Congo Peace Talks Set to Open in Uganda

KAMPALA, Uganda — Congolese rebels and government officials prepared on Thursday for direct peace talks in the Ugandan capital, Kampala, their first face-to-face encounter since the rebels relinquished Goma, one of Congo’s principal cities, after capturing it last month.

“Since May, we asked Kabila to come to the table,” said Amani Kabasha, a spokesman for the March 23 rebels, or M23, at the rebel-held border post of Rumangabo. Mr. Kabasha said his delegation was awaiting vehicles sent by the Ugandan government to carry them to Kampala. “He didn’t agree, he used force, arms, fighting. But now, because he was defeated, he agrees,” Mr. Kabasha said, referring to President Joseph Kabila.

An uneasy rhythm of commerce and calm returned to Goma this week as Congolese government soldiers again patrolled the streets and the port and airport reopened, allowing a fresh influx of people and cargo, as well as much-needed humanitarian aid for more than 100,000 people displaced by the recent fighting.

“It’s as good as it has been for the last two and a half weeks,” Tariq Riebl, a humanitarian coordinator for Oxfam in Goma, said Thursday. But the situation remained “very dynamic, very fluid,” he said.

In the strategic area of Masisi, to the northwest of Goma, fighting has continued to flare between government troops and numerous militias. Masisi has long been a hotbed of militia groups and ethnic tensions, and humanitarian relief workers said they were increasingly worried about the situation.

Furthermore, neither side has said it has any real faith in the upcoming talks, which delegates said would likely begin Friday, or possibly late Thursday.

“It’s not a negotiation,” said a Congolese government spokesman, Lambert Mende. “We will receive a grievance from M23 and help the president compare with what was decided in 2009,” when the peace agreement for which the rebels are named was signed on March 23.

“We are not very optimistic, because we know that M23 is a very small part of the problem; we need the problem to be solved regionally, and internationally,” Mr. Mende said.

The governments of Uganda and Rwanda have denied accusations by a United Nations panel of covertly supporting the M23 rebels, including in the rebels’ capture of Goma. Both countries have been accused of supporting other Congolese rebels groups in the past.

Many of the rebels’ demands, which the government has dismissed, would benefit Rwanda and Uganda, which are two main transit points for commercial exports from eastern Congo.

“We want more than decentralization, we want federalism,” said Mr. Kabasha, although the specific demands had not yet been finalized. “The eastern parts of Congo’s interests are in eastern Africa. Decentralization means that the leader is near the population.”

In recent days there have been reports of lootings and rape, summary executions and recruitment of children, the United Nations office for humanitarian affairs has said. In Goma, there have also been reports of targeted killings.

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Apple to Resume U.S. Manufacturing

For the first time in years, Apple will manufacture computers in the United States, the chief executive of Apple, Timothy D. Cook, said in interviews with NBC and Bloomberg Businessweek.

“Next year, we will do one of our existing Mac lines in the United States,” he said in an interview to be broadcast Thursday on “Rock Center With Brian Williams” on NBC.

Apple, the biggest company in the world by market value, moved its manufacturing to Asia in the late 1990s. As an icon of American technology success and innovation, the California-based company has been criticized in recent years for outsourcing jobs abroad.

“I don’t think we have a responsibility to create a certain kind of job,” Mr. Cook said in the Businessweek interview. “But I think we do have a responsibility to create jobs.”

The company plans to spend $100 million on the American manufacturing in 2013, according to the interviews, a small fraction of its overall factory investments and an even tinier portion of its available cash.

In the interviews, Mr. Cook said the company would work with partners and that the manufacturing would be more than just the final assembly of parts. He noted that parts of the company’s ubiquitous iPhone, including the “engine” and the glass screen, were already made in America.

Over the last few years, sales of the iPhone, iPod and iPad have overwhelmed Apple’s line of Macinotsh computers, the basis of the company’s early business. Revenue from the iPhone alone made up 48 percent of the company’s total revenue for its fiscal fourth quarter ended Sept. 30.

But as recently as October, Apple introduced a new, thinner iMac, the product that pioneered the technique of building the computer innards in the flat screen.

