The New Old Age Blog: Taking a Zen Approach to Caregiving

You try to help your elderly father. Irritated and defensive, he snaps at you instead of going along with your suggestion. And you think “this is so unfair” and feel a rising tide of anger.

How to handle situations like this, which arise often and create so much angst for caregivers?

Jennifer Block finds the answer in what she calls “contemplative caregiving” — the application of Buddhist principles to caregiving and the subject of a year-long course that starts at the San Francisco Zen Center in a few weeks.

This approach aims to cultivate compassion, both for older people and the people they depend on, said Ms. Block, 49, a Buddhist chaplain and the course’s lead instructor. She’s also the former director of education at the Zen Hospice project in San Francisco and founder of the Beyond Measure School for Contemplative Care, which is helping develop a new, Zen-inspired senior living community in the area.

I caught up with Ms. Block recently, and what follows is an edited transcript of our conversation.

Let’s start with your experience. Have you been a caregiver?

My experience in caregiving is as a professional providing spiritual care to individuals and families when they are facing and coping with aging and sickness and loss and dying, particularly in hospital and hospice settings.

What kinds of challenges have you witnessed?

People are for the most part unprepared for caregiving. They’re either untrained or unable to trust their own instincts. They lack confidence as well as knowledge. By confidence, I mean understanding and accepting that we don’t know all the answers – what to do, how to fix things.

This past weekend, I was on the phone with a woman who’d brought her mom to live near her in assisted living. The mom had been to the hospital the day before. My conversation with the daughter was about helping her see the truth that her mother needed more care and that was going to change the daughter’s responsibilities and her life. And also, her mother was frail, elderly, and coming nearer to death.

That’s hard, isn’t it?

Yes, because we live in a death-denying society. Also, we live in a fast-paced, demanding world that says don’t sit still — do something. But people receiving care often need most of all for us to spend time with them. When we do that, their mortality and our grief and our helplessness becomes closer to us and more apparent.

How can contemplative caregiving help?

We teach people to cultivate a relationship with aging, sickness and dying. To turn toward it rather than turning away, and to pay close attention. Most people don’t want to do this.

A person needs training to face what is difficult in oneself and in others. There are spiritual muscles we need to develop, just like we develop physical muscles in a gym. Also, the mind needs to be trained to be responsive instead of reactive.

What does that mean?

Here’s an example. Let’s say you’re trying to help your mother, and she says something off-putting to you like “you’ve always been terrible at keeping house. It’s no wonder you lost my pajamas.”

The first thing is to notice your experience. To become aware of that feeling, almost like being slapped emotionally. To notice your chest tightening.

Then I tell people to take a deep breath. And say something to themselves like “soften” to address that tightness. That’s how you can stay facing something uncomfortable rather than turning away.

If I were in this position, I might say something to myself like “hello unhappiness” or “hello suffering” or “hello aging” to tether myself.

The second step would be curiosity about that experience. Like, wow, where do I feel that anger that rose up in me, or that fear? Oh, it’s in my chest. I’m going to feel that, stay with it, investigate it.

Why is that important?

Because as we investigate something we come to understand it. And, paradoxically, when we pay attention to pain it changes. It softens. It moves. It lessens. It deepens. And we get to know it and learn not to be afraid of it or change it or fix it but just come alongside of it.

Over hours, days, months, years, the mind and heart come to know pain. And the response to pain is compassion — the wish for the alleviation of pain.

Let’s go back to what mother said about your housekeeping and the pajamas. Maybe you leave the room for five minutes so you can pay attention to your reaction and remember your training. Then, you can go back in and have a response rather than a reaction. Maybe something like “Mom, I think you’re right. I may not be the world’s best housekeeper. I’m sorry I lost your pajamas. It seems like you’re having a pretty strong response to that, and I’d like to know why it matters so much to you. What’s happening with you today?”

Are other skills important?

Another skill is to become aware of how much we receive as well as give in caregiving. Caregiving can be really gratifying. It’s an expression of our values and identity: the way we want the world to be. So, I try to teach people how this role benefits them. Such as learning what it’s like to be old. Or having a close, intimate relationship with an older parent for the first time in decades. It isn’t necessarily pleasant or easy. But the alternative is missing someone’s final chapter, and that can be a real loss.

What will you do in your course?

We’ll teach the principles of contemplative care and discuss them. We’ll have homework, such as ‘Bring me three examples of someone you were caring for who was caring toward you in return.’ That’s one way of practicing attention. And people will train in meditation.

