Many States Say Cuts Would Burden Fragile Recovery

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Fernanda Santos contributed reporting.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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India Ink: In Hyderabad, Anger and Frustration

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Wall Street Edges Ahead

Stocks rose on Wall Street Friday, bolstered by better-than-expected earnings from Hewlett-Packard.

The Standard & Poor’s 500-stock index climbed 0.3 percent, the Dow Jones industrial average rose the same amount and the Nasdaq composite index added 0.4 percent.

The S.&P. 500 has dropped 1.9 percent over the last two sessions, its worst two-day drop since early November, putting the benchmark index on pace for its first weekly decline of the year. The retreat was triggered by minutes from the Federal Reserve’s January meeting, released earlier in the week, that suggested stimulus measures may end earlier than thought.

Still, the index was up more than 5 percent for the year and has held above the 1,500-point level.

“When you get a move like that, you are bound to see a pause, and the Fed minutes is a good enough reason to at least reassess,” said Michael Marrale, head of research, sales and trading at ITG in New York.

But, he added, “ultimately, we are going to see rates go higher and, ultimately, that will take money out of bonds and into equities.”

Hewlett-Packard, the maker of personal computers and printers, climbed 7.8 percent after the company’s quarterly revenue and forecasts beat analysts’ expectations as it continued to cut costs.

Abercrombie & Fitch, the clothing retailer, fell 5.1 percent after it reported a drop in fourth-quarter comparable sales, even as the latest quarterly earnings topped estimates.

The insurer American International Group posted fourth-quarter results that beat analysts’ expectations. Shares advanced 3.8 percent.

Marvell Technology Group, a chip maker, rose 1.5 percent after the company gained market share in the hard-disk drive and flash-storage businesses.

The European Commission forecast on Friday that growth in the 27-nation European Union would rise only 0.3 percent this year, while growth in the 17 members that use the euro would fall 0.1 percent for a second year of recession. Stock markets in Europe were mostly ahead in afternoon trading after a sharp pullback on Thursday.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Read More..

Combes Named to Lead Alcatel-Lucent Through Troubled Time

BERLIN — Alcatel-Lucent, the struggling French telecom equipment maker, on Friday hired a former Vodafone and France Télécom executive, Michel Combes, to lead the company through what might be a major downsizing.

Mr. Combes, 51, will take over for Ben Verwaayen, who had failed in four years to bring the equipment maker, created by the 2006 merger of Alcatel of France and Lucent Technologies of New Jersey, to sustained profit.

Mr. Combes left Vodafone last summer after agreeing to take over as chief executive of SFR, a French mobile operator owned by Vivendi. But the sudden departure of Jean-Bernard Lévy as Vivendi chief executive caused Mr. Combes to withdraw from the job.

In brief remarks to Alcatel-Lucent senior executives this morning in Paris, Mr. Combes outlined his plans to conduct a “listening tour” of employees, shareholders and other stakeholders before formulating a strategy for Alcatel-Lucent, which lost €1.4 billion, or $1.9 billion, in 2012 as sales fell 6 percent.

The company is in the midst of cutting 7 percent of its global workforce, some 5,500 of 76,000 jobs, by the end of this year.

In a statement, Mr. Combes said he would work to return Alcatel-Lucent to lasting profitability, something that has eluded the company since the trans-Atlantic merger.

“This is a company I know well and I look forward to succeeding Ben, working with the key international customers, and driving the business into sustained profitability for its customers, employees and shareholders,” Mr. Combes said in a statement.

But Alcatel-Lucent’s shares fell 1 percent in Paris trading following the announcement to €1.13. Aleksander Peterc, an analyst in London at Exane BNP Paribas, said investors had been hoping for an executive with more of a proven track record as a cost-cutter. Mr. Peterc said that Mr. Combes should quickly identify which businesses are for sale.

The company has indicated that its optical submarine cable business and its enterprise business of selling equipment to large companies and organizations, are both on the block, Mr. Peterc said.

“Alcatel-Lucent is in a crisis situation and even just identifying which businesses it intends to sell would be a step forward that could save thousands of jobs,” Mr. Peterc said. “They have tried for six years since the merger and have spent €4 billion on restructuring to turn this company around and it hasn’t worked yet.”

