Obama to Visit Israel in Spring

WASHINGTON — President Obama plans to travel to Israel this spring for the first time since taking office, as he and Prime Minister Benjamin Netanyahu try to move past the friction of the last four years now that both have won re-election.

By making Israel a stop on the first overseas trip of his new term, Mr. Obama hopes to demonstrate support for the Jewish state despite doubts among some of its backers. But the trip also seems designed to signal a desire to restart what has been a fraught relationship, and not to be seen as an ambitious effort to revive a stalled peace process.

“The start of the president’s second term and the formation of a new Israeli government offer the opportunity to reaffirm the deep and enduring bonds between the United States and Israel,” Jay Carney, the White House spokesman, said Tuesday, “and to discuss the way forward on a broad range of issues of mutual concern, including, of course, Iran and Syria.”

Mr. Carney said Mr. Obama would also travel to Jordan and the West Bank. The Israeli news media reported that Mr. Obama would arrive on March 20, but the White House would not discuss any dates for the trip.

Mr. Netanyahu’s office said a visit by the president would be “an important opportunity to underscore the friendship and strong partnership between Israel and the United States.”

The relationship between the two leaders has been edgy for years over issues like Israel’s settlements in the West Bank and ways to stop Iran’s nuclear program.

While Mr. Obama won a clear victory in November, Mr. Netanyahu emerged from elections last month in a weakened state, winning enough seats to retain office but forced to recruit centrist lawmakers for a coalition that might temper his policies. He has until March 16 to present his new government.

Mr. Obama is not expected to unveil concrete proposals for bringing Israelis and Palestinians together during his visit or initiate a specific new peace process. But advisers hope that just by showing up and talking about these issues, Mr. Obama will show that he is not walking away from them.

Dennis Ross, a former Middle East adviser to Mr. Obama, attributed the trip to “a desire to connect with the Israeli public at a time when he can go and not have high expectations about having to produce something.”

The president “can create a new beginning with the same prime minister but with a new Israeli government,” Mr. Ross said.

Some peace advocates welcomed the trip but said it should go beyond atmospherics. “The key is, they’ve got to use this as a real substantive jumping off point for a serious diplomatic initiative,” said Jeremy Ben-Ami, the president of J Street, a Washington advocacy group. “This has to be more than a photo op to show that he cares.”

A former Israeli defense official said the trip’s announcement might have been timed to send a message to Israelis and even influence the composition of the next government amid talk of restarting the peace effort. The former official said a more centrist government would allow the sides more room to maneuver.

Also on the agenda this trip will be Iran and the continuing strife in Syria that threatens to descend into a wider regional conflict. Israel last week struck a convoy of antiaircraft weapons inside Syria that it feared was being moved to Hezbollah forces.

“The United States can put an end to the Iranian threat,” President Shimon Peres of Israel said in an address to Parliament on Tuesday, “and I believe that the president of the United States is determined to do it.”

While Mr. Obama visited Israel in 2008 as a candidate, he did not travel there during his first term, a fact that became fodder on the campaign trail last year. A television commercial from a group called the Emergency Committee for Israel said Mr. Obama had “traveled all over the Middle East but he hasn’t found time to visit our ally and friend, Israel.” Mitt Romney, the Republican presidential nominee, ran his own advertisement criticizing the president for not going to Israel.

Only four sitting presidents have visited Israel: Richard M. Nixon and Jimmy Carter each went once, George W. Bush twice, and Bill Clinton four times. Mr. Bush, considered one of the strongest friends Israel has had in the Oval Office, did not visit until 2008, near the end of his presidency.

Isabel Kershner contributed reporting from Jerusalem.

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Media Decoder Blog: Twitter Is Acquiring Bluefin Labs

Twitter confirmed on Tuesday that it was acquiring Bluefin Labs, a company that analyzes online chatter about TV shows and companies and sells its findings.

Twitter is paying nearly $100 million for Bluefin, according to a person with direct knowledge of the sale, making it the Web site’s biggest acquisition to date. The person insisted on anonymity because the terms of the deal were not disclosed publicly.

The deal suggests a new line of business for Twitter, which is under pressure to increase its revenue. Bluefin calls itself a social TV analytics company, one of many that have cropped up as Facebook and Twitter have created an instantaneous stream of commentary that helps inform television producers and distributors. Companies like CBS, which televised the Super Bowl on Sunday, pay Bluefin for information about what is being said about them online.

“We believe that Bluefin’s data science capabilities and social TV expertise will help us create innovative new ad products and consumer experiences in the exciting intersection of Twitter and TV,” the Twitter chief operating officer, Ali Rowghani, said in a blog post about the deal.

