Japan appoints new ambassador to China

TOKYO: Japan on Thursday appointed a new ambassador to China, months after the last nominee died before he could take up his post and as tensions simmer between Tokyo and Beijing over disputed territory.

Career diplomat Masato Kitera's appointment will be effective on Monday, the foreign ministry said, while local media reported that the 60-year-old will be dispatched to Beijing next month to formally succeed Uichiro Niwa.

Japan initially picked Shinichi Nishimiya, another career diplomat, for the post but before he could take up the role he fell ill in a Tokyo street in September and was taken to hospital, dying a few days later.

Kitera is set to become Tokyo's point man in the ongoing dispute over an island chain in the East China Sea, which Tokyo controls under the name the Senkaku Islands but Beijing claims as the Diaoyu Islands.

Their nationalisation in September provoked sometimes violent anti-Japanese demonstrations across China that targeted Japanese businesses.

A subsequent consumer boycott of Japanese produce has dented the huge trade ties between the two countries, notably in the automobile and home electronics sectors.

Niwa raised hackles at home when he accurately predicted a plan by Tokyo's nationalist governor to buy the islands could cause a crisis between China and Japan, jeopardising economic ties.

Kitera joined the ministry in 1976 and is currently serving as assistant chief cabinet secretary in the prime minister's office.

- AFP/xq

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Parliament adjourned over differences on FDI

NEW DELHI: Both houses of Parliament were adjourned till 12 noon soon after they met on the first day of the winter session over differences on FDI in retail.

In the Lok Sabha, BSP members rushed towards Speaker Meira Kumar's podium protesting the law and order in Uttar Pradesh.

The Samajwadi Party in turn demanded the rollback of the LPG price hike.

Earlier, Prime Minister Manmohan Singh sought cooperation of all his colleagues in both the Houses to come together and address issues and challenges facing the nation.

Against the backdrop of vociferous opposition to FDI in retail and a threat of a no-confidence motion, Singh also reminded the Opposition of the obligation to work together to enable parliamentary democracy to grapple with the formidable challenges before the country.

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Study finds mammograms lead to unneeded treatment

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.

It's the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call "cancer" are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don't really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it's relatively new to the debate over breast cancer screening.

"We're coming to learn that some cancers — many cancers, depending on the organ — weren't destined to cause death," said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, "once a woman is diagnosed, it's hard to say treatment is not necessary."

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday's New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it's most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment.

Researchers used federal surveys on mammography and cancer registry statistics from 1976 through 2008 to track how many cancers were found early, while still confined to the breast, versus later, when they had spread to lymph nodes or more widely.

The scientists assumed that the actual amount of disease — how many true cases exist — did not change or grew only a little during those three decades. Yet they found a big difference in the number and stage of cases discovered over time, as mammograms came into wide use.

Mammograms more than doubled the number of early-stage cancers detected — from 112 to 234 cases per 100,000 women. But late-stage cancers dropped just 8 percent, from 102 to 94 cases per 100,000 women.

The imbalance suggests a lot of overdiagnosis from mammograms, which now account for 60 percent of cases that are found, Bleyer said. If screening were working, there should be one less patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage, he explained.

"Instead, we're diagnosing a lot of something else — not cancer" in that early stage, Bleyer said. "And the worst cancer is still going on, just like it always was."

Researchers also looked at death rates for breast cancer, which declined 28 percent during that time in women 40 and older — the group targeted for screening. Mortality dropped even more — 41 percent — in women under 40, who presumably were not getting mammograms.

"We are left to conclude, as others have, that the good news in breast cancer — decreasing mortality — must largely be the result of improved treatment, not screening," the authors write.

The study was paid for by the study authors' universities.

"This study is important because what it really highlights is that the biology of the cancer is what we need to understand" in order to know which ones to treat and how, said Dr. Julia A. Smith, director of breast cancer screening at NYU Langone Medical Center in New York. Doctors already are debating whether DCIS, a type of early tumor confined to a milk duct, should even be called cancer, she said.

Another expert, Dr. Linda Vahdat, director of the breast cancer research program at Weill Cornell Medical College in New York, said the study's leaders made many assumptions to reach a conclusion about overdiagnosis that "may or may not be correct."

"I don't think it will change how we view screening mammography," she said.