Mr. Verwaaven, the former chief of the British operator BT, had integrated the Alcatel and Lucent product lines and organizations under a unified brand. When he announced on Feb. 7 that he would step down, he said in a conference call with analysts that the company was reviewing its entire business portfolio with an eye to possible asset sales.

In December, the company secured €1.62 billion in emergency financing from to buy more time. As a condition of the loans, the company pledged a percentage of revenues derived from future asset sales.

Martin Nilsson, an analyst at Handelsbanken in Stockholm, said that Mr. Combes would likely be forced to take major steps to expedite the resizing of the French company, including selling some businesses. The company employs only 12 percent of its work force, roughly 9,000 people, in France. The rest are spread around the world, mostly in the United States, China, India, the Netherlands, Japan and South Korea.

“I think irrespective of the C.E.O. they had chosen, this is the main challenge for Alcatel-Lucent at this time,” Mr. Nilsson said. “It has been seemingly very difficult for this company to reach sustained profitability. That is a very hard for any company to maintain.”

In another potential signal that Alcatel-Lucent may be entering a phase of greater reorganization, the company announced it had appointed Jean C. Monty, the former president and chief executive of Nortel Networks and of Bell Canada, as vice chairman of the board, a new position.

Philippe Camus, the Alcatel-Lucent chairman, said in a statement that Mr. Monty would be working closely with Mr. Combes to sort out the company’s future.

“We are fortunate to have such an experienced colleague to support Michel Combes in his new role,” Mr. Camus said. “I’m looking forward to working more closely with Jean and I’m convinced Alcatel-Lucent will benefit from his incredible knowledge of our business.”

Mr. Nilsson said that Alcatel-Lucent’s turnaround will not be easy. Selling money-losing businesses and cutting research and development spending to increase profit will also decrease Alcatel-Lucent’s base of sales and could limit its future growth potential by slowing the development of new products.

“It is very easy for tech companies to get into a downward spiral,” Mr. Nilsson said.

The company has declined to say which businesses it might sell. In 2012, sales of Alcatel-Lucent’s optical networking and wireless networking businesses fell by 20.3 percent and 17.2 percent, respectively, from 2011. The company blamed the declines on the rapid transition by U.S. operators to faster network gear based on Long Term Evolution technology, which reduced demand for Alcatel-Lucent’s second- and third-generation products.

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IHT Rendezvous: Russian Nationalists Say ‘Nyet’ to Foreign Words

LONDON — Nationalist Russian legislators have introduced a bill to hold back a tide of foreign words, specifically English ones, which they claim is swamping the Russian language.

A bill submitted by the minority Liberal Democratic Party would impose fines of up to $1,700 on officials, advertisers and journalists who use foreign words rather than their Russian equivalents.

Their main gripe appears to be with English words that have crept into Russian since the collapse of the Soviet Union, according to the broadcaster Russia Today.

“They specifically mention the Russian words that ended up as ‘dealer’, ’boutique’, ‘manager’, ‘single’, ‘OK’ and ‘wow’,” RT said on its Web site.

The legislators were said to have taken their inspiration from France and Poland, which have laws to protect their national languages from foreign incursions, and from Quebec, where local officials zealously guard the Canadian province’s French-language tradition.

Given the onward march of English as the dominant world language, the efforts of the language purists may ultimately be doomed.

The tendency of languages to adopt foreign words is scarcely a modern phenomenon. Russian itself has a multitude of borrowings from languages as diverse as Mongolian and Latin.

Borrowings often reflect concepts or linguistic nuances that do not exist in the native language. English borrowed “mammoth” and “sable” from the Russians as well as the more recent “agitprop” and “gulag.”

Alina Sabitova, writing for the Russkiy Mir Foundation, which promotes Russian language and culture, acknowledged that proscriptive laws in countries such as Poland and France were rarely observed in practice.

That cast doubt on the claim of Vladimir V. Zhirinovsky, the Liberal Democratic Party leader, that “all major countries have purged foreign loan words from their national languages.”

