Syrian army on offensive in Aleppo after university blast


BEIRUT (Reuters) - Syrian armed forces launched a renewed offensive in the northern city of Aleppo on Wednesday, state media said, a day after 87 people were killed in explosions at the city's university.


The state news agency SANA said the military had killed dozens of "terrorists" - a term Damascus uses for rebels trying to overthrow President Bashar al-Assad - in the new fighting.


Reuters cannot independently verify reports due to media restrictions in Syria.


"The Armed Forces carried out several special operations against the mercenary terrorists in Aleppo and its countryside, inflicting heavy losses upon them in several areas," SANA said.


Aleppo is split roughly in half between government and rebel forces. SANA said dozens of "terrorists" were killed in the rebel strongholds of Sukari, Bab al-Hadeed and Bustan al-Qasr.


Government forces also killed militants in al-Laramon, a area of Aleppo from which Damascus says two rockets were fired into the University of Aleppo on Tuesday, it added.


If confirmed, the government's report of a rocket attack would suggest rebels in the area had been able to obtain and deploy more powerful weapons than previously used.


The Syrian Observatory for Human Rights, a Britain-based monitoring group, said 87 people were killed and dozens wounded in the explosions, but it could not identify the source of the blasts. It said the toll could rise to more than 100 as there were still body parts that were unaccounted for.


State television showed a body lying on the street and burning cars. An entire facade of a multi-story university building had crumbled and cars were overturned. An interior shot of a corridor showed that the ceiling had caved in.


Amateur video footage showed students carrying books out of the university after one of the explosions, walking quickly away from rising smoke. The camera then shakes to the sound of another explosion and people begin to run.


Syria has been plunged into bloodshed since a violent government crackdown in early 2011 on peaceful demonstrations for democratic reform which turned the unrest into an armed insurgency bent on overthrowing Assad.


Each side in the 22-month-old conflict blamed the other for Tuesday's blasts at the university, located in a government-held area of Syria's most populous city.


Some activists in Aleppo said a government air strike caused the explosions, while state television accused terrorists of firing two rockets at the university. A rebel fighter said the blasts appeared to have been caused by surface-to-surface missiles.


The nearest rebel-controlled area, Bustan al-Qasr, is more than a mile away from the university.


The Observatory said rebel sources on the ground reported they were fighting with government forces in the early hours of Wednesday around Bustan al-Qasr, implying a renewed push by government forces to expel the insurgents.


(Reporting by Oliver Holmes; Editing by Jon Boyle)



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Japan mulling military equipment near disputed isles






TOKYO: Japan may station military equipment on islands near an archipelago at the centre of a dispute with China, officials said Wednesday, after a number of airborne near-confrontations.

The defence ministry will ask for money in the next fiscal year to study the idea of putting mobile radars and communication systems on islands near the Japan-controlled Senkakus, which Beijing calls the Diaoyus, a defence spokesman said.

"The study is part of our plan to operate in southwestern islands with flexibility," the spokesman said.

The comment came after reports said Japan is considering permanently stationing F-15 fighter jets on Shimoji, a small island near the Senkakus.

Defence Minister Itsunori Onodera denied that and said Tuesday: "We are studying various options as to how to build a sound security system in our southwestern waters."

The maritime dispute, which has simmered for years, heated up last year when the Japanese government nationalised some of the islands, triggering anger and demonstrations in China.

Observers said the protests had some backing from communist authorities in Beijing, who use nationalism to bolster their claims to legitimacy.

Tokyo's defence ministry has said F-15s were sent airborne to head off Chinese state-owned -- but not military -- planes four times in December, including one occasion when Japanese airspace was breached.

They were also mobilised in January, it said.

On the occasion when Japan says its airspace was breached, the air force did not detect the Chinese aircraft, which had already moved off by the time fighter jets were scrambled.

- AFP/ir



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Salman Khurshid Trust case: HC seeks inquiry report from EOW

LUCKNOW: The Lucknow bench of the Allahabad high court on Wednesday, ordered the investigating agency Economic Offences Wing (EOW), Uttar Pradesh (UP) police, to present its report on the inquiry done so far into allegations of anomalies in the Salman Khurshid Trust case on February 1.

The order was passed by a division bench comprising Justice Uma Nath and Justice Satish Chandra on a public interest litigation (PIL) filed by social activist Nutan Thakur.