A government-appointed task force that gives screening advice calls for mammograms every other year starting at age 50 and stopping at 75. The American Cancer Society recommends them every year starting at age 40.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the study should not be taken as "a referendum on mammography," and noted that other high-quality studies have affirmed its value. Still, he said overdiagnosis is a problem, and it's not possible to tell an individual woman whether her cancer needs treated.

"Our technology has brought us to the place where we can find a lot of cancer. Our science has to bring us to the point where we can define what treatment people really need," he said.

___

Online:

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

Screening advice: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Egypt's Morsi Wins U.S., Israeli Gratitude

Egyptian President Mohammed Morsi is being credited with brokering the cease-fire today between Israel and Hamas, but the international gratitude and praise he is gettting could come with a political price at home.

Both Secretary of State Hillary Clinton and President Obama heaped praise on the Egyptian president. Obama called his Egyptian counterpart today to thank him for his efforts in the negotiations, and Clinton expressed her gratitude personally in the press conference announcing the deal.

"I want to thank President Morsi for his personal leadership to de-escalate the situation in Gaza and end the violence," said Clinton. "This is a critical moment for the region. Egypt's new government is assuming the responsibility and leadership that has long made this country a cornerstone of regional stability and peace."

FULL COVERAGE: Israel-Gaza Conflict

In the last week Egypt emerged as the third and maybe the most pivotal party in the conflict between Israel and Hamas. Both Obama and Clinton made multiple calls to Morsi, understanding the long-term diplomatic consequences for America's historically strongest Arab ally in the Middle East, an ally that receives billions of dollars in aid annually.

Khaed Desouki/AFP/Getty Images

Hillary Clinton Announces Israel-Hamas Ceasefire Watch Video

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The latest crisis was considered a crucial moment for Morsi. Both the U.S. and Israel for years had come to trust and depend on former Egyptian President Hosni Mubarak's right hand man, Intelligence Chief Omar Suleiman. He brokered the initial peace deal between Hamas and Israel and was respected by both sides. Suleiman lost power when Mubarak stepped down and died in July.

Under Morsi, Egypt, whose new governing Muslim Brotherhood party has a relationship with Hamas, also must maintain its peace treaty with Israel to keep diplomatic relations with the United States. But Morsi has a different mandate. As the first democratically-elected president, he is accountable to the people of Egypt, and must walk a fine line between meeting his constituents wants' and maintaining Egypt's diplomatic needs.

Throughout the crisis Morsi and Egyptian officials have spouted harsh rhetoric against Israel, calling the Jewish state the aggressors in the conflict and declaring that the Palestinians have the right to self-defense.

PHOTOS: Israel, Hamas Fight Over Gaza

Behind the scenes, however, Morsi has received high marks by his Israeli counterparts with Israeli President Shimon Peres calling the Egyptian president a "nice surprise" at the height of the talks on Tuesday.

Those familiar with how the cease-fire was eventually brokered credit the Egyptians, and say this was an Egyptian achievement, announced in Egypt.

But the fact that the announcement was made by Egyptian Foreign Minister Mohamed Kamel Amr, allowed Morsi some political cover from the negative swelling of Egyptian opinion over this deal.

While the U.S., Israel and Hamas may be happy about the deal, there has been significant backlash from Egyptian citizens who claim that despite the election and Morsi's Muslim Brotherhood background, he is no different than Mubarak, a puppet of the West. There are reports of calls for national protests this Friday.

There are also Egyptians who claim the president they elected cares more about the Palestinians than the many domestic problems Egyptians are facing.

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Hamas-Israel ceasefire takes hold but mistrust runs deep

CAIRO/GAZA (Reuters) - A ceasefire between Israel and Gaza's Hamas rulers took hold on Thursday after eight days of conflict, although deep mistrust on both sides cast doubt on how long the Egyptian-sponsored deal can last.

Even after the ceasefire came into force late on Wednesday, a dozen rockets from the Gaza Strip landed in Israel, all in open areas, a police spokesman said. In Gaza, witnesses reported an explosion shortly after the truce took effect at 9 p.m (2 p.m. Eastern Time), but there were no casualties and the cause was unclear.

The deal prevented, at least for the moment, an Israeli ground invasion of the Palestinian enclave following bombing and rocket fire which killed five Israelis and 162 Gazans, including 37 children.

