Most Afghan refugees want to remain in Pakistan

Monday 17 December 2012

Islamabad, Dec 17 : More than 1.6 million Afghan refugees registered in Pakistan are due to be repatriated by the end of the year. With just three weeks to go, however, a recent United Nations survey found that roughly 80 percent have no intention of returning to Afghanistan.

According to the U.N. survey, most Afghan families living in Pakistan feel Afghanistan is just not safe enough to go back home. Others cited the inability to earn a living and the lack of anywhere to live in their native country.

Pakistan's Minister for States and Frontier Regions Shaukat Ullah acknowledged the challenges involved in convincing refugees to return to their country after decades of living in Pakistan.

"After 32 years, if a person is returning from a country where he has been born and he is going to a country like Afghanistan, they will think 100 times," said Ullah.

Since the Taliban takeover of Afghanistan in the 1990s, Pakistan has hosted one of the largest refugee populations in the world. Some 3.8 million have crossed back over the border into Afghanistan.

The UNHCR has offered plastic buckets, soap, blankets, cash and a one-way ticket for those still living in Pakistan, and succeeded in encouraging another 72,000 people to return to Afghanistan this year.

But there still are 1.6 million official Afghan refugees here. UNHCR representative Neill Wright said the organization was waiting to hear what Pakistan has planned for these refugees after the December 31, 2012 deadline.

"I know that the government is very actively engaged in considering what its policy will be in terms of the management of Afghan refugees in 2013, and in terms of supporting this continued partnership that we have with Afghanistan over voluntary repatriation, and I look forward to hearing what that strategy will be," said Wright.

Responding to concerns that there will be another wave of refugees from Afghanistan after international combat forces leave the country in 2014, Wright said contingency plans are under consideration.

"This is clearly an issue that I am involved in discussions with many people, senior politicians, people in Afghanistan, members of the international community. Of course, when you do contingency planning, you look at a worst-case scenario and you look at a best-case scenario, and if you are sensible you will probably look at something in the middle," said Wright.

Many Afghan refugees live in very poor conditions in Pakistan. According to the UNHCR, less than one quarter of them work, and almost three quarters of Afghan children are not going to school.

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After 10 years of Karzai's rule, has life improved in Afghanistan?

Kabul, Dec 17 : Many Afghans see dark clouds of uncertainty looming over the calendar as the 2014 deadline approaches for most foreign troops to withdraw, and worry that after that the international community will abandon them.

Over the last decade, billions of aid dollars have flowed into Afghanistan, and thousands of foreign soldiers and tens of thousands of civilians have died during the effort to bring peace and a modicum of prosperity to the country. Meanwhile, the government of President Hamid Karzai has passed laws meant to improve the lives of his citizens. Nevertheless, Afghanistan still faces huge problems, such as widespread violence, official corruption, grinding poverty and a booming narcotics trade.

“Plagued by factionalism and corruption, Afghanistan is far from ready to assume responsibility for security when U.S. and NATO forces withdraw in 2014,” think tank International Crisis Group said in a recent report.Security The Taliban are regaining land and power lost after they were toppled by U.S.-backed forces in 2001.

While there have been more than 2,000 American military casualties during this time, civilians have borne the brunt of the violence. In the first six months of 2012 alone, more than 3,000 civilians were killed or injured, according the United Nations. This number was down 15 percent from a year earlier.

Anti-government and coalition insurgents were responsible for 80 percent of the civilian casualties, the U.N. says.More than 300,000 Afghan National Army soldiers and Afghan National Police members have been trained to replace foreign soldiers. Afghan security forces face big challenges, such as attrition, illiteracy and insurgent infiltration.

Poverty and corruption Most Afghans are not just living in fear of an insurgent attack or NATO airstrike. They fear hunger and worry that they and their families won’t survive another winter.

Afghans are among the poorest people on earth. According to the World Bank, per capita GDP was around $576 in 2011, up from $158 in 2002.

More than half of children under the age of five are malnourished, according to the World Food Program.

Afghanistan remains largely dependent on foreign aid – the World Bank says that 90 percent of the country’s national budget is still financed by governments and other foreign organizations.

Along with the huge inflows of foreign aid and poverty is corruption: the country is tied with Somalia and North Korea at the bottom of Transparency International’s Corruption Perception Index 2012.

A 2012 United Nations Office on Drugs and Crime report estimated that Afghans paid $2.5 billion in bribes over 12 months, which is equivalent to almost a quarter of the country’s GDP.

