State of the Art: Tablets Are Hot Holiday Gifts, but Which One to Buy? - Review

From left: J. Emilio Flores for The New York Times, Jim Wilson/The New York Times, Everett Kennedy Brown/European Pressphoto Agency

From left, the Kindle PaperWhite, the iPad Mini and the  Nexus 7.

The other day, I joined NPR for a segment about high-tech holiday gifts. I was ready for the calls from listeners. I’d brushed up on cameras, phones, laptops, music players and game consoles. I was prepared to talk about limiting screen time, digital addiction, cyberbullying. I knew where to get the best deals.

But all six callers had the same question: “What tablet should I get?”

There were variations, of course. “— for my kid?” “— for my elderly father?” “— just for reading?” “— for not much money?” But in general, it was clear: the gadget most likely to be found under the tree this year is thin, battery-powered and flat.

No wonder people are confused. The marketplace has gone tablet-crazy. There’s practically a different model for every man, woman and child.

There’s the venerable iPad, of course. And now the iPad Mini. There are new tablets from Google, also in small and large. There are Samsung’s Note tablets in a variety of sizes, with styluses. There are $200 touch-screen color e-book/video players. There’s a new crop of black-and-white e-book readers. There are stunningly cheap plastic models you’ve never heard of. There are tablets for children (and I don’t mean baby aspirin).

So how are you, the confused consumer, supposed to keep tabs on all these tablets? By taking this handy tour through the jungle of tablets 2012. Keep hands and feet inside the tram at all times.

DIRT-CHEAP KNOCKOFFS You can find no-name tablets for $100 or even less. You can also find mystery-brand Chinese tablets in toy stores, marketed to children.

Don’t buy them. They don’t have the apps, the features, the polish or the pleasure of the nicer ones. The junk drawer is already calling their names.

E-BOOK READERS The smallest, lightest, least expensive, easiest to read tablets are the black-and-white e-book readers. If the goal is simply reading — and not, say, watching movies or playing games — these babies are pure joy.

Don’t bother with the lesser brands; if you’re going to get locked into one company’s proprietary, copy-protected book format, you’ll reduce your chances of library obsolescence if you stick with Amazon or Barnes & Noble.

Each company offers a whole bunch of models. But on the latest models, the page background lights up softly, so that you can read in the dark without a flashlight. (These black-and-white models also look fantastic in direct sun — now you get the best of both lighting conditions.)

The one you want is the Kindle PaperWhite ($120), whose illumination is more even and pleasant than the equivalent Nook’s.

Of course, plain, no-touch, no-light Kindles, with ads on the screen saver, start as low as $70. But the light and the touch-screen are really worth having.

COLOR E-READERS/PLAYERS Amazon and B.& N. each sell a seven-inch tablet that, functionally, lands somewhere between an e-book reader and an iPad. They have beautiful, high-definition touch screens. They play music, TV shows, movies and e-books. They can surf the Web. They even run a few handpicked Android apps like Netflix and Angry Birds.

They’re nowhere near as capable as full-blown, computerlike tablets of the iPad/Nexus ilk, mainly because there are so few apps, accessories and add-ons. But they cost $200; you’re paying only a fraction of the price.

The big two here are, once again, Amazon and B.& N. If you’re not already locked in to one of those companies’ books and videos because you owned a previous model, the Nook HD is the one to get. It’s much smaller and lighter than the Kindle Fire HD. It has a much sharper screen. And the $200 price includes a wall charger (the Fire doesn’t) and no ads (the Fire does). Or get the classy Google Nexus 7, also $200. Although its book/music/movie catalog is far smaller, its Android app catalog is far larger (but see “iPad versus Android,” below).

BIG COLOR READERS/PLAYERS This year, both Amazon and B.& N. have introduced jumbo-screen (9-inch) versions of their HD tablets. Here again, B.& N. offers a better value than its 9-inch Kindle Fire HD rival. For $270, the Nook HD+ offers a sharper screen, lighter weight, no ads, a memory-card slot and a wall charger.

E-mail: pogue@nytimes.com

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Protesters Gather Again in Cairo Streets to Denounce Morsi

CAIRO — Thousands of people flowed into the streets of Cairo, the Egyptian capital, Tuesday afternoon for a day of protest against President Mohamed Morsi’s attempt to assert broad new powers for the duration of the country’s political transition, dismissing his efforts just the night before to reaffirm his deference to Egyptian law and courts.

By early Tuesday afternoon in Cairo, a dense crowd of hundreds had gathered outside the headquarters of a trade group for lawyers, and thousands more had filed in around a small tent city in Tahrir Square. In an echo of the chants against Hosni Mubarak, Egyptian’s ousted president, almost two years ago, they shouted, “Leave, leave!” and “Bring down the regime!” They also denounced the spiritual leader of the Muslim Brotherhood, the Islamist group allied with Mr. Morsi.