But trust was in short supply. The exiled leader of Hamas, Khaled Meshaal, said his Islamist movement would respect the truce if Israel did, but would respond to any violations. "If Israel complies, we are compliant. If it does not comply, our hands are on the trigger," he told a news conference in Cairo.

Israeli Prime Minister Benjamin Netanyahu said he had agreed to "exhaust this opportunity for an extended truce", but told his people a tougher approach might be required in the future.

Both sides quickly began offering differing interpretations of the ceasefire, brokered by Egypt's new Islamist government and backed by the United States, highlighting the many actual or potential areas of discord.

If it holds, the truce will give 1.7 million Gazans respite from days of ferocious air strikes and halt rocket salvoes from militants that have unnerved a million people in southern Israel and reached Tel Aviv and Jerusalem for the first time.

At the United Nations, the Security Council called on both Israel and Hamas to uphold the ceasefire and commended Egypt's President Mohamed Mursi and others for brokering the truce.

The council said in a statement it "deplored the loss of civilian lives resulting from this situation and reiterated the need to take appropriate steps to ensure the safety and well-being of civilians and their protection in accordance with international humanitarian law."

"Allahu akbar, (God is greatest), dear people of Gaza you won," blared mosque loudspeakers in Gaza as the truce took effect. "You have broken the arrogance of the Jews."

Fifteen minutes later, wild celebratory gunfire echoed across the darkened streets, which gradually filled with crowds waving Palestinian flags. Ululating women leaned out of windows and fireworks lit up the sky.

Meshaal thanked Egypt for mediating and praised Iran for providing Gazans with financing and arms. "We have come out of this battle with our heads up high," he said, adding that Israel had been defeated and failed in its "adventure".

Some Israelis staged protests against the deal, notably in the southern town of Kiryat Malachi, where three people were killed by a Gaza rocket during the conflict, army radio said.

Netanyahu said he was willing to give the truce a chance but held open the possibility of reopening the conflict. "I know there are citizens expecting a more severe military action, and perhaps we shall need to do so," he said.

The Israeli leader, who faces a parliamentary election in January, delivered a similar message earlier in a telephone call with U.S. President Barack Obama, his office said.

"AN OPEN PRISON"

According to a text of the agreement seen by Reuters, both sides should halt all hostilities, with Israel desisting from incursions and targeting of individuals, while all Palestinian factions should cease rocket fire and cross-border attacks.

The deal also provides for easing Israeli restrictions on Gaza's residents, who live in what British Prime Minister David Cameron has called an "open prison".

The text said procedures for implementing this would be "dealt with after 24 hours from the start of the ceasefire".

Israeli sources said Israel would not lift a blockade of the enclave it enforced after Hamas, which rejects the Jewish state's right to exist, won a Palestinian election in 2006.

However, Meshaal said the deal covered the opening of all of the territory's border crossings. "The document stipulates the opening of the crossings, all the crossings, and not just Rafah," he said. Israel controls all of Gaza's crossings apart from the Rafah post with Egypt.

Hamas lost its top military commander to an Israeli strike in the conflict and suffered serious hits to its infrastructure and weaponry, but has emerged with its reputation both in the Arab world and at home stronger.

Israel can take comfort from the fact it dealt painful blows to its enemy, which will take many months to recover, and showed that it can defend itself from a barrage of missiles.

"No one is under the illusion that this is going to be an everlasting ceasefire. It is clear to everyone it will only be temporary," said Michael Herzog, a former chief of staff at the Israeli ministry of defense.

"But there is a chance that it could hold for a significant period of time, if all goes well," he told Reuters.

U.S. Defense Secretary Leon Panetta, in a phone call with his Israeli counterpart, praised the performance of a U.S.-backed Israeli anti-rocket system known as "Iron Dome," which the Pentagon said intercepted over 85 percent of rockets fired at Israeli civilians.

Iron Dome "provided decision space for Israel to achieve its strategic goals without forcing further military actions," the Pentagon said in a statement.

Egypt, an important U.S. ally now under Islamist leadership, took center stage in diplomacy to halt the bloodshed. Cairo has walked a fine line between its sympathies for Hamas, an offshoot of the Muslim Brotherhood to which Mursi belongs, and its need to preserve its 1979 peace treaty with Israel and its ties with Washington, its main aid donor.