We’ll also explore our own relationship to aging, sickness, dying and loss. We’ll tell our stories: this is the situation I was in, this is where I felt myself shut down, this was the edge of my comfort or knowledge. And we’ll teach principles from Buddhism. Equanimity. Compassion. Deep inner connectedness.

What can people do on their own?

Mindfulness training is offered in almost every city. That’s one of the core components of this approach.

I think every caregiver needs to have their own caregiver — a therapist or a colleague or a friend, someone who is there for them and with whom they can unburden themselves. I think of caregiving as drawing water from a well. We need to make sure that we have whatever nurtures us, whatever supplies that well. And often, that’s connecting with others.

Are other groups doing this kind of work?

In New York City, the New York Zen Center for Contemplative Care educates the public and professionals about contemplative care. And in New Mexico, the Upaya Zen Center does similar work, much of it centered around death and dying.

People who want to read about this might want to look at a new book of essays, “The Arts of Contemplative Care: Pioneering Voices in Buddhist Chaplaincy and Pastoral Work” (Wisdom Publications, 2012).

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DealBook: Client Redemptions Loom for SAC Capital

12:46 p.m. | Updated

The hedge fund giant SAC Capital Advisors is steeling itself for a possible wave of withdrawal requests from clients amid the government’s intensifying scrutiny of its trading practices.

Investors have about a month to decide whether to pull out money from SAC, the $14 billion fund owned by the billionaire investor Steven A. Cohen.

While posting one of the best investment track records on Wall Street across two decades, SAC has attracted billions of dollars from pension funds, wealthy families and other money management firms. But since late November, when federal prosecutors brought its latest criminal insider trading charge against a former SAC employee — a case that it calls the most lucrative insider trading scheme ever uncovered — those clients are weighing whether continuing their relationship with the fund is worth the reputational risk.

The fund has a standard quarterly redemption deadline, and the next one will fall on Feb. 15. Already, several of SAC’s clients, including Lyxor Asset Management and Titan Advisors, have notified the fund that they intend to withdraw their money. Others, like Skybridge Capital, have told SAC they will continue to invest with the fund.

Questions remain about the intentions of several of SAC’s well-known clients, including Blackstone Group, one of the world’s largest and most influential allocators to hedge funds. Blackstone has about $550 million invested in SAC, making it one of the fund’s largest outside investors. A Blackstone spokesman declined to comment.

The fund has told its employees that it could face at least $1 billion of withdrawals, according to a report in The Wall Street Journal on Friday. A spokesman for SAC said it was “far too early to speculate about redemptions, and we do not expect redemptions to have a significant impact on our funds.”

Any withdrawals from clients would come after a year of decent performance for SAC. In 2012 the firm returned about 13 percent net of fees, which while slightly underperforming the Standard & Poor’s 500 stock market index, is superior to the results of the average hedge fund.

While a spate of redemptions can have a crippling effect on a hedge fund by forcing it to sell its holdings at unfavorable prices, SAC is more insulated than most of its competitors from the ill effects of client withdrawals. That is because of the $14 billion that SAC manages, only about 40 percent of that comes from outside clients. The rest — a fortune of about $8 billion — belongs to Mr. Cohen and his employees.

Also, SAC has protected itself with a stringent redemption policy. The fund’s clients can redeem only 25 percent of their investment each quarter. So, for example, if a client has $200 million invested with SAC, and asks for its money back by the Feb. 15 deadline, SAC would return $50 million every three months beginning in March. That way, SAC is protected from having a forced liquidation of its investment portfolio.

Still, an investor exodus can have a crippling effect on a hedge fund, often causing it to shut down. Last month, Diamondback Capital Management, another hedge fund that became ensnared in the government’s insider trading investigation, closed after its investors sought to pull out roughly one-quarter of the fund’s assets.

Diamondback’s management decided that the most prudent course of action was to wind down rather than reorganize the firm to manage the reduced amount of money.

Like Diamondback, SAC has become embroiled in the government’s broad crackdown on insider trading at hedge funds. At least seven former SAC traders and analysts have been tied to illegal trading while at the fund. And the Securities and Exchange Commission has warned SAC that it might filed a civil action against the fund for failing to properly supervise its employees.

Mr. Cohen has told his employees that he believes he and his fund have at all times acted appropriately, and that the fund has fully cooperated with the government’s investigation.

In recent weeks, SAC has gone on a charm offensive in an attempt to hold on to clients. The fund has told its investors that they would not be responsible for any penalties incurred as a result of any of the government’s legal inquiry. Instead, SAC has told them, Mr. Cohen and his management company would pick up the costs.