Women In 2001, Afghan women were the poster children for the invasion. Promises poured in to help half of the society that was brutalized and banished during the Taliban. Despite the pledges, Afghanistan remains one of the most difficult places in the world to be a woman: it has one of the highest levels of maternal mortality and, according to U.N. estimates, around 90 percent of women suffer from some sort of domestic abuse. Nevertheless, there has been some progress. In 2004, President Karzai signed into law a new constitution granting equality among all its citizens and ensuring women’s rights. And in 2009 the country passed the Elimination of Violence Against Women Law, intended to protect women from abuse, rape, and forced marriages. While the laws were all positive steps such legislation is rarely enforced. The ministry of women’s affairs in Kabul says that from April through July of this year at least 3,600 cases of violence against women were recorded. However, this grim number may be seen as a sign o
f progress because it means more families and women are learning about their rights and reporting their grievances.

Drugs Afghanistan has long-produced about 90 percent of the world's opium, a paste from the poppy plant that is mad into make heroin. At the end of the Taliban’s rule, the government worked with the U.N. to cut production by around 90 percent.

In the last decade, opium production increased again. It is now the largest source of export earnings and accounts for half of Afghanistan's GDP, according to humanitarian news site AlertNet.

All hope is not lost in Afghanistan, progress has been made in small steps rather than the giant leaps expected when United States-backed forces toppled the Taliban.

In 2001, girls were denied an education under the Taliban regime and only 900,000 children were enrolled in school throughout Afghanistan. Today, at least 7 million children are attending classes and 2.5-million are estimated to be girls, according to Amnesty International. In the cities, you see women in the workforce again, doctors, politicians and even business owners.

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The US is abandoning its loyal friends in Afghanistan

Kabul, Dec 17 : The United States has abandoned our most effective and loyal friends in Afghanistan by deliberately failing to implement the Afghan Allies Protection Act. In 2011, I served as the chief adviser on rule of law for the International Security Assistance Force in Kabul (ISAF).

I witnessed the heroism and steadfast courage of our Afghan employees as they resisted threats from the Taliban and from their own government. Now, as we draw down and leave them vulnerable, our government refuses to follow its own laws to save them.

The 2009 act provides up to 7,500 special immigrant visas for Afghans who worked for the United States for at least a year and who face an ongoing and serious threat to their safety. The U.S. Embassy resisted as soon as the law was passed, claiming that allowing these Afghans and their spouses and children to escape the threats to their lives would have a “deleterious impact” on the mission. The embassy also said it would require the strictest scrutiny of the applications, demanding “clear and convincing evidence” of the threat — a higher standard than that required by the law.

As a result, by mid-2011, no visas had been approved. As of today, 5,700 Afghans have applied for visas — and only 32 have been approved. To put this in context, since the start of our intervention in Afghanistan, more than 80 interpreters have been killed in combat.

During my time in Afghanistan, my duties included convincing the Afghan government to abide by its own laws. My country adviser, Abdul, provided invaluable assistance, interpreting my meetings with Afghan officials and giving me critical insight into Afghanistan’s tumultuous politics. Abdul — whom I do not identify further to lessen the risk to his life — had previously worked for USAID in one of the more dangerous rural areas of Afghanistan. As a result, one of his brothers was kidnapped for ransom by the Taliban. After Abdul moved to Kabul, he continued to face threats from both the Taliban and the Afghan government, who wanted him to reveal classified U.S. military information. He was followed around Kabul by elements of the security forces and the National Directorate of Security and received threatening phone calls from phone numbers in Iran and Pakistan.

One day, upon returning from work at ISAF, Abdul discovered a Taliban member in his house, searching for information. He called the police; they promptly arrested the intruder but then detained Abdul, his wife and his children for more than 12 hours. ISAF had to intervene to secure his release. The police allegedly took a bribe to release the Taliban member, and Abdul subsequently received dozens of death threats. In a separate incident, Abdul’s sister was detained by the Taliban, who called Abdul to try to force him to secure the release of insurgents from Afghan custody.

Abdul continues to work for the U.S. government, promoting democracy and the rule of law in Afghanistan. He and his family face death every day. More than a year ago, they applied for U.S. visas: They have not yet been approved.

I found it difficult to tell the Afghan government to obey its laws when it was clear to me that the United States was not doing the same. It is apparent that the State Department has no intention of implementing the Afghan Allies Protection Act to save Abdul, his family or the thousands of Afghans who help us every day.

