Zorbing Accident Kills 1 Man and Injures Another in Russia





MOSCOW — It is called a zorb, an outsize inflatable ball in which people strap themselves, then bounce down a ski slope and, presumably, have a good time doing so. But when a zorb veered off a ski run high in Russia’s Caucasus Mountains earlier this month, there was little anyone could do but watch as the two men inside careened along a jagged ridge and then plunged over a precipice.




The ball tumbled down the mountain at the Dombai ski resort for almost a mile, slamming into rocks as it picked up speed, rescue workers said on Wednesday in a televised statement. One of the men, Denis Burakov, 27, injured his spinal cord and died on the way to a hospital. The other, Vladimir Shcherbakov, 33, suffered a concussion and deep cuts to his arms and face.


The accident on Jan. 3, which a friend of the men filmed on a cellphone and then uploaded to the Internet on Tuesday, has generated concern over unlicensed attractions on Russia’s loosely regulated ski slopes.


The man who harnessed Mr. Burakov and Mr. Shcherbakov into the zorb told the police that they were his first customers, and that he was not licensed to offer rides, having bought the ball two years ago for his own use. On Thursday the police arrested the man, Ravil Chekunov, 25, who said he had charged Mr. Burakov and Mr. Shcherbakov about $10 for the ride.


Russia’s minister of emergency situations called Wednesday for tighter safety precautions at skiing facilities, after a rash of winter sports injuries. Russian television reported this week that 10 people had been seriously injured on a single ski slope in Kolomna, a city 50 miles southeast of Moscow. A woman who descended on a sled broke her spine after she ran into rocks at the bottom.


Russian leaders, notably President Vladimir V. Putin, have tried for years to build interest in downhill skiing in Russia. The country has invested billions of dollars in ski resorts in the Caucasus, and in particular in the Black Sea resort of Sochi, which will host the Winter Olympics in 2014.


Mr. Putin mingled with stunned vacationers at a resort near Sochi during the winter break, and the culture minister, Vladimir R. Medinsky, lavishly praised the local ski conditions on Twitter.


But an investigation into the accident at the Dombai ski resort, less than 100 miles east of Sochi, found 50 unlicensed attractions and guides operating on the mountain, the newspaper Izvestia reported.


A Moscow-based businessman, Montay Imanov, told Izvestia that the zorb that carried the two men was stolen from him at gunpoint in 2009, when he traveled to the region intending to open a zorbing business.


“They didn’t cordon the track off from the gorge,” he said. “It’s just a nightmare. They needed to put six rows of nets there.”


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Gadgetwise Blog: Q&A: Dealing With Duplicate Work on Dropbox

What happens if two people work on the same file at the same time in a shared Dropbox folder? Does one copy of the file overwrite the other?

If two people are editing the same file at the same time, Dropbox saves both versions of the file in the shared folder. The service does not merge the two different files, but adds the words “conflicted copy” to the file name of the second version so it is obvious that two different copies of the same file now exist.

The file name of the second copy also lists the date that the conflict occurred between the two versions of the file. The computer name or name of the person who was working on the file is appended to the name as well, making it somewhat easier to identify the collaborator and ensure that everyone’s changes are incorporated into one final version of the document.

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Children’s Flu Medicine in Short Supply





As influenza cases surge around the country, health officials say they are trying to stem a shortage of treatments for children.




Pharmacies around the country have reported dwindling supplies of liquid Tamiflu, a prescription flu medicine that can ease symptoms if taken within 48 hours of their onset. The drug is available in capsules for adults and a liquid suspension for children and infants.


“There are intermittent shortages of the liquid version (but not the capsule version) due to the supplier’s challenges to meet the current demand,” Carolyn Castel, a spokeswomen for CVS Caremark, said in an e-mail.


Pharmacies around the country are experiencing shortages of the liquid suspension “due to recent increased demand,” Sarah Clark-Lynn, a spokeswoman for the Food and Drug Administration, said on Thursday.


Ms. Clark-Lynn said the F.D.A. was working with the company that markets Tamiflu, Genentech, to increase supplies. The agency is also letting pharmacists know that in emergencies they can compound the adult Tamiflu capsules to make liquid versions for children.


A similar shortage of Tamiflu has hit Canada, which has also been gripped by widespread flu outbreaks, prompting the government there to tap into a national stockpile of the drug.


