Hospitals crack down on workers refusing flu shots

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

__

Online:

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

CDC: http://www.cdc.gov

___

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

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Apple drags on S&P, Nasdaq; Dell jumps after report

NEW YORK (Reuters) - The S&P 500 and Nasdaq ended lower on Monday as worries over demand for Apple products drove down its shares and as investors braced for earnings disappointments.

But Dell Inc's stock jumped 13 percent to about a five-month high at $12.29, offsetting some of the tech-sector weakness, after Bloomberg reported the No. 3 personal computer maker is in talks with private equity firms to go private.

Tech heavyweight Apple lost 3.6 percent to $501.75 and was the biggest weight on both the S&P 500 and Nasdaq 100 <.ndx> indexes after reports that the company has cut orders for LCD screens and other parts for the iPhone 5 this quarter due to weak demand. The stock earlier hit a session low of $498.51, the first dip below $500 since February 16.

"With Apple, it seems as if the sentiment has shifted from this being the one stock that everybody wanted to own to people beginning to look at it as a company (whose) business is slowing down somewhat," said Eric Kuby, chief investment officer of North Star Investment Management Corp in Chicago.

Adding to investor unease, fourth-quarter earnings kick into high gear this week. Analyst estimates for the quarter have fallen sharply since October, with S&P 500 earnings growth now seen up just 1.9 percent from a year ago, Thomson Reuters data showed.

The Dow Jones industrial average <.dji> was up 18.89 points, or 0.14 percent, at 13,507.32. The Standard & Poor's 500 Index <.spx> was down 1.37 points, or 0.09 percent, at 1,470.68. The Nasdaq Composite Index <.ixic> was down 8.13 points, or 0.26 percent, at 3,117.50.

Apple suppliers also lost ground, with Cirrus Logic off 9.4 percent at $28.62 and Qualcomm down 1 percent at $64.24.

The Dow fared better than the other two indexes, helped in part by Hewlett-Packard shares, which rose 4.9 percent to $16.95. The stock, which was up early in the session after JPMorgan upgraded its rating on the stock and raised its price target to $21 from $15, added to gains after the Dell report.

Appliance and electronics retailer Hhgregg Inc slumped 5.7 percent to $7.44 after the company cut its same-store sales forecast for the full year.

Earnings reports are due this week from Goldman Sachs , Bank of America , Intel and General Electric , among other companies. Third-quarter reports ended with a gain of just 0.1 percent, the worst for an S&P 500 profit period in three years, according to Thomson Reuters data.

President Barack Obama warned Congress at a news conference on Monday that a refusal to raise the U.S. debt ceiling next month could mean a government shutdown and trigger economic chaos.

Volume was roughly 5.6 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with the 2012 average daily closing volume of about 6.45 billion.

Decliners were about even with advancers on the NYSE while decliners outpaced advancers on the Nasdaq by about 12 to 11.

(Additional reporting by Chuck Mikolajczak; Editing by Kenneth Barry and Nick Zieminski)

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Leon Panetta Says U.S. Has Pledged to Help France in Mali

LISBON — In what could draw the United States into another conflict in North Africa, the Obama administration has pledged to help the French who are fighting Islamist militants in Mali, and that assistance could include air and other logistical support, Defense Secretary Leon E. Panetta said on Monday.

Jacquelyn Martin/Associated Press

Defense Secretary Leon E. Panetta boards a plane bound for Portugal on Monday.

The United States was already sharing intelligence with the French when their warplanes on Sunday struck camps, depots and other militant positions deep inside extensive Islamist-held territory in northern Mali. Defense officials said no decisions had been made on whether the United States would also offer help with midflight refueling planes and air transport, but they said those options were under review.

Defense officials would not rule out the possibility that American military transport planes might land in Mali, where the United States has been conducting an ambitious counterterrorism program for years. American spy planes and surveillance drones are in the meantime trying to get a sense of the chaos on the ground. The defense officials would not discuss whether the United States has armed drone aircraft over Mali.

But Mr. Panetta, who spoke to reporters on his plane en route to Portugal for a weeklong trip Europe, said that the chaos in Mali was of deep concern to the administration and praised the French for their actions. He also said “ what we have promised them is that we would work with them, to cooperate with them, to provide whatever assistance we can to try to help them in that effort.”