The bill appeared to be the latest in a patriotic wave of perceived anti-foreign measures to go before the Duma, the lower house of parliament. My colleague Ellen Barry wrote from Moscow last month that many of the proposals sounded eccentric and were unlikely to advance and become law.

Russia Today got itself in hot water on Thursday with the headline “Grammar Nazi Style” on its report of the proposed ban.

One anonymous commenter suggested those responsible should be sent to the gulags, while another declared:

“Russia needs to protect own language for a million parasite words that have infiltrated the country from the West. Russian language is a very rich language and stupid replacement of Russian words with English is bad for the country and culture.”

The language debate in Russia, as elsewhere, has obvious political overtones, with purists frequently railing against American cultural hegemony and English-language imperialism. (A colleague recalls that one Communist-era Polish language activist took particular exception to the phrase “whiskey on the rocks.”)

Language watchdogs can also fall into the trap of overzealousness.

Quebec’s French language office backed down this week after it provoked a furor by warning the owner of an Italian restaurant that there were too many Italian words on his menu.

Where do you stand on the language issue? Do foreign borrowings enrich languages or diminish them? Is the dominance of English a plus or a minus in an increasingly interconnected world? And will new laws do anything to counter the trend?

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Wall Street Shares Slip

Stocks dipped at the opening of trading on Wall Street on Thursday, as data continued to show a slowly improving economy.

The Standard & Poor’s 500-stock index fell 0.5 percent, the Dow Jones industrial average lost 0.3 percent and the Nasdaq composite index lost 0.4 percent in morning trading. European markets were down almost 2 percent in afternoon trading.

In one economic report released Thursday, Washington said the number of Americans filing new claims for unemployment benefits rose 20,000 to a seasonally adjusted 362,000, above expectations for 355,000.

In another report, the government said consumer prices were flat for a second straight month in January, providing scope for the Federal Reserve to maintain its very accommodative monetary policy stance as it tries to stimulate the sluggish economy. Excluding food and energy, consumer prices rose 0.3 percent, the largest gain since May 2011.

The S.&P. 500 index dropped 1.2 percent on Wednesday, its biggest decline since Nov. 14, after minutes from the Federal Reserve’s most recent meeting suggested the central bank may slow or stop buying bonds sooner than expected.

With the benchmark S.&P. index still up 6 percent for the year, many analysts saw the Fed minutes as a trigger for an overdue pullback in equities, as would be the upcoming sequestration in Washington. The sequestration — automatic across-the-board spending cuts put in place as part of a larger congressional budget fight — is due to kick in March 1 unless lawmakers agree on an alternative.

“It’s the sequester, it’s the knee-jerk reaction to yesterday’s Fed minutes and it’s the realization the consumer is slowing,” said Phil Orlando, chief equity market strategist at Federated Investors in New York. “I’d love to see a healthy 5 percent correction. Let’s wash out some of the weak hands and set up for a better move during the year.”

Wal-Mart rose 1.4 percent after the world’s largest retailer reported a larger-than-expected rise in quarterly profit and raised its dividend. Investors weighed the news of better profit against persisting weakness in sales in the United States.

VeriFone Systems tumbled 34 percent after the credit card swipe-machine maker forecast first- and second-quarter profit that were well below analysts’ expectations.

Berry Petroleum jumped 22.6 percent after the oil and gas producer Linn Energy said it would buy the company in an all-stock deal valued at $4.3 billion including debt.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Michael Cooper contributed reporting from New York.

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Personal Best: When to Retire a Running Shoe

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Ryan Hall, one of the world’s best distance runners, used to pride himself on wearing his running shoes into nubs. No more. Now he assiduously replaces his shoes after running about 200 miles in them. He goes through two pairs a month.

“I know that my shoes could probably handle a couple of hundred more miles before they are worn out, but my health is so important to me that I like to always make sure my equipment is fresh,” he said.

Of course Mr. Hall, sponsored by Asics, does not have to pay for his shoes. Most of the rest of us do, and at around $100 a pair they aren’t cheap. Yet we are warned constantly to replace them often, because running in threadbare shoes may lead to injuries that can take months to heal.

