Mediterranean Diet Can Cut Heart Disease, Study Finds

About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study found.

The findings, published on the New England Journal of Medicine’s Web site on Monday, were based on the first major clinical trial to measure the diet’s effect on heart risks. The magnitude of the diet’s benefits startled experts. The study ended early, after almost five years, because the results were so clear it was considered unethical to continue.

The diet helped those following it even though they did not lose weight and most of them were already taking statins, or blood pressure or diabetes drugs to lower their heart disease risk.

“Really impressive,” said Rachel Johnson, a professor of nutrition at the University of Vermont and a spokeswoman for the American Heart Association. “And the really important thing — the coolest thing — is that they used very meaningful end points. They did not look at risk factors like cholesterol of hypertension or weight. They looked at heart attacks and strokes and death. At the end of the day, that is what really matters.”

Until now, evidence that the Mediterranean diet reduced the risk of heart disease was weak, based mostly on studies showing that people from Mediterranean countries seemed to have lower rates of heart disease — a pattern that could have been attributed to factors other than diet.

And some experts had been skeptical that the effect of diet could be detected, if it existed at all, because so many people are already taking powerful drugs to reduce heart disease risk, while other experts hesitated to recommend the diet to people who already had weight problems, since oils and nuts have a lot of calories.

Heart disease experts said the study was a triumph because it showed that a diet is powerful in reducing heart disease risk, and it did so using the most rigorous methods. Scientists randomly assigned 7,447 people in Spain who were overweight, were smokers, had diabetes or other risk factors for heart disease to follow the Mediterranean diet or a low-fat one.

Low-fat diets have not been shown in any rigorous way to be helpful, and they are also very hard for patients to maintain — a reality born out in the new study, said Dr. Steven E. Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic Foundation.

“Now along comes this group and does a gigantic study in Spain that says you can eat a nicely balanced diet with fruits and vegetables and olive oil and lower heart disease by 30 percent,” he said. “And you can actually enjoy life.”

The study, by Dr. Ramon Estruch, a professor of medicine at the University of Barcelona, and his colleagues, was long in the planning. The investigators traveled the world, seeking advice on how best to answer the question of whether a diet alone could make a big difference in heart disease risk. They visited the Harvard School of Public Health several times to consult Dr. Frank M. Sacks, a professor of cardiovascular disease prevention there.

In the end, they decided to randomly assign subjects at high risk of heart disease to three groups. One would be given a low-fat diet and counseled on how to follow it. The other two groups would be counseled to follow a Mediterranean diet. At first the Mediterranean dieters got more intense support. They met regularly with dietitians while the low-fat group just got an initial visit to train them in how to adhere to the diet followed by a leaflet each year on the diet. Then the researchers decided to add more intensive counseling for them, too, but they still had difficulty staying with the diet.

One group assigned to a Mediterranean diet was given extra virgin olive oil each week and was instructed to use at least 4 tablespoons a day. The other group got a combination of walnuts, almonds and hazelnuts and was instructed to eat about an ounce of them each day. An ounce of walnuts, for example, is about a quarter cup — a generous handful. The mainstays of the diet consisted of at least 3 servings a day of fruits and at least two servings of vegetables. Participants were to eat fish at least three times a week and legumes, which include beans, peas and lentils, at least three times a week. They were to eat white meat instead of red, and, for those accustomed to drinking, to have at least 7 glasses of wine a week with meals.

They were encouraged to avoid commercially made cookies, cakes and pastries and to limit their consumption of dairy products and processed meats.

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Mediterranean Diet Can Cut Heart Disease, Study Finds

About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study found.

The findings, published on the New England Journal of Medicine’s Web site on Monday, were based on the first major clinical trial to measure the diet’s effect on heart risks. The magnitude of the diet’s benefits startled experts. The study ended early, after almost five years, because the results were so clear it was considered unethical to continue.

The diet helped those following it even though they did not lose weight and most of them were already taking statins, or blood pressure or diabetes drugs to lower their heart disease risk.

“Really impressive,” said Rachel Johnson, a professor of nutrition at the University of Vermont and a spokeswoman for the American Heart Association. “And the really important thing — the coolest thing — is that they used very meaningful end points. They did not look at risk factors like cholesterol of hypertension or weight. They looked at heart attacks and strokes and death. At the end of the day, that is what really matters.”