A few blocks away, in a square near the American Embassy and the Interior Ministry headquarters, groups of young men resumed a running battle that began nine days ago, throwing rocks and tear gas canisters at riot police officers. Although those clashes grew out of anger over the deaths of dozens of protesters in similar clashes one year ago, many of the combatants have happily adopted the banner of protest against Mr. Morsi as well.

Egyptian television had captured the growing polarization of the country on Monday in split-screen coverage of two simultaneous funerals, each for a teenage boy killed in clashes set off by disputes over the new president’s powers. Thousands of supporters of Mr. Morsi and his allies in the Muslim Brotherhood marched through the streets of the Nile Delta city of Damanhour to bury a 15-year-old killed outside a Brotherhood office during an attack by protesters. And in Tahrir Square here in Cairo, thousands gathered to bury a 16-year-old killed in clashes with riot police officers and to chant slogans blaming Mr. Morsi for his death. “Morsi killed him,” the boy’s father said in a video statement circulated over the Internet.

“Now blood has been spilled by political factions, so this is not going to go away,” said Rabab el-Mahdi, a professor at the American University in Cairo and a left-leaning activist, adding that these were the first deaths rival factions had blamed on each other and not on the security forces of the Mubarak government since the uprising began last year. Still larger crowds were expected in the evening, as marchers from around the city headed for the square. Many schools and other businesses had closed in anticipation of bedlam, and on Monday, the Brotherhood called off a rival demonstration in support of the president, saying it wanted to avoid violence.

Egypt’s Supreme Judicial Council met again on Tuesday to consider its response to the president, and the leader of Al Azhar, a center of Sunni Muslim learning that is regarded as the pre-eminent moral authority here, met with groups of political leaders in an effort to resolve the battle over the president’s decree and the deadlock in the constitutional assembly, which is trying to draw up a new constitution.

But even as Mr. Morsi met with top judges Monday night in an effort to resolve the crisis, a coalition of opposition leaders held a news conference to declare that preserving the role of the courts was only the first step in a broader campaign against what Abdel Haleem Qandeil, a liberal intellectual, called “the miserable failure of the rule of the Muslim Brothers.” Mr. Morsi “unilaterally broke the contract with the people,” he declared. “We have to be ready to stand up to this group, protest to protest, square to square, and to confront the bullying.”

Mr. Morsi’s effort to remove the last check on his power over the political transition had brought the country’s fractious opposition groups together for the first time in a united front against the Brotherhood. But the show of unity papered over deep divisions between groups and even within them, said Ms. Mahdi of the American University.

“This is not a united front, and I am inside it,” she said. “Every single political group in the country is now divided over this — is this decree revolutionary justice or building a new dictatorship? Should we align ourselves with folool” — the colloquial term for the remnants of the old political elite — “or should we be revolutionary purists? Is it a conflict between the Muslim Brotherhood and the pro-Mubarak judiciary, or is this the beginning of a fascist regime in the making?”

Mayy El Sheikh contributed reporting.

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Dark Warnings About Future of Internet Access

PARIS — A commercial and ideological clash is set for next week, when representatives of more than 190 governments, along with telecommunications companies and Internet groups, gather in Dubai for a once-in-a-generation meeting.

The subject: Control of the Internet, politically and commercially.

The stated purpose of the World Conference on International Telecommunications is to update a global treaty on technical standards needed to, say, connect a telephone call from Tokyo to Timbuktu. The previous conference took place in 1988, when the Internet was in its infancy and telecommunications remained a highly regulated, mostly analog-technology business.

Now the Internet is the backbone for worldwide communications and commerce. Critics of the International Telecommunication Union, the agency of the United Nations that is organizing the meeting, see a dark agenda in the meeting. The blogosphere has been raging over supposed plans led by Russia to snatch control of the Internet and hand it to the U.N. agency.

That seems unlikely. Any such move would require an international consensus, and opposition is widespread.

Terry D. Kramer, the former Vodafone executive who is the United States ambassador to the conference, has vowed to veto any change in how the Internet is overseen.

Analysts say the real business of the conference is business. “The far bigger issue — largely obscured by this discussion — are proposals that are more likely to succeed that envision changing the way we pay for Internet services,” Michael Geist, an Internet law professor at the University of Ottawa, said by e-mail.

Hamadoun Touré, secretary general of the I.T.U., has repeatedly said that the U.N. group has no desire to take over the Internet or to stifle its growth. On the contrary, he says, one of the main objectives of the conference is to spread Internet access to more of the four and a half billion people around the world who still do not use it.

And yet, groups as diverse as Google, the Internet Society, the International Trade Union Confederation and Greenpeace warn that the discussions could set a bad precedent, encouraging governments to step up censorship or take other actions that would threaten the integrity of the Internet.

“This is a very important moment in the history of the Internet, because this conference may introduce practices that are inimical to its continued growth and openness,” Vinton G. Cerf, vice president and chief Internet evangelist at Google, said in a conference call.

Google set up a Web site last week, “Take Action,” encouraging visitors to sign a petition for a “free and open Internet.” The campaign is modeled on the successful drive last winter to defeat legislative proposals to crack down on Internet piracy in the United States.

