Real Housewives of Beverly Hills Sneak Peek Moroccan Madness

It's the husbands turn to join in the cat fights on tonight's Real Housewives of Beverly Hills.

Video: 'Housewives' Get 'Real' about Plastic Surgery

A party amongst friends quickly turns sour as Adrienne Maloof's impending lawsuit against Brandi Glanville has the group at odds over which side to take. In an uncharacteristic move, Kyle Richard's husband Mauricio throws in his two cents on the matter, prompting Brandi to lose her cool and throw out a sting of expletives that stuns the room to silence.

Watch an exclusive preview of the drama in the player above!

RHOBH airs Mondays at 9 p.m. on Bravo.

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Hospitals crack down on workers refusing flu shots

CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.

"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."

Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."

Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.

"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."

For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.

A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.

The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."

The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.

According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.

The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.

Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.

Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.

Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.

Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.

Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.

While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.

Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.

Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.

Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.

"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.

Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.

Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.

Calhoun, the Illinois nurse, says she is unsure of her options.

"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."

__

Online:

R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf

CDC: http://www.cdc.gov

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Apple drags on S&P, Nasdaq; Dell jumps after report

NEW YORK (Reuters) - The S&P 500 and Nasdaq ended lower on Monday as worries over demand for Apple products drove down its shares and as investors braced for earnings disappointments.

But Dell Inc's stock jumped 13 percent to about a five-month high at $12.29, offsetting some of the tech-sector weakness, after Bloomberg reported the No. 3 personal computer maker is in talks with private equity firms to go private.

Tech heavyweight Apple lost 3.6 percent to $501.75 and was the biggest weight on both the S&P 500 and Nasdaq 100 <.ndx> indexes after reports that the company has cut orders for LCD screens and other parts for the iPhone 5 this quarter due to weak demand. The stock earlier hit a session low of $498.51, the first dip below $500 since February 16.

"With Apple, it seems as if the sentiment has shifted from this being the one stock that everybody wanted to own to people beginning to look at it as a company (whose) business is slowing down somewhat," said Eric Kuby, chief investment officer of North Star Investment Management Corp in Chicago.

Adding to investor unease, fourth-quarter earnings kick into high gear this week. Analyst estimates for the quarter have fallen sharply since October, with S&P 500 earnings growth now seen up just 1.9 percent from a year ago, Thomson Reuters data showed.

The Dow Jones industrial average <.dji> was up 18.89 points, or 0.14 percent, at 13,507.32. The Standard & Poor's 500 Index <.spx> was down 1.37 points, or 0.09 percent, at 1,470.68. The Nasdaq Composite Index <.ixic> was down 8.13 points, or 0.26 percent, at 3,117.50.

Apple suppliers also lost ground, with Cirrus Logic off 9.4 percent at $28.62 and Qualcomm down 1 percent at $64.24.

The Dow fared better than the other two indexes, helped in part by Hewlett-Packard shares, which rose 4.9 percent to $16.95. The stock, which was up early in the session after JPMorgan upgraded its rating on the stock and raised its price target to $21 from $15, added to gains after the Dell report.

Appliance and electronics retailer Hhgregg Inc slumped 5.7 percent to $7.44 after the company cut its same-store sales forecast for the full year.

Earnings reports are due this week from Goldman Sachs , Bank of America , Intel and General Electric , among other companies. Third-quarter reports ended with a gain of just 0.1 percent, the worst for an S&P 500 profit period in three years, according to Thomson Reuters data.

President Barack Obama warned Congress at a news conference on Monday that a refusal to raise the U.S. debt ceiling next month could mean a government shutdown and trigger economic chaos.

Volume was roughly 5.6 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with the 2012 average daily closing volume of about 6.45 billion.

Decliners were about even with advancers on the NYSE while decliners outpaced advancers on the Nasdaq by about 12 to 11.

(Additional reporting by Chuck Mikolajczak; Editing by Kenneth Barry and Nick Zieminski)

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Mali Islamists counter attack, promise France long war

BAMAKO/PARIS (Reuters) - Al Qaeda-linked Islamist rebels launched a counteroffensive in Mali on Monday after four days of French air strikes on their northern strongholds, seizing the central town of Diabaly and promising to drag France into a brutal Afghanistan-style war.

France, which has poured hundreds of troops into the capital Bamako in recent days, carried out more air strikes on Monday in the vast desert area seized last year by an Islamist alliance grouping al Qaeda's north African wing AQIM alongside Mali's home-grown MUJWA and Ansar Dine militant groups.