Bluefin’s backers have invested about $20 million in the company to date. The impending deal with Twitter was first reported on Monday afternoon by Business Insider.

Bluefin will remain a separate arm of Twitter. Bluefin’s office in Cambridge, Mass., will become an outpost for Twitter.

The acquisition comes six weeks after Twitter and Nielsen announced a partnership to provide a “Nielsen Twitter TV rating” for broadcasters and advertisers. Nielsen and one of its joint ventures, NM Incite, bought a smaller competitor of Bluefin’s, called SocialGuide, in November. The terms of that sale were not disclosed, but SocialGuide’s technology will be used in the Twitter TV rating service, expected to be available in the fall.

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Well: Warning Too Late for Some Babies

Six weeks after Jack Mahoney was born prematurely on Feb. 3, 2011, the neonatal staff at WakeMed Hospital in Raleigh, N.C., noticed that his heart rate slowed slightly when he ate. They figured he was having difficulty feeding, and they added a thickener to help.

When Jack was discharged, his parents were given the thickener, SimplyThick, to mix into his formula. Two weeks later, Jack was back in the hospital, with a swollen belly and in inconsolable pain. By then, most of his small intestine had stopped working. He died soon after, at 66 days old.

A month later, the Food and Drug Administration issued a caution that SimplyThick should not be fed to premature infants because it may cause necrotizing enterocolitis, or NEC, a life-threatening condition that damages intestinal tissue.

---

Catherine Saint Louis speaks about using SimplyThick in premature infants.

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Experts do not know how the product may be linked to the condition, but Jack is not the only child to die after receiving SimplyThick. An F.D.A. investigation of 84 cases, published in The Journal of Pediatrics in 2012, found a “distinct illness pattern” in 22 instances that suggested a possible link between SimplyThick and NEC. Seven deaths were cited; 14 infants required surgery.

Last September, after more adverse events were reported, the F.D.A. warned that the thickener should not be given to any infants. But the fact that SimplyThick was widely used at all in neonatal intensive care units has spawned a spate of lawsuits and raised questions about regulatory oversight of food additives for infants.

SimplyThick is made from xanthan gum, a widely-used food additive on the F.D.A.’s list of substances “generally recognized as safe.” SimplyThick is classified as a food and the F.D.A. did not assess it for safety.

John Holahan, president of SimplyThick, which is based in St. Louis, acknowledged that the company marketed the product to speech language pathologists who in turn recommended it to infants. The patent touted its effectiveness in breast milk.

However, Mr. Holahan said, “There was no need to conduct studies, as the use of thickeners overall was already well established. In addition, the safety of xanthan gum was already well established.”

Since 2001, SimplyThick has been widely used by adults with swallowing difficulties. A liquid thickened to about the consistency of honey allows the drinker more time to close his airway and prevent aspiration.

Doctors in newborn intensive care units often ask non-physician colleagues like speech pathologists to determine whether an infant has a swallowing problem. And those auxiliary feeding specialists often recommended SimplyThick for neonates with swallowing troubles or acid reflux.

The thickener became popular because it was easy to mix, could be used with breast milk, and maintained its consistency, unlike alternatives like rice cereal.

“It was word of mouth, then neonatologists got used to using it. It became adopted,” said Dr. Steven Abrams, a neonatologist at Texas Children’s Hospital in Houston. “At any given time, several babies in our nursery — and in any neonatal unit — would be on it.”

But in early 2011, Dr. Benson Silverman, the director of the F.D.A.’s infant formula section, was alerted to an online forum where doctors had reported 15 cases of NEC among infants given SimplyThick. The agency issued its first warning about its use in babies that May. “We can only do something with the information we are provided with,” he said. “If information is not provided, how would we know?”

Most infants who took SimplyThick did not fall ill, and NEC is not uncommon in premature infants. But most who develop NEC do so while still in the hospital. Some premature infants given SimplyThick developed NEC later than usual, a few after they went home, a pattern the F.D.A. found unusually worrisome.

Even now it is not known how the thickener might have contributed to the infant deaths. One possibility is that xanthan gum itself is not suitable for the fragile digestive systems of newborns. The intestines of premature babies are “much more likely to have bacterial overgrowth” than adults’, said Dr. Jeffrey Pietz, the chief of newborn medicine at Children’s Hospital Central California in Madera.

“You try not to put anything in a baby’s intestine that’s not natural.” If you do, he added, “you’ve got to have a good reason.”