More energy is expected to be spent on how companies make money off the Internet. In one submission to the conference, the European Telecommunications Network Operators’ Association, a lobbying group based in Brussels that represents companies like France Télécom, Deutsche Telekom and Telecom Italia, proposed that network operators be permitted to assess charges for content providers like Internet video companies that use a lot of bandwidth.

Analysts say the proposal is an acknowledgment by European telecommunications companies that they cannot hope to provide digital content. “The telecoms realize that they have lost the battle,” said Paul Budde, an independent telecommunications analyst in Australia. “They are saying, ‘We can’t beat the Googles and the Facebooks, so let’s try to charge them.’ ”

The European lobbying group says that without the new fees, there will be no money to invest in network upgrades needed to deal with a surge in traffic. Regulators have required European telecommunications operators to open their networks to rivals, and the market for broadband is fiercely competitive, with rock-bottom prices.

In the United States, by contrast, most telecommunications companies have been permitted to maintain local monopolies — or duopolies, with cable companies — in broadband, keeping prices higher. And American regulators have ordered broadband providers to give equal priority to all Internet traffic. Such “network neutrality” is incompatible with charging content providers for moving their bits of data.

Analysts say this may explain why American telecommunications companies have not joined the European call for a new business model. “Models that try to force payment terms between nations and telecom operators run a huge risk of cutting off traffic,” Mr. Kramer said in an interview. “Liberalized markets are the only way to expand the success of the Internet.” People who have been briefed on the conference submissions say that not a single European government delegation has endorsed the telecommunications operators’ proposal, and the European Parliament has passed a resolution denouncing it. Only governments, not private groups or companies, can put items on the meeting agenda.

While many documents prepared for the conference remain secret, several people who have seen submissions say there is broad support for Internet connection fees in French-speaking Africa and among Arab nations — countries in which many telecommunications companies are still owned or heavily regulated by governments.

Much of the attention before the 12-day conference has focused on a proposal from Russia that would effectively remove control of the Internet’s infrastructure from a collection of decentralized and apolitical organizations, mostly based in the United States. “Member states,” Russia proposed, “shall have equal rights to manage the Internet, including in regard to the allotment, assignment and reclamation of Internet numbering, naming, addressing and identification resources.”

Those functions are performed by the Internet Corporation for Assigned Names and Numbers, a private organization with an international board that operates under contract with the United States government.

The Russian proposal was widely interpreted as a call to legitimize domestic censorship of the Internet. Yet analysts note that governments inclined to filter the Web, like China and Iran, have not waited for consensus in an international meeting to do so.

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Global Update: Investing in Eyeglasses for Poor Would Boost International Economy

BSIP/UIG Via Getty Images

Eliminating the worldwide shortage of eyeglasses could cost up to $28 billion, but would add more than $200 billion to the global economy, according to a study published last month in the Bulletin of the World Health Organization.

The $28 billion would cover the cost of training 65,000 optometrists and equipping clinics where they could prescribe eyeglasses, which can now be mass-produced for as little as $2 a pair. The study was done by scientists from Australia and the Johns Hopkins Bloomberg School of Public Health.

The authors assumed that 703 million people worldwide have uncorrected nearsightedness or farsightedness severe enough to impair their work, and that 80 percent of them could be helped with off-the-rack glasses, which would need to be replaced every five years.

The biggest productivity savings from better vision would not be in very poor regions like Africa but in moderately poor countries where more people have factory jobs or trades like driving or running a sewing machine.

Without the equivalent of reading glasses, “lots of skilled crafts become very difficult after age 40 or 45,” said Kevin Frick, a Johns Hopkins health policy economist and study co-author. “You don’t want to be swinging a hammer if you can’t see the nail.”

If millions of schoolchildren who need glasses got them, the return on investment could be even greater, he said, but that would be in the future and was not calculated in this study.

Read More..

Global Update: Investing in Eyeglasses for Poor Would Boost International Economy

BSIP/UIG Via Getty Images

Eliminating the worldwide shortage of eyeglasses could cost up to $28 billion, but would add more than $200 billion to the global economy, according to a study published last month in the Bulletin of the World Health Organization.

The $28 billion would cover the cost of training 65,000 optometrists and equipping clinics where they could prescribe eyeglasses, which can now be mass-produced for as little as $2 a pair. The study was done by scientists from Australia and the Johns Hopkins Bloomberg School of Public Health.

The authors assumed that 703 million people worldwide have uncorrected nearsightedness or farsightedness severe enough to impair their work, and that 80 percent of them could be helped with off-the-rack glasses, which would need to be replaced every five years.

The biggest productivity savings from better vision would not be in very poor regions like Africa but in moderately poor countries where more people have factory jobs or trades like driving or running a sewing machine.

Without the equivalent of reading glasses, “lots of skilled crafts become very difficult after age 40 or 45,” said Kevin Frick, a Johns Hopkins health policy economist and study co-author. “You don’t want to be swinging a hammer if you can’t see the nail.”