Mr. Panetta said that even though Mali is far from the United States, the Obama administration was deeply worried about extremist groups there, including Al Qaeda in the Islamic Maghreb, or AQIM. “We’re concerned that any time Al Qaeda establishes a base of operations, while they might not have any immediate plans for attacks in the United States and in Europe, that ultimately that still remains their objective,” he said.

For that reason, Mr. Panetta said, “we have to take steps now to make sure that AQIM does not get that kind of traction.”

The United States has spent between $520 million and $600 million over the last four years to try to combat Islamist militancy in the region, including in Mali, which was until recently considered a prime example of what could be accomplished with American military training. American Special Forces trained Malian troops in marksmanship, border patrol and ambush drills.

But the situation collapsed when heavily armed Islamist fighters returned from combat in Libya and teamed up with jihadist groups like Ansar Dine, or Defenders of the Faith, which have carried out a harsh repression in northern Mali. Elite Malian commanders defected to the enemy and took with them troops, guns and their American-taught skills. An American-trained officer then overthrew Mali’s elected government, paving the way for half of the country to fall to Islamic extremists.

A confidential internal review completed last July by the Pentagon’s Africa Command concluded that the coup had unfolded too quickly for American commanders or intelligence analysts to detect any clear warning signs, but other military officials disagreed, saying the intelligence analysts had grown complacent..

Mr. Panetta sought to make the case that the United States was not surprised by the recent events in Mali and said that the Obama administration had been watching militants there for a long time. “When they began offensive operations to actually take on some cities, it was clear to France and to all of us that could not be allowed to continue, and that’s the reason France has engaged and it’s the reason we’re providing cooperation to them,” he said.

Mr. Panetta also said that “the fact is, we have made a commitment that Al Qaeda is not going to find any place to hide.”

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4 gadgets that defined Vegas electronics show

LAS VEGAS (AP) — The world’s largest gadget show wrapped up on Friday, and the organizers said it was the biggest ever, beating last year’s record in terms of the floor space companies purchased to display their wares.

What was it that drew more than 3,500 companies and 150,000 people to Las Vegas for this mega-event? Here are four gadgets that exemplified the top trends at this year’s International CES.

— Sony‘s 55-inch ultra-high-definition TV

The introduction of high-definition and flat-panel TVs sent U.S. shoppers on a half-decade buying spree as they tossed out old tube sets. Now that the old sets are mostly gone, sales of new TVs are falling. To lure buyers back, Asian TV makers are trying to pull the same trick again. They’re making the sets sharper. This fall, Sony and LG introduced 84-inch sets with four times the resolution of regular high-definition sets. They provide stunning sharpness, but they’re too big for most homes, and at more than $ 20,000, too expensive. At the show, the companies unveiled smaller “ultra-high-definition” sets, measuring 55 inches and 65 inches on the diagonal. They will go on sale this spring. Prices were not announced, but will presumably be a lot lower than for the 84-inch sets, perhaps under $ 10,000.

Both the size and price of these smaller ultra-HD TVs should make them easier buys, but the higher resolution will be a lot less noticeable on a smaller screen, unless viewers sit very close. Analysts expect ultra-HD to remain an exclusive niche product for some years. There’s no easy way to get ultra-HD video content to the sets, so they will mostly be showing regular HD movies. However, the sets can “upscale” the video to make it look better than it does on a regular HD set.

Analyst James McQuivey of Forrester Research believes the TV makers are focusing on the wrong thing. He doesn’t think consumers really care that much about picture quality.

“What matters most is not the number of pixels or the quality of the pixels themselves … but the increasing convenience of the content’s discovery and delivery. This is why TV makers should be investing in a better experience rather than a bigger one,” McQuivey wrote in a blog post.

— LG’s 55-inch OLED TV

Organic light-emitting diodes, or OLEDs, make for thin, extremely colorful screens. They’re already established in smartphone screens, and they have a lot of promise for other applications as well. For years, a promise is all they’ve represented. OLED screens are very hard to make in larger sizes. Now, LG is shipping a 55-inch OLED TV set in Korea, and is expected to bring it to the U.S. this spring for about $ 12,000.

Beyond being thin, power-thrifty and capable of extremely high color saturation, OLEDs are interesting for another reason: they can bend. LCDs have to be laid down on flat glass substrates, but OLEDs can be laid down on flexible glass or plastic. The major obstacle here is that flexible substrates tend to let through air, which destroys OLEDs, but manufacturers seem to have tackled the problem. Samsung showed off a phone that can bend into a tube. It consisted of a rigid plastic box with electronics and an attached display that is as thin as a piece of paper. The company suggested that in the future, it could make displays that fold up like maps — big screens that fit in a pocket.