There have also been changes at the fund. SAC last week told its staff that it was closing its office in Chicago, which is home to about a dozen employees. Such a move is not unusual, as the fund has closed offices before, such as San Francisco, where it saw limited opportunities.

A spokesman said it didn’t make sense to have an office in Chicago. SAC has more than 1,000 employees – portfolio managers, analysts, traders, and support staff – in five offices across the globe, with its headquarters in Stamford, Conn.

Though Mr. Cohen has told his friends and employees that he remains committed to managing money for outside clients, he could decide to follow in the footsteps of several fellow billionaire hedge fund managers.

A number of star investors, having already amassed billions in personal wealth, have decided to get out of the business of managing other people’s money. In recent years, for example, both George Soros and his onetime protégé, Stanley Druckenmiller, returned money to clients and set up so-called family offices to manage their own fortunes.

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Would-Be Inauguration in Venezuela for Chávez

The People’s Love for Chávez Continues:
While Venezuelan President Hugo Chávez lies ill in Cuba, his many fans still flock to the streets at home in support. A recent rally shows Mr. Chávez has established a celebrated and enduring persona.

CARACAS, Venezuela — President Hugo Chávez’s supporters have not ruled out swearing him in from his hospital in Havana. His detractors are calling for government investigators to go check his pulse themselves. The justices whom Mr. Chávez’s allies have named to the Supreme Court have decided that he can continue to govern in absentia.

In a country that Mr. Chávez has dominated for so long, his health crisis and the decision to proceed on Thursday with a quasi-presidential inauguration that he is unable to attend are producing a stream of bizarre developments and national angst about who is in charge.

“Who’s governing Venezuela?” Julio Borges, an opposition member of the National Assembly, said during a noisy legislative debate this week on the biggest issue facing the country, overshadowing other urgent matters like pressures for a painful currency devaluation, stagnant oil production and chronic shortages of food and other staples on store shelves.

Mr. Chávez has long said, “I am the people,” a mantra that his supporters are invoking as they plan to don the sash the president would have worn had he been able to attend his inauguration, symbolically becoming presidents themselves.

“Anyone who has a sash, bring it along, because tomorrow the people will be invested as president of the republic, because the people are Chávez,” Diosdado Cabello, the president of the National Assembly, said Wednesday. “All of us here are Chávez, the people in the street are Chávez, the lady who cooks is Chávez, the comrade who works as a watchman is Chávez, the soldier is Chávez, the woman is Chávez, the farmer is Chávez, the worker is Chávez; we’re all Chávez.”

To no one’s surprise, the Supreme Court, full of Chávez loyalists, ruled on the eve of the ceremony that Mr. Chávez’s inauguration could be postponed and that his team of advisers could smoothly move, in his absence, from one term to the next.

The court declined to set a time limit for the swearing in, raising the possibility that the country’s deepening uncertainty could go on for weeks or months. And it did nothing to clear up the stubborn mystery of the president’s condition.

Luisa Estella Morales, the president of the Supreme Court, said Wednesday at a news conference that there was no need at this time for a delegation to go to Cuba and report back on the condition of Mr. Chávez, 58. Asked if the swearing in could occur in Havana, she said the time and place of the ceremony had not been determined.

 Ms. Morales said the Supreme Court’s ruling was meant to uphold the results of October’s presidential election.

“It’s one of the most important values that we should preserve as a constitutional court,” Ms. Morales said. “The sovereign Venezuelan people have expressed through their vote their desire to continue being governed by President Hugo Rafael Chávez Frías.”

The government has been opaque for months, acknowledging that he suffered from a relapse of cancer in the pelvic area, but not specifying the type of cancer or detailing his prognosis.

The lack of information has left Venezuela tied in knots. Mr. Chávez has loomed so large for so long — with speeches that have lasted for hours, frequent Twitter posts and his outsized singing, ranting, poetry-reciting and foe-bashing personality — that his sudden silence has created a sizable vacuum.

“We don’t have a president,” lamented Estela Martínez, 63, a nurse who has supported Mr. Chávez throughout his 14 years in office. She said she was afraid that the public was not getting the full truth about the president’s condition and that there was far more shouting than clarity from political leaders. “Someone has to take the reins of the country.”

Henrique Capriles Radonski, the opposition candidate who lost to Mr. Chávez in October, criticized the Supreme Court’s decision endorsing a delay in the inauguration. “Institutions should not respond to the interests of a government,” he said.