"France has opened the gates of hell for all the French," said Oumar Ould Hamaha, a spokesman for MUJWA, which has imposed strict sharia, Islamic law, in its northern fiefdom of Gao. "She has fallen into a trap which is much more dangerous than Iraq, Afghanistan or Somalia," he told Europe 1 radio.

Paris is determined to shatter Islamist domination of the north of its former colony, an area many fear could become a launchpad for terrorism attacks on the West and a base for coordination with al Qaeda in Yemen, Somalia and North Africa.

The French defense ministry said it aimed to deploy 2,500 soldiers in the West African state to bolster the Malian army and work with a force of 3,300 West African troops from the immediate region foreseen in a U.N.-backed intervention plan.

The United States, which has operated a counter-terrorism training program in the region, said it was sharing information with French forces and considering providing logistics, surveillance and airlift capability.

"We have a responsibility to go after al Qaeda wherever they are," Defense Secretary Leon Panetta told reporters heading with him on a week-long tour of European capitals.

As French aircraft bombarded mobile columns of Islamist fighters, other fighters launched a counter-attack to the southwest of recent clashes, dislodging government forces from the town of Diabaly, just 350 km (220 miles) northeast of Bamako. French and Malian troops attempting to retake the town were battling Islamists shouting 'Allahu akbar', residents said.

The rebels infiltrated the town overnight from the porous border region with Mauritania, home to AQIM camps housing well-equipped and trained foreign fighters. A spokesman for Ansar Dine said its fighters took Diabaly, working with AQIM members.

Dozens of Islamist fighters died on Sunday when French rockets hit a fuel depot and a customs house being used as a headquarters. The U.N. said an estimated 30,000 people had fled the fighting, joining more than 200,000 already displaced.

France, which has repeatedly said it has abandoned its role as the policeman of its former African colonies, convened a U.N. Security Council meeting for Monday to discuss the Mali crisis.

The European Union announced it would hold an extraordinary meeting of its foreign ministers in Brussels this week to discuss speeding up a EU training mission to help the Malian army and other direct support for the Bamako government.

French Foreign Minister Laurent Fabius said France would do everything to ensure that regional African troops were deployed quickly to follow up on the French military action, which was launched to block a push southwards by the Islamist rebels.

"ORGANISED AND FANATICAL"

"We knew that there would be a counter-attack in the west because that is where the most determined, the most organized and fanatical elements are," French Defense Minister Jean-Yves Le Drian told France's BFM TV.

France has said its sudden intervention on Friday, responding to an urgent appeal from Mali's president, stopped the Islamists from seizing the dusty capital of Bamako.

President Francois Hollande says Operation Serval - named after an African wildcat - is solely aimed at supporting the 15-nation West African bloc ECOWAS which received U.N. backing in December for a military intervention to dislodge the rebels.

Hollande's robust intervention has won plaudits from Western leaders and has also shot down domestic criticism which portrayed him as spineless and indecisive.

Under pressure from Paris, regional states have said they hope to send in their forces this week. Military chiefs from ECOWAS nations will meet in Bamako on Tuesday but regional powerhouse Nigeria, which is due to lead the mission, has cautioned that training and deploying troops will take time.

Two decades of peaceful elections had earned Mali a reputation as a bastion of democracy in turbulent West Africa but that image unraveled after a military coup in March left a power vacuum for MNLA Tuareg rebels to seize the desert north.

MUJWA, an AQIM splinter group drawing support from Arabs and other ethnic groups, took control of Gao, the main city of the north, from the Tuaregs in June, shocking Mali's liberal Muslim majority with amputation of hands for theft under sharia.

Malian Foreign Minister Tyeman Coulibaly said the situation had become "untenable" in the north. "Every day, we were hearing about feet and hands being cut off, girls being raped, cultural patrimony being looted," he told the French weekly Paris Match.

ISLAMISTS DESTROY TIMBUKTU SHRINES

Last week's drive toward Bamako appeared to have been led by Ansar Dine, founded by renegade Tuareg separatist commander Iyad ag Ghali in his northern fiefdom of Kidal.

The group has said that the famed shrines of ancient desert trading town Timbuktu - a UNESCO world heritage site - were un-Islamic and idolatrous. Much of the area's religious heritage has now been destroyed, sparking international outrage.

France's intervention raises the threat for eight French hostages held by al Qaeda allies in the Sahara and for 30,000 French expatriates living in neighboring, mostly Muslim states.

Concerned about reprisals at home, France has tightened security at public buildings and on public transport.

However, top anti-terrorist judge, Marc Trevidic, played down the imminence of the risk, telling French media: "They're not very organized right now ... It could be a counter attack later on after the defeat on the ground. It's often like that."