A second possibility is that batches of the thickener were contaminated with harmful bacteria. In late May 2011, the F.D.A. inspected the plants that make SimplyThick and found violations at one in Stone Mountain, Ga., including a failure to “thermally process” the product to destroy bacteria of a “public health significance.”

The company, Thermo Pac, voluntarily withdrew certain batches. But it appears some children may have ingested potentially contaminated batches.

The parents of Jaden Santos, a preemie who died of NEC while on SimplyThick, still have unused packets of recalled lots, according to their lawyer, Joe Taraska.

The authors of the F.D.A. report theorized that the infants’ intestinal membranes could have been damaged by bacteria breaking down the xanthan gum into too many toxic byproducts.

Dr. Qing Yang, a neonatologist at Wake Forest University, is a co-author of a case series in the Journal of Perinatology about three premature infants who took SimplyThick, developed NEC and were treated. The paper speculates that NEC was “most likely caused by the stimulation of the immature gut by xanthan gum.”

Dr. Yang said she only belatedly realized “there’s a lack of data” on xanthan gum’s use in preemies. “The lesson I learned is not to be totally dependent on the speech pathologist.”

Julie Mueller’s daughter Addison was born full-term and given SimplyThick after a swallow test showed she was at risk of choking. It was recommended by a speech pathologist at the hospital.

Less than a month later, Addison was dead with multiple holes in her small intestine. “It was a nightmare,” said Ms. Mueller, who has filed a lawsuit against SimplyThick. “I was astounded how a hospital and manufacturer was gearing this toward newborns when they never had to prove it would be safe for them. Basically we just did a research trial for the manufacturer.”

Read More..

Well: Warning Too Late for Some Babies

Six weeks after Jack Mahoney was born prematurely on Feb. 3, 2011, the neonatal staff at WakeMed Hospital in Raleigh, N.C., noticed that his heart rate slowed slightly when he ate. They figured he was having difficulty feeding, and they added a thickener to help.

When Jack was discharged, his parents were given the thickener, SimplyThick, to mix into his formula. Two weeks later, Jack was back in the hospital, with a swollen belly and in inconsolable pain. By then, most of his small intestine had stopped working. He died soon after, at 66 days old.

A month later, the Food and Drug Administration issued a caution that SimplyThick should not be fed to premature infants because it may cause necrotizing enterocolitis, or NEC, a life-threatening condition that damages intestinal tissue.

---

Catherine Saint Louis speaks about using SimplyThick in premature infants.

---

Experts do not know how the product may be linked to the condition, but Jack is not the only child to die after receiving SimplyThick. An F.D.A. investigation of 84 cases, published in The Journal of Pediatrics in 2012, found a “distinct illness pattern” in 22 instances that suggested a possible link between SimplyThick and NEC. Seven deaths were cited; 14 infants required surgery.

Last September, after more adverse events were reported, the F.D.A. warned that the thickener should not be given to any infants. But the fact that SimplyThick was widely used at all in neonatal intensive care units has spawned a spate of lawsuits and raised questions about regulatory oversight of food additives for infants.

SimplyThick is made from xanthan gum, a widely-used food additive on the F.D.A.’s list of substances “generally recognized as safe.” SimplyThick is classified as a food and the F.D.A. did not assess it for safety.

John Holahan, president of SimplyThick, which is based in St. Louis, acknowledged that the company marketed the product to speech language pathologists who in turn recommended it to infants. The patent touted its effectiveness in breast milk.

However, Mr. Holahan said, “There was no need to conduct studies, as the use of thickeners overall was already well established. In addition, the safety of xanthan gum was already well established.”

Since 2001, SimplyThick has been widely used by adults with swallowing difficulties. A liquid thickened to about the consistency of honey allows the drinker more time to close his airway and prevent aspiration.

Doctors in newborn intensive care units often ask non-physician colleagues like speech pathologists to determine whether an infant has a swallowing problem. And those auxiliary feeding specialists often recommended SimplyThick for neonates with swallowing troubles or acid reflux.

The thickener became popular because it was easy to mix, could be used with breast milk, and maintained its consistency, unlike alternatives like rice cereal.

“It was word of mouth, then neonatologists got used to using it. It became adopted,” said Dr. Steven Abrams, a neonatologist at Texas Children’s Hospital in Houston. “At any given time, several babies in our nursery — and in any neonatal unit — would be on it.”

But in early 2011, Dr. Benson Silverman, the director of the F.D.A.’s infant formula section, was alerted to an online forum where doctors had reported 15 cases of NEC among infants given SimplyThick. The agency issued its first warning about its use in babies that May. “We can only do something with the information we are provided with,” he said. “If information is not provided, how would we know?”