Announcing the agreement in Cairo, Egyptian Foreign Minister Mohamed Kamel Amr said mediation had "resulted in understandings to cease fire, restore calm and halt the bloodshed".

U.S. Secretary of State Hillary Clinton, standing beside Amr, thanked Mursi for peace efforts that she said showed "responsibility, leadership" in the region.

The Gaza conflict erupted in a Middle East already shaken by last year's Arab uprisings that toppled several veteran U.S.-backed leaders, including Egypt's Hosni Mubarak, and by a civil war in Syria, where President Bashar al-Assad is fighting for survival.

BUS BOMBING

The ceasefire was forged despite a bus bomb explosion that wounded 15 Israelis in Tel Aviv earlier in the day and despite more Israeli air strikes that killed 10 Gazans. It was the first serious bombing in Israel's commercial capital since 2006.

Israel, the United States and the European Union all classify Hamas as a terrorist organization. It seized the Gaza Strip from the Western-backed Palestinian President Mahmoud Abbas in 2007 in a brief but bloody war with his Fatah movement.

"This is a critical moment for the region," Clinton said. "Egypt's new government is assuming the responsibility and leadership that has long made this country a cornerstone for regional stability and peace."

In Amman, U.N. chief Ban Ki-moon urged both sides to stick to their ceasefire pledges. "There may be challenges implementing this agreement," he said, urging "maximum restraint."

(Additional reporting by Noah Browning in Gaza, Ori Lewis, Allyn Fisher-Ilan and Crispian Balmer in Jerusalem, Yasmine Saleh, Shaimaa Fayed and Tom Perry in Cairo, Suleiman al-Khalidi in Amman, Michelle Nichols at the United Nations and Margaret Chadbourn and Phil Steward in Washington.; Writing by Alistair Lyon and David Stamp; Editing by Louise Ireland and Christopher Wilson)

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The world won't end next month, Maya experts insist

MEXICO CITY: Relax doomsayers, the Maya people did not really mark their calendar for the end of the world on December 21, 2012.

As tourists book hotel rooms in Mexico's Maya Riviera and Guatemalan resorts ahead of next month's fateful date, experts are busy debunking the doomsday myth.

The apocalyptic prophecy that has inspired authors and filmmakers never appears in the tall T-shaped stone calendar that was carved by the Maya around the year 669 in southeastern Mexico.

In reality, the stone recounts the life and battles of a ruler from that era, experts say. Plus, the last date on the calendar is actually December 23, 2012, not the 21st, and it merely marks the end of a cycle.

So no need to build giant arks, because the terrible floods, earthquakes and volcanic eruptions depicted in the Hollywood blockbuster "2012" were not prophesied by the Mayas.

"The Mayas had a cyclical idea of time. They were not preoccupied with the end of the world," Mexican archeologist Jose Romero told AFP.

The stone, known as Monument 6, was located in El Tortuguero, an archeological site that was discovered in 1915.

Broken in six pieces, the different fragments are exhibited in US and Mexican museums, including Tabasco's Carlos Pellicer Camara Anthropology Museum and New York's Metropolitan Museum.

The first study on the stone was published by a German researcher in 1978. Since then, various archeologists have examined its significance and agree that it refers to the December 23 date.

"The last inscription refers to December 23, 2012, but the central theme of Monument 6 is not the date, it's not the prophecies or the end of the world. It's the story of (then-ruler) Bahlam Ajaw," Romero said.

The final date represents the end of a cycle in the Mayan long count calendar that began in the year 3114 before Christ. It is the completion of 13 baak t'uunes, a unit of time equivalent to 144,000 days.

"It is not the end of the Mayan long count calendar, which is endless. It's the beginning of a new cycle, that's all," said Mexican historian Erick Velasquez.

Though the Maya made prophecies, they looked at events in the near future and were related to day-to-day concerns like rain, droughts, or harvests.

The belief that the calendar foresees the end of the world comes from Judeo-Christian interpretations, the experts said.

Velasquez warned against giving too much weight to Monument 6, noting that it is just one of more than 5,000 stones from the Mayan culture that have been studied.

The Earth still has a few years left, even in eyes of the ancient Maya: Some stones refer to the year 7000.

- AFP/xq

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Ajmal Kasab hanged and buried in Pune's Yerwada Jail

PUNE: After nearly four years, Ajmal Kasab, the sole surviving Pakistani gunman involved in the Mumbai attacks, was hanged to death at the Yerawada central prison here this morning in a top-secret operation.