Until now, evidence that the Mediterranean diet reduced the risk of heart disease was weak, based mostly on studies showing that people from Mediterranean countries seemed to have lower rates of heart disease — a pattern that could have been attributed to factors other than diet.

And some experts had been skeptical that the effect of diet could be detected, if it existed at all, because so many people are already taking powerful drugs to reduce heart disease risk, while other experts hesitated to recommend the diet to people who already had weight problems, since oils and nuts have a lot of calories.

Heart disease experts said the study was a triumph because it showed that a diet is powerful in reducing heart disease risk, and it did so using the most rigorous methods. Scientists randomly assigned 7,447 people in Spain who were overweight, were smokers, had diabetes or other risk factors for heart disease to follow the Mediterranean diet or a low-fat one.

Low-fat diets have not been shown in any rigorous way to be helpful, and they are also very hard for patients to maintain — a reality born out in the new study, said Dr. Steven E. Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic Foundation.

“Now along comes this group and does a gigantic study in Spain that says you can eat a nicely balanced diet with fruits and vegetables and olive oil and lower heart disease by 30 percent,” he said. “And you can actually enjoy life.”

The study, by Dr. Ramon Estruch, a professor of medicine at the University of Barcelona, and his colleagues, was long in the planning. The investigators traveled the world, seeking advice on how best to answer the question of whether a diet alone could make a big difference in heart disease risk. They visited the Harvard School of Public Health several times to consult Dr. Frank M. Sacks, a professor of cardiovascular disease prevention there.

In the end, they decided to randomly assign subjects at high risk of heart disease to three groups. One would be given a low-fat diet and counseled on how to follow it. The other two groups would be counseled to follow a Mediterranean diet. At first the Mediterranean dieters got more intense support. They met regularly with dietitians while the low-fat group just got an initial visit to train them in how to adhere to the diet followed by a leaflet each year on the diet. Then the researchers decided to add more intensive counseling for them, too, but they still had difficulty staying with the diet.

One group assigned to a Mediterranean diet was given extra virgin olive oil each week and was instructed to use at least 4 tablespoons a day. The other group got a combination of walnuts, almonds and hazelnuts and was instructed to eat about an ounce of them each day. An ounce of walnuts, for example, is about a quarter cup — a generous handful. The mainstays of the diet consisted of at least 3 servings a day of fruits and at least two servings of vegetables. Participants were to eat fish at least three times a week and legumes, which include beans, peas and lentils, at least three times a week. They were to eat white meat instead of red, and, for those accustomed to drinking, to have at least 7 glasses of wine a week with meals.

They were encouraged to avoid commercially made cookies, cakes and pastries and to limit their consumption of dairy products and processed meats.

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Gadgetwise Blog: Q&A: Recommending Web Pages With the Google +1 Button

What happens if I click that +1 button on a Web site?

The +1 button on some Web pages is Google’s version of a personal-approval stamp or recommendation, similar to Facebook’s “Like” button for publicly declaring favorite things on a social network; you probably get the most out of the feature if you are a member of the Google Plus social network. The +1 button often appears on news and entertainment sites around the Web, usually next to Facebook’s “Like” button, and buttons to click for sharing the page by Twitter or e-mail. Other Google properties, like Google Maps, also host a +1 button.

When you click the +1 button on a Web page, your recommendation is noted on your own Google profile page. Google’s guide to the +1 button says you need to have a public Google Profile set up to use the +1 button.

If you happen to use Google Plus, the +1 button is more useful. You can see a list of all the Web sites and pages you have marked. These are listed under the “+1s” tab in the Profile area of your Google Plus page — which is helpful for collecting or just finding those pages again for reference.

The pages you have recommended can also turn up in the search results received by people who happen to be in your Google Plus “circles” of online friends and acquaintances. In those search results, your name appears next to links for pages you have favored, like those for restaurants or products, so your friends can take your opinion into account.

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Iran Enters Nuclear Talks in a Defiant Mood

TEHRAN — When Iran’s nuclear negotiating team sits down with its Western counterparts in Almaty, Kazakhstan, on Tuesday, it will offer no new plans or suggestions, people familiar with the views of the Iranian leadership say. More likely, they say, the Iranian negotiators will sit with arms crossed, demanding a Western change of heart.

Iran’s leaders believe that the effects of Western sanctions have been manageable, and Iran continues to make progress on what it says is a peaceful nuclear energy program. And Iran’s leaders see that North Korea, which openly admits that it wants nuclear weapons, has performed three nuclear tests without suffering any real penalties.