Most infants who took SimplyThick did not fall ill, and NEC is not uncommon in premature infants. But most who develop NEC do so while still in the hospital. Some premature infants given SimplyThick developed NEC later than usual, a few after they went home, a pattern the F.D.A. found unusually worrisome.

Even now it is not known how the thickener might have contributed to the infant deaths. One possibility is that xanthan gum itself is not suitable for the fragile digestive systems of newborns. The intestines of premature babies are “much more likely to have bacterial overgrowth” than adults’, said Dr. Jeffrey Pietz, the chief of newborn medicine at Children’s Hospital Central California in Madera.

“You try not to put anything in a baby’s intestine that’s not natural.” If you do, he added, “you’ve got to have a good reason.”

A second possibility is that batches of the thickener were contaminated with harmful bacteria. In late May 2011, the F.D.A. inspected the plants that make SimplyThick and found violations at one in Stone Mountain, Ga., including a failure to “thermally process” the product to destroy bacteria of a “public health significance.”

The company, Thermo Pac, voluntarily withdrew certain batches. But it appears some children may have ingested potentially contaminated batches.

The parents of Jaden Santos, a preemie who died of NEC while on SimplyThick, still have unused packets of recalled lots, according to their lawyer, Joe Taraska.

The authors of the F.D.A. report theorized that the infants’ intestinal membranes could have been damaged by bacteria breaking down the xanthan gum into too many toxic byproducts.

Dr. Qing Yang, a neonatologist at Wake Forest University, is a co-author of a case series in the Journal of Perinatology about three premature infants who took SimplyThick, developed NEC and were treated. The paper speculates that NEC was “most likely caused by the stimulation of the immature gut by xanthan gum.”

Dr. Yang said she only belatedly realized “there’s a lack of data” on xanthan gum’s use in preemies. “The lesson I learned is not to be totally dependent on the speech pathologist.”

Julie Mueller’s daughter Addison was born full-term and given SimplyThick after a swallow test showed she was at risk of choking. It was recommended by a speech pathologist at the hospital.

Less than a month later, Addison was dead with multiple holes in her small intestine. “It was a nightmare,” said Ms. Mueller, who has filed a lawsuit against SimplyThick. “I was astounded how a hospital and manufacturer was gearing this toward newborns when they never had to prove it would be safe for them. Basically we just did a research trial for the manufacturer.”

Read More..

Nanoparticles in Food Raise Concern by Advocacy Group

Nanomaterials, substances broken down by technology into molecule-size particles, are starting to enter the food chain through well-known food products and their packaging, but there is little acknowledgment by the companies using them, according to a new report from a nonprofit group that works to enhance corporate accountability.

Some companies may not even know whether nanomaterials are present in their products, the corporate accountability group As You Sow said.

Only 26 out of 2,500 companies, including PepsiCo, Whole Foods and the corporate parent of Pizza Hut and Taco Bell, responded to a survey from As You Sow about their use of nanomaterials.

“Only 14 said they don’t use nanomaterials, and of those only two had any policies on the use of nanomaterials,” said Andy Behar, chief executive of As You Sow. Various food companies have said they are interested in nanotechnology, which can help make products creamier without additional fat, intensify and improve flavors and brighten colors.

Their small size allows nanoparticles to go places in the body where larger particles cannot and enter cells. They have been found in the blood stream after ingestion and inhalation, and while research on their health effects is limited, studies have shown them to have deleterious effects on mice and cells.

“We’re not taking a no nano position,” Mr. Behar said. “We’re saying just show it’s safe before you put these things into food or food packaging.”

He noted that the European Union requires labeling of foods containing nanomaterials and that the European Food Safety Authority has published guidance for assessing nanomaterials in food and animal feed.

Last April, the Food and Drug Administration issued an unusually emphatic statement on nanomaterials, saying it did not have enough data to determine the safety of nanomaterials in food.

The Environmental Protection Agency is evaluating various nanoparticles used in consumer products, like sunscreens.

As You Sow tested 10 varieties of powdered doughnuts for the presence of nanoparticles. With the help of an independent lab, it found that Hostess Donettes and Dunkin’ Donuts Powdered Cake Donuts tested positive for the presence of titanium dioxide materials of less than 10 nanometers. Titanium dioxide is used to brighten white substances. The nano variety is under investigation by the E.P.A.

Michelle King, a spokeswoman for Dunkin’ Donuts, said the company was working with its supplier to validate As You Sow’s findings. Hostess Brands went out of business during the test and closed its factories.

