crow of "The X Factor."

The young, and the young at heart, were delighted by the sight and sound of marching bands, performers and, of course, the giant balloons. The sunny weather quickly surpassed 50 degrees.

Alan Batt and his 11-year-old twins, Kyto and Elina, took in the parade at the end of the route, well away from the crowd and seemingly too far away for a good view. But they had an advantage: Two tall stepladders they hauled over from their apartment eight blocks away — one for each twin.

"We're New Yorkers," the 65-year-old Batt said. "We know what we're doing."

With the height advantage, "I get to see everything!" Kyto said.

At nearby Greeley Square, social worker Lowell Herschberger, 40, of Brooklyn, sought in vain to tear his sons, 8-year-old Logan and 6-year-old Liam, from a foosball table set up in the tiny park as the balloons crept by on the near horizon.

"Hey, guys — there's Charlie Brown," he said, pointing at the old standby balloon.

The boys didn't look up.

"I guess they're over it," the father said with a shrug.

Mayor Michael Bloomberg was reflective Thursday as he praised police, firefighters, armed services personnel, sanitation workers and volunteers involved in the storm response. His office was coordinating the distribution of 26,500 meals at 30 sites in neighborhoods affected by Sandy, and other organizations also were pitching in.

The disaster zones on Staten Island were flooded — this time with food and volunteers from Glen Rock, N.J. organized using social media.

"We had three carloads of food," said volunteer Beth Fernandez. "The whole town of Glen Rock pitched in. ... It's really cool. It's my best, my favorite Thanksgiving ever."

On Long Island, the Long Beach nonprofit Surf For All hosted a Thanksgiving event that fed 1,200 people. Carol Gross, 72, a Long Beach native, said she went to volunteer but was turned away because of a surplus of helpers.

"A lot of people like me, old-timers, we've never seen anything like this horror," she said, recalling the destruction.

Gross' brother, Jerry, who moved to Arizona in the 1960s, was stunned by what he saw when he returned for Thanksgiving.

"To come back and see the boardwalk all devastated like it is, it's like going to Manhattan and finding Times Square gone," he said.

George Alvarez, whose Toms River, N.J., home suffered moderate damage when Sandy hit the coast, said his family usually does "the traditional big dinner" on Thanksgiving. But this year, they chose to attend a community dinner held at an area church.

"This storm not only impacted us, it impacted a lot of our friends, our community, our psyche," Alvarez said shortly before his family headed out for their meal. "We could have had our usual dinner here at home, but this year it felt like we should be with others who are experiencing the same concerns we are. We made it through this devastating storm, and that's something to celebrate."

Across the country, other cities offered a mix of holiday cheer and acts of charity.

Thousands of people made the most of the mild, sunny fall weather to watch Detroit's Thanksgiving parade, hours ahead of the Lions' annual home game.

Floats and marching bands poured down Woodward Avenue on Thursday morning, with many spectators forgoing the cold-weather gear of past parades. Detroit's temperature hit 52 degrees at 11 a.m., with a warm wind blowing from the South.

Parade participants also included NASCAR driver Brad Keselowski, a 28-year-old Rochester Hills native and the first Michigan-born driver to win the Sprint Cup Series.

In San Francisco, lines of the homeless and less fortunate began forming late Wednesday outside a church in the city's tough Tenderloin district that expected to serve more than 5,000 meals, said the Rev. Cecil Williams.

"We must make sure people can overcome all adversities," Williams said. "You can, you will and you must."

___

AP radio correspondent Julie Walker, AP video journalist Ted Shaffrey and Associated Press writers Kiley Armstrong and Karen Matthews in New York, Alison Barnwell on Long Island, Bruce Shipkowski in New Jersey and Terry Collins in San Francisco contributed to this report.

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Former Ivory Coast leader’s wife wanted by ICC

THE HAGUE, Netherlands (AP) — The International Criminal Court unsealed an indictment Thursday against former Ivory Coast President Laurent Gbagbo‘s wife on charges including murder, rape and persecution. It was the first time in the court’s 10-year history it has charged a woman.

The world’s first permanent war crimes tribunal said the arrest warrant was issued on Feb. 29 for former first lady Simone Gbagbo for crimes against humanity.

Her husband, Laurent Gbagbo, is already in custody at the court’s detention unit in The Hague facing similar charges stemming from his fight to retain power after losing a 2010 presidential election. If his wife is extradited, they could face justice together in an unprecedented husband-wife trial.

But a senior member of Ivory Coast President Alassane Ouattara‘s government, who requested anonymity because he wasn’t authorized to speak to the media, said Ivory Coast has already informed the ICC that the nation will not let her go.