As a result, Iran’s leaders feel that they, not the West, hold the upper hand in negotiations. “The West has no option but stopping to threaten Iran and reduce sanctions,” said Kazem Anbarloui, the editor in chief of the state newspaper Resalat, who was appointed by Iran’s supreme leader, Ayatollah Ali Khamenei. “But it seems they just want to talk for the sake of talks.”

Further signaling that they expect a grand gesture, Iranian officials last week turned down a Western proposal to gradually lift sanctions on trading in gold in return for the closing of a mountain bunker enrichment facility called Fordo. They said the site, which is under an inspection regime by the United Nations nuclear watchdog, would never be shut down, because it afforded protection against attacks, particularly from Israel.

“Such a proposal would only help the Zionist regime to threaten our facilities,” an influential lawmaker, Ala’edin Borujerdi, told reporters. “They would never dare to attack us, but why would we tempt them?”

In recent days, dozens of Iranian politicians have made defiant statements, urging the United States and other nations to accept Iranian nuclear “realities,” which means unconditional acceptance of Iran’s nuclear energy program.

“If they want constructive negotiations, it’s better this time they come with a new strategy and credible proposals,” the top nuclear negotiator, Saeed Jalili, told reporters before his departure to Kazakhstan.

As a sign of their resistance to Western pressures, Iranian officials on Saturday announced the mass installment of higher-yielding enrichment centrifuges, said they had discovered new uranium mines, and designated new sites for future nuclear projects.

“You should raise the level of your tolerance,” Fereydoun Abbasi-Davani, the head of the Atomic Energy Organization of Iran, said on Saturday. “Try to find ways for cooperation with a country that is moving towards technological progress.”

On Sunday, Iranian lawmakers signed a petition urging their negotiating team to defend national interests in Almaty. “The West must learn that Iran’s nuclear train, which moves on the rails of peaceful goals, will never stop,” the petition read, according to the semiofficial Fars news agency.

At the same time, a former top nuclear negotiator, Ali Larijani, who is currently the head of the Iranian Parliament, stressed that reports by the United Nations watchdog, the International Atomic Energy Agency, had no effect on the “will and determination of the Iranian nation.”

Iranian officials do not deny that the sanctions have had an impact — Iran’s oil sales have fallen by more than half because of sanctions, and the national currency lost over 40 percent of its value in 2012, amid the international isolation of its central bank. But they say they are confident that the country can withstand any hardships the West imposes.

“The U.S. government is imposing all its power to impose pressure on us; they tell other countries not to trade with us,” President Mahmoud Ahmadinejad said on Saturday. “We will pass this situation.”

Ayatollah Khamenei gave much the same message in two addresses this month. “If the Iranian people had wanted to surrender to the Americans, they would not have carried out a revolution,” he said in a meeting at his private home, which was broadcast by the Iranian news media. “The people, particularly the underprivileged classes, truly feel the hardships. But they do not separate themselves from the Islamic Republic, because they know that the Islamic Republic and the dear Islam are the powerful hands which can solve the problems.”

In elevators, in private taxis and at family parties in the Iranian capital, many hope that the talks in Almaty will bring an end to the decade-long nuclear standoff. But few expect much. “Both the U.S. and our leaders will never give in,” said one judge who did not want his name mentioned because of the nature of his work. “There can only be one winner and one loser; no compromise.”

Ramtin Rastin contributed reporting.

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Major Banks Aid in Payday Loans Banned by States

Major banks have quickly become behind-the-scenes allies of Internet-based payday lenders that offer short-term loans with interest rates sometimes exceeding 500 percent.

With 15 states banning payday loans, a growing number of the lenders have set up online operations in more hospitable states or far-flung locales like Belize, Malta and the West Indies to more easily evade statewide caps on interest rates.

While the banks, which include giants like JPMorgan Chase, Bank of America and Wells Fargo, do not make the loans, they are a critical link for the lenders, enabling the lenders to withdraw payments automatically from borrowers’ bank accounts, even in states where the loans are banned entirely. In some cases, the banks allow lenders to tap checking accounts even after the customers have begged them to stop the withdrawals.

“Without the assistance of the banks in processing and sending electronic funds, these lenders simply couldn’t operate,” said Josh Zinner, co-director of the Neighborhood Economic Development Advocacy Project, which works with community groups in New York.