“That really unexpected increase in demand — far above other influenza seasons — has really depleted the usual stocks which in any other season would have been more than sufficient,” Dr. Barbara Raymond, director of pandemic preparedness for the Public Health Agency of Canada, told The Ottawa Citizen.


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Children’s Flu Medicine in Short Supply





As influenza cases surge around the country, health officials say they are trying to stem a shortage of treatments for children.




Pharmacies around the country have reported dwindling supplies of liquid Tamiflu, a prescription flu medicine that can ease symptoms if taken within 48 hours of their onset. The drug is available in capsules for adults and a liquid suspension for children and infants.


“There are intermittent shortages of the liquid version (but not the capsule version) due to the supplier’s challenges to meet the current demand,” Carolyn Castel, a spokeswomen for CVS Caremark, said in an e-mail.


Pharmacies around the country are experiencing shortages of the liquid suspension “due to recent increased demand,” Sarah Clark-Lynn, a spokeswoman for the Food and Drug Administration, said on Thursday.


Ms. Clark-Lynn said the F.D.A. was working with the company that markets Tamiflu, Genentech, to increase supplies. The agency is also letting pharmacists know that in emergencies they can compound the adult Tamiflu capsules to make liquid versions for children.


A similar shortage of Tamiflu has hit Canada, which has also been gripped by widespread flu outbreaks, prompting the government there to tap into a national stockpile of the drug.


“That really unexpected increase in demand — far above other influenza seasons — has really depleted the usual stocks which in any other season would have been more than sufficient,” Dr. Barbara Raymond, director of pandemic preparedness for the Public Health Agency of Canada, told The Ottawa Citizen.


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DealBook: For Some Dead Brands, a Tortuous Path to Resurrection

At a time when bankruptcy auctions are filled with sad tales of beleaguered brands, snagging a well-known name for pennies on the dollar can seem like a sure bet for ambitious investors.

Yet, as Stephen F. Heese and Stephen M. Julius describe, buying the rights to a name and restarting operations requires years of dedication.

The two, who were classmates at Harvard Business School in the 1980s, manage their own capital at Stellican, an investment firm. Their goal: to seek out so-called heritage brands — those remembered for their high quality and authenticity — and rebuild a company. One project is the revival of Chris-Craft, once the largest pleasure boat manufacturer in the United States.

The notion of buying and resurrecting a beloved brand can be appealing across product categories, as reflected by the current bidding dance for Hostess or the woefully long ordeal of Saab, which was sold to Chinese and Japanese investors last year.

Chris-Craft, which Stellican now operates, was known for its meticulous design and use of wood and chrome. Its boats were widely sought after and associated with the many celebrities and public figures who owned them, including Katharine Hepburn, Frank Sinatra and Presidents Franklin Delano Roosevelt and John F. Kennedy. That image made it appealing to Stellican’s principals.

Yet, while nostalgia can be a powerful marketing tool, business school case studies are filled with would-be white knights that needed more than money to succeed. For example, Excelsior Henderson, a motorcycle maker twice rescued from bankruptcy, ultimately failed. Yet, Triumph Motorcycles was revived in 1984 and has operated since.

“Brands are not like tech start-ups where there is a template — X number of years to prototype, X number of years to harvest,” said Nancy F. Koehn, a Harvard Business School marketing professor. “A big piece of it is art; there’s an alchemy to it.”

The death and rebirth of Chris-Craft played out over decades. The company was founded by Christopher Columbus Smith, who built his first vessel in 1874 and soon developed a reputation as a master. The Smith family sold Chris-Craft in 1960, around the time fiberglass began displacing wood as the material of choice for boats.

By 1968, Chris-Craft had been sold to the media mogul Herb Siegel. It stopped making wood boats, and expanded beyond powerboats, adding sailboats and houseboats to its offerings. Market share and profits declined.

Enter Stellican. Mr. Julius, with assistance from Mr. Heese, had previously resuscitated Riva, a premium Italian boat maker, in 1998. He sold it to the Italian yacht company Ferretti Group in 2000.

Before joining forces for the Riva deal, Mr. Julius and Mr. Heese took different paths after Harvard. Mr. Julius started his career with the Boston Consulting Group and eventually moved to London. Mr. Heese, a certified public accountant by training, headed to what was then Price Waterhouse and later to the Erico International Corporation, a privately held manufacturer of electrical and mechanical hardware.

