The New Old Age Blog: New Help for Hoarders

There were times, Sandra Stark remembers, when she couldn’t use her kitchen or sit on her sofa. Her collections — figurines, vases, paperweights — had overtaken every closet, drawer and surface. Stacks of clothing and old magazines added to the clutter.

Her daughters came in and threw everything away — to Ms. Stark’s horror — but a year later her home was again barely navigable. “I couldn’t throw out my garbage,” she said. “I put it in plastic bags, but I couldn’t take it out.”

A drop-in support group sponsored by the Mental Health Association of San Francisco helped her begin to control her hoarding behavior, and she has made considerable headway. “My bedroom is still a work in progress,” said Ms. Stark, 67. “But I can cook again.”

She has become a trained peer responder who works with others with this disorder. Many of the Mental Health Association’s clients are older adults: A woman in her 70s occupies one small room because the rest of her spacious house — leaking and mildewed — is filled with stuff she can’t discard. An 87-year-old, a compulsive thrift-store shopper, faces eviction because the city health department says she has created a safety hazard. “I’ll say, ‘Of these dozen black leather coats, pick two,’” Ms. Stark said, mapping her strategy to help keep the woman in her home.

Researchers are not sure if hoarding intensifies with age, but the problems it creates certainly do. “The older you get, the more stuff you’ve been able to accumulate,” said Randy Frost, co-author of the book “Stuff” and a Smith College psychologist. “And older people are less physically able to deal with it.” They are more prone to falls as they try to maneuver between piles of possessions and in a crisis, emergency crews may have trouble even entering their dwellings.

When I last wrote about hoarding almost three years ago (uncorking a wave of readers’ lamentation), I couldn’t offer much in the way of help except to steer people to the OCD Foundation. Though hoarding may not be a form of obsessive-compulsive disorder, its site remains useful.

At the time, experts knew what didn’t solve the problem, namely psychoactive drugs or “dumpster therapy,” in which well-meaning friends or family toss hoarders’ possessions, in a temporary fix that doesn’t change their behavior. But researchers were only starting to figure out what did work.

“This is an area in which there haven’t been a lot of answers,” said Eduardo Vega, executive director of the Mental Health Association of San Francisco. Now, “there’s a lot more hope and good will.”

Across the country, for example, cities, counties and states have formed about 80 hoarding task forces so that housing and health departments, senior service agencies, law enforcement and emergency units can coordinate their responses.

On the mental health front, the revised Diagnostic and Statistical Manual V is scheduled for publication in the spring, and many expect it will recognize hoarding as a distinct disorder with diagnostic criteria and a numeric code. That will make psychologists and other professionals more aware of the problem and, Mr. Vega said, “it will be easier to get insurers and providers to pay for treatment.”

Increasingly, there is treatment. Researchers have published studies showing that cognitive behavioral therapy can help, by encouraging people to reevaluate their attachment to possessions and supporting their decisions to start discarding.

Among patients in therapy groups, Dr. Frost has shown, 70 to 80 percent showed some improvement, he said. “That doesn’t mean they’re freed of symptoms, but their lives are improved and the behavior significantly reduced.”

Questions remain; several published studies use small samples that are heavily comprised of females, though hoarding may be more common among men. It is not clear, Dr. Frost said, whether cognitive therapy is as effective among older adults. And it is easier to find an individual therapist or a group in major cities than elsewhere. (Here’s a locator.)

But Dr. Frost and his co-authors have published a workbook called “Buried in Treasures,” along with a free facilitator’s guide, that allows people with hoarding disorders to form their own 15-session action workshops, led by peers rather than professionals. That approach, too, has brought measurable improvement (when used in groups, not individually), a study shows. “Here’s a way people can start working on this on their own,” Dr. Frost said.

Diagnostic criteria, treatment centers, workbooks, published research — all this is more than mental health professionals could offer years back. Still, compulsive hoarding remains a stubborn problem, a safety risk for older people and a heartache for their families.

“It’s really difficult for adult children,” who worry about their parents, but can’t induce them to change, Dr. Frost said. “There may be a history of animosity. Many report they grew up feeling their hoarding parents cared more about their possessions than about them.” The children, young or grown, could probably use a support group, too.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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The Next War: In Federal Budget Cutting, F-35 Fighter Jet Is at Risk

Luke Sharrett for The New York Times

Vice Adm. David Venlet was named to lead the Joint Strike Fighter program in 2010 after problems had left it behind schedule and over budget.

LEXINGTON PARK, Md. — The Marine version of the F-35 Joint Strike Fighter, already more than a decade in the making, was facing a crucial question: Could the jet, which can soar well past the speed of sound, land at sea like a helicopter?