The banking industry says it is simply serving customers who have authorized the lenders to withdraw money from their accounts. “The industry is not in a position to monitor customer accounts to see where their payments are going,” said Virginia O’Neill, senior counsel with the American Bankers Association.

But state and federal officials are taking aim at the banks’ role at a time when authorities are increasing their efforts to clamp down on payday lending and its practice of providing quick money to borrowers who need cash.

The Federal Deposit Insurance Corporation and the Consumer Financial Protection Bureau are examining banks’ roles in the online loans, according to several people with direct knowledge of the matter. Benjamin M. Lawsky, who heads New York State’s Department of Financial Services, is investigating how banks enable the online lenders to skirt New York law and make loans to residents of the state, where interest rates are capped at 25 percent.

For the banks, it can be a lucrative partnership. At first blush, processing automatic withdrawals hardly seems like a source of profit. But many customers are already on shaky financial footing. The withdrawals often set off a cascade of fees from problems like overdrafts. Roughly 27 percent of payday loan borrowers say that the loans caused them to overdraw their accounts, according to a report released this month by the Pew Charitable Trusts. That fee income is coveted, given that financial regulations limiting fees on debit and credit cards have cost banks billions of dollars.

Some state and federal authorities say the banks’ role in enabling the lenders has frustrated government efforts to shield people from predatory loans — an issue that gained urgency after reckless mortgage lending helped precipitate the 2008 financial crisis.

Lawmakers, led by Senator Jeff Merkley, Democrat of Oregon, introduced a bill in July aimed at reining in the lenders, in part, by forcing them to abide by the laws of the state where the borrower lives, rather than where the lender is. The legislation, pending in Congress, would also allow borrowers to cancel automatic withdrawals more easily. “Technology has taken a lot of these scams online, and it’s time to crack down,” Mr. Merkley said in a statement when the bill was introduced.

While the loans are simple to obtain — some online lenders promise approval in minutes with no credit check — they are tough to get rid of. Customers who want to repay their loan in full typically must contact the online lender at least three days before the next withdrawal. Otherwise, the lender automatically renews the loans at least monthly and withdraws only the interest owed. Under federal law, customers are allowed to stop authorized withdrawals from their account. Still, some borrowers say their banks do not heed requests to stop the loans.

Ivy Brodsky, 37, thought she had figured out a way to stop six payday lenders from taking money from her account when she visited her Chase branch in Brighton Beach in Brooklyn in March to close it. But Chase kept the account open and between April and May, the six Internet lenders tried to withdraw money from Ms. Brodsky’s account 55 times, according to bank records reviewed by The New York Times. Chase charged her $1,523 in fees — a combination of 44 insufficient fund fees, extended overdraft fees and service fees.

For Subrina Baptiste, 33, an educational assistant in Brooklyn, the overdraft fees levied by Chase cannibalized her child support income. She said she applied for a $400 loan from Loanshoponline.com and a $700 loan from Advancemetoday.com in 2011. The loans, with annual interest rates of 730 percent and 584 percent respectively, skirt New York law.

Ms. Baptiste said she asked Chase to revoke the automatic withdrawals in October 2011, but was told that she had to ask the lenders instead. In one month, her bank records show, the lenders tried to take money from her account at least six times. Chase charged her $812 in fees and deducted over $600 from her child-support payments to cover them.

“I don’t understand why my own bank just wouldn’t listen to me,” Ms. Baptiste said, adding that Chase ultimately closed her account last January, three months after she asked.

A spokeswoman for Bank of America said the bank always honored requests to stop automatic withdrawals. Wells Fargo declined to comment. Kristin Lemkau, a spokeswoman for Chase, said: “We are working with the customers to resolve these cases.” Online lenders say they work to abide by state laws.

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The Texas Tribune: Advocates Seek Mental Health Changes, Including Power to Detain

Matt Rainwaters for Texas Monthly

The Sherman grave of Andre Thomas’s victims.

SHERMAN — A worried call from his daughter’s boyfriend sent Paul Boren rushing to her apartment on the morning of March 27, 2004. He drove the eight blocks to her apartment, peering into his neighbors’ yards, searching for Andre Thomas, Laura Boren’s estranged husband.

Expanded coverage of Texas is produced by The Texas Tribune, a nonprofit news organization. To join the conversation about this article, go to texastribune.org.