This abject moral failure reflects poorly on us as a country and threatens our ability to recruit allies in the future. How will we prevent another Ben¬ghazi-style attack when no locals will work with us because we won’t protect them? How will we capitalize on the Arab Spring without locals to help us understand the local language and politics? How can we push other countries to observe the rule of law when we so clearly do not follow our own?

While I made it home safely, Abdul continues to face danger every day.

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Elf on the shelf gives children's hospital patients a Christmas treat

Washington, Dec 17 : The Elf on the Shelf is, of course, a Christmas tradition born from one Georgia family's annual ritual: The Elf came from the North Pole, appeared in a different spot each day and then flew home to the North Pole nightly to report back to Santa. It's now part of millions of families' Christmas each year around the world.

"We are inspired by the work they do with children," a spokesperson for the family-owned company told ABCNews.com. "We were delighted to be able to partner with them. The people who work with sick children are nearest and dearest to our hearts."

And just like that, in a bit of Christmas magic, last week 15 Elves - one for each of the hospital's 12 floors plus one for the family house, the same-day surgery facility and the hospital as a whole - arrived with Elf dust from the North Pole.

Ever since, the Elves' daily arrival from the North Pole, always in a different location on each floor, has been captivating patients like Kylie, a five-year-old in the hospital for a neurological operation.

"I met her as she was getting ready to go in for a surgical procedure, and she would have nothing to do with me," Jessica Kellough, one of the hospital's child life specialists, told ABCNews.com. "When I mentioned that our Elf had arrived that morning, she turned and looked at me and her eyes got really big and [it was the] first time I got a response from her. The only thing she wanted to do or talk about was finding the Elf."

"It's a huge motivator for her and it got her mind off her surgery," Kellough said, noting the nurses and therapists are also using the Elves with patients who are being rehabilitated, to get them up and moving in search of the Elves around the hospital.

"They all have them at home so they're excited to know that the Elves haven't forgotten them now that they're at the hospital," she said.

Elf on the Shelf has partnered with children's hospitals in the past, according to the company spokesman, but this is the first time the Elves have made their way from the North Pole to Le Bonheur.

Le Bonheur, which treats nearly 250,000 kids from across the country with all different ailments every year, is known for its innovative practices to keep patients stimulated - earlier this year the building's window washers dressed as real-life superheroes - and says they hope, like so many families, to make the Elf on the Shelf one of the hospital's annual traditions.

"Sometimes when you're at the hospital, especially around Christmas, some of the magic seems lost," Kellough said. "This year something seems different. Elf has brought back some of that magic this year. It's just been inspiring to see the power the Elf has had here."

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Cowboys nose tackle Joshua Brent charged with intoxicated vehicular manslaughter

New York, Dec 17: According to the Dallas Morning News, Dallas Cowboys nose tackle Joshua Brent has been arrested and charged with intoxicated vehicular manslaughter by the Irving Police Department following an accident on East State Highway 114 that claimed the life of Cowboys practice squad linebacker Jerry Brown.

According to the report, Brent was traveling at a high rate of speed when his vehicle "hit the outside curb", causing it to flip over and come to rest in the middle of the road. Brent was given a field sobriety test, which he failed, and had blood drawn at a local hospital before booked on the second-degree felony by the Irving PD. Tim MacMahon of ESPN.com reported that Brent was trying to drag Brown from the burning car when the police arrived on scene.

Brown was transported to a local hospital, where he was pronounced dead.

Sadly, this isn't the first time Brent has run afoul of the law in this kind of circumstance. The media reports that Brent was arrested in February of 2009 near the Illinois campus for driving under the influence, driving on a suspended license and speeding. Nobody was hurt in that case. Brent was also sentenced to two years probation, 200 hours of community service, and a fine of about $2,000. Per his plea deal, prosecutors dropped the aggravated DUI/no valid driver's license charge.

"We are deeply saddened by the news of this accident and the passing of Jerry Brown," Cowboys owner Jerry Jones said. "At this time, our hearts and prayers and deepest sympathies are with the members of Jerry's family and all of those who knew him and loved him."

Brown, 25, went undrafted in 2011 and began his professional career in the arena league before playing for the Hamilton Tiger-Cats of the Canadian Football League. Brown went to training camp in 2012 with the Indianapolis Colts and posted 10 tackles before he was waived and re-signed to the practice squad. Brown appeared in one game for the Colts, logging 11 special teams plays in a 35-9 loss to the New York Jets.

The Colts would waive Brown the following week and re-sign him to their practice squad. One week later, Brown's practice squad was terminated and he was signed by the Cowboys.