Military analysts warn that if French action was not followed up by a robust deployment of ECOWAS forces, with logistical and financial support from NATO, then the whole U.N.-mandated Mali mission was unlikely to succeed.

"The French action was an ad-hoc measure. It's going to be a mess for a while, it depends on how quickly everyone can come on board," said Hussein Solomon, a professor at the University of the Free State, South Africa.

(Additional reporting by Emmanuel Jarry, Brian Love and Catherine Bremer in Paris, Justyna Pawlak and Adrian Croft in Busssels and Louis Charbonneau in New York; writing by Daniel Flynn; editing by Pascal Fletcher)

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4 gadgets that defined Vegas electronics show

LAS VEGAS (AP) — The world’s largest gadget show wrapped up on Friday, and the organizers said it was the biggest ever, beating last year’s record in terms of the floor space companies purchased to display their wares.

What was it that drew more than 3,500 companies and 150,000 people to Las Vegas for this mega-event? Here are four gadgets that exemplified the top trends at this year’s International CES.

— Sony‘s 55-inch ultra-high-definition TV

The introduction of high-definition and flat-panel TVs sent U.S. shoppers on a half-decade buying spree as they tossed out old tube sets. Now that the old sets are mostly gone, sales of new TVs are falling. To lure buyers back, Asian TV makers are trying to pull the same trick again. They’re making the sets sharper. This fall, Sony and LG introduced 84-inch sets with four times the resolution of regular high-definition sets. They provide stunning sharpness, but they’re too big for most homes, and at more than $ 20,000, too expensive. At the show, the companies unveiled smaller “ultra-high-definition” sets, measuring 55 inches and 65 inches on the diagonal. They will go on sale this spring. Prices were not announced, but will presumably be a lot lower than for the 84-inch sets, perhaps under $ 10,000.

Both the size and price of these smaller ultra-HD TVs should make them easier buys, but the higher resolution will be a lot less noticeable on a smaller screen, unless viewers sit very close. Analysts expect ultra-HD to remain an exclusive niche product for some years. There’s no easy way to get ultra-HD video content to the sets, so they will mostly be showing regular HD movies. However, the sets can “upscale” the video to make it look better than it does on a regular HD set.

Analyst James McQuivey of Forrester Research believes the TV makers are focusing on the wrong thing. He doesn’t think consumers really care that much about picture quality.

“What matters most is not the number of pixels or the quality of the pixels themselves … but the increasing convenience of the content’s discovery and delivery. This is why TV makers should be investing in a better experience rather than a bigger one,” McQuivey wrote in a blog post.

— LG’s 55-inch OLED TV

Organic light-emitting diodes, or OLEDs, make for thin, extremely colorful screens. They’re already established in smartphone screens, and they have a lot of promise for other applications as well. For years, a promise is all they’ve represented. OLED screens are very hard to make in larger sizes. Now, LG is shipping a 55-inch OLED TV set in Korea, and is expected to bring it to the U.S. this spring for about $ 12,000.

Beyond being thin, power-thrifty and capable of extremely high color saturation, OLEDs are interesting for another reason: they can bend. LCDs have to be laid down on flat glass substrates, but OLEDs can be laid down on flexible glass or plastic. The major obstacle here is that flexible substrates tend to let through air, which destroys OLEDs, but manufacturers seem to have tackled the problem. Samsung showed off a phone that can bend into a tube. It consisted of a rigid plastic box with electronics and an attached display that is as thin as a piece of paper. The company suggested that in the future, it could make displays that fold up like maps — big screens that fit in a pocket.

We’re likely to see the benefits of bendy OLEDs sooner in a less eyebrow-raising but more practical implementation. It may never have occurred to you, but all electronic screens, except for cathode-ray tubes, are flat. With OLEDs, they don’t have to be. LG and Sony showed TV sets with concave screens at the show — not very useful, but an interesting demonstration. In the future, you could have a phone with a screen that laps over onto the edges, providing you with “smart” buttons with labels that change depending on whether you’re in camera mode or music mode. You could have a coffee mug with a wrap-around news and weather ticker. A revolution in design awaits.

By the way, you won’t have to choose between ultra-HD and OLED screens — Sony, Panasonic and LG showed prototype TVs that combine the technologies.

— The Pebble Watch

The Pebble is a “smart” timepiece that can be programmed to do various things, including showing text messages sent to your phone. The high-resolution display is all digital, so it can be programmed with various cool “watch faces.” But what’s really interesting about the Pebble is how it came to be —and that it exists at all.