The State Department in Washington, which has been cautious about getting involved in the contentious political back-and-forth, said Wednesday that it would be eager to improve relations with Venezuela, which have long been strained.

María Iguarán and María Eugenia Díaz contributed reporting.

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Jaguars fire Mularkey after team's worst season

JACKSONVILLE, Fla. (AP) — The Jacksonville Jaguars fired coach Mike Mularkey on Thursday after just one season, the worst in franchise history.

New general manager David Caldwell made the announcement two days after he was hired, giving him a clean slate heading into 2013. Caldwell said he wants to immediately explore every avenue possible to turn the Jaguars around.

"For that to happen as seamlessly as we want, and as quickly as our fans deserve, I feel it is in everyone's best interests for an immediate and clean restart," Caldwell said.

Mularkey, who went 2-14 this season, became the eighth head coach fired since the end of the regular season. He looked like he would be one and done when owner Shad Khan parted ways with general manager Gene Smith last week and gave Mularkey's assistants permission to seek other jobs. Even though Khan ultimately hired Mularkey, Smith directed the coaching search last January that started and ended with the former Atlanta Falcons offensive coordinator.

"Mike Mularkey is leaving our organization with my utmost respect," Khan said. "Mike gave the Jaguars everything he had on and off the field, and his efforts as our head coach will always be appreciated."

Mularkey's brief tenure — he didn't even last a year — was filled with mistakes. His biggest one may have been his loyalty to Smith, who assembled a roster that lacked talent on both sides of the ball.

Mularkey probably stuck with Smith's franchise quarterback, Blaine Gabbert, longer than he should have. And the coach's insistence that the team was closer than outsiders thought and his strong stance that he had the roster to turn things around became comical as the losses mounted. The Jaguars lost eight games by at least 16 points, a staggering number of lopsided losses in a parity-filled league.

Mularkey would have been better served had he said publicly what he voiced privately: that the Jaguars didn't have enough playmakers or a starting-caliber quarterback.

Instead, he never conceded that Jacksonville was a rebuilding project that needed time.

Mularkey signed a three-year contract on Jan. 11, 2012, getting a second chance to be a head coach six years after resigning with the Buffalo Bills.

His return was shaky from the start.

His best player, running back Maurice Jones-Drew, skipped offseason workouts as well as training camp and the preseason in a contract dispute. His first draft pick, receiver Justin Blackmon, was arrested and charged with aggravated DUI in June. And his team was riddled with injuries, including key ones to linebacker Daryl Smith and Jones-Drew.

Even things he had control over went awry.

He had to backtrack after saying Chad Henne would compete with Gabbert for the starting job in March. He created a stir by threatening to fine players up to $10,000 for discussing injuries. He initially played rookie receiver Kevin Elliott over Cecil Shorts III early on. And he really irked some players with tough, padded practices late in a lost season.

Throw in the way he handled injuries to receiver Laurent Robinson (four concussions before going on IR) and Jones-Drew (admittedly should have had foot surgery sooner), and there were reasons to doubt whether Mularkey was cut out to be a head coach. Dating back to his final season in Buffalo, Mularkey has lost 20 of his last 23 games.

Nonetheless, if Khan really wanted to fire Mularkey, he would have done after the season finale along with Smith.

So this was Caldwell's call.

Caldwell and Mularkey spent four years together in Atlanta, getting to know each other well enough that Caldwell didn't need a sit down with Mularkey after he got the GM job Tuesday.

Caldwell and Khan have a news conference scheduled for Thursday afternoon.

Potential replacements for Mularkey include former Chicago Bears coach Lovie Smith, Indianapolis Colts offensive coordinator Bruce Arians, St. Louis Rams offensive coordinator Brian Schottenheimer and San Francisco 49ers offensive coordinator Greg Roman.

Schottenheimer was up for the Jacksonville job last season, and Roman has been linked to the Jaguars since Caldwell became the leading candidate to replace Smith.

Roman and Caldwell were teammates and roommates in the 1990's while attending John Carroll University.

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F.D.A. Requires Cuts to Dosages of Ambien and Other Sleep Drugs

The Food and Drug Administration announced on Thursday that it was requiring manufacturers of popular sleeping pills like Ambien and Zolpimist to cut their recommended dosage in half for women, after laboratory studies showed that they can leave people still sleepy in the morning and at risk for accidents.

The agency issued the requirement for drugs containing the active ingredient zolpidem, by far the most widely used sleep aid. Using lower doses means less of the drug will remain in the blood in the morning hours, and leave people who take it less exposed to the risk of impairment while driving to work.