So here’s a simple question: How do you know when your shoes are ready for those discard bins in gyms? And if you do get injured, is it fair to blame your shoes?

My friend Jen Davis runs more than 100 miles a week, like Mr. Hall, but has a different set of criteria for getting rid of shoes. One is that if they smell bad even after she washes them in her washing machine, it’s time for a new pair. She estimates she puts 500 miles on each pair of shoes.

Henry Klugh, a running coach and manager of The Inside Track, a running store in Harrisburg, Pa., says he goes as far as 2,000 miles in some shoes. He often runs on dirt roads, he said, which are easier on shoes than asphalt is and do not compress and beat up the midsole as much.

My coach, Tom Fleming, has his own method. Put one hand in your shoe, and press on the sole with your other hand. If you can feel your fingers pressing through, those shoes are worn out — the cushioning totally compressed or the outer sole worn thin.

As for me, my practice has been to keep track of the miles I run with each pair and replace them after 300 miles. Who is right? Maybe none of us. According to Rodger Kram, a biomechanics researcher at the University of Colorado, the theory is that you must change shoes before the ethylene vinyl acetate, or E.V.A., that lines most running shoe insoles breaks down.

“Think of a piece of Wonder Bread, kind of fluffy out of the bag,” he said. “But smoosh it down with the heel of your palm, and it is flat with no rebound.”

A moderate amount of cushioning improves running efficiency, he has found. But as to whether cushioning prevents injuries, he said, “I doubt that there are good data.”

Dr. Jacob Schelde of Odense University Hospital in Denmark, has looked for clinical trials that address the cushioning and injury question — and has found none. He’s applying for funds to do one himself, a 15-month study with 600 runners.

Dr. Schelde did find a study on injury rates among runners, published in 2003, that had some relevant data even though it was not a randomized clinical trial and shoe age was not its main focus. The study was large and regularly tested runners in a 13-week training program. The researchers failed to find any clear relationship between how long running shoes were worn and a runner’s risk of injury.

It also is difficult to find good data on how long E.V.A. insoles last. But one exhaustive study, led by Ewald Max Hennig of the biomechanics laboratory at University of Duisburg-Essen in Germany, involved 18 years of shoe testing from 1991 to 2009. The researchers measured the performance of 156 shoe models worn by runners. Dr. Hennig and his colleagues wrote that the sort of mechanical testing that shoe manufacturers do to evaluate cushioning materials does not reflect what happens when people actually run.

Over the years, running shoe quality steadily improved, the researchers reported. The shoes also changed as running fads waxed and waned. Shock attenuation, for example, diminished starting around 2000, when there was talk of shoes providing too much cushioning.

Then, when cushioning became fashionable again, it returned. But so did minimalist shoes designed for the barefoot running fad, which have almost no cushioning.

In Europe, the researchers reported, people typically wear shoes for about 600 miles. But their studies indicated that shoes could last much longer.

Most shoemakers, of course, would prefer to see us trade in sooner. Kira Harrison, a spokeswoman for Brooks, said shoes should last for 400 to 500 miles. The very light models last about 300 miles, she said.

Biomechanical studies have shown that after those distances the shoes lose their bounce, she said: “Everyone in the industry knows that standard.”

Gavin Thomas, a Nike spokesman, said a shoe’s life span depended on the type of shoe — lightweight or more heavily cushioned — and on the runner’s weight and running style. Those who are light on their feet can wear shoes longer than those who pound the ground. Those who run on soft surfaces can keep their shoes longer.

After 300 or 400 miles, Mr. Thomas said, a typical shoe worn by a typical runner will not feel the way it used to, a sign it is worn out.

But Golden Harper, developer of Altra running shoes and founder of the company, said any advice on mileage was “a lot of malarkey.” Mr. Harper, a distance runner, said most runners could feel when their shoes need to be replaced. “You get a sense for it,” he said. “Nothing hurts, but it is going to soon.”

So when should you retire those faithful running shoes, and what happens if you don’t? Despite the doomsday warnings, no one really knows. And with so many variables — type of shoe, runner’s weight, running surfaces, running style — there may never be a simple answer.

But we can take comfort in Dr. Hennig’s work. Even people like Henry Klugh, who put in many more miles than most guidelines suggest may still be fine. Their shoes may still be performing.