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Europol Investigation Shows Fixing Is Suspected in 680 Soccer Matches

Robin Van Lonkhuijsen/Agence France-Presse — Getty Images

Rob Wainwright, the director of Europol, at a press conference in The Hague on Monday.

Soccer is known throughout much of the world as the beautiful game. But the sport’s ugliest side — the scourge of match-fixing — will not soon go away.

With the 2014 World Cup in Brazil drawing closer, a European police intelligence agency said Monday that its 19-month investigation, code-named Operation Veto, revealed widespread occurrences of match-fixing in recent years, with 680 games globally deemed suspicious. The list of match types is staggering: some 150 international matches, mostly in Africa, Asia and Latin America; roughly 380 games in Europe, covering World Cup and European championship qualifiers as well as two Champions League games; and games that run the gamut from lower-division semiprofessional matches to contests in top domestic leagues.

But officials at the news conference at The Hague repeatedly sidestepped questions from reporters on how many of the actual 680 matches cited had been previously reported, and, in some instances, previously prosecuted, and how many of them represented new information.

Nor would the officials identify any of the teams and individuals newly linked to match-fixing, citing the need to guard the confidentiality of police procedures.

Still, one new tantalizing detail did emerge: the revelation that one of the suspicious matches uncovered was a game in the Champions League — the most prestigious annual soccer tournament in the world — and that it was played in England in the last three or four years.

Even as the news conference continued, fans immediately took to social media to speculate on the match in question and, indeed, on which English team might have been involved. Manchester United, Manchester City, Arsenal, Chelsea, Liverpool and Tottenham are the only English teams that have participated in the Champions League during the time frame cited by officials. All six are iconic teams in England’s Premier League, which is by far the world’s most popular soccer league and has an unparalleled global following.

And while the absence of details left it unclear as to whether investigators believed an English team was culpable in fixing a Champions League game, or whether it was an opposing team from another country that had come to England for the match, the fact that match-fixing was now being linked to the country that represents the biggest international stage in soccer left many in the sport apprehensive.

“It would be naïve and complacent of those in the U.K. to think such a criminal conspiracy does not involve the English game and all the football in Europe,” Rob Wainwright, the director of the police intelligence agency, known as Europol, told reporters.

Most of the investigation’s focus, however, was elsewhere. Europol described a wide-ranging network of fixing that struck at the sport’s core. Nearly $11 million in profits and nearly $3 million in bribes were discovered during the investigation, which uncovered “match-fixing activity on a scale we have not seen before,” Wainwright said.

“This is a sad day for European football,” he added.

Fixers typically seek to dictate a game’s result by corrupting the players or the on-field officials, and the Europol officials said Monday that roughly 425 people were under suspicion because of the investigation, with 50 people having been arrested. The scope of the investigation covered games from roughly 2008 to 2011.

An organized crime syndicate based in Asia is believed to be the driving force behind the fixing activity, which stretches across at least 15 countries, Europol officials said. Individual bribes were, in some instances, higher than $136,000, and fixers would place bets on the tainted matches through bookmakers in Asia.

Various matches in Africa, Asia and South and Central America were identified as suspicious, and Declan Hill, a Canadian journalist and the author of “The Fix: Soccer and Organized Crime,” said his reporting on the subject — which was included in Europol’s investigation — had not previously indicated such widespread fixing among national teams.

David Jolly contributed reporting from The Hague.

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TIMESCAST: Super Bowl Ads Recall Days Gone By

February 4, 2013By Fritzie Andrade, Zena Barakat, Emily B. Hager, Erica Berenstein and Pedro Rafael Rosado

TimesCast Media+Tech: The successes and failures of this year’s Super Bowl ads. | Ang Lee on the technology behind “Life of Pi.” | An interactive project encourages action against human trafficking.

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Well: Expressing the Inexpressible

When Kyle Potvin learned she had breast cancer at the age of 41, she tracked the details of her illness and treatment in a journal. But when it came to grappling with issues of mortality, fear and hope, she found that her best outlet was poetry.

How I feared chemo, afraid
It would change me.
It did.
Something dissolved inside me.
Tears began a slow drip;
I cried at the news story
Of a lost boy found in the woods …
At the surprising beauty
Of a bright leaf falling
Like the last strand of hair from my head

Ms. Potvin, now 47 and living in Derry, N.H., recently published “Sound Travels on Water” (Finishing Line Press), a collection of poems about her experience with cancer. And she has organized the Prickly Pear Poetry Project, a series of workshops for cancer patients.