If millions of schoolchildren who need glasses got them, the return on investment could be even greater, he said, but that would be in the future and was not calculated in this study.

Read More..

Dark Warnings About Future of Internet Access

PARIS — A commercial and ideological clash is set for next week, when representatives of more than 190 governments, along with telecommunications companies and Internet groups, gather in Dubai for a once-in-a-generation meeting.

The subject: Control of the Internet, politically and commercially.

The stated purpose of the World Conference on International Telecommunications is to update a global treaty on technical standards needed to, say, connect a telephone call from Tokyo to Timbuktu. The previous conference took place in 1988, when the Internet was in its infancy and telecommunications remained a highly regulated, mostly analog-technology business.

Now the Internet is the backbone for worldwide communications and commerce. Critics of the International Telecommunication Union, the agency of the United Nations that is organizing the meeting, see a dark agenda in the meeting. The blogosphere has been raging over supposed plans led by Russia to snatch control of the Internet and hand it to the U.N. agency.

That seems unlikely. Any such move would require an international consensus, and opposition is widespread.

Terry D. Kramer, the former Vodafone executive who is the United States ambassador to the conference, has vowed to veto any change in how the Internet is overseen.

Analysts say the real business of the conference is business. “The far bigger issue — largely obscured by this discussion — are proposals that are more likely to succeed that envision changing the way we pay for Internet services,” Michael Geist, an Internet law professor at the University of Ottawa, said by e-mail.

Hamadoun Touré, secretary general of the I.T.U., has repeatedly said that the U.N. group has no desire to take over the Internet or to stifle its growth. On the contrary, he says, one of the main objectives of the conference is to spread Internet access to more of the four and a half billion people around the world who still do not use it.

And yet, groups as diverse as Google, the Internet Society, the International Trade Union Confederation and Greenpeace warn that the discussions could set a bad precedent, encouraging governments to step up censorship or take other actions that would threaten the integrity of the Internet.

“This is a very important moment in the history of the Internet, because this conference may introduce practices that are inimical to its continued growth and openness,” Vinton G. Cerf, vice president and chief Internet evangelist at Google, said in a conference call.

Google set up a Web site last week, “Take Action,” encouraging visitors to sign a petition for a “free and open Internet.” The campaign is modeled on the successful drive last winter to defeat legislative proposals to crack down on Internet piracy in the United States.

More energy is expected to be spent on how companies make money off the Internet. In one submission to the conference, the European Telecommunications Network Operators’ Association, a lobbying group based in Brussels that represents companies like France Télécom, Deutsche Telekom and Telecom Italia, proposed that network operators be permitted to assess charges for content providers like Internet video companies that use a lot of bandwidth.

Analysts say the proposal is an acknowledgment by European telecommunications companies that they cannot hope to provide digital content. “The telecoms realize that they have lost the battle,” said Paul Budde, an independent telecommunications analyst in Australia. “They are saying, ‘We can’t beat the Googles and the Facebooks, so let’s try to charge them.’ ”

The European lobbying group says that without the new fees, there will be no money to invest in network upgrades needed to deal with a surge in traffic. Regulators have required European telecommunications operators to open their networks to rivals, and the market for broadband is fiercely competitive, with rock-bottom prices.

In the United States, by contrast, most telecommunications companies have been permitted to maintain local monopolies — or duopolies, with cable companies — in broadband, keeping prices higher. And American regulators have ordered broadband providers to give equal priority to all Internet traffic. Such “network neutrality” is incompatible with charging content providers for moving their bits of data.

Analysts say this may explain why American telecommunications companies have not joined the European call for a new business model. “Models that try to force payment terms between nations and telecom operators run a huge risk of cutting off traffic,” Mr. Kramer said in an interview. “Liberalized markets are the only way to expand the success of the Internet.” People who have been briefed on the conference submissions say that not a single European government delegation has endorsed the telecommunications operators’ proposal, and the European Parliament has passed a resolution denouncing it. Only governments, not private groups or companies, can put items on the meeting agenda.

While many documents prepared for the conference remain secret, several people who have seen submissions say there is broad support for Internet connection fees in French-speaking Africa and among Arab nations — countries in which many telecommunications companies are still owned or heavily regulated by governments.

Much of the attention before the 12-day conference has focused on a proposal from Russia that would effectively remove control of the Internet’s infrastructure from a collection of decentralized and apolitical organizations, mostly based in the United States. “Member states,” Russia proposed, “shall have equal rights to manage the Internet, including in regard to the allotment, assignment and reclamation of Internet numbering, naming, addressing and identification resources.”

Those functions are performed by the Internet Corporation for Assigned Names and Numbers, a private organization with an international board that operates under contract with the United States government.

The Russian proposal was widely interpreted as a call to legitimize domestic censorship of the Internet. Yet analysts note that governments inclined to filter the Web, like China and Iran, have not waited for consensus in an international meeting to do so.