Young Canadian inventor Eric Migicovsky couldn’t find conventional funding to make the watch, so he asked for money on Kickstarter, the biggest “crowdfunding” website. In essence, he asked people to buy watches before he actually had any to sell. The fundraising was a blowout success. Migicovsky raised $ 10.3 million by pre-selling 85,000 Pebbles. At CES, he announced that the watches were ready to ship.

Kickstarter’s goal is to bring things and events into fruition that otherwise wouldn’t happen, by creating a shortcut between the people who want to create something and the people willing to pay for it. The effect is starting to become apparent at CES. At least two other “smart” watches funded through Kickstarter were on display. Some startups were at the show to drum up interest in ongoing Kickstarter campaigns, including a Swedish company that wants to make a speaker with a transparent body, and a California outfit that wants to produce a swiveling, remote-controlled platform for cameras.

— Creative Technology Ltd.’s Interactive Gesture Camera

This $ 150 camera, promoted by Intel, attaches to a computer much like a Webcam. From a single lens, it shoots the world in 3-D, using technology similar to radar. The idea is that you can perform hand gestures in the air in front of the camera, and it lets the computer interpret them. Why would you want this? That’s not really clear yet, but a lot of effort is going into finding an answer. CES was boiling with gadgets attempting to break new ground when it comes to how we interact with computers and appliances like TV sets. The Nintendo Wii game console, with its innovative motion-sensing controllers, and the Microsoft Kinect add-on for the Xbox 360 console, which has its own 3-D-sensing camera, have inspired engineers to pursue ways to ditch —or at least complement— the keyboard, mouse, remote control and even the touchscreen.

Samsung’s high-end TVs already let viewers use hand gestures to control volume, and it expanded the range of recognized gestures with this year’s models. Startup Leap Motion was at the show with another depth-sensing camera kit, this one designed to mount next to a laptop’s touch pad, looking upward.

So far, though, the “new interaction” field hasn’t had a real hit since the Kinect. Consumers may be eager to lose the TV remote, but there’s a holdup caused by the nature of the setup: to effectively control the TV, you need to take command not just of the TV, but of the cable or satellite set-top box. TV makers and the cable companies don’t really talk to each other, and there’s no sign of them uniting on a common approach. Only when both devices can be controlled by hand-waving can we permanently let the remote get lost between the couch cushions.

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Miss New York Mallory Hytes Hagan Wins Miss America

Brooklyn, New York native Mallory Hytes Hagan, 23, was crowned this year's Miss America -- beating out Miss South Carolina Ali Rogers and Miss Oklahoma Alicia Clifton, who placed second and third respectively.

Hagan tap danced to James Brown's Get Up Off That Thing and answered a timely question about armed guards in schools – stating that violence is not the proper way to end violence – to clinch the win Saturday night in Las Vegas.

Related: Miss America Contestant to Have Double Mastectomy

Hagan, whose platform issue is child sexual abuse prevention, attended the Fashion Institute of Technology, and plans to obtain a degree in Cosmetics and Fragrance Marketing.

Clearly, her newly won $50,000 scholarship will be put to good use!

Related: Miss America Host Gary Collins Dead

Miss Wyoming Lexie Madden and Miss Iowa Mariah Cary also made the top five, before falling short to Hagan, who was considered an underdog heading into the competition.

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Flu more widespread in US; eases off in some areas

NEW YORK (AP) — Flu is now widespread in all but three states as the nation grapples with an earlier-than-normal season. But there was one bit of good news Friday: The number of hard-hit areas declined.

The flu season in the U.S. got under way a month early, in December, driven by a strain that tends to make people sicker. That led to worries that it might be a bad season, following one of the mildest flu seasons in recent memory.

The latest numbers do show that the flu surpassed an "epidemic" threshold last week. That is based on deaths from pneumonia and influenza in 122 U.S. cities. However, it's not unusual — the epidemic level varies at different times of the year, and it was breached earlier this flu season, in October and November.

And there's a hint that the flu season may already have peaked in some spots, like in the South. Still, officials there and elsewhere are bracing for more sickness

In Ohio, administrators at Miami University are anxious that a bug that hit employees will spread to students when they return to the Oxford campus next week.

"Everybody's been sick. It's miserable," said Ritter Hoy, a spokeswoman for the 17,000-student school.

Despite the early start, health officials say it's not too late to get a flu shot. The vaccine is considered a good — though not perfect — protection against getting really sick from the flu.

Flu was widespread in 47 states last week, up from 41 the week before, the Centers for Disease Control and Prevention said on Friday. The only states without widespread flu were California, Mississippi and Hawaii.

The number of hard-hit states fell to 24 from 29, where larger numbers of people were treated for flu-like illness. Now off that list: Florida, Arkansas and South Carolina in the South, the first region hit this flu season.