We’re likely to see the benefits of bendy OLEDs sooner in a less eyebrow-raising but more practical implementation. It may never have occurred to you, but all electronic screens, except for cathode-ray tubes, are flat. With OLEDs, they don’t have to be. LG and Sony showed TV sets with concave screens at the show — not very useful, but an interesting demonstration. In the future, you could have a phone with a screen that laps over onto the edges, providing you with “smart” buttons with labels that change depending on whether you’re in camera mode or music mode. You could have a coffee mug with a wrap-around news and weather ticker. A revolution in design awaits.

By the way, you won’t have to choose between ultra-HD and OLED screens — Sony, Panasonic and LG showed prototype TVs that combine the technologies.

— The Pebble Watch

The Pebble is a “smart” timepiece that can be programmed to do various things, including showing text messages sent to your phone. The high-resolution display is all digital, so it can be programmed with various cool “watch faces.” But what’s really interesting about the Pebble is how it came to be —and that it exists at all.

Young Canadian inventor Eric Migicovsky couldn’t find conventional funding to make the watch, so he asked for money on Kickstarter, the biggest “crowdfunding” website. In essence, he asked people to buy watches before he actually had any to sell. The fundraising was a blowout success. Migicovsky raised $ 10.3 million by pre-selling 85,000 Pebbles. At CES, he announced that the watches were ready to ship.

Kickstarter’s goal is to bring things and events into fruition that otherwise wouldn’t happen, by creating a shortcut between the people who want to create something and the people willing to pay for it. The effect is starting to become apparent at CES. At least two other “smart” watches funded through Kickstarter were on display. Some startups were at the show to drum up interest in ongoing Kickstarter campaigns, including a Swedish company that wants to make a speaker with a transparent body, and a California outfit that wants to produce a swiveling, remote-controlled platform for cameras.

— Creative Technology Ltd.’s Interactive Gesture Camera

This $ 150 camera, promoted by Intel, attaches to a computer much like a Webcam. From a single lens, it shoots the world in 3-D, using technology similar to radar. The idea is that you can perform hand gestures in the air in front of the camera, and it lets the computer interpret them. Why would you want this? That’s not really clear yet, but a lot of effort is going into finding an answer. CES was boiling with gadgets attempting to break new ground when it comes to how we interact with computers and appliances like TV sets. The Nintendo Wii game console, with its innovative motion-sensing controllers, and the Microsoft Kinect add-on for the Xbox 360 console, which has its own 3-D-sensing camera, have inspired engineers to pursue ways to ditch —or at least complement— the keyboard, mouse, remote control and even the touchscreen.

Samsung’s high-end TVs already let viewers use hand gestures to control volume, and it expanded the range of recognized gestures with this year’s models. Startup Leap Motion was at the show with another depth-sensing camera kit, this one designed to mount next to a laptop’s touch pad, looking upward.

So far, though, the “new interaction” field hasn’t had a real hit since the Kinect. Consumers may be eager to lose the TV remote, but there’s a holdup caused by the nature of the setup: to effectively control the TV, you need to take command not just of the TV, but of the cable or satellite set-top box. TV makers and the cable companies don’t really talk to each other, and there’s no sign of them uniting on a common approach. Only when both devices can be controlled by hand-waving can we permanently let the remote get lost between the couch cushions.

Gadgets News Headlines – Yahoo! News

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Miss America Mallory Hytes Hagan: Five Things to Know

By Mark Gray

01/13/2013 at 04:00 PM EST

Miss American 2013 Mallory Hytes Hagan

CraigSjodin/ABC

The new Miss America is an Alabama-bred blonde beauty who lives in Brooklyn, N.Y., and loves '80s pop music. But Mallory Hytes Hagan is more than just a pretty face who tap-danced her way into the judges' hearts on Saturday. Here are five things to know about the new Miss America:

1. Modern Day Rags to Riches?
At 18, Hagan moved to New York with only $1,000 in her pocket. "I just didn't know that $1,000 wasn't enough money," she told PEOPLE. "I look back at my parents now for letting me do it and I think, 'Are you crazy?' " I genuinely think they thought I'd be there for three weeks and move back. I hit the ground running and had three job offers in first day."