Mr. Cook did not say in the interviews where in the United States the new manufacturing would occur. But he did defend Apple’s track record in American hiring.

“When you back up and look at Apple’s effect on job creation in the United States, we estimate that we’ve created more than 600,000 jobs now,” Mr. Cook told Businessweek. Those jobs include positions at partners and suppliers.

An Apple spokesman could not be reached for comment Thursday.

Foxconn Technology, which manufactures more than 40 percent of the world’s electronics, is one of Apple’s main overseas manufacturing contractors. Based in Taiwan, Foxconn is China’s largest private employer, with 1.2 million workers, and it has come under intense scrutiny over working conditions inside its factories.

In March, Foxconn pledged to sharply curtail the number of working hours and significantly increase wages. The announcement was a response to a far-ranging inspection by the Fair Labor Association, a monitoring group that found widespread problems — including numerous instances where Foxconn violated Chinese law and industry codes of conduct.

Apple, which recently joined the labor association, had asked the group to investigate plants manufacturing iPhones, iPads and other devices. A growing outcry over conditions at overseas factories prompted protests and petitions, and several labor rights organizations started scrutinizing Apple’s suppliers.

Almost all of the 70 million iPhones, 30 million iPads and 59 million other products Apple sold in 2011 were manufactured overseas. Apple employs 43,000 people in the United States and 20,000 overseas. An additional 700,000 people engineer, build and assemble iPads, iPhones and Apple’s other products, mostly abroad.

At a meeting with Silicon Valley executives in 2011, President Obama asked Steven P. Jobs, then the Apple chief executive, what it would take to make iPhones in the United States. Mr. Jobs, who died later that year, told the president, “Those jobs aren’t coming back.”

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Antismoking Outlays Drop Despite Tobacco Revenue

Faced with tight budgets, states have spent less on tobacco prevention over the past two years than in any period since the national tobacco settlement in 1998, despite record high revenues from the settlement and tobacco taxes, according to a report to be released on Thursday.

Paul J. Richards/Agence France-Presse — Getty Images

State antismoking spending is the lowest since the 1998 national tobacco settlement.

States are on track to collect a record $25.7 billion in tobacco taxes and settlement money in the current fiscal year, but they are set to spend less than 2 percent of that on prevention, according to the report, by the Campaign for Tobacco-Free Kids, which compiles the revenue data annually. The figures come from state appropriations for the fiscal year ending in June.

The settlement awarded states an estimated $246 billion over its first 25 years. It gave states complete discretion over the money, and many use it for programs unrelated to tobacco or to plug budget holes. Public health experts say it lacks a mechanism for ensuring that some portion of the money is set aside for tobacco prevention and cessation programs.

“There weren’t even gums, let alone teeth,” Timothy McAfee, the director of the Office on Smoking and Health at the Centers for Disease Control and Prevention, said, referring to the allocation of funds for tobacco prevention and cessation in the terms of the settlement.

Spending on tobacco prevention peaked in 2002 at $749 million, 63 percent above the level this year. After six years of declines, spending ticked up again in 2008, only to fall by 36 percent during the recession, the report said.

Tobacco use is the No. 1 cause of preventable death in the United States, killing more than 400,000 Americans every year, according to the C.D.C.

The report did not count federal money for smoking prevention, which Vince Willmore, the vice president for communications at the Campaign for Tobacco-Free Kids, estimated to be about $522 million for the past four fiscal years. The sum — about $130 million a year — was not enough to bring spending back to earlier levels.

The $500 million a year that states spend on tobacco prevention is a tiny fraction of the $8 billion a year that tobacco companies spend to market their products, according to a Federal Trade Commission report in September.

Nationally, 19 percent of adults smoke, down from over 40 percent in 1965. But rates remain high for less-educated Americans. Twenty-seven percent of Americans with only a high school diploma smoke, compared with just 8 percent of those with a college degree or higher, according to C.D.C. data from 2010. The highest rate — 34 percent — was among black men who did not graduate from high school.

“Smoking used to be the rich man’s habit,” said Danny McGoldrick, the vice president for research at the Campaign for Tobacco-Free Kids, “and now it’s decidedly a poor person’s behavior.”