Colts general manager Ryan Grigson also issued a statement:

"On behalf of the entire Colts family, our sincerest condolences go out to Jerry's family and friends. He was a good teammate that was well liked by all. Today's tragic news is just another reminder of how fragile life is and how every day given is a gift."

Brent entered the NFL in 2010 when the Cowboys selected him in the seventh round of the 2010 Supplemental Draft. Brent served time in jail for misdemeanor DUI while a student-athlete at Illinois.

The 6-foot-2, 320-pound nose tackle totaled 16 tackles while playing in just under 25 percent of the Cowboys' defensive snaps in 2010, but was limited to 11 games and 13 percent of the defensive snaps in 2011. With starting nose tackle Jay Ratliff battling injuries throughout the season, Brent has started five of 12 games and played in over 41 percent of the Cowboys' defensive snaps, setting career-highs with 22 tackles and 1.5 sacks.

In an unrelated transaction, the Cowboys added defensive tackle Rob Callaway to the 53-man roster, placing cornerback Orlando Scandrick on injured reserve.

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Man accused of stealing same Bentley twice

Washington, Dec 17 : A California man apparently loved a Bentley so much that he allegedly stole it twice in the span of four days, police said.

Robert Ponti, 46, was first busted when deputies ran a registration check on a 2005 Bentley Coupe parked outside of a Jurupa Valley residence.

The registration check showed that the car had been stolen from the city of Brea while the owners were out of town, the Riverside County Sheriff's Office said in a news release.

Deputies watched Ponti and Johnny Villarreal, 37, get into the car and drive away. The pair were stopped and arrested.

The Bentley was taken to a tow yard, it was back on the road, parked outside the same residence where police had found it earlier in the week. Ponti is accused of fraudulently obtaining the luxury coupe from the tow yard.

The vehicle was recovered and Ponti was re-arrested. He faces charges, including possession of stolen property, fraud, forgery, perjury, and committing a felony while out on bail.

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China November inflation bounces off 33-month lows

Beijing, Dec 17 : China's annual consumer inflation rebounded from 33-month lows to 2 percent in November, dimming the chance for more monetary policy easing as its economy recovers.

The data missed analysts' expectations for November inflation to quicken to five-month highs of 2.1 percent from October's 1.7 percent. Food was the key driver of consumer prices last month, with vegetable prices jumping 11.3 percent.

"We expect consumer inflation to not see a big rebound until the first quarter of next year," said Jiang Chao, an analyst at Guotai Junan Securities in Shanghai.

"Therefore, the central bank may stick to its current policy stance and we see little chance of further (policy) loosening towards the year end."

Rebounding price pressures underscore signs that the world's second-biggest economy is turning the corner after a protracted cooldown and will prompt the central bank to focus on containing inflation risks, a policy priority in normal times.

As China's economy breaks away from central planning and as wages rise on average at least 10 percent each year, the central bank has warned inflation will be the biggest long-term risk, a point reiterated by Governor Zhou Xiaochuan last month.

November's data showed price momentum was gathering even in factories.

Factory-gate prices fell 2.2 percent in November from a year earlier, easing from October's 2.8 percent annual drop and boding well for firms struggling with falling profits. Analysts had forecast producer price deflation of 2 percent.

China's producer prices have dropped for nine straight months in reflection of an economic downturn stretching seven consecutive quarters on the back of wilting export growth and lethargic domestic demand.

Economic growth hit a low of 7.4 percent between July and September and is poised for the weakest annual showing this year since 1999.

But things are looking up due in part to policy easing by the central bank, and analysts expect a raft of data due at 0530 GMT to show the economy gained steam in November.

China's central bank cut interest rates twice in June and July and lowered banks' reserve requirement ratio (RRR) three times since late 2011, freeing an estimated 1.2 trillion yuan ($193 billion) for boosting loans.

But it has not cut interest rates or RRR since July and has instead added short-term cash to the banking system through open market operations, a move analysts say underlines its worries about consumer and property price inflation.

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US authorities probe SAC for Weight Watchers

New York, Dec 17: US authorities are investigating Steven A. Cohen's SAC Capital Advisors hedge fund for possible insider trading in the shares of the popular diet company Weight Watchers International Inc, according to people familiar with the matter.

The investigation focuses on trading in Weight Watchers shares in the first half of 2011, when SAC Capital had taken a sizeable position in the stock, and potentially could implicate the billionaire hedge fund manager, the sources said.

Regulatory filings show that Cohen's $14 billion fund briefly held 2.1 million shares in Weight Watchers during the period under scrutiny by authorities - at which time the diet company's stock price roughly doubled.