Kasab was buried inside the premises of Pune's Yerawada Central Jail shortly after he was hanged, Maharashtra chief minister Prithviraj Chavan said.

"Ajmal Kasab was hanged at 7.30am," Maharashtra home minister R R Patil said in Mumbai shortly after the hanging. Pakistan government was kept informed about the execution.

The execution in the Mumbai attack trial brought closure to many in the audacious strike by 10 terrorists of Pakistan-based terror outfit Lashkar-e-Taiba (LeT) in which 166 people were killed. Nine LeT men were killed during the 60-hour siege which began on the night of November 26, 2008.

The prison authorities remained tight-lipped about the details of hanging performed in a well-guarded secret operation amid reports that Kasab did not have any death wish.

Kasab was executed after he exhausted all legal remedies available to escape the noose with President Pranab Mukherjee rejecting his mercy plea following the advice of the Union home ministry.

Inspector general of Prisons (Maharashtra) Meeran Borwankar refused to respond media queries on the execution of Kasab.

There was, however, no official word or briefing by the jail authorities on the last rites of the hanged convict.

Union home minister Sushil Kumar Shinde said Pakistan was informed about the execution of Kasab.

"With the execution of Kasab, we have completed the judicial procedure of 26/11 case." Shinde said in Delhi.

The Indian High Commission in Islamabad informed Pakistan government about Kasab's hanging through letter, he said, adding Pakistan refused to take the letter, which was then sent through fax.

External affairs minister Salman Khurshid said the obligation of keeping Pakistan informed about the hanging was fulfilled.

Special Public Prosecutor Ujjwal Nikam, who appeared for police in the case said the hanging is a "victory" for the country.

"Due process of law has been followed," Patil said, adding that hanging was carried out after President Mukherjee rejected Kasab's mercy petition on November 8. He said Kasab did not have any death wish.

"This is a true homage to the innocent victims, including policemen and security personnel, who laid down their lives," he said.

"Attack on Mumbai was an attack on the entire country," Patil said.

"I do not think there will be any trouble (if Kasab is buried in India) because India has suffered too much and everyone.... and this country has seen the tragedy. 166 people were killed after there days fight against humanity," he said.

Khurshid said India did not get any request from Pakistan for handing over the body of Kasab.

Nikam said by hanging Kasab the country has paid homage to all those policemen and innocent persons who lost their lives.

"By Kasab's conviction and death penalty, we have proved how the entire conspiracy was hatched in Pakistan. We have set an example that India will not tolerate such attacks and the accused will be brought to justice," Nikam told reporters in Mumbai.

Nikam appeared for the prosecution in the sessions court and High Court and assisted senior counsel Gopal Subramanium in the apex court.

A group of Shiv Sena workers raised slogans 'Vande Mataram' slogans outside the Yerawada jail hailing the hanging of Kasab and demanded that simialr justice be meted out to Parliament attack case death row convict Afzal Guru.

Kasab had been lodged in the Arthur Jail Road in Mumbai ever since he was arrested immediately after the attack in 2008. He was convicted and given capital punishment by the trial court on May 6, 2010 which was upheld by the Bombay High Court on February 21, 2011.

The Supreme Court subsequently upheld the sentence on August 29 this year.

Kasab and the other gunmen entered Mumbai by boat on November 26, 2008. Carrying mobile phones, hand grenades and automatic weapons, they fanned out across Mumbai targeting luxury hotels Taj Mahal and Oberoi Trident, a Jewish centre Chabad House and the city's main train station Chhatrapati Shivaji Terminus(CST). (With inputs from PTI)

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OB/GYNs back over-the-counter birth control pills

WASHINGTON (AP) — No prescription or doctor's exam needed: The nation's largest group of obstetricians and gynecologists says birth control pills should be sold over the counter, like condoms.

Tuesday's surprise opinion from these gatekeepers of contraception could boost longtime efforts by women's advocates to make the pill more accessible.

But no one expects the pill to be sold without a prescription any time soon: A company would have to seek government permission first, and it's not clear if any are considering it. Plus there are big questions about what such a move would mean for many women's wallets if it were no longer covered by insurance.

Still, momentum may be building.