Read More..

Egypt’s President Said to Limit Scope of Judicial Decree

CAIRO — President Mohamed Morsi agreed on Monday to limit the scope of a sweeping decree he had issued last week that raised his edicts above any judicial review, according to a report by a television network allied with his party. The agreement, reached with top judicial authorities, would leave most of Mr. Morsi’s actions subject to review by the courts, but it appears to preserve a crucial power: protecting the country’s constitutional council from being dissolved by the courts before it finishes its work.

Ahmed Jadallah/Reuters

Protesters ran for cover during clashes with riot police at Tahrir square in Cairo on Monday.

Tara Todras-Whitehill for The New York Times

Egyptians mourned Mohammed Gaber Salah, an activist who died Sunday from injuries sustained during protests, before his funeral on Monday in Cairo.

The agreement was announced by a spokesman for the president; as of Monday night it had not yet been confirmed by the judges.

The Muslim Brotherhood, the Islamist group that sponsored Mr. Morsi and his party, announced that it was canceling a major demonstration in support of the president that had been planned for Tuesday.

Mr. Morsi’s deal with the judges follows four days of rising tensions and flashes of violence across the country set off by his decree, which removed the last check on his power to rule Egypt.

Mr. Morsi said he was forced to issue the decree in order to protect the constitutional assembly from the courts, which had shuttered Egypt’s first freely elected parliament and disbanded an earlier constituent assembly, both dominated by Mr. Morsi’s Islamist allies. But the scope of the new powers claimed by the president galvanized his political opposition. Vandals attacked more than a dozen offices of his political party, and thousands of people demonstrated in the streets to vent their fears of a new autocracy in a country that had just shaken one off.

The agreement announced on Monday could be a watershed moment for Egypt’s new order: a triumph of respect for the rule of law and the independence of the courts, and a demonstration that Egypt’s new leaders are capable of the kind of compromise in the national interest that often eludes the party leaders in even the most practiced democracies.

But opponents appeared set to hold out for a further withdrawal of presidential authority, as well as the immediate dissolution of the constitutional assembly. Speaking at a press conference while Mr. Morsi was meeting with the judges, the opposition activist and intellectual Abdel Haleem Qandeil called for “a long-term battle,” declaring that the limiting of the decree should only be the first step toward the opposition’s goal of “the withdrawal of the legitimacy of Morsi’s presence in the presidential palace.”

Mr. Morsi’s advisers emphasized on Monday that they had not altered the decree’s language, and they portrayed the agreement with the judges as merely an explanation of the president’s original intent, rather than any pullback.

But the statement Mr. Morsi issued last Thursday to claim his broader powers had explicitly exempted all his future edicts from judicial oversight until a new constitution is ratified, and in recent days Mr. Morsi’s justice minister, Ahmed Mekki, publicly criticized the wording of the decree as over-broad; he argued that the president should add a phrase restricting its application only to presidential edicts related to the constitutional assembly and certain other matters.

Some of the ramifications of the deal remain unclear. Mr. Morsi and the judges of the Supreme Judicial Council agreed to limit the scope of the president’s immunity from judicial review to matters known in Egypt as acts of sovereignty. That is an established formulation in Egyptian law, so interpreting the decree that way meant he would not be claiming new immunity.

By accepting that interpretation, Mr. Morsi in effect pulled back from the aspects of his decree that aroused alarm about a power grab.

Still, the deal appeared to give Mr. Morsi the power he said he had deemed most essential: to protect the constitutional assembly so that it can stay in business long enough to finish a charter and end Egypt’s tortured transition after the overthrow of its former strongman, Hosni Mubarak.

Cracks appeared in Mr. Morsi’s government on Sunday over the decree. At least three other senior advisers resigned over the measure, and the move had also prompted widening street protests and cries from opponents that Mr. Morsi, who already governs without a legislature, was moving toward a new autocracy in Egypt, less than two years after the ouster of the strongman Hosni Mubarak.

With a threatened strike by the nation’s judges, a plunge in the country’s stock market and more street protests looming, Mr. Morsi’s administration initially sent mixed messages on Sunday over whether it was willing to consider a compromise: a spokesman for the president’s party insisted that there would be no change in his edict, but a statement from the party indicated for the first time a willingness to give political opponents “guarantees against monopolizing the fateful decisions of the homeland in the absence of the Parliament.”

Mayy El Sheikh and Mai Ayyad contributed reporting.

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Design: Who Made That Emoticon?

 

“The first line of my obituary is going to mention the smiley face,” says Scott Fahlman, who would rather be remembered for his research into artificial intelligence. But like it or not, Fahlman has become famous for three keystrokes. In 1982, as a young professor at Carnegie Mellon University, he realized the need for a symbol to temper the bickering that plagued online forums. The Internet was just a baby then, and yet already flame wars raged. Fahlman decided that a smiley face could be useful as a “joke marker” (as he called it) to take the sting out of mocking statements or pranks. And so he hunted around the keyboard for a way to make the face. “But what do you use for eyes?” he wondered. Once he found the colon, the rest was easy. He dashed his suggestion off to friends. “I didn’t even proofread the message,” he says.