Luke Sharrett for The New York Times

An F-35B, the Marine Corps version of the Joint Strike Fighter.

On an October day last year, with Lt. Col. Fred Schenk at the controls, the plane glided toward a ship off the Atlantic coast and then, its engine rotating straight down, descended gently to the deck at seven feet a second.

There were cheers from the ship’s crew members, who “were all shaking my hands and smiling,” Colonel Schenk recalled.

The smooth landing helped save that model and breathed new life into the huge F-35 program, the most expensive weapons system in military history. But while Pentagon officials now say that the program is making progress, it begins its 12th year in development years behind schedule, troubled with technological flaws and facing concerns about its relatively short flight range as possible threats grow from Asia.

With a record price tag — potentially in the hundreds of billions of dollars — the jet is likely to become a target for budget cutters. Reining in military spending is on the table as President Obama and Republican leaders in Congress look for ways to avert a fiscal crisis. But no matter what kind of deal is reached in the next few weeks, military analysts expect the Pentagon budget to decline in the next decade as the war in Afghanistan ends and the military is required to do its part to reduce the federal debt.

Behind the scenes, the Pentagon and the F-35’s main contractor, Lockheed Martin, are engaged in a conflict of their own over the costs. The relationship “is the worst I’ve ever seen, and I’ve been in some bad ones,” Maj. Gen. Christopher Bogdan of the Air Force, a top program official, said in September. “I guarantee you: we will not succeed on this if we do not get past that.”

In a battle that is being fought on other military programs as well, the Pentagon has been pushing Lockheed to cut costs much faster while the company is fighting to hold onto a profit. “Lockheed has seemed to be focused on short-term business goals,” Frank Kendall, the Pentagon’s top weapons buyer, said this month. “And we’d like to see them focus more on execution of the program and successful delivery of the product.”

The F-35 was conceived as the Pentagon’s silver bullet in the sky — a state-of-the art aircraft that could be adapted to three branches of the military, with advances that would easily overcome the defenses of most foes. The radar-evading jets would not only dodge sophisticated antiaircraft missiles, but they would also give pilots a better picture of enemy threats while enabling allies, who want the planes, too, to fight more closely with American forces.

But the ambitious aircraft instead illustrates how the Pentagon can let huge and complex programs veer out of control and then have a hard time reining them in. The program nearly doubled in cost as Lockheed and the military’s own bureaucracy failed to deliver on the most basic promise of a three-in-one jet that would save taxpayers money and be served up speedily.

Lockheed has delivered 41 planes so far for testing and initial training, and Pentagon leaders are slowing purchases of the F-35 to fix the latest technical problems and reduce the immediate costs. A helmet for pilots that projects targeting data onto its visor is too jittery to count on. The tail-hook on the Navy jet has had trouble catching the arresting cable, meaning that version cannot yet land on carriers. And writing and testing the millions of lines of software needed by the jets is so daunting that General Bogdan said, “It scares the heck out of me.”

With all the delays — full production is not expected until 2019 — the military has spent billions to extend the lives of older fighters and buy more of them to fill the gap. At the same time, the cost to build each F-35 has risen to an average of $137 million from $69 million in 2001.

The jets would cost taxpayers $396 billion, including research and development, if the Pentagon sticks to its plan to build 2,443 by the late 2030s. That would be nearly four times as much as any other weapons system and two-thirds of the $589 billion the United States has spent on the war in Afghanistan. The military is also desperately trying to figure out how to reduce the long-term costs of operating the planes, now projected at $1.1 trillion.

“The plane is unaffordable,” said Winslow T. Wheeler, an analyst at the Project on Government Oversight, a nonprofit group in Washington.

Todd Harrison, an analyst at the Center for Strategic and Budgetary Assessments, a research group in Washington, said Pentagon officials had little choice but to push ahead, especially after already spending $65 billion on the fighter. “It is simultaneously too big to fail and too big to succeed,” he said. “The bottom line here is that they’ve crammed too much into the program. They were asking one fighter to do three different jobs, and they basically ended up with three different fighters.”

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News Analysis: Sunni Leaders Gaining Clout in Mideast

Mohammed Saber/European Pressphoto Agency

A Palestinian woman in Gaza City on Tuesday walked amid the rubble left from eight days of fighting that ended in a cease-fire.

RAMALLAH, West Bank — For years, the United States and its Middle East allies were challenged by the rising might of the so-called Shiite crescent, a political and ideological alliance backed by Iran that linked regional actors deeply hostile to Israel and the West.

But uprising, wars and economics have altered the landscape of the region, paving the way for a new axis to emerge, one led by a Sunni Muslim alliance of Egypt, Qatar and Turkey. That triumvirate played a leading role in helping end the eight-day conflict between Israel and Gaza, in large part by embracing Hamas and luring it further away from the Iran-Syria-Hezbollah fold, offering diplomatic clout and promises of hefty aid.