Already, anyone 17 or older doesn't need to see a doctor before buying the morning-after pill — a higher-dose version of regular birth control that can prevent pregnancy if taken shortly after unprotected sex. Earlier this year, the Food and Drug Administration held a meeting to gather ideas about how to sell regular oral contraceptives without a prescription, too.

Now the influential American College of Obstetricians and Gynecologists is declaring it's safe to sell the pill that way.

Wait, why would doctors who make money from women's yearly visits for a birth-control prescription advocate giving that up?

Half of the nation's pregnancies every year are unintended, a rate that hasn't changed in 20 years — and easier access to birth control pills could help, said Dr. Kavita Nanda, an OB/GYN who co-authored the opinion for the doctors group.

"It's unfortunate that in this country where we have all these contraceptive methods available, unintended pregnancy is still a major public health problem," said Nanda, a scientist with the North Carolina nonprofit FHI 360, formerly known as Family Health International.

Many women have trouble affording a doctor's visit, or getting an appointment in time when their pills are running low — which can lead to skipped doses, Nanda added.

If the pill didn't require a prescription, women could "pick it up in the middle of the night if they run out," she said. "It removes those types of barriers."

Tuesday, the FDA said it was willing to meet with any company interested in making the pill nonprescription, to discuss what if any studies would be needed.

Then there's the price question. The Obama administration's new health care law requires FDA-approved contraceptives to be available without copays for women enrolled in most workplace health plans.

If the pill were sold without a prescription, it wouldn't be covered under that provision, just as condoms aren't, said Health and Human Services spokesman Tait Sye.

ACOG's opinion, published in the journal Obstetrics & Gynecology, says any move toward making the pill nonprescription should address that cost issue. Not all women are eligible for the free birth control provision, it noted, citing a recent survey that found young women and the uninsured pay an average of $16 per month's supply.

The doctors group made clear that:

—Birth control pills are very safe. Blood clots, the main serious side effect, happen very rarely, and are a bigger threat during pregnancy and right after giving birth.

—Women can easily tell if they have risk factors, such as smoking or having a previous clot, and should avoid the pill.

—Other over-the-counter drugs are sold despite rare but serious side effects, such as stomach bleeding from aspirin and liver damage from acetaminophen.

—And there's no need for a Pap smear or pelvic exam before using birth control pills. But women should be told to continue getting check-ups as needed, or if they'd like to discuss other forms of birth control such as implantable contraceptives that do require a physician's involvement.

The group didn't address teen use of contraception. Despite protests from reproductive health specialists, current U.S. policy requires girls younger than 17 to produce a prescription for the morning-after pill, meaning pharmacists must check customers' ages. Presumably regular birth control pills would be treated the same way.

Prescription-only oral contraceptives have long been the rule in the U.S., Canada, Western Europe, Australia and a few other places, but many countries don't require a prescription.

Switching isn't a new idea. In Washington state a few years ago, a pilot project concluded that pharmacists successfully supplied women with a variety of hormonal contraceptives, including birth control pills, without a doctor's involvement. The question was how to pay for it.

Some pharmacies in parts of London have a similar project under way, and a recent report from that country's health officials concluded the program is working well enough that it should be expanded.

And in El Paso, Texas, researchers studied 500 women who regularly crossed the border into Mexico to buy birth control pills, where some U.S. brands sell over the counter for a few dollars a pack. Over nine months, the women who bought in Mexico stuck with their contraception better than another 500 women who received the pill from public clinics in El Paso, possibly because the clinic users had to wait for appointments, said Dr. Dan Grossman of the University of California, San Francisco, and the nonprofit research group Ibis Reproductive Health.

"Being able to easily get the pill when you need it makes a difference," he said.

___

Online:

OB/GYN group: http://www.acog.org

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Ceasefire or 'De-Escalation'? Words Chosen Carefully

Nov 20, 2012 7:27pm

AP Photo/Hatem Moussa

As news reports emerged Tuesday of a cease-fire or truce to end the crisis in Gaza, American officials made it a point not to use either of those terms.

Instead, U.S. officials were  talking about “de-escalating” the violence in Gaza as a step toward a long-term resolution.

Briefing White House reporters in Phnom Penh, Cambodia,  Deputy National Security Advisor Ben Rhodes repeatedly said “de-escalation” was the goal for ending the violence in Gaza and Israel.