Recent flu reports included holiday weeks when some doctor's offices were closed, so it will probably take a couple more weeks to get a better picture, CDC officials said Friday. Experts say so far say the season looks moderate.

"Only time will tell how moderate or severe this flu season will be," CDC Director Dr. Thomas Frieden said Friday in a teleconference with reporters.

The government doesn't keep a running tally of adult deaths from the flu, but estimates that it kills about 24,000 people in an average year. Nationally, 20 children have died from the flu this season.

Flu vaccinations are recommended for everyone 6 months or older. Since the swine flu epidemic in 2009, vaccination rates have increased in the U.S., but more than half of Americans haven't gotten this year's vaccine.

Nearly 130 million doses of flu vaccine were distributed this year, and at least 112 million have been used. Vaccine is still available, but supplies may have run low in some locations, officials said.

To find a shot, "you may have to call a couple places," said Dr. Patricia Quinlisk, who tracks the flu in Iowa.

In midtown Manhattan, Hyrmete Sciuto got a flu shot Friday at a drugstore. She skipped it in recent years, but news reports about the flu this week worried her.

During her commute from Edgewater, N.J., by ferry and bus, "I have people coughing in my face," she said. "I didn't want to risk it this year."

The vaccine is no guarantee, though, that you won't get sick. On Friday, CDC officials said a recent study of more than 1,100 people has concluded the current flu vaccine is 62 percent effective. That means the average vaccinated person is 62 percent less likely to get a case of flu that sends them to the doctor, compared to people who don't get the vaccine. That's in line with other years.

The vaccine is reformulated annually, and this year's is a good match to the viruses going around.

The flu's early arrival coincided with spikes in flu-like illnesses caused by other bugs, including a new norovirus that causes vomiting and diarrhea, or what is commonly known as "stomach flu." Those illnesses likely are part of the heavy traffic in hospital and clinic waiting rooms, CDC officials said.

Europeans also are suffering an early flu season, though a milder strain predominates there. China, Japan, the West Bank, the Gaza Strip, Algeria and the Republic of Congo have also reported increasing flu.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

Most people with flu have a mild illness. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms.

Some shortages have been reported for children's liquid Tamiflu, a prescription medicine used to treat flu. But health officials say adult Tamiflu pills are available, and pharmacists can convert those to doses for children.

___

Associated Press writers Dan Sewell in Cincinnati, Catherine Lucey in Des Moines, and Malcolm Ritter in New York contributed to this report.

___

Online:

CDC flu: http://www.cdc.gov/flu/index.htm

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Getting comfortable with living on the edge

LONDON (Reuters) - Just as you learn to put up with a nagging toothache, this week is expected to provide fresh evidence that the U.S. economy is getting used to life on the edge of the fiscal cliff.

Of course, putting off that trip to the dentist is not necessarily wise. The longer Washington delays, the more painful it will become to narrow its gaping budget deficit.

But surveys of U.S. consumer confidence in January and of house builder sentiment in December are likely to show resilience, buttressing the argument of equity bulls that Wall Street's firm start to the year is more than a relief rally or a desperate search for higher returns on investment.

Bluford Puttnam, chief economist of CME Group, said the U.S. economy had managed to grow almost 2 percent last year and create about 1.8 million jobs despite stagnation in Europe, a slowdown in China and the deadlocked budget talks.

"So I see a lot of momentum going into 2013," Puttnam said. "If we can get past this fiscal cliff, the economy is poised to have a much more confident year."

Despite fiscal tightening, he said growth could reach 2.5 percent to 3.0 percent.

Puttnam said the next rounds in the budget battle later this quarter would again be bitterly fought and the resolution would again satisfy no one. But, as with the showdown at the end of 2012, the economy would quickly move on.

"There is a one-in-ten chance that the government may even shut down for a week. It's just going to be ugly. And then it will be over. There will be some kind of compromise, and by April it will fade quickly into the background," he said.

THREE GORGES

U.S. retail sales are likely to have increased only 0.2 percent in December, dampened by the budget worries, according to economists polled by Reuters.

But a pair of regional Federal Reserve surveys and the monthly Reuters/University of Michigan consumer poll are projected to improve, while housing starts, new building permits and builders' confidence should all show that the housing recovery stands on firm foundations.

"That's what's really encouraging consumers to feel that the economy is getting better and that the momentum is broadly positive," said Jerry Webman, chief economist at OppenheimerFunds in New York.

While the phrase fiscal cliff used by U.S. Federal Reserve chief Ben Bernanke conjured up an image of an immediate plunge at the start of this year, in truth any austerity was always likely to take effect on the economy gradually.