The inquiry is in its early stages and it is not clear whether anything improper was done either by SAC Capital or Cohen himself, said the people familiar with the matter, who requested anonymity. The trading in Weight Watchers would be permissible as long as it was based on fundamental research or derived from individuals who did not have access to non-public corporate information.

An SAC Capital spokesman said the firm was not aware of any investigation involving Weight Watchers. A spokeswoman for Manhattan U.S. Attorney Preet Bharara declined to comment. A spokesperson for Weight Watchers did not immediately respond to a request for comment.

The new line of pursuit ratchets up pressure on Cohen, 56, one of the hedge fund industry's most successful and best-known managers. The spotlight the probe casts on SAC Capital and Cohen could further rattle the hedge fund's investors, who account for roughly 40 percent of the firm's capital.

Two weeks ago, U.S. prosecutors charged a former SAC Capital employee, Mathew Martoma, with using inside information to generate profits and avoid losses totaling $276 million in shares of two drug stocks. The U.S. Securities and Exchange Commission also has formally warned SAC Capital that the firm could face civil charges.

A number of SAC's investors have said they have not made a decision on whether to redeem money from the firm. Investors have until mid-February to put in a redemption notice.

Martoma has not entered a plea but his lawyer has said he expects to be exonerated. SAC has declined to comment beyond saying, "Mr. Cohen and SAC are confident that they have acted appropriately."

Martoma is the seventh former SAC Capital employee to be charged or implicated by federal authorities for insider trading. The criminal complaint against Martoma, who last worked for CR Intrinsic, an affiliated fund of SAC Capital in 2010, for the first time alleges that Cohen personally approved the decision to sell-out of a big stake the hedge fund had in shares of Elan Corp and Wyeth, now part of Pfizer Inc.

Separately, U.S. authorities are also investigating SAC for suspicious trading in shares of biotech company InterMune Inc. in 2010, according to one of the people familiar with the probes. Officials at InterMune weren't immediately available for comment. The SAC spokesman declined to comment on the InterMune investigation.

Federal authorities have not charged Cohen, whose net worth is estimated by Forbes at about $8.8 billion as of September this year. The hedge fund manager has told his investors and 900 employees that neither he nor the firm has done anything improper in response to Martoma's arrest.

It's not clear what has prompted federal authorities to look into Stamford, Conn.-based SAC Capital's trading in shares of Weight Watchers. One of the people familiar with the investigation said authorities are looking at trading that both booked hefty profits and avoided losses for SAC Capital.

Over his 20 years in the business, Cohen has emerged as one of the pioneers of sophisticated trading. His funds, which charge some of the highest fees in the $2 trillion industry, has boasted an average annual return of 30 percent since launch in 1992.

This year, SAC Capital's main fund is up about 12 percent, compared to the industry average of just over 5 percent. SAC Capital's only down year was in 2008, when it lost 19 percent of its value.

Cohen has endured federal authorities looking into trading at his firm for about five years now. The investigation into SAC Capital ran parallel with the federal government's undercover investigation that led to the October 2009 arrest of Galleon founder Raj Rajaratnam, who was convicted by a federal jury on May 2011 on 14 counts of insider trading.

SAC Capital's big move into Weight Watcher's stock in early 2011 gained attention in part because it came at a time that the once-heavyset Cohen had lost about 20 pounds. (It's not clear if he used Weight Watchers.) The trader has said he lost the weight to help with a chronic bad back.

A first quarter 2011 regulatory filing for SAC Capital showed the firm had acquired 2.1 million shares of the stock. But by the end of the next quarter, a subsequent filing revealed the hedge fund had unloaded nearly all of those shares.

It is not uncommon for a rapid-fire trading firm like SAC Capital to move in and out stocks - even big positions. SAC Capital, in particular, is not known for holding stocks for a long time.

SAC Capital's trading strategy relies on analysts and portfolio managers gathering information about a company's prospects before making a trading decision. Cohen has told people privately he believes his firm has drawn unwanted scrutiny from the government because of its long history of success.

Cohen has become an avid art collector in recent years, with a number of Jeff Koons sculptures gracing the grounds of his 30-room mansion in Greenwich, Conn.

Cohen, who grew up on Long Island in Great Neck, New York, is also pursuing the kind of charitable legacy building done by other famous Wall Street money managers. In 2010, the North Shore-LIJ's pediatric hospital was renamed the Steven and Alexandra Cohen Children's Medical Center of New York, after Cohen and his second wife in recognition of their donations.

More recently, he took a minority ownership stake in the New York Mets baseball team after failing to win the rights to buy another team, the Los Angeles Dodgers.