When asked if he was avoiding using the term “cease-fire,” Rhodes said,  ”No, I mean, there are many ways that you can achieve the goal of a de-escalation.”  He added, ” Our bottom line is, is an end to rocket fire. We’re open to any number of ideas for achieving that goal. We’ve discussed any number of ideas for accomplishing that goal. But it’s going to have to begin with a reduction of tensions and space created for the situation to calm. ”

At the State Department briefing earlier in the day, spokesperson Victoria Nuland was also using “de-escalation.”

Nuland was asked several times why she was using that term instead of “ceasefire”  or “truce.”  She indicated it was because the State Department did not want to get into characterizing acceptable terminology.  “I’m not going to characterize X is acceptable, Y is not acceptable. That’s a subject for negotiation,” she said.

Furthermore, she said, “because the parties are talking, we’re going to be part of that, and we’re not going to negotiate it here from the podium. We’re not going to characterize it here from the podium.”

The message she did want to get across was that “any de-escalation is a step forward.”

Of the long-term aims of Secretary of State Clinton’s last minute mission to Jerusalem, Ramallah and Cairo, Nuland said you “obviously start with a de-escalation of this conflict.”  From there, “we have to see an end to the rocket fire on Israel. We have to see a restoration of calm in Gaza. And the hope is that if we can get through those stages, that will create space for the addressing of broader issues, but I don’t want to prejudge. This is obviously ongoing and live diplomacy.”

Before her meeting  in Jerusalem with Israeli Prime Minister Benjamin Netanyahu, Clinton too avoided using the term “cease-fire.”

After describing America’s commitment to Israel’s security as “rock-solid and unwavering,” Clinton said, “That is why we believe it is essential to de-escalate the situation in Gaza.”

Clinton said that the rocket attacks into Israel from Gaza “must end and a broader calm restored.”  She added that the focus was on  ”a durable outcome that promotes regional stability and advances the security and legitimate aspirations of Israelis and Palestinians alike.”

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Gaza shakes, Israelis killed as Clinton seeks truce

GAZA/JERUSALEM (Reuters) - Israeli air strikes shook the Gaza Strip and Palestinian rockets struck across the border as U.S. Secretary of State Hillary Clinton held talks in Jerusalem in the early hours of Wednesday, seeking a truce that can hold back Israel's ground troops.

Egypt's new Islamist government is mediating talks and had floated hopes for a ceasefire by late Tuesday between Israel and Hamas, the Islamist movement controlling Gaza. However, by the time Clinton met Israeli Prime Minister Benjamin Netanyahu, it was clear there would be more argument, and more violence, first.

Hamas leaders in Cairo accused the Jewish state of failing to respond to proposals and said an announcement on holding fire would not come before daylight on Wednesday. Israel Radio quoted an Israeli official saying a truce was held up due to "a last-minute delay in the understandings between Hamas and Israel."

An initial halt to attacks may, however, not see the sides stand their forces down from battle stations immediately. Clinton, who flies to Cairo to see Egyptian President Mohamed Mursi later on Wednesday, spoke of a deal "in the days ahead."

Like most Western powers, Washington shuns Hamas as an obstacle to peace and has blamed it for the Gaza conflagration. A U.N. Security Council statement condemning the conflict was blocked on Tuesday by the United States, which complained that it "failed to address the root cause," the Palestinian rockets.

As Clinton arrived in Israel after nightfall, Israel was stepping up its bombardment from air and sea. At one point munitions slammed into Gaza at a rate of one every 10 minutes.

Gazan rocket fire waned overnight but resumed before dawn on Wednesday with six launches, Israel said. No one was hurt.

After seven days of hostilities that have killed over 130 Palestinians and five Israelis, both sides are looking for more than a return to the sporadic calm that has prevailed across the blockaded enclave since Israel ended a much more devastating air and ground offensive four years ago.

ELECTION

Netanyahu, who faces an election in two months that he is, for now, favored to win, told Clinton he wanted a "long-term" solution. Failing that, Netanyahu made clear, he stood ready to step up the military campaign to silence Hamas' rockets.

Hamas for its part is exploring the opportunities that last year's Arab Spring has given it to enjoy favor from the new Islamist governments of states once ruled by U.S. proteges, and from Sunni Gulf powers keen to woo it away from Shi'ite Iran. It has used longer-range missiles, some sent by Tehran, and hopes to eclipse Western-backed Palestinian President Mahmoud Abbas.