Aggressive antismoking programs are the main tools that cities and states have to reach the demographic groups in which smoking rates are the highest, making money to finance them even more critical, Mr. McGoldrick said.

The decline in spending comes amid growing certainty among public health officials that antismoking programs, like help lines and counseling, actually work. California went from having a smoking rate above the national average 20 years ago to having the second-lowest rate in the country after modest but consistent spending on programs that help people quit and prevent children from starting, Dr. McAfee said.

An analysis by Washington State, cited in the report, found that it saved $5 in tobacco-related hospitalization costs for every $1 spent during the first 10 years of its program.

Budget cuts have eviscerated some of the most effective tobacco prevention programs, the report said. This year, state financing for North Carolina’s program has been eliminated. Washington State’s program has been cut by about 90 percent in recent years, and for the third year in a row, Ohio has not allocated any state money for what was once a successful program, the report said.

Read More..

Antismoking Outlays Drop Despite Tobacco Revenue

Faced with tight budgets, states have spent less on tobacco prevention over the past two years than in any period since the national tobacco settlement in 1998, despite record high revenues from the settlement and tobacco taxes, according to a report to be released on Thursday.

Paul J. Richards/Agence France-Presse — Getty Images

State antismoking spending is the lowest since the 1998 national tobacco settlement.

States are on track to collect a record $25.7 billion in tobacco taxes and settlement money in the current fiscal year, but they are set to spend less than 2 percent of that on prevention, according to the report, by the Campaign for Tobacco-Free Kids, which compiles the revenue data annually. The figures come from state appropriations for the fiscal year ending in June.

The settlement awarded states an estimated $246 billion over its first 25 years. It gave states complete discretion over the money, and many use it for programs unrelated to tobacco or to plug budget holes. Public health experts say it lacks a mechanism for ensuring that some portion of the money is set aside for tobacco prevention and cessation programs.

“There weren’t even gums, let alone teeth,” Timothy McAfee, the director of the Office on Smoking and Health at the Centers for Disease Control and Prevention, said, referring to the allocation of funds for tobacco prevention and cessation in the terms of the settlement.

Spending on tobacco prevention peaked in 2002 at $749 million, 63 percent above the level this year. After six years of declines, spending ticked up again in 2008, only to fall by 36 percent during the recession, the report said.

Tobacco use is the No. 1 cause of preventable death in the United States, killing more than 400,000 Americans every year, according to the C.D.C.

The report did not count federal money for smoking prevention, which Vince Willmore, the vice president for communications at the Campaign for Tobacco-Free Kids, estimated to be about $522 million for the past four fiscal years. The sum — about $130 million a year — was not enough to bring spending back to earlier levels.

The $500 million a year that states spend on tobacco prevention is a tiny fraction of the $8 billion a year that tobacco companies spend to market their products, according to a Federal Trade Commission report in September.

Nationally, 19 percent of adults smoke, down from over 40 percent in 1965. But rates remain high for less-educated Americans. Twenty-seven percent of Americans with only a high school diploma smoke, compared with just 8 percent of those with a college degree or higher, according to C.D.C. data from 2010. The highest rate — 34 percent — was among black men who did not graduate from high school.

“Smoking used to be the rich man’s habit,” said Danny McGoldrick, the vice president for research at the Campaign for Tobacco-Free Kids, “and now it’s decidedly a poor person’s behavior.”

Aggressive antismoking programs are the main tools that cities and states have to reach the demographic groups in which smoking rates are the highest, making money to finance them even more critical, Mr. McGoldrick said.

The decline in spending comes amid growing certainty among public health officials that antismoking programs, like help lines and counseling, actually work. California went from having a smoking rate above the national average 20 years ago to having the second-lowest rate in the country after modest but consistent spending on programs that help people quit and prevent children from starting, Dr. McAfee said.

An analysis by Washington State, cited in the report, found that it saved $5 in tobacco-related hospitalization costs for every $1 spent during the first 10 years of its program.

Budget cuts have eviscerated some of the most effective tobacco prevention programs, the report said. This year, state financing for North Carolina’s program has been eliminated. Washington State’s program has been cut by about 90 percent in recent years, and for the third year in a row, Ohio has not allocated any state money for what was once a successful program, the report said.