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Investors offer about $38.8 billion in Greek debt buyback

Athens, Dec 17 : Greece is set to purchase back about half of its debt owned by private investors, broadly succeeding in a bond buyback that is key to the country's international bailout, a Greek government official said.

Greek and foreign bondholders offered the targeted 30 billion euros ($38.8 billion) in the deal, which is central to efforts by Greece's euro zone and International Monetary Fund lenders to cut its debt to manageable levels.

"The buyback went well in broad terms. The amount offered by investors was within the range expected, about 30 billion euros," the official said on condition of anonymity. He did not provide more details.

No formal announcement is expected, another official said.

The buyback accounts for about half of a broader, 40-billion euro EU/IMF debt relief package for Athens agreed in November. The package broadly doubles the average maturity of its rescue loans to almost 30 years and cuts its interest rates by one percentage point to a level far below 1 percent.

Under its terms, Athens will spend up to 10 billion euros of borrowed money to buy back bonds with a nominal value of about 30 billion euros. This is nearly half the 63 billion euros of Greek debt held by private investors eligible for the plan.

Since the bonds are to be bought far below their nominal value, the country's net debt burden would fall by about 20 billion euros.

A successful buyback will ensure that the IMF, which contributes about a third of Greece's bailout loans, will stay on board of the rescue. It would also unlock the payment of 34.4 billion euros of aid later this month.

Athens badly needs that money to refloat its ailing economy by replenishing the capital of its cash-strapped banks and settle arrears with government suppliers.

The EU and the IMF have been withholding rescue payments to Greece for six months because it had fallen short of promises to shore up its finances, privatize and make its economy more competitive.

Athens has received 148.6 billion euros in EU/IMF funds since May 2010. It stands to get almost 90 billion euros more by the end of 2014.

But the rescue comes at a heavy price. Austerity measures taken in exchange for aid have plunged the country into economic depression. Unemployment hit a record 26 percent in September, the highest in the euro zone.

The economy is going through its fifth consecutive year of recession and is expected to have shrunk by 24 percent when recovery begins in 2014.

The buyback was expected to go well after Greek banks, which hold about 17 billion euros of bonds, announced shortly before a deadline they would take part. Two Cypriot lenders also said they would offer their bonds.

Foreign investors have offered between 15 and 16 billion euros worth of bonds, Greek newspapers reported, citing initial estimates without saying how they got them.

Athens' hopes of drawing enough investors to the scheme grew after it announced better-than-expected terms, with price ranges at a premium over market prices.

The price range varied from a minimum of 30.2 to 38.1 percent and a maximum of 32.2 to 40.1 percent of the principal amount, depending on the maturities of the 20 series of outstanding bonds.

Hedge funds, which bought the debt at rock-bottom prices when it was feared the country would exit the euro, are estimated to hold a large part of Greek debt and the offer was seen as good enough to make them a nice profit.

"Athens put forth a reasonable if not generous offer for hedge funds to participate," Sassan Ghahramani, CEO at New York-based Macro Advisers, a hedge fund consultancy, said.

"I expect there will be strong participation from hedge funds, tendering a substantial portion of their Greek bond holdings," he said.

The government also enticed Greek bankers by offering to protect them from possible shareholder lawsuits stemming from the buyback.

Greek bankers had been reluctant to take part, in the fear they would book losses on top of the ones they incurred earlier this year when Athens enforced a debt cut on its bondholders.

But the lenders were nevertheless expected to participate because they depend on the bailout funds that Athens stands to receive if its bailout continues smoothly.

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Decades-old treatment guidelines for anorexia challenged

Islamabad, Dec 17 : Adolescents hospitalized with anorexia nervosa who receive treatment based on current recommendations for refeeding fail to gain significant weight during their first week in the hospital, according to a new study by UCSF researchers.

The findings, published in the Journal of Adolescent Health with an accompanying editorial, challenge the current conservative approach to feeding adolescents with anorexia nervosa during hospitalization for malnutrition.

The American Psychiatric Association, American Dietetic Association and others recommend starting with about 1,200 calories per day and advancing slowly by 200 calories every other day. This "start low and go slow" approach is intended to avoid refeeding syndrome -- a potentially fatal condition resulting from rapid electrolyte shifts, a well-known risk when starting nutrition therapy in a starving patient.

The UCSF study is the first to test these recommendations, which have been in place since 2000. "Our findings show that the current recommendations are just not effective," said Andrea Garber, PhD, RD, associate professor of pediatrics in the Division of Adolescent Medicine at UCSF, who led the research with colleagues in the UCSF Adolescent Eating Disorders Program.