Women eliminate zolpidem from their bodies more slowly than men and the agency told manufacturers that the recommended dosage for women should be lowered to 5 milligrams from 10 milligrams for immediate-release products like Ambien, Edluar and Zolpimist. Dosages for extended-release products should be lowered to 6.25 milligrams from 12.5, the agency said. The agency also recommended lowering dosages for men.

An estimated 10 to 15 percent of women will have a level of zolpidem in their blood that impairs driving eight hours after taking the pill, while only about 3 percent of men do, said Dr. Robert Temple, deputy director for clinical science in the F.D.A.'s Center for Drug Evaluation and Research.

Doctors will still be told that they can prescribe the higher dosage if the lower one does not work, Dr. Temple said.

“Most people thought that by the morning it is gone,” he said. “What we’re reminding people is that is sort of true, but that in some women who take a full 10 milligram dose, and in a lot of people who take the control release dose, it is not entirely true. Some people will be impaired in the morning.”

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Nokia Sees Results From New Smartphone Line

BERLIN — Nokia said Thursday that its struggling mobile phone business was showing signs of a rebound, turning a profit in the fourth quarter fueled by sales of its Lumia smartphones that use Microsoft software.

Stephen Elop, the Nokia chief executive, said sales of smartphones and more basic cellphones, as well as profitability at the Nokia Siemens network-equipment venture, all came in better than expected during the three months through December.

“While we definitely experienced some tough challenges in the first half of 2012, we are managing through these issues,” Mr. Elop said in a conference call with journalists.

Nokia has amassed nearly €5 billion, or $6.5 billion, in losses since Mr. Elop, a former Microsoft executive, announced plans to phase out Nokia phones that used its own Symbian operating system for the Lumia line, which uses the Windows Phone 8 software, in February 2011.

Sales of Lumia phones increased only modestly during the early part of 2012, raising concern that the company’s turnaround strategy, marked by cost cutting and the sale of subsidiary businesses, would not be enough to save the former market leader.

But in the fourth quarter, amid heavy television and print ad spending in Europe and North America, Nokia said it sold 4.4 million Lumia phones, up from 2.9 million in the third quarter.

The company said revenue from the sale of 86.3 million mobile phones of all kinds amounted to €3.9 billion in the quarter, without providing comparative figures.

The company’s shares surged as much as 16 percent in Helsinki on the news.

In a statement, Nokia said that it expected operating profit at its devices and services business, which makes up about half of its total sales, to break even or generate a profit of as much as 2 percent of sales in the fourth quarter. In October, Nokia had told investors that it expected the business to make an operating loss of as much as 10 percent of sales.

But sales of its Lumia smartphone and Asha feature phones rose more than expected. Also, Nokia Siemens, its network gear venture, will report an operating profit of 13 percent to 15 percent of sales in the fourth quarter, compared with an expected range of 4 percent to 12 percent.

Looking ahead, Nokia said it expected to return to an operating loss of 2 percent of sales in the first quarter amid the post-holiday buying lull and harsh competition. But the results for the coming three months could vary widely, Nokia warned, from an even bigger 6 percent operating loss to a 2 percent operating profit.

Pete Cunningham, an analyst at Canalys, a research firm in Reading, England, said Nokia’s improving financial position was a positive step. But the company, which ceded its market leadership to Samsung and Apple, is not out of the woods yet.

“On face value, this is a positive for Nokia,” Mr. Cunningham said. “But 2013 could still turn out to be another very difficult year for Nokia. It is way too premature to say that the company has made a turnaround.”

Mr. Cunningham said he used the Lumia 920, Nokia’s newest smartphone, during the Christmas holidays and liked the experience.

“But the more I used the phone, the more apparent it became to me that there are big gaps between Lumia and its competitors in terms of the functionality and usability of its apps,” Mr. Cunningham said. “I still think there is a lot of work to be done on Lumia.”

Mr. Elop said Nokia would continue to innovate to close the gap with competitors. The big issues that Nokia faces, he said, are “managing efficiently, building great products and changing the way we operate. We’re beginning to see that happen.”

Nokia’s shares closed up nearly 13 percent at €3.39 in Helsinki trading.

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Iranian Captives Freed in Major Prisoner Exchange in Syria

ISTANBUL — More than 2,000 prisoners incarcerated by the Syrian authorities were being released on Wednesday in return for 48 Iranians freed by rebels after five months in captivity in what appeared to be the biggest prisoner swap since the uprising against President Bashar al-Assad began almost two years ago.