“We informed them of this a long time ago,” he said.

The court’s chief prosecutor, Fatou Bensouda, urged Ivory Coast to extradite Gbagbo.

“The type of crimes committed in the aftermath of the 2010 elections did not happen by chance — they were planned and coordinated at the highest political and military levels and all those bearing the greatest responsibility must be held to account,” Bensouda said in a statement.

She said prosecutors continue to investigate crimes committed by both sides in Ivory Coast’s bloody power struggle and expect to issue further arrest warrants in the future.

“The investigations are objective, impartial and independent, and are conducted in strict accordance with the law,” she said.

Ivory Coast officials are holding the 63 year old under house arrest in the northwest town of Odienne. Last week, Ivorian prosecutor Noel Dje Enrike Yahau said lawyers had questioned Simone Gbagbo there for two days and that the domestic charges against her remained the same: genocide, blood crimes and economic crimes.

Unsealing the ICC arrest warrant issued nearly nine months ago appears to be a tactic by the court to put pressure on Ouattara’s administration to hand over Ms. Gbagbo.

If authorities in Ivory Coast want to prosecute her, they have to convince judges at The Hague tribunal that their case involves the same crimes she is charged with at the ICC. It is a court of last resort, meaning it only takes cases from countries unwilling or unable to prosecute them.

The international court said in the warrant that there is evidence pro-Gbagbo forces deliberately attacked perceived supporters of Ouattara in the aftermath of the election.

Judges who reviewed evidence supporting the charges against Ms. Gbagbo said they found “there are reasonable grounds to believe that Ms. Gbagbo bears individual criminal responsibility for the crimes … as ‘an indirect co-perpetrator.’”

The warrant called Gbagbo an “alter ego for her husband” with the power to make state decisions. It said there is evidence to suggest she “instructed the pro-Gbagbo forces to commit crimes against individuals who posed a threat to her husband’s power.”

Her husband was the first former head of state to be taken into custody by the court when he was extradited to The Hague by the Ivory Coast government last year.

Prosecutors say about 3,000 people died in violence by both sides after Gbagbo refused to concede defeat following the election. Ouattara finally took power in April 2011 with the help of French and U.N. forces.

Ivory Coast is not a member state of the court, but has voluntarily accepted its jurisdiction.

It is very rare for a woman to be charged by an international war crimes court. In the past, the Yugoslav war crimes tribunal convicted former Bosnian Serb President Biljana Plavsic of persecution and sentenced her to 11 years imprisonment.

The announcement of the arrest warrant and Ivory Coast’s refusal to hand over Gbagbo appeared likely to raise tensions between supporters of her husband and those who back Ouattara.

Moussa Toure Zeguen, a leader of the Gbagbo allies in exile in Ghana, said by phone from Accra that the former president’s supporters had no faith in the Ivorian authorities to give Simone Gbagbo a fair trial.

“We don’t trust them. The only thing that Ouattara is doing is revenge,” Zeguen said. “He wants to try us without trying any of the fighters from his side who also committed crimes. It is not fair, and this cannot bring reconciliation.”

____

Associated Press writers Rukmini Callimachi in Dakar, Senegal, and Robbie Corey-Boulet in Abidjan, Ivory Coast, contributed to this report.

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Do drunks have to go to the ER?

NEW YORK (Reuters Health) – With the help of a checklist, ambulance workers may be able to safely reroute drunk patients to detoxification centers instead of emergency rooms, according to a new study.

Researchers in Colorado found no serious medical problems were reported after 138 people were sent to a detox center to sleep it off, instead of to an ER.

In 2004, according to the researchers, it’s estimated that 0.6 percent of all U.S. ER visits were made by people without any problems other than being drunk. Those visits ended up costing about $ 900 million.

“Part of the issue has been – as it is in many busy ER departments – there’s a lot of chronic alcoholics that are brought in by ambulance, police or just come in. Often they are brought in because they have not committed a crime or there is limited space in our detoxification center. So the majority were brought to the ER department,” said Dr. David Ross, the study’s lead author from Penrose-St. Francis Health Services in Colorado Springs.

Ross said the ambulance company where he serves as medical director created the checklist with the help of the local detox center, which provided limited medical care by a nurse, and the local hospitals to reduce the number of drunks without medical needs being sent to the local ERs.

They created a checklist with 29 yes-or-no questions, such as whether the patient is cooperating with the ambulance worker’s examination and if the patient is willing to go to the detox center.

The patient was sent to the ER if the ambulance worker checked “no” on any question.

The researchers then went back to look at the patients they transported between December 2003 and December 2005 to see whether or not any of them ended up having serious medical problems at the detox center.