Study participants were hospitalized due to signs of malnutrition, including low body temperature, blood pressure, heart rate and body mass index. The vast majority of the 35 primarily white, female adolescent patients received low calorie diets based on the current recommendations. Patients were fed six small meals per day, and when they refused food, they were given high calorie liquid supplements as a replacement. The patients' vital signs were monitored closely, with their heart rates measured continuously and electrolytes checked twice a day.

While the low calorie diets did prevent refeeding syndrome for those patients, about 83 percent of them also experienced significant initial weight loss and no overall weight gain until their eighth day in the hospital. This finding represents "a missed opportunity," according to Garber.

"Studies show that weight gain during hospitalization is crucial for patients' long-term recovery," she said, "we have to make the most out of their short time in the hospital."

Although 94 percent of patients in the study started on fewer than 1,400 calories a day, it included a range of diets from 800 to 2,200 calories. This range allowed the researchers to examine the effect of increasing calories. According to Garber, two important findings emerged:

The calorie level of the starting diet predicted the amount of weight that would be lost in the hospital. In other words, those on lower calorie diets lost significantly more weight.

Higher calorie diets led to less time in the hospital. In fact, Garber said, "we showed that for every 100 calories higher, the hospital stay was almost one day shorter."

While the study finds that current recommendations are too cautious, it raises other questions, according to the research team. For example, while a shorter hospital stay may reduce insurance costs, patients may not be ready to go home yet.

"Shorter is not necessarily better" said Garber. "We have to consider the potential implications down the line, both psychological and emotional."

Another unanswered question relates to refeeding syndrome, which remains "a very real fear," according to Barbara Moscicki, MD, a professor of pediatrics in the Division of Adolescent Medicine at UCSF and senior author on the paper. Moscicki says that the team is proceeding cautiously since more aggressive approaches to feeding and supplementation have not yet been well studied.

Nevertheless, the researchers say that the study results are a promising start because no adverse events were seen in the study subjects on the higher calorie diets. "If we can improve weight gain with higher calories," Garber said, "then we're on the right path."

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Daily wheezing treatment no different from intermittent in toddlers

Islamabad, Dec 17 : Pediatricians often treat young children who have frequent bouts of wheezing with a daily dose of an inhaled steroid to keep asthma symptoms at bay. But results of a recent study are likely to change that.

Washington University School of Medicine in St. Louis, found that daily inhaled steroid treatment was no different from preventing wheezing episodes than treating the child with higher doses of the drug at the first signs of a respiratory tract infection. They also found that daily treatment was comparable to use of the inhaled steroid intermittently at decreasing the severity of respiratory-tract illnesses, reducing the number of episode-free days or school absences, lowering the need for a "rescue" inhaler for acute asthma symptoms, improving quality of life or reducing visits to urgent care or the emergency room.

The researchers, who make up the National Institutes of Health (NIH)-funded Childhood Asthma Research and Education (CARE) Network, studied nearly 300 preschool-age children with frequent wheezing and at high risk for future persistent asthma in a trial called MIST (Maintenance and Intermittent Inhaled Corticosteroids in Wheezing Toddlers). Their findings are published in The New England Journal of Medicine.

"We wanted to understand how to best treat young children who have repeated episodes of wheezing, most of whom appear symptomatic just when they have colds," says Leonard B. Bacharier, MD, a Washington University pediatric asthma and allergy specialist at St. Louis Children's Hospital. "Our goal was to start therapy at the first signs of a viral respiratory tract infection or cold to interrupt or slow the progression of symptoms. This trial was aimed to try to prevent wheezing severe enough that requires oral steroids and really gets in the way of children's lives."

A 2006 study by the same group of researchers, called the PEAK trial (Prevention of Early Asthma in Kids) found that daily treatment was effective in reducing episodes of wheezing requiring oral steroids. However, physicians and parents reported concerns about the drug's effects on growth and are often reluctant to follow the treatment plan, so the researchers began to look for an alternative.

Children in the yearlong MIST trial were between 12 months and 53 months old, had recurrent wheezing and were at high risk for a worsening of asthma-like symptoms that could require treatment with oral steroids and/or a visit to urgent care or emergency room. During the trial, the children received either a dose of budesonide once a day through a nebulizer or an inactive placebo. At the first signs of a respiratory tract illness, those children who received the inactive placebo received a higher dose of budesonide twice a day, while those who received daily budesonide received a placebo twice daily and kept taking their regular budesonide. Neither the patients nor the physicians knew who received the active drug until the trial was over.