“The creative process can be really healing,” Ms. Potvin said in an interview. “Loss, mortality and even hopefulness were on my mind, and I found that through writing poetry I was able to express some of those concepts in a way that helped me process what I was thinking.”

In April, the National Association for Poetry Therapy, whose members include both medical doctors and therapists, is to hold a conference in Chicago with sessions on using poetry to manage pain and to help adolescents cope with bullying. And this spring, Tasora Books will publish “The Cancer Poetry Project 2,” an anthology of poems written by patients and their loved ones.

Dr. Rafael Campo, an associate professor of medicine at Harvard, says he uses poetry in his practice, offering therapy groups and including poems with the medical forms and educational materials he gives his patients.

“It’s always striking to me how they want to talk about the poems the next time we meet and not the other stuff I give them,” he said. “It’s such a visceral mode of expression. When our bodies betray us in such a profound way, it can be all the more powerful for patients to really use the rhythms of poetry to make sense of what is happening in their bodies.”

On return visits, Dr. Campo’s patients often begin by discussing a poem he gave them — for example, “At the Cancer Clinic,” by Ted Kooser, from his collection “Delights & Shadows” (Copper Canyon Press, 2004), about a nurse holding the door for a slow-moving patient.

How patient she is in the crisp white sails
of her clothes. The sick woman
peers from under her funny knit cap
to watch each foot swing scuffing forward
and take its turn under her weight.
There is no restlessness or impatience
or anger anywhere in sight. Grace
fills the clean mold of this moment
and all the shuffling magazines grow still.

In Ms. Potvin’s case, poems related to her illness were often spurred by mundane moments, like seeing a neighbor out for a nightly walk. Here is “Tumor”:

My neighbor walks
For miles each night.
A mantra drives her, I imagine
As my boys’ chant did
The summer of my own illness:
“Push, Mommy, push.”
Urging me to wind my sore feet
Winch-like on a rented bike
To inch us home.
I couldn’t stop;
Couldn’t leave us
Miles from the end.

Karin Miller, 48, of Minneapolis, turned to poetry 15 years ago when her husband developed testicular cancer at the same time she was pregnant with their first child.

Her husband has since recovered, and Ms. Miller has reviewed thousands of poems by cancer patients and their loved ones to create the “Cancer Poetry Project” anthologies. One poem is “Hymn to a Lost Breast,” by Bonnie Maurer.

Oh let it fly
let it fling
let it flip like a pancake in the air
let it sing: what is the song
of one breast flapping?

Another is “Barn Wish” by Kim Knedler Hewett.

I sit where you can’t see me
Listening to the rustle of papers and pills in the other room,
Wondering if you can hear them.
Let’s go back to the barn, I whisper.
Let’s turn on the TV and watch the Bengals lose.
Let’s eat Bill’s Doughnuts and drink Pepsi.
Anything but this.

Ms. Miller has asked many of her poets to explain why they find poetry healing. “They say it’s the thing that lets them get to the core of how they are feeling,” she said. “It’s the simplicity of poetry, the bare bones of it, that helps them deal with their fears.”

---

Have you written a poem about cancer? Please share them with us in the comments section below.

Read More..

Well: Expressing the Inexpressible

When Kyle Potvin learned she had breast cancer at the age of 41, she tracked the details of her illness and treatment in a journal. But when it came to grappling with issues of mortality, fear and hope, she found that her best outlet was poetry.

How I feared chemo, afraid
It would change me.
It did.
Something dissolved inside me.
Tears began a slow drip;
I cried at the news story
Of a lost boy found in the woods …
At the surprising beauty
Of a bright leaf falling
Like the last strand of hair from my head

Ms. Potvin, now 47 and living in Derry, N.H., recently published “Sound Travels on Water” (Finishing Line Press), a collection of poems about her experience with cancer. And she has organized the Prickly Pear Poetry Project, a series of workshops for cancer patients.

“The creative process can be really healing,” Ms. Potvin said in an interview. “Loss, mortality and even hopefulness were on my mind, and I found that through writing poetry I was able to express some of those concepts in a way that helped me process what I was thinking.”

In April, the National Association for Poetry Therapy, whose members include both medical doctors and therapists, is to hold a conference in Chicago with sessions on using poetry to manage pain and to help adolescents cope with bullying. And this spring, Tasora Books will publish “The Cancer Poetry Project 2,” an anthology of poems written by patients and their loved ones.

Dr. Rafael Campo, an associate professor of medicine at Harvard, says he uses poetry in his practice, offering therapy groups and including poems with the medical forms and educational materials he gives his patients.