In her PIL, filed on October 15 last year, Thakur had demanded registration of a case on the basis of the charges levelled against the Zakir Hussain Trust run by union minister Salman Khurshid and his wife Louise.

Thakur had also expressed doubt over free and fair inquiry into the allegations under present political circumstances, hence she has asked the court to supervise the probe.

After hearing the PIL, the court on October 18 directed the news channel 'Aaj Tak' to present relevant documents and CD of its sting operation which exposed the alleged anomalies. The channel submitted the documents and the CD in a sealed cover before the court on Wednesday.

The PIL was filed after allegations of anomalies in the distribution of aid to disabled people were levelled against Khurshid's Trust.

The state government had also ordered the EOW to probe the matter. However, social activist Arvind Kejriwal had then also raised questions over the fairness of the EOW probe and had accused the Akhilesh Yadav government of trying to shield Khurshid.

Six parties, including state government through principal secretary home, EOW, central government through ministry of social justice, principal secretary social welfare UP, Aaj Tak through editor India Today group and Dr Zakir Hussain Memorial Trust, were made respondents in the PIL.

Appearing on behalf of the union government, senior counsel Vivek Tankha had then claimed that it was a proxy PIL filed in a casual manner to malign and scandalise a person.

On behalf of the state government, additional advocate general Bulbul Godiyal had also raised objections regarding the maintainability of the PIL. However, the petitioner counsel Ashok Pandey had then argued that investigation should be done after lodging an FIR.

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ER visits tied to energy drinks double since 2007


SAN FRANCISCO (AP) — A new government survey suggests the number of people seeking emergency treatment after consuming energy drinks has doubled nationwide during the past four years, the same period in which the supercharged drink industry has surged in popularity in convenience stores, bars and on college campuses.


From 2007 to 2011, the government estimates the number of emergency room visits involving the neon-labeled beverages shot up from about 10,000 to more than 20,000. Most of those cases involved teens or young adults, according to a survey of the nation's hospitals released late last week by the Substance Abuse and Mental Health Services Administration.


The report doesn't specify which symptoms brought people to the emergency room but calls energy drink consumption a "rising public health problem" that can cause insomnia, nervousness, headache, fast heartbeat and seizures that are severe enough to require emergency care.


Several emergency physicians said they had seen a clear uptick in the number of patients suffering from irregular heartbeats, anxiety and heart attacks who said they had recently downed an energy drink.


More than half of the patients considered in the survey who wound up in the emergency room told doctors they had downed only energy drinks. In 2011, about 42 percent of the cases involved energy drinks in combination with alcohol or drugs, such as the stimulants Adderall or Ritalin.


"A lot of people don't realize the strength of these things. I had someone come in recently who had drunk three energy drinks in an hour, which is the equivalent of 15 cups of coffee," said Howard Mell, an emergency physician in the suburbs of Cleveland, who serves as a spokesman for the American College of Emergency Physicians. "Essentially he gave himself a stress test and thankfully he passed. But if he had a weak heart or suffered from coronary disease and didn't know it, this could have precipitated very bad things."


The findings came as concerns over energy drinks have intensified following reports last fall of 18 deaths possibly tied to the drinks — including a 14-year-old Maryland girl who died after drinking two large cans of Monster Energy drinks. Monster does not believe its products were responsible for the death.


Two senators are calling for the Food and Drug Administration to investigate safety concerns about energy drinks and their ingredients.


The energy drink industry says its drinks are safe and there is no proof linking its products to the adverse reactions.


Late last year, the FDA asked the U.S. Health and Human Services to update the figures its substance abuse research arm compiles about emergency room visits tied to energy drinks.


The Substance Abuse and Mental Health Services Administration's survey was based on responses it receives from about 230 hospitals each year, a representative sample of about 5 percent of emergency departments nationwide. The agency then uses those responses to estimate the number of energy drink-related emergency department visits nationwide.


The more than 20,000 cases estimated for 2011 represent a small portion of the annual 136 million emergency room visits tracked by Centers for Disease Control and Prevention.


The FDA said it was considering the findings and pressing for more details as it undertakes a broad review of the safety of energy drinks and related ingredients this spring.