Read More..

Apple to Resume U.S. Manufacturing

For the first time in years, Apple will manufacture computers in the United States, the chief executive of Apple, Timothy D. Cook, said in interviews with NBC and Bloomberg Businessweek.

Kevork Djansezian/Getty Images

Timothy D. Cook, Apple's chief executive, introduced new products in October, including a thinner iMac.

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“Next year, we will do one of our existing Mac lines in the United States,” he said in an interview to be broadcast Thursday on “Rock Center With Brian Williams” on NBC.

Apple, the biggest company in the world by market value, moved its manufacturing to Asia in the late 1990s. As an icon of American technology success and innovation, the California-based company has been criticized in recent years for outsourcing jobs abroad.

“I don’t think we have a responsibility to create a certain kind of job,” Mr. Cook said in the Businessweek interview. “But I think we do have a responsibility to create jobs.”

The company plans to spend $100 million on the American manufacturing in 2013, according to the interviews, a small fraction of its overall factory investments and an even tinier portion of its available cash.

In the interviews, Mr. Cook said the company would work with partners and that the manufacturing would be more than just the final assembly of parts. He noted that parts of the company’s ubiquitous iPhone, including the “engine” and the glass screen, were already made in America.

Over the last few years, sales of the iPhone, iPod and iPad have overwhelmed Apple’s line of Macinotsh computers, the basis of the company’s early business. Revenue from the iPhone alone made up 48 percent of the company’s total revenue for its fiscal fourth quarter ended Sept. 30.

But as recently as October, Apple introduced a new, thinner iMac, the product that pioneered the technique of building the computer innards in the flat screen.

Mr. Cook did not say in the interviews where in the United States the new manufacturing would occur. But he did defend Apple’s track record in American hiring.

“When you back up and look at Apple’s effect on job creation in the United States, we estimate that we’ve created more than 600,000 jobs now,” Mr. Cook told Businessweek. Those jobs include positions at partners and suppliers.

An Apple spokesman could not be reached for comment Thursday.

Foxconn Technology, which manufactures more than 40 percent of the world’s electronics, is one of Apple’s main overseas manufacturing contractors. Based in Taiwan, Foxconn is China’s largest private employer, with 1.2 million workers, and it has come under intense scrutiny over working conditions inside its factories.

In March, Foxconn pledged to sharply curtail the number of working hours and significantly increase wages. The announcement was a response to a far-ranging inspection by the Fair Labor Association, a monitoring group that found widespread problems — including numerous instances where Foxconn violated Chinese law and industry codes of conduct.

Apple, which recently joined the labor association, had asked the group to investigate plants manufacturing iPhones, iPads and other devices. A growing outcry over conditions at overseas factories prompted protests and petitions, and several labor rights organizations started scrutinizing Apple’s suppliers.

Read More..

India Ink: India's Parliament Opens Door to Foreign Retail Investors

After two days of sometimes ear-splitting debate, India’s Lok Sabha, or lower house, of Parliament voted down a measure prohibiting large foreign retailers like Wal-Mart from entering the country. Of the 543 members in the house, 218 voted in favor of a proposition banning these companies from the country, and 253 against.

Rival leaders from Uttar Pradesh, Samajwadi Party leader Mulayam Singh Yadav and Bahujan Samaj Party leader Mayawati, walked out before the debate and their parties’ abstentions helped defeat the measure.

The issue will now travel to the upper house of Parliament.

Allowing foreign multi-brand retailers into India has been a matter of debate for years, and was fast-tracked this year by a government under fire from allegations of corruption and paralysis. Here’s recent India Ink coverage on the issue:

The United Progressive Alliance government announced in September that they would allow big department stores who carry multiple brands, like Wal-Mart Stores, into the country but “laid out some very specific conditions,” Heather Timmons reported.

In an interview with India Ink in the same month, Anand Sharma, the minister of commerce and industry, said that despite the conditions some companies had “already expressed interest, from Tesco to Carrefore to Wal-Mart and Marks and Spencer.”