“It’s always striking to me how they want to talk about the poems the next time we meet and not the other stuff I give them,” he said. “It’s such a visceral mode of expression. When our bodies betray us in such a profound way, it can be all the more powerful for patients to really use the rhythms of poetry to make sense of what is happening in their bodies.”

On return visits, Dr. Campo’s patients often begin by discussing a poem he gave them — for example, “At the Cancer Clinic,” by Ted Kooser, from his collection “Delights & Shadows” (Copper Canyon Press, 2004), about a nurse holding the door for a slow-moving patient.

How patient she is in the crisp white sails
of her clothes. The sick woman
peers from under her funny knit cap
to watch each foot swing scuffing forward
and take its turn under her weight.
There is no restlessness or impatience
or anger anywhere in sight. Grace
fills the clean mold of this moment
and all the shuffling magazines grow still.

In Ms. Potvin’s case, poems related to her illness were often spurred by mundane moments, like seeing a neighbor out for a nightly walk. Here is “Tumor”:

My neighbor walks
For miles each night.
A mantra drives her, I imagine
As my boys’ chant did
The summer of my own illness:
“Push, Mommy, push.”
Urging me to wind my sore feet
Winch-like on a rented bike
To inch us home.
I couldn’t stop;
Couldn’t leave us
Miles from the end.

Karin Miller, 48, of Minneapolis, turned to poetry 15 years ago when her husband developed testicular cancer at the same time she was pregnant with their first child.

Her husband has since recovered, and Ms. Miller has reviewed thousands of poems by cancer patients and their loved ones to create the “Cancer Poetry Project” anthologies. One poem is “Hymn to a Lost Breast,” by Bonnie Maurer.

Oh let it fly
let it fling
let it flip like a pancake in the air
let it sing: what is the song
of one breast flapping?

Another is “Barn Wish” by Kim Knedler Hewett.

I sit where you can’t see me
Listening to the rustle of papers and pills in the other room,
Wondering if you can hear them.
Let’s go back to the barn, I whisper.
Let’s turn on the TV and watch the Bengals lose.
Let’s eat Bill’s Doughnuts and drink Pepsi.
Anything but this.

Ms. Miller has asked many of her poets to explain why they find poetry healing. “They say it’s the thing that lets them get to the core of how they are feeling,” she said. “It’s the simplicity of poetry, the bare bones of it, that helps them deal with their fears.”

---

Have you written a poem about cancer? Please share them with us in the comments section below.

Read More..

DealBook: Dell Nears a Buyout Deal of More Than $23 Billion

Dell Inc. neared an agreement on Monday to sell itself to a group led by its founder and the investment firm Silver Lake for more than $23 billion, people briefed on the matter said, in what would be the biggest buyout since the financial crisis.

If completed, a takeover would be the most radical attempt yet by Michael S. Dell to revive the company that bears his name. Such is the size of the potential deal that Mr.
Dell has called upon Microsoft, one of his most important business partners, to shore up the proposal with additional financial muscle. The question will now turn to whether taking the personal computer maker private will accomplish what years of previous turnaround efforts have not.

The final details were being hammered out on Monday evening, and a deal could be announced as soon as Tuesday. Still, last-minute snags could cause the negotiations to collapse, the people briefed on the matter cautioned.

The consortium is expected to pay between $13.50 and $13.75 a share, these people said. Mr. Dell is expected to contribute his nearly 16 percent stake to the deal, worth about $3.8 billion under the current set of terms. He is also expected to contribute hundreds of millions of dollars in fresh capital from his own fortune.

Silver Lake would likely contribute roughly $1 billion, these people added. Microsoft is expected to put in about $2 billion, though that would likely come in the form of preferred shares or debt.

Dell is also expected to bring home some of the cash that is currently held in offshore accounts to help with the financing.

A spokesman for Dell declined to comment.

For decades, Dell benefited from its status as a pioneer in the market for personal computers. Founded in 1984 in a dormitory room at the University of Texas, the company grew into one of the biggest computer makers in the world, built on the simple premise that customers would flock to customize their machines.

By the late 1990s, its fast-rising stock created a company worth $100 billion and minted a class of “Dellionaires” whose holdings made for big fortunes, at least on paper. Mr. Dell himself amassed a fortune worth an estimated $16 billion and formed a quietly powerful investment firm to manage those riches.