In 1991, Mr. Julius formed Stellican as an advisory and investment vehicle for his family’s assets. In 1998, while living in Italy, he called Mr. Heese, who was in the United States, to ask if he could help set up distribution in the United States for Riva. Mr. Heese officially joined Stellican in 2001, and the partners began work on the Chris-Craft deal.

Although the two would not discuss their firm’s financial returns, they say they expect internal return rates higher than 35 percent on their investments.

Stellican owns no more than two companies at once, and typically has an investment ceiling of $10 million. “We put all our eggs in one or two baskets,” Mr. Julius said.

Chris-Craft’s path to revival was tortuous. In 1981, the Chris-Craft boatyard was bought by G. Dale Murray, but Mr. Siegel retained rights to the Chris-Craft name.

Mr. Murray’s company went bankrupt in 1988, and was bought by the Outboard Marine Corporation, which sold several brands of boats as well as outboard engines, before going bankrupt in 2001. After Mr. Heese read about the bankruptcy, he contacted Mr. Julius.

Stellican acquired the assets of Chris-Craft (finished and unfinished boats) and the trademark for the name in separate transactions. The complicated process of acquiring the assets included a 12-hour, 20-way auction held in a conference room at the Chicago office of the law firm Skadden, Arps, Meagher, Slate & Flom.

Four hundred industry players gathered, all competing for the Chris-Craft assets. Mr. Julius, bidding on behalf of Stellican, lost out to the owner of Genmar Industries, Irwin Jacobs, who had teamed up with Bombardier to buy all of Outboard Marine’s assets for $95 million.

As he left the room, Mr. Julius told Mr. Jacobs to call him if he ever wanted to sell Chris-Craft. That call came just days later. In March 2001, Stellican bought the Chris-Craft assets from Genmar for $5 million.

Acquiring the Chris-Craft name, which was still owned by Mr. Siegel, was next. But Mr. Siegel refused to sell the name rights to Stellican. So, when Mr. Julius learned Mr. Siegel was in the process of selling his media company, Chris-Craft Industries, to Rupert Murdoch’s News Corporation, he approached Mr. Murdoch directly.

They reached a deal that enabled Stellican to buy the brand for $5 million.

Restarting operations was a bit more daunting. During the decades when Chris-Craft languished, its products had become middle market, Mr. Julius said. Scrapping the old product line was Stellican’s first order of business.

“It was always, ‘I remember,’ followed by a smile and a positive memory,” he said. Chris-Craft evoked the innocence and promise of post-World War II America — and Henry Fonda piloting a 1950s model in “On Golden Pond.” Building products that fulfilled that promise became their mantra, Mr. Heese said.

Restoring Chris-Craft also required rebuilding its dealer network. Mr. Julius said that dealers were initially skeptical that the type of customer he described — one obsessed with beauty and performance, not price — existed. The company makes 20- to 36-foot boats whose prices range from about $50,000 to $550,000.

He had to sell his products to dealers and feel comfortable they could sell them to customers.

Cost control also remained important, a role falling to Mr. Heese, who signs every check as chief executive. “We’re very hard-nosed when it comes to investing our own money,” he said.

Chris-Craft continues to bolster its dealer network worldwide. In June, the company plans to release a line of Chris-Craft branded sports apparel for a wider market. The company just signed a deal with IMG, which will serve as its licensing agent for watches, sunglasses and toys.

After starting at zero, Chris-Craft sales were $32 million in 2012. Its high was $60 million in 2008.

In between, Stellican bought Indian Motorcycles in 2006, turned it around, and sold it to Polaris Industries in 2011.

The partners acknowledge that their efforts may not have worked at a traditional private equity firm, most of which seek companies with positive cash flows.

Product innovation separates the winners from the losers when it comes to brand revivals, said Scott Galloway, a marketing professor at the Stern School of Business at New York University. “Brands lose value because they get fat, dumb and happy,” he said.

Although Stellican has received attractive offers for Chris-Craft, it plans to hold onto it for now. Mr. Heese said he was in no hurry to begin chasing deals again, a process he described as “gut-wrenching.”

“When you’re buying a company that’s in bankruptcy, you’re sitting across from people who screwed up,” Mr. Heese said. “They’re not dumb — they just got one thing wrong,” he said.

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Venezuelan Court: Chávez Swearing-In Can Be Postponed



CARACAS, Venezuela (AP) — Venezuelan opposition leader Henrique Capriles is condemning the Supreme Court's endorsement of a delay in President Hugo Chavez's inauguration.