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

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

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

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The Lede: Reporters in Syria See No End in Sight

It has been nearly two years since Syria’s president, Bashar al-Assad, deployed troops to clear the streets of first peaceful protesters and then armed rebels intent on overthrowing him.

The ensuing war, a mix of the sectarian, political and personal, has turned bustling streets, workplaces and homes across the country into rubble-strewn battlegrounds, contested bitterly for the smallest strategic value. On the front lines in two of the country’s largest cities, Damascus, the capital, and Aleppo, reporters have suggested in recent days that there is no end in sight.

Goran Tomasevic of Reuters, a photographer who has produced some of the conflict’s most telling images, spent a month in what were once suburbs of Damascus. He described what he called “bloody stalemate.”

I watched both sides mount assaults, some trying to gain just a house or two, others for bigger prizes, only to be forced back by sharpshooters, mortars or sprays of machinegun fire.

As in the ruins of Beirut, Sarajevo or Stalingrad, it is a sniper’s war; men stalk their fellow man down telescopic sights, hunting a glimpse of flesh, an eyeball peering from a crack, use lures and decoys to draw their prey into giving themselves away.

Fighting is at such close quarters that on one occasion a rebel patrol stumbled into an army unit inside a building; hand grenades deafened us and shrapnel shredded plaster, a sudden clatter of Kalashnikov cartridges and bullets coming across the cramped space gave way in seconds to the groans of the wounded.

The division between religious groups, Mr. Tomasevic wrote, has become more distinct:

Days are punctuated by regular halts for prayer in a conflict, now 23 months old, that has become increasingly one pitting Syria’s Sunni Muslim majority, stiffened by Islamist radicals, against Alawites led by Assad; they have support from Iran, from whose Shi’ite Islam their faith is derived.

Typical of the frontline routine was an attack that a couple of dozen men of the brigade Tahrir al-Sham — roughly “Syrian Freedom” — mounted in Ain Tarma on January 30, aiming to take over or at least damage an army checkpoint further up the lane.

I photographed one two-man fire team crouch against a breeze-block garden wall, about 50 meters from their target.

In blue jeans, sneakers and muffled against a morning chill, their role was to wait for comrades to hit the army position with rocket-propelled grenades then rake the soldiers with their AK-47 automatic rifles as they were flushed out into the open.

There was little to make a sound in the abandoned streets. The attackers whispered to each other under their breath.

Then two shots rang out. One of the two riflemen, heavy set and balding, screamed in pain and collapsed back on the tarmac.

The day’s assault was going wrong before it even started.

Ian Pannell of the BBC reported on a similar deadlock, outside Aleppo. “Too much has been lost to talk of winners and losers,” Mr. Pannell said. “But make no mistake. The rebellion is advancing.” The rebel forces’ next targets, he said, include a base said to house some of Syria’s reported chemical weapon stockpile, and the city’s airport. Victory in either fight, it seems, would most likely serve only to lengthen and complicate the fight.

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DealBook: Office Depot and OfficeMax Announce Plans to Merge, After Erroneous Release

9:40 a.m. | Updated

Office Depot and OfficeMax announced their plans to merge on Wednesday, just hours after an erroneous release about the deal briefly surfaced.

Under the terms of the deal, Office Depot said it would issue 2.69 new shares of common stock for each share of OfficeMax. At that level, the transaction would value OfficeMax at $13.50, or roughly $1.19 billion, a premium of more than 25 percent to the company’s closing price last week.

The deal has been anticipated, as the companies face an increasingly difficult competitive environment. Both companies, which are burdened with big real estate footprints, have struggled against lower-priced rivals like Amazon.com and Costco. By uniting, the two companies should be able to cut costs and better negotiate prices.

“In the past decade, with the growth of the internet, our industry has changed dramatically,” Neil Austrian, chairman and chief executive officer of Office Depot, said in a statement. “Combining our two companies will enhance our ability to serve customers around the world, offer new opportunities for our employees, make us a more attractive partner to our vendors, and increase stockholder value.”