Bank of America Merrill Lynch describes the challenges the United States faces in coming months rather as three fiscal gorges it must leap over.

The government could hit the debt ceiling approved by Congress as early as mid-February; across-the-board spending cuts are due to kick in on March 1; and the ‘continuing resolution' to fund all discretionary government spending expires on March 27.

Ideally, investors would like Democrats and Republicans to resolve all three issues with an overarching agreement to slash the deficit by $4 trillion over the next decade.

Instead, given the dysfunctional state of politics, Webman said the best that could be hoped for was another short-term fix that cuts spending and ends some tax breaks.

"The U.S. doesn't move by grand bargains, by big deals. We move by incremental decisions, and I think we'll make some imperfect but improved decisions over the course of 2013," he said.

CHINA ON THE MEND, EUROPE EERILY CALM

Encouraging economic news from China, including stronger-than-expected exports and imports in December, has also supported the start-of-year move by financial market investors out of cash and into riskier assets.

Figures on Friday are expected to show that the world's second-largest economy grew 7.8 percent from a year earlier, rebounding from the 7.4 percent pace of the third quarter and further allaying fears of a hard landing.

"Given some of the bearish commentary on China a few months ago, this should be a relief for markets and it's good for the world economy," said Derry Pickford, macro analyst at investment managers Ashburton in London.

Continuing calm in the euro zone has also helped equities, even though full-year German GDP data on Tuesday will serve as a reminder of the area's economic malaise.

Europe's largest economy contracted last quarter as factories slashed output in response to weak demand from Germany's neighbors, the Economy Ministry said on Friday.

At a news conference a day earlier, European Central Bank President Mario Draghi said he expected a recovery in euro zone growth later this year. But he ruled out an early end to the ECB's crisis policy measures and cautioned that risks were still tilted to the downside. Markets shrugged.

In Europe as in the United States, investors seem to have got used to high levels of policy uncertainty, said Ethan Harris, chief U.S. economist at Bank of America Merrill Lynch.

"It appears that the markets will look past brinkmanship moments unless policy makers break new ground," he said.

In Europe, that might mean not just threatening to eject Greece from the euro zone but actually forcing the exit. In the United States, that might mean not just threatening to violate the debt ceiling but actually doing so, Harris said in a report.

As long as such extreme events do not occur, Harris expects periodic swoons in confidence but no acute crisis.

"This renewed resilience is important because we expect many brinkmanship moments in the months ahead. A now-regular pattern has been established where deals are only struck at the last minute and often under market pressure," he wrote.

(Editing by Patrick Graham)

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France bombs Islamist strongholds deep in north Mali

BAMAKO/PARIS (Reuters) - French fighter jets pounded Islamist rebel strongholds deep in northern Mali on Sunday as Paris poured more troops into the capital Bamako, awaiting a West African force to dislodge al Qaeda-linked insurgents from the country's north.

The attacks on Islamist positions near the ancient desert trading town of Timbuktu and Gao, the largest city in the north, marked a decisive intensification on the third day of the French mission, striking at the heart of the vast area seized by rebels in April.

France is determined to end Islamist domination of northern Mali, which many fear could act as a base for attacks on the West and for links with al Qaeda in Yemen, Somalia and North Africa.

Defense Minister Jean-Yves Le Drian said France's sudden intervention on Friday had prevented the advancing rebels from seizing Bamako. He vowed that air strikes would continue.

"The president is totally determined that we must eradicate these terrorists who threaten the security of Mali, our own country and Europe," he told French television.

Residents and rebel leaders had reported air raids early on Sunday in the towns of Lere and Douentza in central Mali, forcing Islamists to withdraw. As the day progressed, French jets struck targets further to the north, including near the town of Kidal, the epicenter of the rebellion.

In Gao, a dusty town on the banks of the Niger river where Islamists have imposed an extreme form of sharia law, residents said French jets pounded the airport and rebel positions. A huge cloud of black smoke rose from the militants' camp in the city's north, and pick-up trucks ferried dead and wounded to hospital.

"The planes are so fast you can only hear their sound in the sky," resident Soumaila Maiga said by telephone. "We are happy, even though it is frightening. Soon we will be delivered."

Paris said four Rafale jets flew from France to strike rebel training camps, logistics depots and infrastructure around Gao with the aim of weakening the rebels and preventing them from returning southward.

"We blocked the terrorists' advance and from today what we've started to do is to destroy the terrorists' bases behind the front line," French Foreign Minister Laurent Fabius told LCI television.

France has deployed about 550 soldiers to Mali under "Operation Serval" -- named after an African wildcat -- split between Bamako and the town of Mopti, 500 km (300 miles) north.