"We will examine this additional information ... as a part of our ongoing investigation into potential safety issues surrounding the use of energy-drink products," FDA spokeswoman Shelly Burgess said in a statement.


Beverage manufacturers fired back at the survey, saying the statistics were misleading and taken out of context.


"This report does not share information about the overall health of those who may have consumed energy drinks, or what symptoms brought them to the ER in the first place," the American Beverage Association said in a statement. "There is no basis by which to understand the overall caffeine intake of any of these individuals — from all sources."


Energy drinks remain a small part of the carbonated soft drinks market, representing only 3.3 percent of sales volume, according to the industry tracker Beverage Digest. Even as soda consumption has flagged in recent years, energy drinks sales are growing rapidly.


In 2011, sales volume for energy drinks rose by almost 17 percent, with the top three companies — Monster, Red Bull and Rockstar — each logging double-digit gains, Beverage Digest found. The drinks are often marketed at sporting events that are popular among younger people such as surfing and skateboarding.


From 2007 to 2011, the most recent year for which data was available, people from 18 to 25 were the most common age group seeking emergency treatment for energy drink-related reactions, the report found.


"We were really concerned to find that in four years the number of emergency department visits almost doubled, and these drinks are largely marketed to younger people," said Al Woodward, a senior statistical analyst with the Substance Abuse and Mental Health Services Administration who worked on the report.


Emergency physician Steve Sun said he had seen an increase in such cases at the Catholic hospital where he works on the edge of San Francisco's Golden Gate Park.


"I saw one young man who had mixed energy drinks with alcohol and we had to admit him to the hospital because he was so dehydrated he had renal failure," Sun said. "Because he was young he did well in the hospital, but if another patient had had underlying coronary artery disease, it could have led to a heart attack."


___


Follow Garance Burke on Twitter at http://twitter.com/garanceburke


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NRA Ad Calls Obama 'Elitist Hypocrite'


Jan 16, 2013 12:04am







ap barack obama mi 130115 wblog NRA Ad Calls Obama Elitist Hypocrite Ahead of Gun Violence Plan

Pablo Martinez Monsivais/AP Photo


As the White House prepares to unveil a sweeping plan aimed at curbing gun violence, the National Rifle Association has launched a preemptive, personal attack on President Obama, calling him an “elitist hypocrite” who, the group claims, is putting American children at risk.


In 35-second video posted online Tuesday night, the NRA criticizes Obama for accepting armed Secret Service protection for his daughters, Sasha and Malia, at their private Washington, D.C., school while questioning the placement of similar security at other schools.


“Are the president’s kids more important than yours? Then why is he skeptical about putting armed security in our schools, when his kids are protected by armed guards at their school?” the narrator says.


“Mr. Obama demands the wealthy pay their fair share of taxes, but he’s just another elitist hypocrite when it comes to a fair share of security,” it continues. “Protection for their kids and gun-free zones for ours.”


The immediate family members of U.S. presidents – generally considered potential targets – have long received Secret Service protection.


The ad appeared on a new website for a NRA advocacy campaign – “NRA Stand and Fight” — that the gun-rights group appears poised to launch in response to Obama’s package of gun control proposals that will be announced today.


It’s unclear whether the video will air on TV or only on the web. The NRA did not respond to ABC News’ request for comment.  The domain for the website is registered to Ackerman McQueen, the NRA’s long-standing public relations firm.


The White House had no comment on the NRA ad.


In the wake of last month’s mass shooting at Sandy Hook Elementary School, the Obama administration has met with a cross-section of advocacy groups on all sides of the gun debate to formulate new policy proposals.


The NRA, which met with Vice President Joe Biden last week, has opposed any new legislative gun restrictions, including expanded background checks and limits on the sale of assault-style weapons, instead calling for armed guards at all American schools.


Obama publicly questioned that approach in an interview with “Meet the Press” earlier this month, saying, “I am skeptical that the only answer is putting more guns in schools. And I think the vast majority of the American people are skeptical that that somehow is going to solve our problem.”


Still, the White House has been considering a call for increased funding for police officers at public schools and the proposal could be part of a broader Obama gun policy package.


Fifty-five percent of Americans in the latest ABC News/Washington Post poll say they support adding armed guards at schools across the country.