For more articles on mental health and criminal justice in Texas, as well as a timeline of the Andre Thomas case: texastribune.org

Matt Rainwaters for Texas Monthly

Laura Boren

He drove past the brightly colored slides, swings and bouncy plastic animals in Fairview Park across the street from the apartment where Ms. Boren, 20, and her two children lived. He pulled into a parking spot below and immediately saw that her door was broken. As his heart raced, Mr. Boren, a white-haired giant of a man, bounded up the stairwell, calling out for his daughter.

He found her on the white carpet, smeared with blood, a gaping hole in her chest. Beside her left leg, a one-dollar bill was folded lengthwise, the radiating eye of the pyramid facing up. Mr. Boren knew she was gone.

In a panic, he rushed past the stuffed animals, dolls and plastic toys strewn along the hallway to the bedroom shared by his two grandchildren. The body of 13-month-old Leyha Hughes lay on the floor next to a blood-spattered doll nearly as big as she was.

Andre Boren, 4, lay on his back in his white children’s bed just above Leyha. He looked as if he could have been sleeping — a moment away from revealing the toothy grin that typically spread from one of his round cheeks to the other — except for the massive chest wound that matched the ones his father, Andre Thomas (the boy was also known as Andre Jr.), had inflicted on his mother and his half-sister as he tried to remove their hearts.

“You just can’t believe that it’s real,” said Sherry Boren, Laura Boren’s mother. “You’re hoping that it’s not, that it’s a dream or something, that you’re going to wake up at any minute.”

Mr. Thomas, who confessed to the murders of his wife, their son and her daughter by another man, was convicted in 2005 and sentenced to death at age 21. While awaiting trial in 2004, he gouged out one of his eyes, and in 2008 on death row, he removed the other and ate it.

At least twice in the three weeks before the crime, Mr. Thomas had sought mental health treatment, babbling illogically and threatening to commit suicide. On two occasions, staff members at the medical facilities were so worried that his psychosis made him a threat to himself or others that they sought emergency detention warrants for him.

Despite talk of suicide and bizarre biblical delusions, he was not detained for treatment. Mr. Thomas later told the police that he was convinced that Ms. Boren was the wicked Jezebel from the Bible, that his own son was the Antichrist and that Leyha was involved in an evil conspiracy with them.

He was on a mission from God, he said, to free their hearts of demons.

Hospitals do not have legal authority to detain people who voluntarily enter their facilities in search of mental health care but then decide to leave. It is one of many holes in the state’s nearly 30-year-old mental health code that advocates, police officers and judges say lawmakers need to fix. In a report last year, Texas Appleseed, a nonprofit advocacy organization, called on lawmakers to replace the existing code with one that reflects contemporary mental health needs.

“It was last fully revised in 1985, and clearly the mental health system has changed drastically since then,” said Susan Stone, a lawyer and psychiatrist who led the two-year Texas Appleseed project to study and recommend reforms to the code. Lawmakers have said that although the code may need to be revamped, it will not happen in this year’s legislative session. Such an undertaking requires legislative studies that have not been conducted. But advocates are urging legislators to make a few critical changes that they say could prevent tragedies, including giving hospitals the right to detain someone who is having a mental health crisis.

From the time Mr. Thomas was 10, he had told friends he heard demons in his head instructing him to do bad things. The cacophony drove him to attempt suicide repeatedly as an adolescent, according to court records. He drank and abused drugs to try to quiet the noise.

bgrissom@texastribune.org

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Mobile Revolution Buffets Taiwan PC Rivals

TAIPEI — Two computer-making neighbors in the technologically inclined economy of Taiwan seem headed in opposite directions.

Personal computer sales have slumped worldwide as smartphones and tablets have proliferated and gained in popularity. One Taiwan heavyweight, Acer, has shared in the suffering: It is expected to report a second straight annual loss in 2012 after losing 6.6 billion Taiwan dollars, or $223 million at the current exchange rate, in 2011.

But another Taiwan-based PC company, Asustek, which sells computers under the Asus name, grew 43 percent in the quarter that ended in September, to 6.7 billion dollars in net income. The company’s PC sales rose 6.4 percent even as industrywide PC shipments declined 4.9 percent in the last three months of 2012, according to the research firm Gartner.

The companies’ divergent fortunes expose both the mistakes and the opportunities for PC makers in an epic shift in the way consumers use technology.