During that two year period, the ambulance workers transported 718 drunks. The detox center received 138 and the local ERs got 580.

Overall, 11 of the patients who were taken to detox were turned away because there was no room, their blood alcohol level exceeded the limit, their family came to pick them up or they were combative.

Another four patients at the detox center were taken to the ER because of minor complications, including chest and knee pain. However, there were no serious complications reported.

“We really believe that we did not miss anybody with a serious illness and injury that didn’t go to the ER as they should have,” said Ross.

But the researchers write in the Annals of Emergency Medicine that their study did have some limitations.

Specifically, the researchers did not plan in advance to do a study when they were creating the checklist, which means their findings are limited to whatever information was collected at the detox center and ERs.

Also, the number of people who were sent to the detox center in their study is relatively small, so it’s hard to tell how many serious complications they’d see among a larger group of people.

“We tried to estimate how likely we would have been to encounter a serious event… We estimated at most we’d encounter three serious adverse events (in 748 patients),” Ross told Reuters Health.

SOURCE: http://bit.ly/QgPCT5 Annals of Emergency Medicine, online November 9, 2012.

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Ivory Coast: New prime minister named

ABIDJAN, Ivory Coast (AP) — President Alassane Ouattara has tapped Foreign Minister Daniel Kablan Duncan to serve as prime minister in a new government one week after the surprise dissolution of cabinet.

The appointment of Duncan, a member of the PDCI party of former President Henri Konan Bedie, was announced at a press conference Wednesday by Amadou Gon Coulibaly, general secretary of the presidency.

Ouattara dissolved the cabinet last week over a feud between his political party and the PDCI over proposed changes to the country’s marriage law.

The PDCI supported Ouattara in the November 2010 runoff election in exchange for the prime minister’s post, helping him defeat incumbent President Laurent Gbagbo. Gbagbo’s refusal to cede office led to five months of violence that claimed at least 3,000 lives before Ouattara’s forces won.

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Tom Hanks, Will Farrell offer custom recordings

NEW YORK (AP) — Imagine having William Shatner supply your outgoing voicemail message. Or maybe you’d prefer Morgan Freeman coolly telling callers to wait for the beep. Or perhaps having Betty White joke around is more your speed.

All it takes is $ 299 and some luck.

The advocacy group Autism Speaks is offering custom-recorded messages from those celebrities as well as Will Ferrell, Carrie Fisher, Tom Hanks, Derek Jeter, Leonard Nimoy, Patrick Stewart and Ed Asner.

From Dec. 3 to Dec. 9, a limited number of 20-second long MP3 messages will be recorded by each celebrity on a first-come, first-served basis for fans to do with as they wish. All requests must be of the PG variety.

Asner, the curmudgeonly Emmy Award winner of “The Mary Tyler Moore Show” and “Lou Grant,” dreamed up the unusual fundraiser with his son Matt, who works for Autism Speaks.

“I think people will get a charge out of it,” says Asner, who is currently on Broadway in the play “Grace.” ”I’ll probably say, ‘What are you wearing?’ Or, ‘Take it off.’ Something like that.”

All proceeds will support autism research and advocacy efforts.

If he could get a message from one of the other stars participating, which would Asner want?

“I’m awfully stuck on Will Ferrell, having been subjected to him in ‘Elf,’” Asner says. “But they’re all such standouts — Patrick Stewart, Leonard Nimoy, Shatner. The list doesn’t stop. Even Betty White,” he adds about his “MTM” co-star. “She’s still got some good left in her.”

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“Irrational” factors may drive end of life access to radiation

NEW YORK (Reuters Health) – Access to radiation treatments to ease cancer symptoms in the last days of life may be driven by costs and other non-medical considerations, a new U.S. study concludes.

Researchers looking at Medicare claims over nearly a decade found that only a small proportion of cancer patients received radiation in their final 30 days of life, but of those who did get the treatment – typically used to ease pain and other symptoms in the terminal stages of the disease – one in five got more than the recommended number of doses.

“The use of radiation itself was low, what was high was the percentage of patients who were getting 10 days or more,” said Dr. Ashleigh Guadagnolo of the MD Anderson Cancer Center at the University of Texas, who led the study.

Guadagnolo declined to comment on whether the number of treatments was appropriate, but one cancer expert said that the study showed wasteful, irrational thinking behind some radiation therapy.

Dr. Otis Brawley, chief medical officer of the American Cancer Society, said that while radiation therapy for palliative care is reasonable, 10 or more treatments for patients during the last month of life is a “waste of resources.”

The conundrum, Brawley told Reuters Health, was that patients who received radiation got too much, but that too many patients who could have benefited from radiation got no therapy.