“The issue is, are there some sensible steps that we can take to make sure that somebody like the individual in Newtown can’t walk into a school and gun down a bunch of children in a shockingly rapid fashion.  And surely, we can do something about that,” Obama said at a news conference on Monday.


“Responsible gun owners, people who have a gun for protection, for hunting, for sportsmanship, they don’t have anything to worry about,” he said.


ABC News’ Mary Bruce and Jay Shaylor contributed reporting. 



SHOWS: Good Morning America World News







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France steps up Mali operation, Africans try to catch up


BAMAKO (Reuters) - France hit Islamist rebels in Mali with fresh air strikes and deployed armored cars on Tuesday, stepping up its intervention in the West African state as regional allies struggled to accelerate their plans to send in troops.


Paris has poured hundreds of soldiers into Mali and carried out air raids since Friday in the northern half of the country, which was seized last year by an Islamist alliance combining al Qaeda's north African wing AQIM with Mali's home-grown MUJWA and Ansar Dine rebel groups.


Western and regional states fear the insurgents will use Mali's north, a vast and inhospitable area of desert and rugged mountains the size of Texas, as a base for attacks on the African continent and also in Europe.


West African defense chiefs were meeting in the Malian capital Bamako on Tuesday to approve plans for speeding up the deployment of 3,300 regional troops, foreseen in a United Nation-backed intervention plan to be led by Africans. France sent its forces into Mali last week to block a surprise southwards push by the rebels.


Speaking during a visit to the United Arab Emirates, President Francois Hollande said French forces carried out further air strikes overnight in Mali "which hit their targets".


"We will continue the deployment of forces on the ground and in the air," Hollande said. "We have 750 troops deployed at the moment and that will keep increasing so that as quickly as possible we can hand over to the Africans."


A column of French armored vehicles rumbled into the dusty riverside capital overnight. The vehicles, which had driven up from a French base in Ivory Coast, were expected to move northwards eventually towards the combat zone.


France's defense ministry has said it plans to deploy 2,500 soldiers in its former colony to bolster the Malian army and work with the intervention force provided by the ECOWAS grouping of West African states.


Hollande saw the ECOWAS deployment taking "a good week".


There are some concerns that a delay in following up on the French air bombardments of Islamist bases and fuel depots with a ground offensive could allow the insurgents to slip away into the desert and mountains, regroup and counter-attack.


The rebels, who French officials say are mobile and well-armed, have shown they can hit back, dislodging government forces from Diabaly, 350 km (220 miles) from Bamako on Monday.


Foreign Minister Laurent Fabius, accompanying Hollande, said the offensive against the Malian rebels could take some time, and the current French level of involvement could last weeks.


Gulf Arab states would also help the Mali campaign, Fabius added, and there would be a meeting of donors for the operation most likely in Addis Ababa at the end of January.


QUESTIONS OVER READINESS


ECOWAS mission head in Bamako Aboudou Toure Cheaka said the West African troops would be on the ground in a week. Their immediate mission would be to help stop the rebel advance while preparations for a full intervention plan continued.


The original timetable for the 3,300-strong U.N.-sanctioned African force - to be backed by western logistics, money and intelligence services - did not initially foresee full deployment before September due to logistical constraints.


Senegal, Burkina Faso, Niger, Nigeria and Guinea have all offered troops. But regional powerhouse Nigeria, which is due to lead the mission, has cautioned that even if some troops arrive in Mali soon, their training and equipping will take more time.


Nigerian President Goodluck Jonathan told foreign diplomats in Abuja late on Monday that the Nigerian contingent would be in Mali before next week. "We can no longer surrender any part of the globe to extremism," he said.


But Sub-Saharan Africa's top oil producer, which already has hundreds of peacekeepers in Sudan's Darfur and is fighting a bloody and difficult insurgency at home against Islamist sect Boko Haram, could struggle to deliver on its troop commitment.


One senior government adviser in Nigeria said the Mali deployment was stretching the country's military.


"The whole thing's a mess. We don't have any troops with experience of those extreme conditions, even of how to keep all that sand from ruining your equipment. And we're facing battle-hardened guys who live in those dunes," the adviser said, asking not to be named because of the sensitivity of the subject.


Security experts have warned that the multinational intervention in Mali, couched in terms of a campaign by governments against "terrorism", could provoke a jihadist backlash against France and the West, and African allies.