The emoticon — perhaps one of the first online memes — spread to other campuses, hitching a ride in e-mails. And as the Web expanded in the ’90s, so, too, did the colon-hyphen-parenthesis. “Wherever the Internet went, the smiley face was there within weeks,” Fahlman says. The symbol has endured because it’s a quick way to soothe hurt feelings or express joy. But Fahlman still hears complaints that it is a hallmark of lazy writing. His critics tend to raise questions like “Would Shakespeare have used a smiley face?” Yes, Fahlman says, if Shakespeare were around today, thumb-tapping a screed “about parking at the Globe Theater, he might say something intemperate. And then he might think twice about it and want to use an emoticon.”

FACE VALUE

Tyler Schnoebelen, who has a Ph.D. in linguistics, analyzed millions of Twitter messages to understand how people use emoticons.

You found that about 10 percent of the tweets in your sample had emoticons in them. Why so many? In a full paragraph, you might be able to express how you’re feeling. But it becomes harder in a tweet, where you only have a few words.

What is the difference between people who use :-) and people who use :) ? The people who use :) follow a younger set of celebrities. They swear more, and they use spellings like “sooooo” and “loooove.”

What about ;) ? Is it a flirt? Yes, we can assume that. It tends to appear near words like “horny,” “attractive,” “hot” and “dirty.” It doesn’t occur near words like “pleasant” or “irritated.” The world of ;) is sexy.

Do you use emoticons? Actually, yes, I’ve become a connoisseur of them. I love the :))) — it’s like saying “I’m soooooooo happy.” But I don’t personally use that emoticon, because to me it looks like someone with multiple chins. And over the last year, I’ve been using the ;) a lot.

So now that you’ve finished this research on the emoticon, you’re ;)-ing a lot? Yes, now I do more flirting.

THE UNIVERSAL LANGUAGE?

Western-style emoticons often read from left to right, as “sideways faces.” Japanese thumb-typists, meanwhile, have invented their own system.

m(_ _)m

Bowing down in apology

(>_<)

Ouch!

(9_9)

Tired

d(-_-)b

Wearing headphones

(;_;)

Crying

(=_=)

Bored

(^_-)

Winking

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Hospitals Face Pressure From Medicare to Avert Readmissions

After years of gently prodding hospitals to make sure discharged patients do not need to return, the federal government is now using its financial muscle to discourage readmissions.

Medicare last month began levying financial penalties against 2,217 hospitals it says have had too many readmissions. Of those hospitals, 307 will receive the maximum punishment, a 1 percent reduction in Medicare’s regular payments for every patient over the next year, federal records show.

One of those is Barnes-Jewish Hospital in St. Louis, which will lose $2 million this year. Dr. John Lynch, the chief medical officer, said Barnes-Jewish could absorb that loss this year, but “over time, if the penalties accumulate, it will probably take resources away from other key patient programs.”

The crackdown on readmissions is at the vanguard of the Affordable Care Act’s effort to eliminate unnecessary care and curb Medicare’s growing spending, which reached $556 billion this year. Hospital inpatient costs make up a quarter of that spending and are projected to grow by more than 4 percent annually in coming years, according to the Congressional Budget Office.

The readmission penalties will recoup about $300 million this year. But the goal is to pressure hospitals to pay attention to what happens to their patients after they walk out the door. The penalties have captured the attention of hospitals, and many are trying to improve their supervision of discharged patients’ recoveries.

“I’ve been doing this for over two decades and talking to hospital leaders about readmissions, and I used to get polite but blank stares,” said Dr. Eric Coleman, a professor at the University of Colorado Anschutz Medical Campus who has devised widely adopted methods to reduce hospitalizations. “Now they’re paying attention.”

With nearly one in five Medicare patients returning to the hospital within a month — about two million people a year — readmissions cost the government more than $17 billion annually.

Hospitals’ traditional reluctance to tackle readmissions is rooted in Medicare’s payment system. Medicare generally pays hospitals a set fee for a patient’s stay, so the shorter the visit, the more revenue a hospital can keep. Hospitals also get paid when patients return. Until the new penalties kicked in, hospitals had no incentive to make sure patients didn’t wind up coming back. The maximum penalty is set to double next October and then reach 3 percent of reimbursements in October 2015. Medicare also is expanding the list of conditions it will assess in setting punishments.

Right now it only evaluates readmissions of heart attack, heart failure and pneumonia patients, counting every rebound, even ones not related to the original reason for hospitalization. The penalties are based on readmission rates in the past and applied to future payments for all Medicare patients.

Researchers say that while some readmissions are unavoidable, many are caused by the short shrift hospitals have given patients on their way out.

Jonathan Blum, principal deputy administrator for the Centers for Medicare and Medicaid Services, said the penalties had helped galvanize hospitals’ efforts to avoid readmissions. “We’ve seen a small but significant reduction,” he said. “That tells me we’ve focused the industry on improvement.”