The exchange, brokered by Turkey and Qatar, came days after Mr. Assad warned on Sunday that he would not abandon the fight against armed adversaries pressing on the approaches to the Syrian capital, Damascus, and brushed aside calls for him to quit.

Word of the exchange dominated news in Iran, the Syrian government’s only Middle East ally, leading the Web site of the official Islamic Republic News Agency. Iran state television showed a brief clip of the released hostages at the Sheraton Hotel in Damascus, grinning, flashing victory signs and holding flowers. In an interview on Iran state TV, the Foreign Ministry spokesman, Ramin Mehmanparast, thanked those involved in the swap for the hostages and expressed happiness that “we managed to get them released.”

Precise details of the exchange, including when the 48 Iranians would be repatriated, remained unclear. Mr. Mehmanparast also said two Iranian engineers who had been abducted earlier in Syria remained captive. But Prime Minister Recep Tayyip Erdogan of Turkey, a regional power broker allied to the Western and Arab nations seeking Mr. Assad’s departure, said he hoped the exchange on Wednesday would lead to freedom for more prisoners in Syria.

“We wish many other innocent people, and people in need, to be released from Syrian jails without delay,” Mr. Erdogan said in a televised news conference in Niamey, Nigeria, where he arrived on an official visit.

“This process needs to be appreciated. We are not in a position to say anything more than, ‘May this produce some good.’ ”

The exchange emerged from months of behind-the-scenes negotiations involving a Turkish charitable foundation, the Humanitarian Relief Foundation, an Islamist-leaning aid organization based in Istanbul and widely known as I.H.H.

The aid group had set up an operation center in Damascus to unite 2,130 prisoners, including 73 women, at one base while another aid team remained in Douma, near the Syrian capital, to oversee the return of the 48 Iranians.

“Captivity is a hard thing,” said Bulent Yildirim, the foundation’s director, who coordinated the exchange in Damascus.

“I saw young women crying, many people lost a lot of weight, and there were also many sick people.”

The Syrian opposition has claimed that the Iranians are members of Iran’s Islamic Revolutionary Guards Corps, but Tehran has denied the assertion, saying the captives are Shiite civilian pilgrims. The Iranians were seized in August while traveling on a bus from Damascus International Airport to a Shiite shrine on the outskirts of the capital, Iran’s Press TV said.

Opposition fighters had threatened to kill the Iranians unless Mr. Assad’s forces halted military operations. But since then the fighting around Damascus has intensified.

Iran is Mr. Assad’s main ally in a region where most Arab states and neighboring Turkey have turned against him. The Iranian captives offered the rebels holding them a source of powerful pressure on the Syrian leader to release opposition prisoners in return.

“We expect the swap to be completed in the next hour,” Huseyin Oruc, a member of the aid group’s executive board said in a telephone interview around midday. He said the captives released by the Syrian authorities included four Turks and a Palestinian.

By midafternoon it was not clear whether the 2,130 prisoners had been freed.

“It is the first time that the ‘humanitarian diplomacy’ we initiated succeeded in releasing such a large group of people at once,” Mr. Oruc said. “There are many more held captive and our efforts to free them will continue without delay.”

The Turkish aid group gained international attention in 2010 for organizing a flotilla of boats heading to Gaza, ostensibly with relief supplies, that prompted a deadly Israeli commando raid in which eight Turks and an American of Turkish descent died. At the time of the raid, the group was reported to have extensive connections with Turkey’s political elite. The episode began an unraveling of Turkey’s once close ties with Israel.

In recent months, the organization has also been part of negotiations to free smaller numbers of prisoners, including two Turkish journalists held in Syria, Reuters reported. It has been active since the early 1990s in charitable works in the Middle East and Africa, focusing most recently on Gaza.

Since the start of the uprising against Mr. Assad, the organization has also cast itself as a leading private charitable organization in Syria, delivering food and other basic supplies and pursuing what it calls “humanitarian diplomacy” to help free captive civilians.

While the numbers involved in Wednesday’s exchange seemed dramatic, some rebel commanders said more modest prisoner exchanges had become a feature of the conflict.

The leader of a rebel fighting group in the central city of Hama, reached via Skype, said pro-government militia members had captured his uncle and two other relatives in a village in the northern Idlib province more than a month ago.