The Supreme Court sided with Venezuela's government and ruling party earlier Wednesday in the heated dispute with the opposition while the ailing leader struggles with complications a month after cancer surgery in Cuba.


Capriles says that "institutions should not respond to the interests of a government."


Supreme Court President Luisa Estella announced that it's legal for lawmakers to delay Chavez's swearing-in for a new term, which had been scheduled for Thursday.


Pro-Chavez lawmakers voted Tuesday to delay the ceremony, allowing Chavez to take the oath of office at a later date before the Supreme Court.


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Tool Kit: Mobile Devices Provide Power for Smartphones and Tablets


You undoubtedly know people so smitten with their smartphones and tablets that they experience separation anxiety when asked to put them away, even if it’s just long enough to get through dinner. But that is nothing compared with the angst they feel when their devices’ batteries are getting low. Think tremors and rending of garments.


If you happen to be one of those people, you might consider joining a 12-step program — or maybe just buying a backup battery for recharging on the go. The market for these mobile power sources has grown exponentially in the last two years, with more compact and more powerful options available that allow you to recharge hundreds of times. Which one is best depends on how much power you want on hand and how much weight you are willing to carry.


“Mobile chargers are becoming one of our most popular categories,” said Victor Setton, the chief executive of Mobile City in TriBeCa, who bought one himself after he missed critical moments of extended play at the United States Open because he left the match to recharge his phone. “Everybody has had moments like that when you are watching your phone power down and it’s killing you.”


First, you need to determine how much standby power you need. Battery capacity is measured in milliampere hours (mAh). The more milliampere hours a battery has, the longer it will run, somewhat like gallons of gas in a car. Most smartphone batteries have a capacity of 1,500 to 2,100 mAh while tablet batteries are in the 6,000 to 11,000 mAh range. To fully recharge these devices, you need an auxiliary source that meets or exceeds that capacity.


If all you want is a quick charge to give you a couple of hours until you can get to a wall socket, go with something small, inexpensive and lightweight like the 1,800 mAh Triple C Power Mate Plus ($29), which plugs directly into an iPhone 3GS, 4 or 4S; the company, Triple C Designs, is working on one that will be compatible with an iPhone 5. The Power Mate Plus is about the size of a woman’s compact, weighs 1.2 ounces and comes in a variety of decorative designs.


The 2,200 mAh MiPow Power Tube ($39) is compatible with a wider range of mobile devices and will completely charge a smartphone. Encased in what looks like brushed aluminum, it weighs 2.5 ounces and is the size of a cigarette lighter. There are incrementally larger-capacity Power Tubes up to the 5,500 mAh version ($99), which weighs 4.8 ounces and can charge a smartphone a couple of times or charge a tablet 50 percent.


A larger footprint and more heft will provide even more charging capacity. Take the HyperJuice Mini ($100), which is about as big as a smartphone but thicker, weighs 8.4 oz and delivers 7,200 mAh. It also has the advantage of multiple charging ports so that two mobile devices can be charged at once as long as they are USB compatible.


Hyperjuice offers battery chargers with progressively larger capacities up to 61,000 mAh ($450). That charger is about the size of a thick paperback book and weighs 4.7 pounds. It is compatible only with Apple products but has enough oomph to keep a MacBook going 32 hours, extend iPad battery life an additional 89 hours or fully recharge an iPhone up to 52 times.


For those who prefer not to juggle one more device, there are charging sleeves or jackets that snap onto the devices they already have. Mophie is the leading provider of iPhone charging cases with its popular Juice Pack Air ($80). It has a 1,500 mAh capacity and adds 2.5 ounces to the weight of an iPhone 4 or 4S. An iPhone 5 version is expected early this year.


For Android users, there is PowerSkin, with 1,500 mAh charging cases for a variety of smartphones. They range in price from $40 to $80, with some selling for as little as $5 with shipping if the model has been discontinued.


If you want a charging case for the iPad, there is the KudoCase ($130), which relies partly on solar power. It converts outdoor and indoor light into energy for a continual trickle charge. Just know that six hours of sunlight offers only about an hour of iPad time, so you will still need to recharge the case occasionally by plugging it into an outlet.


The Powermonkey Extreme ($200), also has a solar component, with a separate solar panel for recharging off the grid. Marketed to rugged outdoorsy types, the 9,000 mAh Powermonkey weighs 8.5 ounces without the solar panel and is compatible with most mobile devices including hand-held GPS systems. It is shock-resistant and, if submerged, is waterproof up to 30 minutes.