U.S. officials have warned of links between AQIM, Boko Haram in Nigeria and al Shabaab Islamic militants fighting in Somalia.


Al Shabaab, which foiled a French effort at the weekend to rescue a French secret agent it was holding hostage, urged Muslims around the world to rise up against what it called "Christian" attacks against Islam.


"Our brothers in Mali, show patience and tolerance and you will win. War planes never liberate a land," Sheikh Ali Mohamud Rage, al Shabaab's spokesman, said in an audio statement posted on the rebel-run www.somaliamemo.net website


The ECOWAS deployment plan is being fast-tracked following a plea for help by Mali's government after mobile columns of Islamist fighters threatened last week the central Malian garrison towns of Mopti and Sevare, with its key airport.


U.N.: THOUSANDS FLEE FIGHTING


French Prime Minister Jean-Marc Ayrault said France's goals were to stop the rebels, to "safeguard the existence of Mali".


U.S. officials said Washington was sharing information with French forces in Mali and considering providing logistics, surveillance and airlift capability.


"We have made a commitment that al Qaeda is not going to find anyplace to hide," U.S. Defense Secretary Leon Panetta told reporters as he began a visit to Europe.


French intervention has raised the risk for eight French hostages held by al Qaeda allies in the Sahara and for 30,000 French expatriates living in neighboring, mostly Muslim states. Concerned about reprisals at home, France has tightened security at public buildings and on public transport.


The U.N. said an estimated 30,000 people had fled the latest fighting in Mali, joining more than 200,000 already displaced.


U.N. Secretary-General Ban Ki-moon welcomed on Monday the French-led military intervention in Mali and voiced the hope that it would halt the Islamist assault.


Amnesty International said at least six civilians were killed in recent fighting in the town of Konna, where French aircraft had earlier bombarded rebel positions, and called on both sides to spare non-combatants.


France, which has repeatedly said it has abandoned its role as the policeman of its former African colonies, convened a U.N. Security Council meeting Monday to discuss the crisis.


French U.N. Ambassador Gerard Araud told reporters after the meeting that the United States, Canada, Belgium, Denmark and Germany had also offered logistical support for France's Mali operation.


(Additional reporting by Elizabeth Pineau and Raissa Kasolowsky in Abu Dhabi; Felix Onuah in Abuja and Tim Cocks in Lagos; Abdi Sheikh in Mogadishu; Michelle Nichols Louis Charbonneau at the United Nations; Richard Valdmanis in Dakar; Writing by Pascal Fletcher; editing by David Stamp)



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Extended smoking ban takes effect






SINGAPORE: The extended smoking ban in public areas kicked in on Tuesday.

The National Environment Agency (NEA) said it will step up spot checks by about 70 per cent after three months, which is some 8,000 additional hours per month.

In a spot check at Toa Payoh MRT station on Tuesday, seven smokers were caught in an hour for smoking where they were not supposed to.

Smokers are now not allowed to light up at the common areas of all residential buildings, covered linkways and walkways, overhead pedestrian bridges, as well as within a five-metre radius of bus shelters.

For the first three months of the new ban, the NEA said it will take on a more advisory approach.

But come April 15, first time offenders will be fined S$200, while repeat offenders could be fined as much as S$1,000.

Eileen Yap, a NEA inspector, said: "We realise that the public in general are not aware of such bans and the awareness level is not so high in the beginning, so in these three months, NEA will be advising smokers and we'll be working with the community in general to create awareness, so that everyone can have cleaner air."

Smokers hope the NEA will exercise some flexibility when it comes to enforcing the ban.

A smoker, who did not reveal his name, said: "We can't be smoking outside when it's raining or pouring. So they have to fine tune the balance. They probably have to list down under what circumstance it's forgivable, or if there is a second chance, or if not they have to find a solution - a sheltered smoking area for example."

Last year, some 4,000 smokers were caught flouting the rules. This is 800 cases, or 17 per cent less than in 2011.

- CNA/xq



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PM has understood nation's mood, BJP says

NEW DELHI: The BJP lauded Prime Minister Manmohan Singh on Tuesday for talking tough with Pakistan, saying he had understood the mood of the nation after the brutal killing of two Indian soldiers.