2. She Wants to Jump Out of a Plane!
Hagan claims she's not a risk taker, but she would love to go skydiving because it's "completely out of control" – the opposite of how she usually behaves. "I think it would be amazing," she said. "I'm truly a Capricorn, so I like to plan out what's going to happen. I think it's about the drive. I'd love to go skydiving. Why not?"

3. She's No Longer the 'Bridesmaid'
If it appeared that Hagan was genuinely shocked when her name was announced as the new Miss America it's because she was. "As a teen, I was third, second and first runner-up. In Miss New York, I was first runner-up twice. My thought process was, 'They're going to get another first runner up photo of me.' I'm thrilled to be here but I didn't expect it at all."

4. She Wants to Stop Sexual Abuse of Children

Her platform, Stop It Now! (which works to prevent child sexual abuse), is close to her heart because several of the women (and possibly some of the men) in her family were sexually abused as children, she told reporters in a press conference. "I never was, but it was something I was going through in my teenage years as my family was trying to find peace in that," she says. She thinks mandatory child sexual awareness education would be "an incredible step for America."

5. She Loves Cosmetics
She may not be different than many women with her interest in cosmetics, but Hagan wants to make a career out of it. A student studying advertising, communications and marketing at the Fashion Institute of Technology, Hagan's dream job would be the global marketing director for a cosmetic company. As part of her duties as Miss America, Hagan will work with Artistry cosmetics. "This will be a wonderful internship," she said.

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Flu more widespread in US; eases off in some areas

NEW YORK (AP) — Flu is now widespread in all but three states as the nation grapples with an earlier-than-normal season. But there was one bit of good news Friday: The number of hard-hit areas declined.

The flu season in the U.S. got under way a month early, in December, driven by a strain that tends to make people sicker. That led to worries that it might be a bad season, following one of the mildest flu seasons in recent memory.

The latest numbers do show that the flu surpassed an "epidemic" threshold last week. That is based on deaths from pneumonia and influenza in 122 U.S. cities. However, it's not unusual — the epidemic level varies at different times of the year, and it was breached earlier this flu season, in October and November.

And there's a hint that the flu season may already have peaked in some spots, like in the South. Still, officials there and elsewhere are bracing for more sickness

In Ohio, administrators at Miami University are anxious that a bug that hit employees will spread to students when they return to the Oxford campus next week.

"Everybody's been sick. It's miserable," said Ritter Hoy, a spokeswoman for the 17,000-student school.

Despite the early start, health officials say it's not too late to get a flu shot. The vaccine is considered a good — though not perfect — protection against getting really sick from the flu.

Flu was widespread in 47 states last week, up from 41 the week before, the Centers for Disease Control and Prevention said on Friday. The only states without widespread flu were California, Mississippi and Hawaii.

The number of hard-hit states fell to 24 from 29, where larger numbers of people were treated for flu-like illness. Now off that list: Florida, Arkansas and South Carolina in the South, the first region hit this flu season.

Recent flu reports included holiday weeks when some doctor's offices were closed, so it will probably take a couple more weeks to get a better picture, CDC officials said Friday. Experts say so far say the season looks moderate.

"Only time will tell how moderate or severe this flu season will be," CDC Director Dr. Thomas Frieden said Friday in a teleconference with reporters.

The government doesn't keep a running tally of adult deaths from the flu, but estimates that it kills about 24,000 people in an average year. Nationally, 20 children have died from the flu this season.

Flu vaccinations are recommended for everyone 6 months or older. Since the swine flu epidemic in 2009, vaccination rates have increased in the U.S., but more than half of Americans haven't gotten this year's vaccine.

Nearly 130 million doses of flu vaccine were distributed this year, and at least 112 million have been used. Vaccine is still available, but supplies may have run low in some locations, officials said.

To find a shot, "you may have to call a couple places," said Dr. Patricia Quinlisk, who tracks the flu in Iowa.

In midtown Manhattan, Hyrmete Sciuto got a flu shot Friday at a drugstore. She skipped it in recent years, but news reports about the flu this week worried her.

During her commute from Edgewater, N.J., by ferry and bus, "I have people coughing in my face," she said. "I didn't want to risk it this year."