Explaining the benefits for rural producers he said:

“It will benefit the rural economy with the farmers, who will get a better price for what they produce. What perishes to a large extent will reach the market or the kitchens.”

The announcement was met with skepticism from industry and analysts, Vikas Bajaj reported, but there was hope that “If they follow through, it could prompt a new economic boom in India, where once-brisk growth has slowed markedly in recent years. But it is a big if.”

In a later article he focused on the way foreign direct investment in retail “often divides Indians as much by age as by their livelihoods.”

“Those younger than 25, a group that includes about half the country’s 1.2 billion people, appear quite open and eager to try foreign brands and shopping experiences, researchers say,” Mr. Bajaj wrote.

The Prime Minister, in a rare address to the nation, tried to assuage small retailers’s fears in late September, by saying that they “had nothing to fear from the impending arrival of giant Western retailers like Wal-Mart or Carrefour because there was a place for everyone, large or small, in a growing economy.”

The government may be overly optimistic about the benefits of allowing foreign direct investment into the retail sector, judging by Wal-Mart’s experience in other countries.

And even if that is not true, “any long-term impacts of Wal-Mart’s Mexico business have been overshadowed this year by the company’s involvement in a bribery scandal there,” and was “sure to find similar demands for bribes in India – especially now that ample evidence exists that the company has paid them elsewhere,” Heather Timmons wrote in an article titled, “Can Wal-Mart Build a Nation?”

In November, Wal-Mart said that an internal “investigation into violations of a federal anti-bribery law had extended beyond Mexico to China, India and Brazil, some of the retailer’s most important international markets,” Stephanie Clifford and David Barstow wrote in the New York Times.

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Europe Fines Electronics Makers $1.92 Billion

BRUSSELS — Europe’s top antitrust regulator on Wednesday announced fines totaling 1.47 billion euros, or $1.92 billion, for seven companies accused of fixing the price of picture tubes for television and computer screens over 10 years, through 2006.

The regulator, Joaquín Almunia, said the activity had helped delay the market adoption of flat-panel screens for TVs and computers.

The fines added up to the largest single penalty for price fixing yet imposed by the European Commission.

Companies that received some of the highest fines included LG Electronics, Philips, Samsung, Panasonic and Toshiba. Chunghwa, a Taiwanese company, received full immunity from fines because it revealed the conspiracy. The companies involved operated two cartels, one for computer screens and the other for televisions, Mr. Almunia said.

Senior managers involved in the cartel dubbed their gatherings “greens meetings” because they usually were followed by a game of golf, according to the European Commission. Meetings between lower level managers were dubbed “glass meetings,” although the commission did not explain the origins of that term.

The commission said the cartels operated for a decade, beginning around 1996, and had engaged in the most organized market manipulation it had ever investigated. The conspiracies included price fixing, market sharing, customer allocation and exchanges of sensitive commercial information.

The cartels “feature all the worst kinds of anticompetitive behavior that are strictly forbidden to companies doing business in Europe,” said Mr. Almunia. There had been “serious harm” to producers in Europe and to consumers, he said, explaining that the cathode ray tubes had accounted for up to 70 percent of the price of screens.

The commission’s antitrust division can fine offenders up to 10 percent of their annual worldwide sales. But unlike regulators in the United States, the commission has no criminal powers and may not prosecute or seek to jail participants for cartel offenses.

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Extended Use of Breast Cancer Drug Suggested

The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.

In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.

“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.

Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs as well might be taken for a longer duration.

“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”

Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.

Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.

About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them would be in premenopausal women with ER-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.

The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.

In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing nine years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.

About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.

There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.

Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.

“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.

Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.

Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots.

“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.

Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.

Read More..

Extended Use of Breast Cancer Drug Suggested

The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.

In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.

“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.

Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs as well might be taken for a longer duration.

“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”

Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.

Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.

About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them would be in premenopausal women with ER-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.

The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.

In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing nine years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.

About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.

There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.

Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.

“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.

Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.

Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots.

“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.

Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.

Read More..

At War Blog: In Afghanistan, Humor Finds Its Way in Lost Translation

Funny isn’t an adjective often used to describe Afghanistan. Yet to many Afghans, the war and the foreigners waging it can present a surprising source of humor.