For more than a decade, with no serious alternatives for consumers, Acer, Dell and Hewlett-Packard treated the PC as a commodity: All of their machines used the same Intel chips and Microsoft software and even looked similar, analysts said. In that environment, PC makers made money by focusing on marketing and by cutting costs.

For Acer, much of that strategy was driven by the former chief executive, Gianfranco Lanci, who led the company from 2004 to 2011. During his tenure, the company focused only on marketing and distribution, while gutting research and development and outsourcing design and production, analysts said.

The spread of smartphones and tablets has challenged that business model. Consumers have more choices and increasingly focus on how their devices look and feel, how mobile they are and what content they can provide access to.

“At the moment, the PC market is saturated,” said Tracy Tsai, an analyst at Gartner. “When most users have a PC already, they are not looking for just a cheaper notebook. They want something better.”

That has meant meager profits or none for global PC brands. H.P. reported a $12.7 billion loss in the business year that ended in September 2012, while Dell’s poor performance has resulted in an effort to take the company private.

It is a problem that has manifested itself on the street as well. Stam Chuang, a manager at a retail shop in the Guanghua Digital Plaza in Taipei, said notebook sales at his store had dropped 10 percent during the past year.

“There’s only a set amount of demand for computing out there,” Mr. Chuang said. “So if consumers decide they want a tablet or smartphone, that share will get taken out of PCs.”

Because of its research and development cuts, Acer has struggled to produce smartphones and tablets that can compete with the sleek products from mobile powerhouses like Amazon.com, Apple and Samsung, analysts said.

Asustek, however, followed a strategy that emphasized design and innovation. Its personal computer growth in 2012 was driven by the Zenbook, an ultrathin laptop with a metallic finish, stereo speakers and backlit keys.

Jonney Shih, the chairman of Asustek, said he had foreseen the mobile revolution and wanted his company to differentiate itself from the competition.

“Even 10 years ago, I knew I had to be prepared,” Mr. Shih said.

He added that with computer architecture and chips shrinking, he had recognized that “the ‘phone computer’ was going to happen.”

Mr. Shih has become a cheerleader for what he calls “design thinking,” pushing his employees to be creative about building products that enrich the experience for consumers. Asustek incorporated a design and artistry category into its employee evaluation system.

The two companies’ revenue numbers are similar: In the third quarter of 2012, Acer brought in 87.4 billion dollars in revenue, compared with 96 billion dollars for Asustek, according to Bloomberg data.

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IHT Rendezvous: As Oscars Fever Builds, Some Chinese Ask: ‘What About Our Films?’

BEIJING — As Oscar fever grows around the world with the 85th Academy Awards set to begin in Los Angeles just hours from now, excitement is building in China, even though it has no films in competition. There is also a sense of frustration here about why China’s movies aren’t nominated for the world’s biggest awards?

China sees itself as advancing in many ways, growing richer and more powerful, so its inability to come up with serious Oscars contenders rankles.

The most popular answer to the question, held by ordinary Chinese and film experts alike, is: “Too few good films. That’s the real reason in recent years Chinese films have moved further and further away from the Oscars dream,” wrote The International Herald Leader newspaper, in a story carried on the country’s popular Tencent entertainment site.

An article by The Economic Daily, carried on People’s Daily Web site, gave another interpretation: “The Oscars have never been a communal forum, the films taken seriously have only the responsibility to portray the North American world view and the lives they’re willing to see.”

As I’ve explored elsewhere, strict censorship hobbles the Chinese film industry. Directors are increasingly voicing their frustration in public, yet there’s little they can do against the directives of the state. One result of this hamstringing of talent is it’s virtually impossible to make probing films about contemporary society, which has many social tensions the government doesn’t want openly explored. Instead, filmmakers retreat to the safety of historical themes, with tales of warring dynasties commonplace.

Also, strict import rules governing overseas movies mean few may be shown here. As a person with the handle LA-YIN wrote on Sina Weibo, the microblog: “With the exception of Ang Lee’s ‘Life of Pi,’ none of the nominated films has screened in China.”

Much attention is being focused on a prediction of winners in an annual list drawn up by the actress Zhang Ziyi. Ms. Zhang starred in “Crouching Tiger, Hidden Dragon,” a hit in 2000 by the Taiwanese director Ang Lee. She is also the first Chinese star from the People’s Republic of China to be listed on the jury for the Oscars, in 2005, Xinhua, the state news agency, reported.