Referring to the Jan 8 killing of two soldiers by Pakistanis near the Jammu and Kashmir border, BJP leader Sushma Swaraj said Manmohan Singh's "most important statement" was that there could no more business as usual with Islamabad.

She said the incident was "so barbaric" that the prime minister had "understood the mood of the country".

The Bharatiya Janata Party leader said she spoke to National Security Advisor Shivshankar Menon a day after the soldiers were killed by Pakistani troops.

One of the soldiers was beheaded and his head carried away, and the other soldier's body was mutilated.

Congress spokesman Manish Tewari said the government's future action -- diplomatic and tactical -- "should be left to the foreign office and the national security establishment".

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Hospitals crack down on workers refusing flu shots


CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.


"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.


Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.


Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.


In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.


Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.


Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.


"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."


Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."


Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.


"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."


For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.


A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.


At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.


The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."


The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.


According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.


The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.


Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.


Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.


Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.


Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.


Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.


While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.


Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.


Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.


Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.


"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.


Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.


Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.


Calhoun, the Illinois nurse, says she is unsure of her options.


"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."


__


Online:


R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf


CDC: http://www.cdc.gov


___


AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner


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Armstrong Admits Doping in Tour, Sources Say













Lance Armstrong today admitted to Oprah Winfrey that he used performance enhancing drugs to win the Tour de France, sources told ABC News.


A government source tells ABC News that Armstrong is now talking with authorities about paying back some of the US Postal Service money from sponsoring his team. He is also talking to authorities about confessing and naming names, giving up others involved in illegal doping. This could result in a reduction of his lifetime ban, according to the source, if Armstrong provides substantial and meaningful information.


Armstrong made the admission in what sources describe as an emotional interview with Winfrey to air on "Oprah's Next Chapter" on Jan. 17.


The 90-minute interview at his home in Austin, Texas, was Armstrong's first since officials stripped him of his world cycling titles in response to doping allegations.


Word of Armstrong's admission comes after a Livestrong official said that Armstrong apologized today to the foundation's staff ahead of his interview.


The disgraced cyclist gathered with about 100 Livestrong Foundation staffers at their Austin headquarters for a meeting that included social workers who deal directly with patients as part of the group's mission to support cancer victims.


Armstrong's "sincere and heartfelt apology" generated lots of tears, spokeswoman Katherine McLane said, adding that he "took responsibility" for the trouble he has caused the foundation.






Riccardo S. Savi/Getty Images|Ray Tamarra/Getty Images











Lance Armstrong Doping Confession: Why Now? Watch Video









Lance Armstrong Stripped of Tour de France Titles Watch Video







McLane declined to say whether Armstrong's comments included an admission of doping, just that the cyclist wanted the staff to hear from him in person rather than rely on second-hand accounts.


Armstrong then took questions from the staff.


Armstrong's story has never changed. In front of cameras, microphones, fans, sponsors, cancer survivors -- even under oath -- Lance Armstrong hasn't just denied ever using performance enhancing drugs, he has done so in an indignant, even threatening way.


Armstrong, 41, was stripped of his seven Tour de France titles and banned from the sport for life by the U.S. Anti-Doping Agency in October 2012, after allegations that he benefited from years of systematic doping, using banned substances and receiving illicit blood transfusions.


"Lance Armstrong has no place in cycling and he deserves to be forgotten in cycling," Pat McQuaid, the president of the International Cycling Union, said at a news conference in Switzerland announcing the decision. "This is a landmark day for cycling."


The U.S. Anti-Doping Agency issued a 200-page report Oct. 10 after a wide-scale investigation into Armstrong's alleged use of performance-enhancing substances.


Armstrong won the Tour de France from 1999 to 2005.


According to a source, speaking to ABC News, a representative of Armstrong's once offered to make a donation estimated around $250,000 to the agency, as "60 Minutes Sports" on Showtime first reported.


Lance Armstrong's attorney Tim Herman denied it. "No truth to that story," Herman said. "First Lance heard of it was today. He never made any such contribution or suggestion."


Armstrong, who himself recovered from testicular cancer, created the Lance Armstrong Foundation (now known as the LIVESTRONG Foundation) to help people with cancer cope, as well as foster a community for cancer awareness. Armstrong resigned late last year as chairman of the LIVESTRONG Foundation, which raised millions of dollars in the fight against cancer.






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