Finally, there are mobile chargers that come in special bags with pockets to contain cords and devices, so you can charge discreetly and not have to spread everything out on a table at Starbucks.


An example is the Timbuk2 Power Commute ($199). It has dedicated, faux fur-lined pockets to separate and protect devices, as well as the included 3,600 mAh charger. There are also little openings between pockets through which the charger cables can be threaded, and a nifty organizer pocket for partitioning pens, change, business cards and other small stuff.


So with your power anxiety remedied, you can move on to other neuroses, like the bacterial density on your mobile device’s touch screen.


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Americans Under 50 Fare Poorly on Health Measures, New Report Says





Younger Americans die earlier and live in poorer health than their counterparts in other developed countries, with far higher rates of death from guns, car accidents and drug addiction, according to a new analysis of health and longevity in the United States.




Researchers have known for some time that the United States fares poorly in comparison with other rich countries, a trend established in the 1980s. But most studies have focused on older ages, when the majority of people die.


The findings were stark. Deaths that occur before age 50 accounted for about two-thirds of the difference in life expectancy between males in the United States and their counterparts in 16 other developed countries, and about one-third of the difference for females. The countries in the analysis included Canada, Japan, Australia, France, Germany and Spain.


The 378-page study by a panel of experts convened by the Institute of Medicine and the National Research Council is the first to systematically compare death rates and health measures for people of all ages, including American youth. It went further than other studies in documenting the full range of causes of death, from diseases to accidents to violence. It was based on a broad review of mortality and health studies and statistics.


The panel called the pattern of higher rates of disease and shorter lives “the U.S. health disadvantage,” and said it was responsible for dragging the country to the bottom in terms of life expectancy over the past 30 years. American men ranked last in life expectancy among the 17 countries in the study, and American women ranked second to last.


“Something fundamental is going wrong,” said Dr. Steven Woolf, chairman of the Department of Family Medicine at Virginia Commonwealth University, who led the panel. “This is not the product of a particular administration or political party. Something at the core is causing the U.S. to slip behind these other high-income countries. And it’s getting worse.”


Car accidents, gun violence and drug overdoses were major contributors to years of life lost by Americans before age 50.


The rate of firearm homicides was 20 times higher in the United States than in the other countries, according to the report, which cited a 2011 study of 23 countries. And though suicide rates were lower in the United States, firearm suicide rates were six times higher.


Sixty-nine percent of all American homicide deaths in 2007 involved firearms, compared with an average of 26 percent in other countries, the study said. “The bottom line is that we are not preventing damaging health behaviors,” said Samuel Preston, a demographer and sociologist at the University of Pennsylvania, who was on the panel. “You can blame that on public health officials, or on the health care system. No one understands where responsibility lies. But put it all together and it is creating a very negative portrait.”


Panelists were surprised at just how consistently Americans ended up at the bottom of the rankings. The United States had the second-highest rate of heart disease and the third-highest rate of lung disease, a legacy of high smoking rates in past decades. American adults also have the highest diabetes rates.


Youths fared no better. The United States has the highest infant mortality rate, and its young people have the highest rates of sexually transmitted diseases; teen pregnancy; alcohol and drug abuse; and deaths from car crashes. Americans had the lowest probability of surviving to the age of 50. The report’s second chapter details health indicators for youth where the United States ranks near or at the bottom. There are so many that the list takes up four pages. Chronic diseases, including heart disease, also played a role for people under 50.


“We expected to see some bad news and some good news,” Dr. Woolf said. “But the U.S. ranked near and at the bottom in almost every heath indicator. That stunned us.”


There were bright spots. Death rates from cancers that can be detected with tests, such as breast cancer, were lower in the United States. Adults had better control over their cholesterol and high blood pressure. And the very oldest Americans — above 75 — tended to outlive their counterparts.


The panel sought to explain the poor performance. It noted the United States has a highly fragmented health care system, with limited primary care resources and a large uninsured population. It has the highest rates of poverty among the countries studied.


Education also played a role. Americans who have not graduated from high school die from diabetes at three times the rate of those with some college, Dr. Woolf said. In the other countries, more generous social safety nets buffer families with low income and education from the health consequences of poverty, the report said.


Still, even the most likely people to be healthy, like college-educated Americans and those with high incomes, fare worse on many health indicators, the report said.