While the deal has been years in the making, it was initially announced prematurely. A news release announcing the merger of the two office supply retailers was posted early Wednesday morning on Office Depot’s Web site, but it quickly disappeared.

Several news organizations reported the terms disclosed in the errant news release for Office Depot’s earnings. The details were buried on page four of the release under the header “Other Matters.”

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

The episode is reminiscent of other times that companies’ earnings releases were published prematurely. Last fall, Google’s third-quarter earnings were published three hours early, which the technology giant blamed on a mistake by R.R. Donnelley & Sons, the company’s printer.

Representatives for Office Depot and OfficeMax were not immediately available for comment on the erroneous release.

Strategically, the deal makes sense, as the companies deal with a changing competitive environment.

Combined, the companies reported about $4.4 billion in revenue for their third quarter of 2012; in comparison, Staples disclosed $6.4 billion in revenue for the same period.

Office Depot has also been under pressure from an activist hedge fund, Starboard Value, which sent a letter to the retailer’s board last fall. In it, Starboard called for more cost cuts and a greater focus on higher-margin businesses like copy and print services. With a 14.8 percent stake, Starboard is the company’s biggest investor.

In announcing the deal, the two companies emphasized their new financial heft.

With the merger, the retailers expect to generate $400 million to $600 million in annual cost savings. The combined entity would also have $1 billion in cash, given them additional firepower to invest in the business.

“We are excited to bring together two companies intent on accelerating innovation for our customers and better differentiating us for success in a dynamic and highly competitive global industry,” Ravi Saligram, chief executive of OfficeMax, said in a statement. “We are confident that there will be exciting new opportunities for employees as part of a truly global business.

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The New Old Age Blog: The Reluctant Caregiver

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The New Old Age Blog: The Reluctant Caregiver

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Bits Blog: PopSugar, a Web Site for Women, Gets a Makeover

PopSugar, the blog that is eye candy for celebrity- and fashion-obsessed women, is getting a makeover.

The redesigned site is still photography-heavy, with big pictures and headlines like “Kate Middleton Shows Her Baby Bump” and “Reese Witherspoon’s Leg Workout.” But now, all topics — including fashion, parenting, cooking, gossip and fitness — are combined under PopSugar instead of at separate blogs, and posts offer ways to shop for everything from shoes to nursery decorations.

The message, said Brian Sugar, PopSugar’s co-founder and chief executive, is that it has grown up and matured beyond its previous existence as a blog network.

“We were a blog network, and what we’re trying to be is a real destination that women check on a daily basis,” Mr. Sugar said.

PopSugar is Exhibit A for several of the trends that are currently reshaping digital media.

One example is online video and video advertising. PopSugar originally described itself as a digital Condé Nast — a collection of lifestyle blogs, similar to Condé Nast’s various magazine titles. But it turns out that the magazine business is not the best model to emulate anymore.

That is largely because advertisers are willing to pay more for video ads. Each month, PopSugar produces 250 videos, ranging from live red-carpet interviews to 40-minute online workouts, and people watch them 50 million times.

To make video that was good enough that people would want to watch, PopSugar spent $10 million on video studios, and focuses on live video that viewers cannot find elsewhere online. It had its highest viewership during last year’s Oscars, when 1.2 million people tuned in to its online show.

“In the future, you’ve got to believe when you turn on a TV, whether you’re on a channel or a URL, does it really matter?” Mr. Sugar said. “So as a media company, we need to be prepared for that and invest in it because that’s the future for high-paying advertiser content.”

Like other Web companies, PopSugar was forced to shift from relying solely on advertising to finding another revenue stream: e-commerce. Now it makes half its revenue from e-commerce, including fees retailers pay when a shopper clicks on an item on PopSugar and a $35 monthly subscription box it sells to 12,000 readers.

“It’s a challenge to create a business today solely based on display advertising,” Mr. Sugar said. “A person that reads articles is worth less than a person who watches video who is worth less than a person who clicks to a retailer and then actually buys things from us.” PopSugar is also starting a new daily show, PopSugar Live, that will air every afternoon.

The site wants to become a new kind of search engine. A big search box dominates its shopping site, but unlike Google or Amazon.com, some of the results PopSugar shows are handpicked by editors.