The vaccine is no guarantee, though, that you won't get sick. On Friday, CDC officials said a recent study of more than 1,100 people has concluded the current flu vaccine is 62 percent effective. That means the average vaccinated person is 62 percent less likely to get a case of flu that sends them to the doctor, compared to people who don't get the vaccine. That's in line with other years.

The vaccine is reformulated annually, and this year's is a good match to the viruses going around.

The flu's early arrival coincided with spikes in flu-like illnesses caused by other bugs, including a new norovirus that causes vomiting and diarrhea, or what is commonly known as "stomach flu." Those illnesses likely are part of the heavy traffic in hospital and clinic waiting rooms, CDC officials said.

Europeans also are suffering an early flu season, though a milder strain predominates there. China, Japan, the West Bank, the Gaza Strip, Algeria and the Republic of Congo have also reported increasing flu.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

Most people with flu have a mild illness. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms.

Some shortages have been reported for children's liquid Tamiflu, a prescription medicine used to treat flu. But health officials say adult Tamiflu pills are available, and pharmacists can convert those to doses for children.

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Associated Press writers Dan Sewell in Cincinnati, Catherine Lucey in Des Moines, and Malcolm Ritter in New York contributed to this report.

___

Online:

CDC flu: http://www.cdc.gov/flu/index.htm

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Getting comfortable with living on the edge

LONDON (Reuters) - Just as you learn to put up with a nagging toothache, this week is expected to provide fresh evidence that the U.S. economy is getting used to life on the edge of the fiscal cliff.

Of course, putting off that trip to the dentist is not necessarily wise. The longer Washington delays, the more painful it will become to narrow its gaping budget deficit.

But surveys of U.S. consumer confidence in January and of house builder sentiment in December are likely to show resilience, buttressing the argument of equity bulls that Wall Street's firm start to the year is more than a relief rally or a desperate search for higher returns on investment.

Bluford Puttnam, chief economist of CME Group, said the U.S. economy had managed to grow almost 2 percent last year and create about 1.8 million jobs despite stagnation in Europe, a slowdown in China and the deadlocked budget talks.

"So I see a lot of momentum going into 2013," Puttnam said. "If we can get past this fiscal cliff, the economy is poised to have a much more confident year."

Despite fiscal tightening, he said growth could reach 2.5 percent to 3.0 percent.

Puttnam said the next rounds in the budget battle later this quarter would again be bitterly fought and the resolution would again satisfy no one. But, as with the showdown at the end of 2012, the economy would quickly move on.

"There is a one-in-ten chance that the government may even shut down for a week. It's just going to be ugly. And then it will be over. There will be some kind of compromise, and by April it will fade quickly into the background," he said.

THREE GORGES

U.S. retail sales are likely to have increased only 0.2 percent in December, dampened by the budget worries, according to economists polled by Reuters.

But a pair of regional Federal Reserve surveys and the monthly Reuters/University of Michigan consumer poll are projected to improve, while housing starts, new building permits and builders' confidence should all show that the housing recovery stands on firm foundations.

"That's what's really encouraging consumers to feel that the economy is getting better and that the momentum is broadly positive," said Jerry Webman, chief economist at OppenheimerFunds in New York.

While the phrase fiscal cliff used by U.S. Federal Reserve chief Ben Bernanke conjured up an image of an immediate plunge at the start of this year, in truth any austerity was always likely to take effect on the economy gradually.

Bank of America Merrill Lynch describes the challenges the United States faces in coming months rather as three fiscal gorges it must leap over.

The government could hit the debt ceiling approved by Congress as early as mid-February; across-the-board spending cuts are due to kick in on March 1; and the ‘continuing resolution' to fund all discretionary government spending expires on March 27.

Ideally, investors would like Democrats and Republicans to resolve all three issues with an overarching agreement to slash the deficit by $4 trillion over the next decade.

Instead, given the dysfunctional state of politics, Webman said the best that could be hoped for was another short-term fix that cuts spending and ends some tax breaks.

"The U.S. doesn't move by grand bargains, by big deals. We move by incremental decisions, and I think we'll make some imperfect but improved decisions over the course of 2013," he said.

CHINA ON THE MEND, EUROPE EERILY CALM

Encouraging economic news from China, including stronger-than-expected exports and imports in December, has also supported the start-of-year move by financial market investors out of cash and into riskier assets.

Figures on Friday are expected to show that the world's second-largest economy grew 7.8 percent from a year earlier, rebounding from the 7.4 percent pace of the third quarter and further allaying fears of a hard landing.