The report also explored less conventional explanations. Could cultural factors like individualism and dislike of government interference play a role? Americans are less likely to wear seat belts than their counterparts and more likely to ride motorcycles without helmets.    


The United States is a bigger, more heterogeneous society with greater levels of economic inequality, and comparing its health outcomes to those in countries like Sweden or France may seem lopsided. But the panelists point out that this country spends more on health care than any other in the survey. And as recently as the 1950s, Americans scored better in life expectancy and disease than many of the other countries in the current study.


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Americans Under 50 Fare Poorly on Health Measures, New Report Says





Younger Americans die earlier and live in poorer health than their counterparts in other developed countries, with far higher rates of death from guns, car accidents and drug addiction, according to a new analysis of health and longevity in the United States.




Researchers have known for some time that the United States fares poorly in comparison with other rich countries, a trend established in the 1980s. But most studies have focused on older ages, when the majority of people die.


The findings were stark. Deaths that occur before age 50 accounted for about two-thirds of the difference in life expectancy between males in the United States and their counterparts in 16 other developed countries, and about one-third of the difference for females. The countries in the analysis included Canada, Japan, Australia, France, Germany and Spain.


The 378-page study by a panel of experts convened by the Institute of Medicine and the National Research Council is the first to systematically compare death rates and health measures for people of all ages, including American youth. It went further than other studies in documenting the full range of causes of death, from diseases to accidents to violence. It was based on a broad review of mortality and health studies and statistics.


The panel called the pattern of higher rates of disease and shorter lives “the U.S. health disadvantage,” and said it was responsible for dragging the country to the bottom in terms of life expectancy over the past 30 years. American men ranked last in life expectancy among the 17 countries in the study, and American women ranked second to last.


“Something fundamental is going wrong,” said Dr. Steven Woolf, chairman of the Department of Family Medicine at Virginia Commonwealth University, who led the panel. “This is not the product of a particular administration or political party. Something at the core is causing the U.S. to slip behind these other high-income countries. And it’s getting worse.”


Car accidents, gun violence and drug overdoses were major contributors to years of life lost by Americans before age 50.


The rate of firearm homicides was 20 times higher in the United States than in the other countries, according to the report, which cited a 2011 study of 23 countries. And though suicide rates were lower in the United States, firearm suicide rates were six times higher.


Sixty-nine percent of all American homicide deaths in 2007 involved firearms, compared with an average of 26 percent in other countries, the study said. “The bottom line is that we are not preventing damaging health behaviors,” said Samuel Preston, a demographer and sociologist at the University of Pennsylvania, who was on the panel. “You can blame that on public health officials, or on the health care system. No one understands where responsibility lies. But put it all together and it is creating a very negative portrait.”


Panelists were surprised at just how consistently Americans ended up at the bottom of the rankings. The United States had the second-highest rate of heart disease and the third-highest rate of lung disease, a legacy of high smoking rates in past decades. American adults also have the highest diabetes rates.


Youths fared no better. The United States has the highest infant mortality rate, and its young people have the highest rates of sexually transmitted diseases; teen pregnancy; alcohol and drug abuse; and deaths from car crashes. Americans had the lowest probability of surviving to the age of 50. The report’s second chapter details health indicators for youth where the United States ranks near or at the bottom. There are so many that the list takes up four pages. Chronic diseases, including heart disease, also played a role for people under 50.


“We expected to see some bad news and some good news,” Dr. Woolf said. “But the U.S. ranked near and at the bottom in almost every heath indicator. That stunned us.”


There were bright spots. Death rates from cancers that can be detected with tests, such as breast cancer, were lower in the United States. Adults had better control over their cholesterol and high blood pressure. And the very oldest Americans — above 75 — tended to outlive their counterparts.


The panel sought to explain the poor performance. It noted the United States has a highly fragmented health care system, with limited primary care resources and a large uninsured population. It has the highest rates of poverty among the countries studied.


Education also played a role. Americans who have not graduated from high school die from diabetes at three times the rate of those with some college, Dr. Woolf said. In the other countries, more generous social safety nets buffer families with low income and education from the health consequences of poverty, the report said.


Still, even the most likely people to be healthy, like college-educated Americans and those with high incomes, fare worse on many health indicators, the report said.


The report also explored less conventional explanations. Could cultural factors like individualism and dislike of government interference play a role? Americans are less likely to wear seat belts than their counterparts and more likely to ride motorcycles without helmets.    