Medicare’s tough love is not going over well everywhere. Academic medical centers are complaining that the penalties do not take into account the extra challenges posed by extremely sick and low-income patients. For these people, getting medicine and follow-up care can be a struggle.

At Barnes-Jewish Hospital, Dr. Lynch said physicians from all over the Midwest referred their sickest heart patients to his facility for transplants and other major interventions. But those patients can skew his hospital’s readmissions numbers, he said: “The weaker your heart, the more advanced your emphysema, the more likely you are to be readmitted to the hospital.”

Dr. Lynch said Barnes-Jewish set up follow-up appointments for patients who didn’t have their own doctors. But about half of the patients never showed up, he said, even after the hospital made reminder phone calls and arranged for free rides. Sending nurses to see patients at home did not significantly reduce readmission rates either, he said.

“Many of us have been working on this for other reasons than a penalty for many years, and we’ve found it’s very hard to move,” Dr. Lynch said. He said the penalties were unfair to hospitals with the double burden of caring for very sick and very poor patients.

“For us, it’s not a readmissions penalty,” he said. “It’s a mission penalty.”

Various studies, including one commissioned by Medicare, have found that the hospitals with the most poor and African-American patients tended to have higher readmission rates than hospitals with more affluent and Caucasian patients. But the studies also determined that some safety-net hospitals performed better than average, showing that hospitals can overcome the challenges posed by the kinds of patients they treat.

In some ways, the debate parallels the one on education — specifically, whether educators should be held accountable for lower rates of progress among children from poor families.

“Just blaming the patients or saying ‘it’s destiny’ or ‘we can’t do any better’ is a premature conclusion and is likely to be wrong,” said Dr. Harlan Krumholz, director of the Center for Outcomes Research and Evaluation at Yale-New Haven Hospital, which prepared the study for Medicare. “I’ve got to believe we can do much, much better.”

Some researchers fear the Medicare penalties are so steep, they will distract hospitals from other pressing issues, like reducing infections and surgical mistakes and ensuring patients’ needs are met promptly. “It should not be our top priority,” said Dr. Ashish Jha, a professor at the Harvard School of Public Health who has studied readmissions. “If you think of all the things in the Affordable Care Act, this is the one that has the biggest penalties, and that’s just crazy.”

With pressure to avert readmissions rising, some hospitals have been suspected of sending patients home within 24 hours, so they can bill for the services but not have the stay counted as an admission. But most hospitals are scrambling to reduce the number of repeat patients, with mixed success.

A few days after Eda Laurion was discharged from the Banner Del E. Webb Medical Center near Phoenix after treatment for her congestive heart failure in August, a nurse showed up at her house.

“She helped explained the medicines I’m taking, the side effects, what they do for you,” said Ms. Laurion, 91, of Sun City West.

Still, readmissions can’t always be prevented. The nurse, Sue Koner, sent Ms. Laurion back to the hospital after two weeks for dangerously low sodium caused by an undiagnosed kidney problem. However, Ms. Laurion avoided re-hospitalization in October when Ms. Koner deduced that her hallucinations were a reaction to an antibiotic.

Overseeing former patients is expensive and time-consuming, so many hospitals are relying on financing from community health organizations and foundations. Ms. Koner works for Sun Health, a foundation-supported nonprofit. Since Sun Health started its program in November 2011, only nine of 213 patients have been readmitted.

Dr. Krumholz said hospitals should think of readmissions as a challenge to overcome. “One day, we’ll look back,” he said, “and we’ll be incredulous that one out of every five patients ended up back in the hospital.”

This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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Hospitals Face Pressure From Medicare to Avert Readmissions

After years of gently prodding hospitals to make sure discharged patients do not need to return, the federal government is now using its financial muscle to discourage readmissions.

Medicare last month began levying financial penalties against 2,217 hospitals it says have had too many readmissions. Of those hospitals, 307 will receive the maximum punishment, a 1 percent reduction in Medicare’s regular payments for every patient over the next year, federal records show.

One of those is Barnes-Jewish Hospital in St. Louis, which will lose $2 million this year. Dr. John Lynch, the chief medical officer, said Barnes-Jewish could absorb that loss this year, but “over time, if the penalties accumulate, it will probably take resources away from other key patient programs.”

The crackdown on readmissions is at the vanguard of the Affordable Care Act’s effort to eliminate unnecessary care and curb Medicare’s growing spending, which reached $556 billion this year. Hospital inpatient costs make up a quarter of that spending and are projected to grow by more than 4 percent annually in coming years, according to the Congressional Budget Office.

The readmission penalties will recoup about $300 million this year. But the goal is to pressure hospitals to pay attention to what happens to their patients after they walk out the door. The penalties have captured the attention of hospitals, and many are trying to improve their supervision of discharged patients’ recoveries.