"Given some of the bearish commentary on China a few months ago, this should be a relief for markets and it's good for the world economy," said Derry Pickford, macro analyst at investment managers Ashburton in London.

Continuing calm in the euro zone has also helped equities, even though full-year German GDP data on Tuesday will serve as a reminder of the area's economic malaise.

Europe's largest economy contracted last quarter as factories slashed output in response to weak demand from Germany's neighbors, the Economy Ministry said on Friday.

At a news conference a day earlier, European Central Bank President Mario Draghi said he expected a recovery in euro zone growth later this year. But he ruled out an early end to the ECB's crisis policy measures and cautioned that risks were still tilted to the downside. Markets shrugged.

In Europe as in the United States, investors seem to have got used to high levels of policy uncertainty, said Ethan Harris, chief U.S. economist at Bank of America Merrill Lynch.

"It appears that the markets will look past brinkmanship moments unless policy makers break new ground," he said.

In Europe, that might mean not just threatening to eject Greece from the euro zone but actually forcing the exit. In the United States, that might mean not just threatening to violate the debt ceiling but actually doing so, Harris said in a report.

As long as such extreme events do not occur, Harris expects periodic swoons in confidence but no acute crisis.

"This renewed resilience is important because we expect many brinkmanship moments in the months ahead. A now-regular pattern has been established where deals are only struck at the last minute and often under market pressure," he wrote.

(Editing by Patrick Graham)

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India Ink: Woman Raped by Seven Men in Punjab, Police Say

NEW DELHI — The police said Sunday that a 29-year-old woman had been raped by a bus driver, a conductor and five other men in the northern Indian state of Punjab in an episode that recalls the recent attack in Delhi that has caused widespread outrage.

The woman in the Punjab attack boarded a bus on Friday bound for Gurdaspur to visit her in-laws, the police chief of Gurdaspur, Raj Jit Singh, said in a telephone interview. When she got off the bus, the driver offered her a ride on his motorcycle, perhaps to her in-laws’ village, the police said. Instead, he took her to a nearby village, where he and six other men, including the bus conductor, raped her repeatedly through the night.

The next morning, the driver dropped her at her in-laws’ home, where the woman told family members of the rape and then reported it to the police, Mr. Singh said.

Six men, including the bus driver and conductor, have been arrested, he said. All of the men are their 20s.

Gurmesh Singh, the deputy police superintendent for the region, said it was unclear how or why the bus driver persuaded the woman to go with him on his motorcycle. She was in a state of distress during the bus ride, Mr. Singh said, and originally refused to get off the bus when it reached its destination.

The Press Trust of India reported that the bus driver did not stop when requested.

The gang rape of a woman on a bus in New Delhi on Dec. 16, and her death from injuries sustained during the attack, has led to widespread protests and calls for increased policing and tougher laws against sexual assault in India.

The evidence against five of the men arrested in the New Delhi rape is being heard this month in a special fast-track court created for sexual assault cases.

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Biden seeks video game industry input on guns

WASHINGTON (AP) — Looking for broader remedies to gun violence, Vice President Joe Biden is reaching out to the video game industry for ideas as the White House seeks to assemble proposals in response to last month’s massacre at a Connecticut elementary school.

Biden is scheduled to meet with video game representatives Friday as the White House explores cultural factors that may contribute to violent behavior.

The vice president, who is leading a task force that will present recommendations to President Barack Obama on Tuesday, met with other representatives from the entertainment industry, including Comcast Corp. and the Motion Picture Association of America, on Thursday.

Friday’s meeting comes a day after the National Rifle Association rejected Obama administration proposals to limit high-capacity ammunition magazines and dug in on its opposition to an assault weapons ban, which Obama has previously said he will propose to Congress. The NRA was one of the pro-gun rights groups that met with Biden during the day.

NRA president David Keene, asked Friday if the NRA has enough support in Congress to fend off legislation to ban sales of assault weapons, indicated it does. “I do not think that there’s going to be a ban on so-called assault weapons passed by the Congress,” he said on NBC’s “Today.”

In previewing the meeting with the video game industry, Biden recalled how the late Sen. Daniel Patrick Moynihan of New York lamented during crime bill negotiations in the 1980s that the country was “defining deviancy down.”

It’s unclear what, if anything, the administration is prepared to recommend on how to address the depiction of violence in the media.