The United States is a bigger, more heterogeneous society with greater levels of economic inequality, and comparing its health outcomes to those in countries like Sweden or France may seem lopsided. But the panelists point out that this country spends more on health care than any other in the survey. And as recently as the 1950s, Americans scored better in life expectancy and disease than many of the other countries in the current study.


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Obama’s Pick for Treasury Is Said to Be His Chief of Staff





WASHINGTON – President Obama will announce on Thursday that he intends to elevate his chief of staff and former budget director, Jacob J. Lew, to be his next secretary of Treasury, according to officials familiar with the decision.




If confirmed by the Senate, Mr. Lew, 57, would be Mr. Obama’s second Treasury secretary, replacing Timothy F. Geithner, the last remaining principal on Mr. Obama’s original economic team, at the head of that team.


While Mr. Lew has much less experience than Mr. Geithner in international economics and financial markets, he would come to the job with far more expertise in fiscal policy and in dealing with Congress than Mr. Geithner did when he became secretary at the start of Mr. Obama’s term. That shift in skills reflects the changed demands of the times, as emphasis has shifted from the global recession and financial crisis of the president’s first years to the continuing budget fights with Republicans in Congress to stabilize the growth of federal debt.


The partisan tension over the budget between Mr. Obama and Republicans suggests that Mr. Lew will face a grilling by Senate Republicans in confirmation hearings. But despite weeks of speculation that Mr. Lew would be named Treasury secretary, Republicans have not signaled that they plan to mount the kind of opposition they raised to Mr. Obama’s potential nomination of Susan E. Rice, the ambassador to the United Nations, for secretary of state, and Chuck Hagel as secretary of defense; the president named Mr. Hagel on Monday, and eventually settled on Senator John F. Kerry, Democrat of Massachusetts, for secretary of state.


Mr. Lew’s departure would create an important vacancy for what would be Mr. Obama’s fifth White House chief of staff, a turnover rate that is in contrast with the stability at Mr. Geithner’s Treasury. Leading candidates are said to include Denis McDonough, currently the deputy national security adviser in the White House; and Ron Klain, a former chief of staff to Vice President Joseph R. Biden Jr.


Mr. Lew had a brief turn in the financial industry before joining the Obama administration four years ago, working at the financial giant Citicorp, first as managing director of Citi Global Wealth Management and then as chief operating officer of Citigroup Alternative Investments.


His first job with Mr. Obama was at the State Department, where Mr. Lew was the deputy secretary responsible for managing day-to-day operations of the department and its international economic policy. Secretary of State Hillary Rodham Clinton protested to Mr. Obama when the president in 2010 tapped Mr. Lew to replace Peter R. Orszag as budget director.


It was Mr. Lew’s second stint heading the Office of Management and Budget. He previously served in President Bill Clinton’s second term, helping to negotiate a bipartisan budget deal with Congressional Republicans that led to four years of budget surpluses. In the 1980s, Mr. Lew was a senior aide to House Speaker Thomas P. O’Neill, a Democrat, also advising in budget negotiations with President Ronald Reagan.


He has been deeply involved in the deficit negotiations over the last two years. And, if he were quickly confirmed, as Treasury secretary his first test could come as soon as next month, when analysts expect a fight over raising the debt ceiling, which is the legal limit on the amount that the government can borrow.


Republican leaders have said they would refuse to raise the ceiling unless Mr. Obama agrees to equal spending cuts, particularly in entitlement programs like Medicare and Social Security. Mr. Obama has said that he will not negotiate over the ceiling, with the country’s full faith and credit at stake.


With battle lines already drawn, the country is expected to run out of room under the ceiling sometime between mid-February and March. At that point, Congress would need to raise the borrowing limit, or the country would start defaulting on obligated payments, like those promised to seniors, doctors, contractors and bondholders.


Mr. Lew’s role as an Obama negotiator in 2011 did not endear him to Republicans, in particular House Speaker John A. Boehner, and he took a lower-profile role in the most recent negotiations at year-end. The White House was eager to avoid controversy given the likelihood of Mr. Lew’s nomination to Treasury. Instead Mr. Geithner and Rob Nabors, the director of legislative affairs, were lead negotiators.


Mr. Lew, a native of New York, is known for his low-key, professorial style and organizational skills. While he was a favorite of Mr. Obama and other staff members as chief of staff, Mr. Lew made it known that he did not want to continue in that post for a second term.


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