Afghans around the country tell anecdotes about encounters with NATO troops. The best of these are encapsulated, shared and sometimes aggrandized in the form of half-funny, half-sad tales told over warm chai or at picnics. Sometimes told with a laugh, sometimes told with a tone of bitterness, these stories tend to be about cultural mishaps and miscommunication that, 11 years after the start of the international intervention, still occur with alarming frequency.

Every province seems to have its own variations of these tales. Here, I will share three that I heard while meeting with local entrepreneurs in Bamian, Kabul and Kandahar city, respectively. All of them are based – or so my informants tell me – on actual events.

But even if they are apocryphal, these are the narratives that Afghans are telling in everyday conversations about foreigners – when the foreigners aren’t around.

1. A Disproportionate Response

Over a picnic lunch on the shores of beautiful Band-e-Amir, Afghanistan’s first national park, an 18-year-old high school student from Bamian Center laughingly told me this story:

One day, the New Zealand Provincial Reconstruction Team had lunch with some local village elders. At the end of the meal, they wanted to thank their hosts. One of them spoke on behalf of the team, saying: “Thank you for your great hospitality. The food was delicious.”

But the interpreter was confused. He translated: “Thank you for your great food. We will build you a hospital.”

The elders were surprised, but delighted. But not so much when the hospital never materialized.

Later, I shared this with a friend who works for NATO. He shook his head. “That’s no joke,” he said. “I caught my interpreter making the same mistake in Daikundi last week.”

2. “Not on the agenda!”

A colleague in Kabul who works in a nongovernmental organization that does media training had a collection of linguistic mishaps to share. This one was the most memorable.

A United States military trainer was making a routine visit to an Afghan government official whom he mentored. He was excited because new computers had just been delivered, and he wanted to hear how the devices were working.

The trainer had a thick Southern accent that, evidently, his interpreter found hard to understand.

“How’s the system?” the trainer asked.

“How’s your sister?” the interpreter said, translating.

The government official was visibly angry, to the American’s confusion: “My sister?! Who are you to be asking about my sister?!” The interpreter translated the official’s response into English, but said “system” instead of “sister.”

Trainer: “Yeah, your system! We just delivered new computer systems.”

Interpreter’s translation: “Yeah, your sister. You have beautiful sister.”

The Afghan, roaring: “You better stop talking about my sister!” The interpreter kept the miscommunication going, again telling the American that the official had said “system.”

Trainer: “Hey, relax! It’s on the agenda.”

The Afghan, huffing and puffing: “My sister is most definitely NOT on the agenda!” He stormed out.

The American was perplexed. The interpreter shrugged.

3. The Best Job Ever

I recounted these anecdotes to a friend whom I was visiting in Kandahar city. After having a good laugh, this friend shared one as well. “This one is definitely true,” he said, “because my friend was the interpreter!”

Back in 2004, an officer at Kandahar Airfield hired a group of local residents to do some manual labor. When the workers arrived, the officer instructed his interpreter: “O.K., tell them to get their shovels and start working. I will be back in an hour.”

The interpreter thought it was an odd request, but he translated anyway: “O.K., he says to go shower and come back in an hour.”

And so the workers went to the local bathhouse. When the officer returned, he angrily asked the interpreter, “Where have all the men gone?”

“They went to the bathhouse,” the interpreter replied.

The officer was furious. “Why would they do that?”

“Well, because you told them to…”

The officer suddenly understood what had happened. He grabbed a shovel and shoved it at the interpreter. “SHOVEL! I said shovel, not shower!”

At least in this story, there was a moment of comprehension and a confrontation was avoided. But all these stories make me wonder: How often have hospitals been accidentally promised? And how often did those mistranslations cause bad blood? We may never know.

Eileen Guo lives in Kabul, where she runs Impassion Media, a start-up that delivers social media and mobile technology solutions in emerging markets and frontier environments. She first worked in Afghanistan as a research assistant for the military’s Counterinsurgency Training Center and wrote about her experiences for At War. You can read more of her writing about Afghanistan at her personal blog, and follow her on Twitter.

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