In Bamako, a Reuters cameraman saw more than 100 French troops disembark on Sunday from a military cargo plane at the international airport, on the outskirts of the capital.

The city's streets were calm, with the sun streaking through the dusty air as the seasonal Harmattan wind blew from the Sahara. Many cars had French flags draped from the windows to celebrate Paris's intervention.

"We thank France for coming to our aid," said resident Mariam Sidibe. "We hope it continues till the north is free."

AFRICAN TROOPS EXPECTED

More than two decades of peaceful elections had earned Mali a reputation as a bulwark of democracy, but that image unraveled in a matter of weeks after a military coup in March which left a power vacuum for the Islamist rebellion.

France convened a U.N. Security Council meeting for Monday to discuss Mali. French President Francois Hollande's intervention has won plaudits from leaders in Europe, Africa and the United States but it is not without risks.

It raised the threat level for eight French hostages held by al Qaeda allies in the Sahara and for the 30,000 French expatriates living in neighboring, mostly Muslim states.

Concerned about reprisals, France has tightened security at public buildings and on public transport. It advised its 6,000 citizens to leave Mali as spokesmen for Ansar Dine and al Qaeda's north Africa wing AQIM promised to exact revenge.

In its first casualty of the campaign, Paris said a French pilot was killed on Friday when rebels shot down his helicopter.

Hours earlier, a French intelligence officer held hostage in Somalia by al Shabaab extremists linked to al Qaeda was killed in a failed commando raid to free him.

Hollande says France's aim is simply to support a mission by West African bloc ECOWAS to retake the north, as mandated by a U.N. Security Council resolution in December.

With Paris pressing West African nations to send their troops quickly, Ivory Coast President Alassane Ouattara, who holds the rotating ECOWAS chairmanship, kick-started the operation to deploy 3,300 African soldiers.

Ouattara, installed in power with French military backing in 2011, convened a summit of the 15-nation bloc for Saturday in Ivory Coast to discuss the mission.

"The troops will start arriving in Bamako today and tomorrow," said Ali Coulibaly, Ivory Coast's African Integration Minister. "They will be convoyed to the front."

The United States is considering sending a small number of unarmed surveillance drones to Mali as well as providing logistics support, a U.S. official told Reuters. Britain and Canada have also promised logistical support.

Former French colonies Senegal, Niger and Burkina Faso have all pledged to deploy 500 troops within days. In contrast, regional powerhouse Nigeria, due to lead the ECOWAS force, has suggested it would take time to train and equip the troops.

HOUSE-TO-HOUSE SEARCHES

France, however, appeared to have assumed control of the operation on the ground. Its airstrikes allowed Malian troops to drive the Islamists out of the strategic town of Konna, which they had briefly seized this week in their southward advance.

Calm returned to Konna after three nights of combat as the Malian army crushed any remaining rebel fighters. A senior army official said more than 100 rebels had been killed.

"Soldiers are patrolling the streets and have encircled the town," one resident, Madame Coulibaly, told Reuters by phone. "They are searching houses for arms or hidden Islamists."

Analysts expressed doubt, however, that African nations would be able to mount a swift operation to retake north Mali -- a harsh, sparsely populated terrain the size of France -- as neither the equipment nor ground troops were prepared.

"My first impression is that this is an emergency patch in a very dangerous situation," said Gregory Mann, associate professor of history at Columbia University, who specializes in francophone Africa and Mali in particular.

While France and its allies may be able to drive rebel fighters from large towns, they could struggle to prise them from mountain redoubts in the region of Kidal, 300 km (200 miles) northeast of Gao.

Human Rights Watch said at least 11 civilians, including three children, had been killed in the fighting. A spokesman for Doctors Without Borders in neighboring Mauritania said about 200 Malian refugees had fled across the border to a camp at Fassala and more were on their way.

In Bamako, civilians tried to contribute to the war effort.

"We are very proud and relieved that the army was able to drive the jihadists out of Konna. We hope it will not end there, that is why I'm helping in my own way," said civil servant Ibrahima Kalossi, 32, one of over 40 people who queued to donate blood for wounded soldiers.

(Additional reporting by Adama Diarra, Tiemoko Diallo and Rainer Schwenzfeier in Bamako, Pascal Fletcher in Johannesburg, Joe Bavier in Abidjan, Catherine Bremer, Leila Aboud and John Irish in Paris and Phil Stewart in Washington; Writing by Daniel Flynn; Editing by Will Waterman and Roger Atwood)

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Biden seeks video game industry input on guns

WASHINGTON (AP) — Looking for broader remedies to gun violence, Vice President Joe Biden is reaching out to the video game industry for ideas as the White House seeks to assemble proposals in response to last month’s massacre at a Connecticut elementary school.