“This study shows there’s a lot of irrationality in how we treat patients,” said Brawley, who was not involved in the new work.

Doctors use radiation not only to blast away cancer cells and tumors when attempting to cure cancer, but also as an alternative to steroids and pain medications to relieve bleeding and painful symptoms when cancer spreads to the bones, brain and spine.

Many previous studies have focused on the use of chemotherapy at the end of a cancer patient’s life, but the new report, published Monday in the Journal of Clinical Oncology, is the first to examine how doctors use radiation with terminal patients, according to Guadagnolo’s team.

The researchers were interested specifically in what factors might determine when radiation treatment is given to terminal cancer patients, and especially whether Medicare payment policies have any influence on the treatment’s use.

So the researchers evaluated more than 202,000 Medicare claims for patients over age 65 who died from the five most common cancers in the U.S., including lung, breast, prostate, colorectal and pancreatic cancers between 2000 and 2007.

They assumed that most radiation treatments during a patient’s final 30 days were palliative, that is, meant to treat symptoms rather than to cure the cancer.

Overall, about 15,000 patients (a little more than seven percent) received radiation therapy in the last month of life. And of those, almost 18 percent spent more than 10 of their final 30 days getting radiation treatments.

Factors that were linked to receiving 10 or more treatments included being white, not receiving hospice care and being treated in a freestanding cancer treatment facility rather than a university-associated hospital.

The costs for patients who got radiation treatment amounted to an additional $ 3,453 per patient, on average. However, among those who were getting hospice care and radiation, the combined costs were $ 2,675 less than the costs for patients who got neither radiation nor hospice care.

Medicare caps payments for patients who elect hospice care at a daily rate that’s below what a radiation treatment would cost, the report points out. And a general decline in the use of radiation from 2000 to 2007 tracks with an increase in hospice use.

Besides cost, previous research has also found a variety of barriers to access in the use of radiation therapy at the end of life, including race, sex, household income, nursing home residence and travel time to a hospital, the authors note.

“The take home message for me from this study was that it’s not likely the case that we’re going to save money by forgoing radiation and in fact, radiation is probably a little bit underutilitzed,” Dr. Stephen Lutz, a radiation specialist at the Blanchard Valley Regional Cancer Center in Ohio, told Reuters Health. Lutz was not involved in the study.

Dr. Michael Steinberg, a radiation oncologist at the David Geffen School of Medicine at UCLA, said the costs need to be put into context. Many patients in his practice don’t want to be on narcotics or steroids that can cause many unpleasant side effects such as mental fogginess.

“(Narcotics and steroids) are not necessarily solutions, this is more like warehousing very old patients and something to be avoided, if you can control the pain with a short course of radiation, there is a value proposition,” said Steinberg, who was not involved in the new study.

On the other hand, radiation therapy to lessen cancer symptoms has limits since its pain-reducing effects can take days as opposed to hours for narcotics, noted Dr. Stephen Gripp, a radiation oncologist at the University Hospital Düsseldorf at Heinrich-Heine-University.

Plus, there’s the inconvenience factor.

“Radiotherapy (transport, positioning on the table, waiting) is annoying or even painful for terminally ill patients,” Gripp told Reuters Health in an email.

In past research, radiation oncologists have examined how many treatments are appropriate for end-of-life care and found in some cases, such as bone metastasis, a single treatment is just as effective in reducing pain as multiple treatments.

However, doctors tend to be reluctant to use fewer treatments for patients who are near death, Lutz said, because they are unsure how long the patient will survive and benefit from the treatments.

In 2011, the American Society for Radiation Oncology, a trade group, published guidelines to help doctors reduce the number of treatments for patients with bone metastasis.

The study was unable to “tell why patients got radiation; nor do we have any data in this study on what benefit they received or whether it improved their quality of life,” Guadagnolo told Reuters Health.

The study had other shortcomings, Steinberg noted.

“When you look at cost – why do these patients cost more to get the radiation – it’s not just because of the radiation, they’re typically getting a lot of other things as well,” Steinberg said.

Experts said that the long-term risks for radiation therapy in terminal patients were negligible, and most patients wouldn’t survive to see any longer-term side effects.

“This is more about a broken payment system than anything about radiation overdose,” Steinberg concluded.

SOURCE: http://bit.ly/UR8kwk Journal of Clinical Oncology, online November 19, 2012.

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Clinton’s high-profile swan song

Secretary of State Hillary Rodham Clinton at a meeting with President Barack Obama, second from left, and Japan's …Secretary of State Hillary Rodham Clinton was supposed to be heading for the exit, even as the fight over who should succeed her escalated. Instead, America's top diplomat sped Tuesday to the Middle East on an urgent mission to douse flaring violence between Israel and Hamas, the Islamist Palestinian group that controls Gaza.