Many netizens are pointing out that Ms. Zhang’s list runs at an estimated 90 percent accuracy rate. So what’s she tapping?

Best Director? Mr. Lee and Steven Spielberg (“Lincoln”) are in tight competition, she writes. “Emotionally, I’m drawn to Ang Lee. Intellectually I’m drawn to Spielberg. These are the two films I’ve liked most this year.”

Best Film? “Lincoln. Whether you like the movie or not, it gives off glamor and radiance. I salute Spielberg’s youthfulness,” she wrote.

China is 16 hours ahead of Los Angeles, so watching will be tricky for people headed into a normal working day on Monday. As –Mostro- wrote on a microblog site, “It’s the Oscars today!!!!!!! But it’ll only be on tomorrow, Beijing time ….I can’t watch it,” followed by four yellow, grimacing emoticons.

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Drone Pilots Found to Get Stress Disorders Much as Those in Combat Do

U.S. Air Force/Master Sgt. Steve Horton

Capt. Richard Koll, left, and Airman First Class Mike Eulo monitored a drone aircraft after launching it in Iraq.

The study affirms a growing body of research finding health hazards even for those piloting machines from bases far from actual combat zones.

“Though it might be thousands of miles from the battlefield, this work still involves tough stressors and has tough consequences for those crews,” said Peter W. Singer, a scholar at the Brookings Institution who has written extensively about drones. He was not involved in the new research.

That study, by the Armed Forces Health Surveillance Center, which analyzes health trends among military personnel, did not try to explain the sources of mental health problems among drone pilots.

But Air Force officials and independent experts have suggested several potential causes, among them witnessing combat violence on live video feeds, working in isolation or under inflexible shift hours, juggling the simultaneous demands of home life with combat operations and dealing with intense stress because of crew shortages.

“Remotely piloted aircraft pilots may stare at the same piece of ground for days,” said Jean Lin Otto, an epidemiologist who was a co-author of the study. “They witness the carnage. Manned aircraft pilots don’t do that. They get out of there as soon as possible.”

Dr. Otto said she had begun the study expecting that drone pilots would actually have a higher rate of mental health problems because of the unique pressures of their job.

Since 2008, the number of pilots of remotely piloted aircraft — the Air Force’s preferred term for drones — has grown fourfold, to nearly 1,300. The Air Force is now training more pilots for its drones than for its fighter jets and bombers combined. And by 2015, it expects to have more drone pilots than bomber pilots, although fighter pilots will remain a larger group.

Those figures do not include drones operated by the C.I.A. in counterterrorism operations over Pakistan, Yemen and other countries.

The Pentagon has begun taking steps to keep pace with the rapid expansion of drone operations. It recently created a new medal to honor troops involved in both drone warfare and cyberwarfare. And the Air Force has expanded access to chaplains and therapists for drone operators, said Col. William M. Tart, who commanded remotely piloted aircraft crews at Creech Air Force Base in Nevada.

The Air Force has also conducted research into the health issues of drone crew members. In a 2011 survey of nearly 840 drone operators, it found that 46 percent of Reaper and Predator pilots, and 48 percent of Global Hawk sensor operators, reported “high operational stress.” Those crews cited long hours and frequent shift changes as major causes.

That study found the stress among drone operators to be much higher than that reported by Air Force members in logistics or support jobs. But it did not compare the stress levels of the drone operators with those of traditional pilots.

The new study looked at the electronic health records of 709 drone pilots and 5,256 manned aircraft pilots between October 2003 and December 2011. Those records included information about clinical diagnoses by medical professionals and not just self-reported symptoms.

After analyzing diagnosis and treatment records, the researchers initially found that the drone pilots had higher incidence rates for 12 conditions, including anxiety disorder, depressive disorder, post-traumatic stress disorder, substance abuse and suicidal ideation.

But after the data were adjusted for age, number of deployments, time in service and history of previous mental health problems, the rates were similar, said Dr. Otto, who was scheduled to present her findings in Arizona on Saturday at a conference of the American College of Preventive Medicine.

The study also found that the incidence rates of mental heath problems among drone pilots spiked in 2009. Dr. Otto speculated that the increase might have been the result of intense pressure on pilots during the Iraq surge in the preceding years.

The study found that pilots of both manned and unmanned aircraft had lower rates of mental health problems than other Air Force personnel. But Dr. Otto conceded that her study might underestimate problems among both manned and unmanned aircraft pilots, who may feel pressure not to report mental health symptoms to doctors out of fears that they will be grounded.