“I’ve been doing this for over two decades and talking to hospital leaders about readmissions, and I used to get polite but blank stares,” said Dr. Eric Coleman, a professor at the University of Colorado Anschutz Medical Campus who has devised widely adopted methods to reduce hospitalizations. “Now they’re paying attention.”

With nearly one in five Medicare patients returning to the hospital within a month — about two million people a year — readmissions cost the government more than $17 billion annually.

Hospitals’ traditional reluctance to tackle readmissions is rooted in Medicare’s payment system. Medicare generally pays hospitals a set fee for a patient’s stay, so the shorter the visit, the more revenue a hospital can keep. Hospitals also get paid when patients return. Until the new penalties kicked in, hospitals had no incentive to make sure patients didn’t wind up coming back. The maximum penalty is set to double next October and then reach 3 percent of reimbursements in October 2015. Medicare also is expanding the list of conditions it will assess in setting punishments.

Right now it only evaluates readmissions of heart attack, heart failure and pneumonia patients, counting every rebound, even ones not related to the original reason for hospitalization. The penalties are based on readmission rates in the past and applied to future payments for all Medicare patients.

Researchers say that while some readmissions are unavoidable, many are caused by the short shrift hospitals have given patients on their way out.

Jonathan Blum, principal deputy administrator for the Centers for Medicare and Medicaid Services, said the penalties had helped galvanize hospitals’ efforts to avoid readmissions. “We’ve seen a small but significant reduction,” he said. “That tells me we’ve focused the industry on improvement.”

Medicare’s tough love is not going over well everywhere. Academic medical centers are complaining that the penalties do not take into account the extra challenges posed by extremely sick and low-income patients. For these people, getting medicine and follow-up care can be a struggle.

At Barnes-Jewish Hospital, Dr. Lynch said physicians from all over the Midwest referred their sickest heart patients to his facility for transplants and other major interventions. But those patients can skew his hospital’s readmissions numbers, he said: “The weaker your heart, the more advanced your emphysema, the more likely you are to be readmitted to the hospital.”

Dr. Lynch said Barnes-Jewish set up follow-up appointments for patients who didn’t have their own doctors. But about half of the patients never showed up, he said, even after the hospital made reminder phone calls and arranged for free rides. Sending nurses to see patients at home did not significantly reduce readmission rates either, he said.

“Many of us have been working on this for other reasons than a penalty for many years, and we’ve found it’s very hard to move,” Dr. Lynch said. He said the penalties were unfair to hospitals with the double burden of caring for very sick and very poor patients.

“For us, it’s not a readmissions penalty,” he said. “It’s a mission penalty.”

Various studies, including one commissioned by Medicare, have found that the hospitals with the most poor and African-American patients tended to have higher readmission rates than hospitals with more affluent and Caucasian patients. But the studies also determined that some safety-net hospitals performed better than average, showing that hospitals can overcome the challenges posed by the kinds of patients they treat.

In some ways, the debate parallels the one on education — specifically, whether educators should be held accountable for lower rates of progress among children from poor families.

“Just blaming the patients or saying ‘it’s destiny’ or ‘we can’t do any better’ is a premature conclusion and is likely to be wrong,” said Dr. Harlan Krumholz, director of the Center for Outcomes Research and Evaluation at Yale-New Haven Hospital, which prepared the study for Medicare. “I’ve got to believe we can do much, much better.”

Some researchers fear the Medicare penalties are so steep, they will distract hospitals from other pressing issues, like reducing infections and surgical mistakes and ensuring patients’ needs are met promptly. “It should not be our top priority,” said Dr. Ashish Jha, a professor at the Harvard School of Public Health who has studied readmissions. “If you think of all the things in the Affordable Care Act, this is the one that has the biggest penalties, and that’s just crazy.”

With pressure to avert readmissions rising, some hospitals have been suspected of sending patients home within 24 hours, so they can bill for the services but not have the stay counted as an admission. But most hospitals are scrambling to reduce the number of repeat patients, with mixed success.

A few days after Eda Laurion was discharged from the Banner Del E. Webb Medical Center near Phoenix after treatment for her congestive heart failure in August, a nurse showed up at her house.

“She helped explained the medicines I’m taking, the side effects, what they do for you,” said Ms. Laurion, 91, of Sun City West.

Still, readmissions can’t always be prevented. The nurse, Sue Koner, sent Ms. Laurion back to the hospital after two weeks for dangerously low sodium caused by an undiagnosed kidney problem. However, Ms. Laurion avoided re-hospitalization in October when Ms. Koner deduced that her hallucinations were a reaction to an antibiotic.

Overseeing former patients is expensive and time-consuming, so many hospitals are relying on financing from community health organizations and foundations. Ms. Koner works for Sun Health, a foundation-supported nonprofit. Since Sun Health started its program in November 2011, only nine of 213 patients have been readmitted.

Dr. Krumholz said hospitals should think of readmissions as a challenge to overcome. “One day, we’ll look back,” he said, “and we’ll be incredulous that one out of every five patients ended up back in the hospital.”

This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Read More..