As for other companies, mobile is a challenge for PopSugar. A quarter of its readers don’t visit on desktops, but it has not yet figured out how to make as much money on mobile readers as it does on desktop ones.

“The desktop is just over,” Mr. Sugar said. “But I think we’re all struggling with it. It’s difficult to make as much money on a smaller screen.”

Still, he said the six-year-old company, which changed its name to PopSugar from Sugar Inc. as part of the redesign, is profitable.

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The Lede: North Korean Video Shows Obama in Flames

North Korea has released a new propaganda video that shows President Obama and United States troops in flames and credits Washington with leading the impoverished country to become a proud nuclear power.

Songs, operas and novels that stoke hatred against the United States and belittle South Korea are daily fare for North Koreans living under a leadership that uses propaganda as a critical tool of governing. In the last several years, the country has taken its campaign to the Internet, posting thousands of videos onto YouTube that provide outsiders with rare glimpses into the world of North Korean propaganda.

More recently, the country’s propagandists have been busy trumpeting the successful launch of a satellite in December and a Feb. 12 nuclear test, telling North Koreans that their country was becoming a high-tech nuclear power under its young leader, Kim Jong-un.

“Thanks to the Americans,” the latest work by the propagandists, is a 90-second video that was uploaded on YouTube by the North’s official Uriminzokkiri Web site on Sunday.

“It is not incorrect to say that the United States’ gangster-like policy of hostility prompted us to become a most strong military power,” says the text that scrolls across the screen. “Thus it can be said that it was ‘thanks to’ the Americans that we conducted a nuclear test.”

In the video, flames are superimposed on footage of Mr. Obama in Congress, American troops and screen shots of a South Korean television station reporting the North’s nuclear test. It ends with an animated simulation of a nuclear device exploding in an underground test site.

The scorching of the United States in “nuclear flames” or a “nuclear holocaust” is a recurring theme in North Korean statements. A ubiquitous propaganda poster in North Korean towns calls for a “score-settling war” against the Americans.

While North Korea has faced chronic food shortages and growing trade sanctions, its propaganda strives to inspire nationalistic pride among its people, portraying their country as a small nation prospering despite the constant bullying of the “imperialist” Americans.

Part of another video, posted on YouTube by the country’s Korean Central Television on Feb. 12, showed a boy wearing a red scarf singing a song against the backdrop of rockets flying into space and satellites circling the Earth.

“We will fill the space with satellites,” the boy sang. “We will grow to be conquerors of the space.”

Another video posted early this month showed a North Korean man dreaming about circling Earth on a homemade spacecraft and looking down to see the Korean Peninsula unified and Manhattan being attacked by missiles and going up in smoke.

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Wall St. Shares Inch Ahead

Shares on Wall Street inched higher in early trading on Tuesday, putting the Standard & Poor’s 500-stock index on track to extend its seven-week winning streak.

Shortly after the opening bell, the S.&P. 500 was up 0.3 percent, while the Dow Jones industrial average was up 0.1 percent. The Nasdaq composite rose 0.2 percent.

The strong start to the year has been helped by legislators in Washington, who temporarily averted a series of automatic spending cuts and tax increases, as well as by better-than-expected earnings and economic data. The Federal Reserve’s stimulus policy has also been a major factor.

But further gains for the benchmark S.&P. index have been a struggle as investors look for new catalysts to lift the index, which hovers near five-year highs.

The compromise by lawmakers on across-the-board spending cuts, known as sequestration, only postponed until March 1 a resolution to the Congressional budget fight.

The faster pace in merger-and-acquisition activity, a sign of optimism about the outlook on Wall Street, has resulted in more than $158 billion in deals announced so far in 2013.

“The firm market tone continues," said Andre Bakhos, director of market analytics at Lek Securities in New York, "fueled by a lack of negative surprises as well as an increase in M.&A. activity, adding confidence to market valuations.”

“The market has been able to shrug off minor negatives as it looks ahead to a potential bigger hurdle in the sequestration,” he said. “Until then, the situation looks stable.”