Hamas has spoken of an easing of Israel's blockade on the 40-km (25-mile) slice of Mediterranean coast that is home to 1.7 million people. It may count on some sympathy from Mursi, though Egypt's first freely elected leader, whose Muslim Brotherhood inspired Hamas' founders, has been careful to stick by the 1979 peace deal with Israel struck by Cairo's former military rulers.

Clinton, who broke off from an Asian tour with President Barack Obama and assured Netanyahu of "rock-solid" U.S. support for Israel's security, spoke of seeking a "durable outcome" and of Egypt's "responsibility" for promoting peace.

She repeated international calls for the kind of lasting, negotiated, comprehensive Israeli-Palestinian settlement that has eluded the two peoples for decades - something neither of the two warring parties seems seriously to be anticipating.

"In the days ahead, the United States will work with our partners here in Israel and across the region toward an outcome that bolsters security for the people of Israel, improves conditions for the people of Gaza and moves toward a comprehensive peace for all people of the region," Clinton said.

"It is essential to de-escalate the situation in Gaza. The rocket attacks from terrorist organizations inside Gaza on Israeli cities and towns must end and a broader calm restored," she said.

"SELF-DEFENCE"

Netanyahu, who has appeared in no immediate rush to repeat the invasion of winter 2008-09 in which over 1,400 Palestinians died, said: "If there is a possibility of achieving a long-term solution to this problem with diplomatic means, we prefer that.

"But if not, I'm sure you understand that Israel will have to take whatever action is necessary to defend its people."

As Israeli aircraft have carried out hundreds of strikes on rocket stores, launchpads and suspected Hamas command posts since assassinating the head of its military wing a week ago. Tens of thousands of Israeli soldiers have been preparing tanks and infantry units for a possible invasion.

During the night, explosions again rocked the city of Gaza and other parts of the Strip, while rockets from the enclave, some essentially home-made, others Iranian-designed and smuggled through tunnels from Egypt, landed in southern Israel.

One reached as far as Rishon Lezion, near Tel Aviv, on Tuesday, the latest to jar Israel's metropolis, long untroubled by Palestinian attacks. Another rocket fell close to Jerusalem, the holy city claimed by both sides in the conflict.

Medical officials in Gaza said 31 Palestinians were killed on Tuesday. An Israeli soldier and a civilian died when rockets exploded near the Gaza frontier, police and the army said.

Gaza medical officials say 138 people have died in Israeli strikes, mostly civilians, including 34 children. In all, five Israelis have died, including three civilians killed last week.

AMMUNITION STORES

Obama, whose relations with the hawkish Netanyahu have long been strained, has said he wants a diplomatic solution, rather than a possible Israeli ground operation in the densely populated territory, home to 1.7 million Palestinians.

Israel's military said it targeted overnight more than 100 sites in Gaza, including rocket launchers, tunnels and the Ministry of Internal Security, used by Hamas as a command center. Israeli police said more than 150 rockets had been fired from Gaza by Tuesday evening.

"No country would tolerate rocket attacks against its cities and against its civilians," Netanyahu said with U.N. Secretary-General Ban Ki-moon, who arrived in Jerusalem from talks in Cairo, at his side. "Israel cannot tolerate such attacks."

Critics have accused Israel of using disproportionate force that has killed civilians. Israel accuses Hamas of putting Gaza's people in harm's way by siting rockets among them.

Media groups have criticized attacks on Gaza media facilities. On Tuesday, three local journalists died in air strikes on their vehicles.

A building housing AFP's bureau was bombed. The French news agency said its staff were unhurt. Israel's military said it had been targeting a Hamas intelligence centre in the tower.

Hamas executed six Palestinians accused of spying for Israel, who a security source quoted by Hamas Aqsa radio said had been "caught red-handed" with "filming equipment to take footage of positions." The radio said they had been shot.

Militants on a motorcycle dragged the body of one of the men through the streets.

A delegation of nine Arab ministers, led by the Egyptian foreign minister, visited Gaza in a further signal of heightened Arab solidarity with the Palestinians.

(Additional reporting by Cairo bureau; Writing by Alastair Macdonald; Editing by Lisa Shumaker)

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