Biden is scheduled to meet with video game representatives Friday as the White House explores cultural factors that may contribute to violent behavior.

The vice president, who is leading a task force that will present recommendations to President Barack Obama on Tuesday, met with other representatives from the entertainment industry, including Comcast Corp. and the Motion Picture Association of America, on Thursday.

Friday’s meeting comes a day after the National Rifle Association rejected Obama administration proposals to limit high-capacity ammunition magazines and dug in on its opposition to an assault weapons ban, which Obama has previously said he will propose to Congress. The NRA was one of the pro-gun rights groups that met with Biden during the day.

NRA president David Keene, asked Friday if the NRA has enough support in Congress to fend off legislation to ban sales of assault weapons, indicated it does. “I do not think that there’s going to be a ban on so-called assault weapons passed by the Congress,” he said on NBC’s “Today.”

In previewing the meeting with the video game industry, Biden recalled how the late Sen. Daniel Patrick Moynihan of New York lamented during crime bill negotiations in the 1980s that the country was “defining deviancy down.”

It’s unclear what, if anything, the administration is prepared to recommend on how to address the depiction of violence in the media.

White House press secretary Jay Carney last month suggested that not all measures require government intervention.

“It is certainly the case that we in Washington have the potential, anyway, to help elevate issues that are of concern, elevate issues that contribute to the scourge of gun violence in this country, and that has been the case in the past, and it certainly could be in the future,” Carney said then.

In a statement, a half dozen entertainment groups, including the Motion Picture Association of America, said they “look forward to doing our part to seek meaningful solutions.”

On gun control, however, the Obama administration is assembling proposals to curb gun violence that would include a ban on sales of assault weapons, limits on high-capacity ammunition magazines and universal background checks for gun buyers.

“The vice president made it clear, made it explicitly clear, that the president had already made up his mind on those issues,” Keene said after the meeting. “We made it clear that we disagree with them.”

Opposition from the well-funded and politically powerful NRA underscores the challenges that await the White House if it seeks congressional approval for limiting guns and ammunition. Obama can use his executive powers to act alone on some gun measures, but his options on the proposals opposed by the NRA are limited without Congress’ cooperation.

Obama has pushed reducing gun violence to the top of his domestic agenda following last month’s mass shooting at an elementary school in Newtown, Conn., where a gunman slaughtered 20 children and six adults before killing himself. The president put Biden in charge of an administration task force and set a late January deadline for proposals.

“I committed to him I’d have these recommendations to him by Tuesday,” Biden said Thursday, during a separate White House meeting with sportsmen and wildlife groups. “It doesn’t mean it’s the end of the discussion, but the public wants us to act.”

The vice president later met privately with the NRA and other gun-owner groups for more than 90 minutes. Participants in the meeting described it as an open and frank discussion, but one that yielded little movement from either side on long-held positions.

Keene told NBC there is a fundamental disagreement over what would actually make a difference in curbing gun violence.

Richard Feldman, the president of the Independent Firearm Owners Association, said all were in agreement on a need to keep guns out of the hands of criminals and the mentally ill. But when the conversation turned to broad restrictions on high-capacity magazines and assault weapons, Feldman said Biden suggested the president had already made up his mind to seek a ban.

“Is there wiggle room and give?” Feldman said. “I don’t know.”

White House officials said the vice president didn’t expect to win over the NRA and other gun groups on those key issues. But the administration was hoping to soften their opposition in order to rally support from pro-gun lawmakers on Capitol Hill.

Biden’s proposals are also expected to include recommendations to address mental health care and violence on television, in movies and video games. Those issues have wide support from gun-rights groups and pro-gun lawmakers.

As the meetings took place in Washington, a student was shot and wounded at a rural California high school and another student was taken into custody.

During his meeting with sporting and wildlife groups, Biden said that while no recommendations would eliminate all future shootings, “there has got to be some common ground, to not solve every problem but diminish the probability that our children are at risk in their schools and diminish the probability that firearms will be used in violent behavior in our society.”

Several Cabinet members have also taken on an active role in Biden’s gun violence task force, including Attorney General Eric Holder. He met Thursday with Wal-Mart, the nation’s largest firearms seller, along with other retailers such as Bass Pro Shops and Dick’s Sporting Goods.

The president hopes to announce his administration’s next steps to tackle gun violence shortly after he is sworn in for a second term. He has pledged to push for new measures in his State of the Union address.

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Follow Julie Pace at http://twitter.com/jpaceDC

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