The No. 2 office supply retailer in the United States, Office Depot, surged 24 percent. The company is said to be in merger talks with a smaller rival, OfficeMax. OfficeMax shares jumped 30 percent.

The computer maker Dell reports fourth-quarter results on Tuesday, and it is expected to show earnings per share fall to 39 cents from 51 cents a year earlier. Analysts will have their first chance to question management on a buyout deal struck earlier this month by its chief executive, Michael Dell, private equity firm Silver Lake and Microsoft.

According to the Thomson Reuters data through Friday, of the 388 companies in the S.&P. 500 that have reported results, 69.8 percent have exceeded analysts’ expectations, compared with a 62 percent average since 1994 and 65 percent over the last four quarters.

Fourth-quarter earnings for S.&P. 500 companies are estimated to have risen 5.6 percent, according to the data, above a 1.9 percent forecast at the start of the earnings season.

European shares rose on Tuesday, lifted by gains at food group Danone and fresh signs of a German economic recovery, although broader market sentiment remained cautious ahead of Italian elections this weekend.

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National Briefing | South: Abortion Curbs Clear Senate in Arkansas

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

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National Briefing | South: Abortion Curbs Clear Senate in Arkansas

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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IHT Rendezvous: As Europe Moves to Cap Bonuses, Britain Hesitates

LONDON — It is hard to imagine any European politician losing votes these days by promising to curb bankers’ pay, which may explain why members of the European Parliament are enthusiastically pushing for the toughest restrictions on bank bonuses since the 2008 financial crisis.

Representatives of the Parliament and of the 27 European Union governments were meeting on Tuesday to finalize a deal on banking law that would include pegging bankers’ bonuses at no more than their annual salaries.

The Parliament’s demands for a bonus cap reflect public outrage at continued revelations of huge payouts to bankers. But a side effect has been to hold up enactment of global banking regulations designed to strengthen the capacity of banks to withstand a future crisis.

A majority of member states have come around to supporting the bonus cap. Germany, a late convert to the idea, is prepared to compromise on the issue in order to ensure the wider banking changes are adopted by the elected European Parliament.

The debate has left the British government out on a limb, as it fights a possibly doomed rearguard action to protect the interests of the City of London, Europe’s biggest financial center.

The Conservative-led government believes the bonus cap could have the perverse effect of increasing bankers’ fixed pay, while allowing less opportunity to claw back variable bonuses in the event of poor performance.

Boris Johnson, the outspoken Conservative mayor of London, was quoted on Tuesday as saying, “we don’t need Europe butting in on bonuses,” as he attacked the European proposals as a threat to the City’s international competitiveness.

In the light of popular anti-banker sentiment, however, the British government has been relying on quiet diplomacy to argue its case with European partners in order to avoid the perception that it pushing the agenda of “fat cat” bankers.

It has been left largely to the business media to press the case against a bonus cap. Allister Heath, writing at the City A.M. Web site on Tuesday, suggested that a cap would be a “disaster for London.”

In an editorial this week, which said adoption of the bonus cap would be a defeat for common sense, the Financial Times wrote: “The parliamentarians’ pet idea is a result of populism mixed with ignorance of how banking works.”

“A cap on the ratio of variable to fixed pay will do little to lower total compensation (which is what outrages voters sick of bailing out failed banks),” according to the Financial Times. “It will just encourage higher fixed salaries to compensate for the lack of bonuses that tend to be far larger.”

Mr. Heath, in his City A.M. column, suggested that George Osborne, the British finance minister, was “seemingly too frightened by anti-City sentiment” to block the Brussels proposals.

“The cap will lead to further boosts to base pay, increasing fixed costs and risk,” Mr. Heath wrote. “When business volumes drop, the only answer will be to sack people, rather than cutting bonuses.”

“The fact is U.K. regulators have already created a bonus framework that is tough but fair,” according to Nick Goodway, writing in the London Evening Standard. “Europe is trying to bring in one that could have dire consequences for London’s status as one of the world’s top three financial centers.”

Does this all amount to special pleading on behalf of overpaid bankers? Or do the opponents of the bonus cap have a point? Is the European Parliament guilty of populism, or simply displaying good sense with its proposals to outlaw excessive bonuses?

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