She said she planned to conduct two follow-up studies: one that tries to compensate for possible underreporting of mental health problems by pilots and another that analyzes mental health issues among sensor operators, who control drone cameras while sitting next to the pilots.

“The increasing use of remotely piloted aircraft for war fighting as well as humanitarian relief should prompt increased surveillance,” she said.

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Drone Pilots Found to Get Stress Disorders Much as Those in Combat Do

U.S. Air Force/Master Sgt. Steve Horton

Capt. Richard Koll, left, and Airman First Class Mike Eulo monitored a drone aircraft after launching it in Iraq.

The study affirms a growing body of research finding health hazards even for those piloting machines from bases far from actual combat zones.

“Though it might be thousands of miles from the battlefield, this work still involves tough stressors and has tough consequences for those crews,” said Peter W. Singer, a scholar at the Brookings Institution who has written extensively about drones. He was not involved in the new research.

That study, by the Armed Forces Health Surveillance Center, which analyzes health trends among military personnel, did not try to explain the sources of mental health problems among drone pilots.

But Air Force officials and independent experts have suggested several potential causes, among them witnessing combat violence on live video feeds, working in isolation or under inflexible shift hours, juggling the simultaneous demands of home life with combat operations and dealing with intense stress because of crew shortages.

“Remotely piloted aircraft pilots may stare at the same piece of ground for days,” said Jean Lin Otto, an epidemiologist who was a co-author of the study. “They witness the carnage. Manned aircraft pilots don’t do that. They get out of there as soon as possible.”

Dr. Otto said she had begun the study expecting that drone pilots would actually have a higher rate of mental health problems because of the unique pressures of their job.

Since 2008, the number of pilots of remotely piloted aircraft — the Air Force’s preferred term for drones — has grown fourfold, to nearly 1,300. The Air Force is now training more pilots for its drones than for its fighter jets and bombers combined. And by 2015, it expects to have more drone pilots than bomber pilots, although fighter pilots will remain a larger group.

Those figures do not include drones operated by the C.I.A. in counterterrorism operations over Pakistan, Yemen and other countries.

The Pentagon has begun taking steps to keep pace with the rapid expansion of drone operations. It recently created a new medal to honor troops involved in both drone warfare and cyberwarfare. And the Air Force has expanded access to chaplains and therapists for drone operators, said Col. William M. Tart, who commanded remotely piloted aircraft crews at Creech Air Force Base in Nevada.

The Air Force has also conducted research into the health issues of drone crew members. In a 2011 survey of nearly 840 drone operators, it found that 46 percent of Reaper and Predator pilots, and 48 percent of Global Hawk sensor operators, reported “high operational stress.” Those crews cited long hours and frequent shift changes as major causes.

That study found the stress among drone operators to be much higher than that reported by Air Force members in logistics or support jobs. But it did not compare the stress levels of the drone operators with those of traditional pilots.

The new study looked at the electronic health records of 709 drone pilots and 5,256 manned aircraft pilots between October 2003 and December 2011. Those records included information about clinical diagnoses by medical professionals and not just self-reported symptoms.

After analyzing diagnosis and treatment records, the researchers initially found that the drone pilots had higher incidence rates for 12 conditions, including anxiety disorder, depressive disorder, post-traumatic stress disorder, substance abuse and suicidal ideation.

But after the data were adjusted for age, number of deployments, time in service and history of previous mental health problems, the rates were similar, said Dr. Otto, who was scheduled to present her findings in Arizona on Saturday at a conference of the American College of Preventive Medicine.

The study also found that the incidence rates of mental heath problems among drone pilots spiked in 2009. Dr. Otto speculated that the increase might have been the result of intense pressure on pilots during the Iraq surge in the preceding years.

The study found that pilots of both manned and unmanned aircraft had lower rates of mental health problems than other Air Force personnel. But Dr. Otto conceded that her study might underestimate problems among both manned and unmanned aircraft pilots, who may feel pressure not to report mental health symptoms to doctors out of fears that they will be grounded.

She said she planned to conduct two follow-up studies: one that tries to compensate for possible underreporting of mental health problems by pilots and another that analyzes mental health issues among sensor operators, who control drone cameras while sitting next to the pilots.

“The increasing use of remotely piloted aircraft for war fighting as well as humanitarian relief should prompt increased surveillance,” she said.

Read More..