But since then, growing competition has sapped Dell’s strength. Rivals like Lenovo and Samsung have made the PC-making business less profitable. Last month, the market research firm Gartner reported that Dell sold 37.6 million PCs worldwide in 2012, a 12.3 percent drop from the previous year’s shipments. Perhaps more significant is the emergence of the smartphone and the tablet, two classes of devices that have eaten away at sales of traditional computers.

Mr. Dell has sought to move the company into the more lucrative and stable business of providing corporations with software services, spending billions of dollars on acquisitions to lead that transformation. The aim is to refashion Dell into something more like I.B.M. or Oracle. Even so, manufacturing PCs still makes up half of the company’s business.

The company’s stock had fallen in 59 percent in the 10 years ended Jan. 13, the last business day before word of the buyout talks emerged. That has actually made Dell more tempting as a takeover target for its founder and Silver Lake, which see it as undervalued.

A Dell deal would be a watershed moment for the leveraged buyout industry: It would be the largest takeover since the Blackstone Group paid $25 billion for Hilton Hotels in the summer of 2007. No leveraged buyout since the financial crisis has surpassed the $7.2 billion that Kohlberg Kravis Roberts and others paid for the Samson Investment company, an oil and gas driller, in the fall of 2011.

Private equity executives have hungered for the chance to strike a deal worth more than $10 billion, an accomplishment believed difficult because of the sheer size of financing required. Dell will take on more than $15 billion in debt, an enormous amount arranged by no fewer than four banks.

Leading the charge for Dell is Silver Lake, known as one of the biggest investors in technology companies.

But the debt markets have been soaring over the past two years, as the cost of junk bonds has stayed low. Persistent low interest rates has prompted debt buyers to seek investments that carry higher yields

Dell was unusually well-placed to make a deal with private equity. The company carries $4.9 billion in long-term debt, which some analysts have regarded as a manageable amount. And its management has signaled a willingness to bring back at least some of the company’s cash horde that is held overseas, despite potentially ringing up a hefty tax bill.

And then there is the matter of Mr. Dell’s stake. Advisers to Dell have taken pains to structure the transaction to avoid the potential conflicts of interest involved in a chief executive taking his company private, the people briefed on the matter said.

A special committee of Dell’s board has hired an independent investment bank, Evercore Partners, as an adviser who will seek out alternative takeover bids.
It is unclear whether the company’s biggest investors will accept a deal at the levels that the buyer consortium is advocating. Shares of Dell fell 2.6 percent, to $13.27, on Monday after reports of the proposed price range emerged.

Still, an analyst with Sanford C. Bernstein, A. M. Sacconaghi, wrote in a research note last month that he believed Mr. Dell was likely to succeed in at least taking the company private.

“Net net, we believe that if a deal goes to a shareholder vote it will likely be approved,” he wrote — cautioning that victory is dependent on activist investors not clamoring for a significantly higher price.

But going private may not solve all of the company’s problems. Mr. Sacconaghi said that a leveraged buyout makes sense so long as Dell is able to stanch bleeding in its PC business and bring back some of its overseas cash over time.

The bigger question is whether Mr. Dell will undertake more drastic changes at the company once it is away from the glare of the public markets. Analysts at Barclays wrote last month that shedding unattractive businesses, like its consumer PC arm, would make a take-private more attractive.

Absent big moves, the strain of the additional debt could starve Dell of the cash it needs to tackle additional acquisitions to complete its transformation into an enterprise software company.

Biggest Private Equity-Backed Leveraged Buyouts

DEAL, IN BILLIONS	TARGET	BUYER	ANNOUNCED
Source: Thomson Reuters *At time of deal, including assumption of debt, not adjusted for inflation.
$44.3	TXU	Morgan Stanley, Citigroup, Lehman Brothers Holdings, Kohlberg Kravis Roberts, Texas Pacific Group and Goldman Sachs	February 2007
37.7	Equity Office Properties Trust	Blackstone Group	November 2006
32.1	HCA	Bain Capital, Kohlberg Kravis Roberts and Merrill Lynch Global Private	July 2006
30.2	RJR Nabisco	Kohlberg Kravis Roberts	October 1988
30.1	BAA	Grupo Ferrovial SA, Caisse de Depot et Placement and GIC Special Invest	March 2006
27.6	Harrah’s Entertainment	Texas Pacific Group and Apollo Management	October 2006
27.4	Kinder Morgan	GS Capital Partners, The Carlyle Group and Riverstone Holdings	May 2006
27.2	Alltel	TPG Capital and GS Capital Partners	May 2007
27.0	First Data	Kohlberg Kravis Roberts	April 2007
26.7	Hilton Hotels	Blackstone Group	July 2007

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