Amid early, disputed reports of a possible truce, Clinton had several major goals: Ease the violence, bolster Egyptian President Mohammed Morsi, and avoid an appearance of giving Hamas any sort of legitimacy on the world stage. The U.S. regards Hamas as a terrorist group and deals only with the Palestinian Authority of President Mahmoud Abbas, which controls the West Bank but has been relegated to the sidelines of the latest deadly clashes.

As Clinton winged her way to the troubled region, President Barack Obama—en route to Washington from a trip to Asia—spoke by telephone to Morsi from Air Force One, their third such conversation in 24 hours.

Obama "commended President Morsi's efforts to pursue a de-escalation," Deputy National Security Adviser Ben Rhodes told reporters aboard the presidential plane. "And he also underscored that President Morsi's efforts reinforce the important role that President Morsi and Egypt play on behalf of regional security and the pursuit of broader peace between the Palestinians and Israelis."

Morsi, whose country shares a peace accord with Israel and a border with Gaza, is thought to have sway with Hamas.

Clinton was to stop in Jerusalem for talks with Israeli Prime Minister Benjamin Netanyahu, in Ramallah to meet with Abbas and in Cairo for discussions with Morsi. State Department spokeswoman Victoria Nuland said Clinton aimed for a "de-escalation of violence and a durable outcome that ends the rocket attacks on Israeli cities and towns and restores a broader calm."

American officials have been leery of using the term "cease-fire," preferring variations on "de-escalation" of the conflict.

Clinton's visit came as the political battle over the Sept. 11 terrorist attack on the American compound in Benghazi, Libya, clouded the debate over who will succeed her.

Republicans have accused the Obama administration of covering up the role of suspected extremists in the assault, and questioned whether Clinton's State Department correctly handled requests for more security at the site. The president's foes have targeted Susan Rice, the U.S. ambassador to the United Nations, who at the request of the White House in several television interviews incorrectly tied the attack to protests sparked by an Internet video that ridiculed Islam.

The Benghazi strike claimed the lives of Ambassador Chris Stevens and three other Americans. It has also highlighted the uncertain fate of so-called Arab spring countries—like Egypt—where popular movements swept aside decades-old authoritarian regimes.

Ahead of Clinton's visit, the White House renewed its support for Israel's military operations but hinted at disapproval of a possible ground offensive. Netanyahu's government has called up thousands of troops in what could be preparations for such an onslaught.

Rhodes told reporters the U.S. would prefer to see the Israelis work "diplomatically and peacefully" to resolve the crisis, noting both Palestinian and Israeli civilians would be at risk in the event of a ground assault.

Clinton's stop in Ramallah underscored a diplomatic peculiarity of her trip: Top U.S. officials regard the Palestinian Authority as such minor players in the current crisis, neither Obama nor Clinton have spoken to Abbas since the violence escalated nearly a week ago.

While Clinton by Monday had reached out to leaders—including Jordan's King Abdullah; the foreign ministers of Israel, Egypt, France and Turkey; Egypt's prime minister; and U.N. Secretary-General Ban Ki-moon—she had not spoken to Abbas.

By refusing to deal directly with Hamas and reaching out to the Palestinian Authority instead, Clinton appeared to be trying to resolve the conflict without involving one of the key participants.

Rhodes on Tuesday reiterated U.S. conditions for dealing directly with Hamas: The group must renounce terrorism and recognize Israel's right to exist.

He also defended Clinton's trip to Ramallah, calling it a worthwhile investment "both as it relates to what's happening in Gaza and our efforts going forward to improve the situation in Gaza, but also in terms of our broader efforts to pursue peace between the Israelis and Palestinians."

Rhodes's message was implicit but unmistakable:  If the Palestinians want a lasting peace deal, they should align with the Palestinian Authority and not with Hamas or other extremist groups.

The U.S. has for years been steadfast in its posture toward Hamas. Massachusetts Sen. John Kerry, a top contender for Clinton's job, did not talk to Hamas when he made a surprise visit to Gaza in January 2009.

Clinton headed to the Middle East after traveling to Asia with Obama on what aides to both expected would be their final joint trip overseas, including a history-making stop in Myanmar.

Aboard Air Force One on a flight between Rangoon and Cambodia, the one-time political rivals sat in Obama's private office sharing memories of their work together.

"As the president said, it wasn't just the last four years; they have been through a lot together over the last five or six years," Rhodes said. "But right now there is urgent business to be done."

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