During the study, parents were asked to keep a daily diary of symptoms, such as coughing, wheezing, difficulty breathing or other symptoms that interfered with normal activities, as well as a list of medications, visits to a health-care provider or absences from daycare or school.

Because previous studies had shown that daily inhaled corticosteroid therapy was more effective than placebo, the researchers expected to see the same in the MIST trial. But that's not what they found.
"The two groups were comparable in terms of episodes requiring oral steroids, symptom days, albuterol use and the time before oral steroids were needed," Bacharier says. "All of the relevant indicators of disease activity were comparable."

The results show there are a variety of treatments physicians can consider for children with frequent wheezing, Bacharier says.

"While daily therapy continues to be the recommended approach, in this group of children, whose disease is really evident only during respiratory tract illnesses with very few or no symptoms outside of that, instructing parents to treat them at the earliest signs of illness with a high dose of inhaled steroid diminishes the likelihood of an episode of illness requiring oral steroids comparable to giving them daily therapy," Bacharier says.

Washington University School of Medicine enrolled 75 children at St. Louis Children's Hospital. The other centers participating in the trial were the University of California, San Diego; University of Wisconsin-Madison; University of Arizona; National Jewish Health and University of Colorado School of Medicine; University of New Mexico School of Medicine; University of Wisconsin School of Medicine and Public Health, Milwaukee, Wis.

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Test for Alzheimer's disease predicts cognitive decline in parkinson's disease

Islamabad, Dec 17 : A method of classifying brain atrophy patterns in Alzheimer's disease patients using MRIs can also detect cognitive decline in Parkinson's disease, according to a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania. Researchers also found that higher baseline Alzheimer's patterns of atrophy predicted long-term cognitive decline in cognitively normal Parkinson's patients.

"On the basis of a simple neuroimaging study, we can now predict which patients with Parkinson's disease will experience long-term cognitive decline or develop dementia in the future," said the study's lead author, Daniel Weintraub, MD, associate professor of Geriatric Psychiatry with Penn's Perelman School of Medicine and the Philadelphia Veterans Affairs Medical Center. "Diagnostic tests like this can help us determine which patients would benefit from future clinical trials of medications aiming to stave off or prevent dementia progression in Parkinson's disease."

This research raises the possibility that both Alzheimer's disease and Parkinson's disease pathology contribute to cognitive decline in Parkinson's disease. Researchers are still uncertain whether the neurodegeneration seen in these patients is caused by primary Parkinson's disease pathology, Alzheimer's pathology, a combination of the two, or is a form of compensation.

As biomarkers for Alzheimer's and Parkinson's disease continue to emerge, the researchers suggest at least an overlap in regions undergoing neurodegeneration with cognitive decline, and point to the Spatial Pattern of Abnormalities for Recognition of Alzheimer's disease (SPARE-AD) classification system to detect brain atrophy in Parkinson's disease, to detect patients at imminent risk of cognitive decline before clinically identifiable symptoms emerge.

Around 80 percent of Parkinson's patients become demented over the course of the illness. Some patients experience cognitive impairment relatively soon after the disease strikes, while others won't experience dementia until the very end of their disease. Duration and severity of the disease and advanced age are risk factors for dementia, while nearly 20 percent of patients never have dementia. Over half of Parkinson's patients with dementia have significant signs of Alzheimer's disease-related plaques and neurofribrillary tangles on autopsy, and similar brain regions, such as the hippocampus and medial temporal lobe, have been reported to be affected in both diseases.

The Penn research team applied a pattern classification individual-based score, the SPARE-AD score, to a cross-sectional cohort of 84 Parkinson's patients including patients with dementia, mild cognitive impairment and no dementia. In the cross-sectional analyses, the SPARE-AD score correlated to cognitive impairment across all groups. From this group, 59 Parkinson's patients without dementia were followed for an additional two years. Researchers determined that a higher baseline SPARE-AD score predicted worsening cognitive performance over time, even in those patients with normal cognition at baseline.

In addition to Dr. Weintraub, the research team included Nicole Dietz, John Duda, David Wolk, Jimit Doshi, Sharon Xie, Christos Davatzikos, Christopher Clark, and Andrew Siderowf, representing the Penn Udall Center for Parkinson's Research and the Perelman School of Medicine's departments of Psychiatry, Neurology, Radiology, Biostatistics and Epidemiology. Dr. Weintraub and Dr. Duda are also with Philadelphia Veterans Affairs Medical Center.

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