 “The  only  way to release them is capturing  hostages,” the commander said, adding that negotiations were under way to win the release of his relatives in return for 12 captives held by the rebels. Two months ago, the commander said, nine members of the pro-government militia, known as shabiha, were  exchanged for five captured rebels. Syria’s uprising began in March 2011 with peaceful demonstrations, but a harsh suppression broadened into civil war with an estimated 60,000 people killed, according to United Nations estimates.

Sebnem Arsu reported from Istanbul and Alan Cowell from London. Hwaida Saad contributed reporting from Beirut, Lebanon, and Thomas Erdbrink from Tehran.

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Why bother with a Facebook phone? Facebook’s app is already on 86% of iPhones and iPads

Rumors suggesting Facebook (FB) is working on a smartphone have resurfaced a number of times over the past year. Each time, Facebook denied the various claims. Facebook may indeed still be working on its own phone but as a new report from market research firm NPD Group shows, it probably doesn’t need to.

[More from BGR: Is Samsung the new Apple?]

Facebook makes money by gathering information about its users and serving targeted ads based on that data. Allowing users to update Facebook with fresh data as often as possible is obviously beneficial to the company, and smartphones present a terrific opportunity to give users access to their Facebook accounts from anywhere. The more people using Facebook’s mobile apps, the better, and Facebook’s smartphone penetration is absolutely staggering right now.

[More from BGR: iPhone 5 now available with unlimited service, no contract on Walmart’s $ 45 Straight Talk plan]

According to data published by NPD Group on Tuesday, Facebook’s iOS application was used by 86% of iPhone, iPad and iPod touch owners as of November 2012. On the Android platform, 70% of smartphone and tablet owners used Facebook’s mobile app in November.

No other third-party app even comes close to approaching Facebook’s mobile penetration. Google’s (GOOG) YouTube app is the next most popular third-party app on iOS with 40% penetration and Amazon’s (AMZN) mobile application is the second most popular third-party Android app with just 28% penetration.

So why would Facebook bother making its own phone?

One answer — perhaps the obvious one — is that an own-brand smartphone with custom software would give Facebook access to far more personal data than it can reach using third-party applications. Considering Facebook’s track record with matters relating to privacy, however, users may be reluctant to buy a Facebook phone.

In any case, a Facebook phone certainly doesn’t seem like a necessity for the time being. Instead, focusing on ways to effectively monetize the hundreds of millions of users who interact with Facebook from a smartphone or tablet each month might be a wiser use of resources.

This article was originally published on BGR.com

Social Media News Headlines – Yahoo! News

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AP Source: Surgery reveals damage to RG3's ACL

WASHINGTON (AP) — A person familiar with the situation says the surgery on Robert Griffin III's knee revealed damage to the ACL.

The Washington Redskins quarterback had surgery Wednesday morning to repair a torn lateral collateral ligament in his right knee. The procedure also examined Griffin's ACL, which he tore while playing for Baylor in 2009. Another torn ACL would complicate Griffin's chances of returning by the start of next season.

The person spoke to The Associated Press on condition of anonymity because the Redskins had not made an announcement about the latest details surrounding the rookie quarterback's injury.

Griffin sprained the LCL last month and reinjured the knee in Sunday's playoff loss to the Seattle Seahawks.

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Economic Scene: Health Care and Pursuit of Profit Make a Poor Mix

Thirty years ago, Bonnie Svarstad and Chester Bond of the School of Pharmacy at the University of Wisconsin-Madison discovered an interesting pattern in the use of sedatives at nursing homes in the south of the state.

Patients entering church-affiliated nonprofit homes were prescribed drugs roughly as often as those entering profit-making “proprietary” institutions. But patients in proprietary homes received, on average, more than four times the dose of patients at nonprofits.

Writing about his colleagues’ research in his 1988 book “The Nonprofit Economy,” the economist Burton Weisbrod provided a straightforward explanation: “differences in the pursuit of profit.” Sedatives are cheap, Mr. Weisbrod noted. “Less expensive than, say, giving special attention to more active patients who need to be kept busy.”

This behavior was hardly surprising. Hospitals run for profit are also less likely than nonprofit and government-run institutions to offer services like home health care and psychiatric emergency care, which are not as profitable as open-heart surgery.

A shareholder might even applaud the creativity with which profit-seeking institutions go about seeking profit. But the consequences of this pursuit might not be so great for other stakeholders in the system — patients, for instance. One study found that patients’ mortality rates spiked when nonprofit hospitals switched to become profit-making, and their staff levels declined.

These profit-maximizing tactics point to a troubling conflict of interest that goes beyond the private delivery of health care. They raise a broader, more important question: How much should we rely on the private sector to satisfy broad social needs?