White House press secretary Jay Carney last month suggested that not all measures require government intervention.

“It is certainly the case that we in Washington have the potential, anyway, to help elevate issues that are of concern, elevate issues that contribute to the scourge of gun violence in this country, and that has been the case in the past, and it certainly could be in the future,” Carney said then.

In a statement, a half dozen entertainment groups, including the Motion Picture Association of America, said they “look forward to doing our part to seek meaningful solutions.”

On gun control, however, the Obama administration is assembling proposals to curb gun violence that would include a ban on sales of assault weapons, limits on high-capacity ammunition magazines and universal background checks for gun buyers.

“The vice president made it clear, made it explicitly clear, that the president had already made up his mind on those issues,” Keene said after the meeting. “We made it clear that we disagree with them.”

Opposition from the well-funded and politically powerful NRA underscores the challenges that await the White House if it seeks congressional approval for limiting guns and ammunition. Obama can use his executive powers to act alone on some gun measures, but his options on the proposals opposed by the NRA are limited without Congress’ cooperation.

Obama has pushed reducing gun violence to the top of his domestic agenda following last month’s mass shooting at an elementary school in Newtown, Conn., where a gunman slaughtered 20 children and six adults before killing himself. The president put Biden in charge of an administration task force and set a late January deadline for proposals.

“I committed to him I’d have these recommendations to him by Tuesday,” Biden said Thursday, during a separate White House meeting with sportsmen and wildlife groups. “It doesn’t mean it’s the end of the discussion, but the public wants us to act.”

The vice president later met privately with the NRA and other gun-owner groups for more than 90 minutes. Participants in the meeting described it as an open and frank discussion, but one that yielded little movement from either side on long-held positions.

Keene told NBC there is a fundamental disagreement over what would actually make a difference in curbing gun violence.

Richard Feldman, the president of the Independent Firearm Owners Association, said all were in agreement on a need to keep guns out of the hands of criminals and the mentally ill. But when the conversation turned to broad restrictions on high-capacity magazines and assault weapons, Feldman said Biden suggested the president had already made up his mind to seek a ban.

“Is there wiggle room and give?” Feldman said. “I don’t know.”

White House officials said the vice president didn’t expect to win over the NRA and other gun groups on those key issues. But the administration was hoping to soften their opposition in order to rally support from pro-gun lawmakers on Capitol Hill.

Biden’s proposals are also expected to include recommendations to address mental health care and violence on television, in movies and video games. Those issues have wide support from gun-rights groups and pro-gun lawmakers.

As the meetings took place in Washington, a student was shot and wounded at a rural California high school and another student was taken into custody.

During his meeting with sporting and wildlife groups, Biden said that while no recommendations would eliminate all future shootings, “there has got to be some common ground, to not solve every problem but diminish the probability that our children are at risk in their schools and diminish the probability that firearms will be used in violent behavior in our society.”

Several Cabinet members have also taken on an active role in Biden’s gun violence task force, including Attorney General Eric Holder. He met Thursday with Wal-Mart, the nation’s largest firearms seller, along with other retailers such as Bass Pro Shops and Dick’s Sporting Goods.

The president hopes to announce his administration’s next steps to tackle gun violence shortly after he is sworn in for a second term. He has pledged to push for new measures in his State of the Union address.

___

Follow Julie Pace at http://twitter.com/jpaceDC

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Jason Sudeikis and Olivia Wilde Are Engaged

People Exclusive

By Julie Jordan

01/12/2013 at 04:45 PM EST

Jason Sudeikis and Olivia Wilde

AKM-GSI

Saturday Night Live funnyman Jason Sudeikis is definitely serious about his relationship with actress Olivia Wilde. The actor proposed to Wilde shortly after the holidays, PEOPLE has learned exclusively.

"They are so excited," says a source close to both. "And very, very happy."

Sudeikis, 37, and Wilde, 28, who has said she fell "blissfully, hopelessly, wildly in love" with the actor, began dating in November of 2011 and moved in together last year.

The couple has been spotted together everywhere from Lawrence, Kan., to Austin, Texas, and most recently in Rome, where Wilde is filming the drama The Third Person.

No word yet on a wedding date.

Wilde will next be seen in The Incredible Burt Wonderstone in March and Ron Howard's Rush, out in September.

Meanwhile, Sudeikis has the animated film Epic in May and We're the Millers, costarring Jennifer Aniston, which hits theaters in August.

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