From health to pensions to education, the United States relies on private enterprise more than pretty much every other advanced, industrial nation to provide essential social services. The government pays Medicare Advantage plans to deliver health care to aging Americans. It provides a tax break to encourage employers to cover workers under 65.

Businesses devote almost 6 percent of the nation’s economic output to pay for health insurance for their employees. This amounts to nine times similar private spending on health benefits across the Organization for Economic Cooperation and Development, on average. Private plans cover more than a third of pension benefits. The average for 30 countries in the O.E.C.D. is just over one-fifth.

We let the private sector handle tasks other countries would never dream of moving outside the government’s purview. Consider bail bondsmen and their rugged sidekicks, the bounty hunters.

American TV audiences may reminisce fondly about Lee Majors in “The Fall Guy” chasing bad guys in a souped-up GMC truck — a cheap way to get felons to court. People in most other nations see them as an undue commercial intrusion into the criminal justice system that discriminates against the poor.

Our reliance on private enterprise to provide the most essential services stems, in part, from a more narrow understanding of our collective responsibility to provide social goods. Private American health care has stood out for decades among industrial nations, where public universal coverage has long been considered a right of citizenship. But our faith in private solutions also draws on an ingrained belief that big government serves too many disparate objectives and must cater to too many conflicting interests to deliver services fairly and effectively.

Our trust appears undeserved, however. Our track record suggests that handing over responsibility for social goals to private enterprise is providing us with social goods of lower quality, distributed more inequitably and at a higher cost than if government delivered or paid for them directly.

The government’s most expensive housing support program — it will cost about $140 billion this year — is a tax break for individuals to buy homes on the private market.

According to the Tax Policy Center, this break will benefit only 20 percent of mostly well-to-do taxpayers, and most economists agree that it does nothing to further its purported goal of increasing homeownership. Tax breaks for private pensions also mostly benefit the wealthy. And 401(k) plans are riskier and costlier to administer than Social Security.

From the high administrative costs incurred by health insurers to screen out sick patients to the array of expensive treatments prescribed by doctors who earn more money for every treatment they provide, our private health care industry provides perhaps the clearest illustration of how the profit motive can send incentives astray.

By many objective measures, the mostly private American system delivers worse value for money than every other in the developed world. We spend nearly 18 percent of the nation’s economic output on health care and still manage to leave tens of millions of Americans without adequate access to care.

Britain gets universal coverage for 10 percent of gross domestic product. Germany and France for 12 percent. What’s more, our free market for health services produces no better health than the public health care systems in other advanced nations. On some measures — infant mortality, for instance — it does much worse.

In a way, private delivery of health care misleads Americans about the financial burdens they must bear to lead an adequate existence. If they were to consider the additional private spending on health care as a form of tax — an indispensable cost to live a healthy life — the nation’s tax bill would rise to about 31 percent from 25 percent of the nation’s G.D.P. — much closer to the 34 percent average across the O.E.C.D.

A quarter of a century ago, a belief swept across America that we could reduce the ballooning costs of the government’s health care entitlements just by handing over their management to the private sector. Private companies would have a strong incentive to identify and wipe out wasteful treatment. They could encourage healthy lifestyles among beneficiaries, lowering use of costly care. Competition for government contracts would keep the overall price down.

We now know this didn’t work as advertised. Competition wasn’t as robust as hoped. Health maintenance organizations didn’t keep costs in check, and they spent heavily on administration and screening to enroll only the healthiest, most profitable beneficiaries.

One study of Medicare spending found that the program saved no money by relying on H.M.O.’s. Another found that moving Medicaid recipients into H.M.O.’s increased the average cost per beneficiary by 12 percent with no improvement in the quality of care for the poor. Two years ago, President Obama’s health care law cut almost $150 billion from Medicare simply by reducing payments to private plans that provide similar care to plain vanilla Medicare at a higher cost.

Today, again, entitlements are at the center of the national debate. Our elected officials are consumed by slashing a budget deficit that is expected to balloon over coming decades. With both Democrats and Republicans unwilling to raise taxes on the middle class, the discussion is quickly boiling down to how deeply entitlements must be cut.

We may want to broaden the debate. The relevant question is how best we can serve our social needs at the lowest possible cost. One answer is that we have a lot of room to do better. Improving the delivery of social services like health care and pensions may be possible without increasing the burden on American families, simply by removing the profit motive from the equation.

E-mail: eporter@nytimes.com;

Twitter: @portereduardo

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