For the United States and Israel, the shifting dynamics offer a chance to isolate a resurgent Iran, limit its access to the Arab world and make it harder for Tehran to arm its agents on Israel’s border. But the gains are also tempered, because while these Sunni leaders are willing to work with Washington, unlike the mullahs in Tehran, they also promote a radical religious-based ideology that has fueled anti-Western sentiment around the region.

Hamas — which received missiles from Iran that reached Israel’s northern cities — broke with the Iranian axis last winter, openly backing the rebellion against the Syrian president, Bashar al-Assad. But its affinity with the Egypt-Qatar-Turkey axis came to fruition this fall.

“That camp has more assets that it can share than Iran — politically, diplomatically, materially,” said Robert Malley, the Middle East program director for the International Crisis Group. “The Muslim Brotherhood is their world much more so than Iran.”

The Gaza conflict helps illustrate how Middle Eastern alliances have evolved since the Islamist wave that toppled one government after another beginning in January 2011. Iran had no interest in a cease-fire, while Egypt, Qatar and Turkey did.

But it is the fight for Syria that is the defining struggle in this revived Sunni-Shiite duel. The winner gains a prized strategic crossroads.

For now, it appears that that tide is shifting against Iran, there too, and that it might well lose its main Arab partner, Syria. The Sunni-led opposition appears in recent days to have made significant inroads against the government, threatening the Assad family’s dynastic rule of 40 years and its long alliance with Iran. If Mr. Assad falls, that would render Iran and Hezbollah, which is based in Lebanon, isolated as a Shiite Muslim alliance in an ever more sectarian Middle East, no longer enjoying a special street credibility as what Damascus always tried to sell as “the beating heart of Arab resistance.”

If the shifts seem to leave the United States somewhat dazed, it is because what will emerge from all the ferment remains obscure.

Clearly the old leaders Washington relied on to enforce its will, like President Hosni Mubarak of Egypt, are gone or at least eclipsed. But otherwise confusion reigns in terms of knowing how to deal with this new paradigm, one that could well create societies infused with religious ideology that Americans find difficult to accept. The new reality could be a weaker Iran, but a far more religiously conservative Middle East that is less beholden to the United States.

Already, Islamists have been empowered in Egypt, Libya and Tunisia, while Syria’s opposition is being led by Sunni insurgents, including a growing number identified as jihadists, some identified as sympathizing with Al Qaeda. Qatar, which hosts a major United States military base, also helps finance Islamists all around the region.

In Egypt, President Mohamed Morsi resigned as a member of the Muslim Brotherhood only when he became head of state, but he still remains closely linked with the movement. Turkey, the model for many of them, has kept strong relations with Washington while diminishing the authority of generals who were longstanding American allies.

“The United States is part of a landscape that has shifted so dramatically,” said Mr. Malley of the International Crisis Group. “It is caught between the displacement of the old moderate-radical divide by one that is defined by confessional and sectarian loyalty.”

The emerging Sunni axis has put not only Shiites at a disadvantage, but also the old school leaders who once allied themselves with Washington.

The old guard members in the Palestinian Authority are struggling to remain relevant at a time when their failed 20-year quest to end the Israeli occupation of Palestinian lands makes them seem both anachronistic and obsolete.

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No. 1 Indiana rolls past No. 14 N Carolina 83-59

BLOOMINGTON, Ind. (AP) — No. 1 Indiana had something to prove Tuesday night — that it could play defense.

Just two days after the Hoosiers put together their best game this season, they delivered an even more impressive performance, getting 20 points from Cody Zeller and 19 each from Will Sheehey and Victor Oladipo, running away from No. 14 North Carolina 83-59 in the ACC-Big Ten Challenge.

"Our guys played great basketball tonight," coach Tom Crean said. "We played against an incredible opponent, everybody understands how great North Carolina is. Our guys had an edge to them tonight, and it was on the defensive end as much as anything else."

The conventional wisdom is that the Hoosiers (7-0) are one of the nation's top scoring teams.

But the detractors have questioned Indiana's willingness to defend and some have even suggested that weakness has allowed No. 2 Duke to close the gap on the nation's top-ranked team.

North Carolina coach Roy Williams disagrees.

"I think they are," he said when asked whether Indiana deserved to be No. 1. "The thing I like about them is they really are a team. They don't have one guy that beats you up, they beat you so many different ways."

Williams and the Tar Heels (5-2) learned that lesson the hard way in Bloomington.

In the second half, the Tar Heels shot just 27.8 percent from the field and went 0 for 5 from 3-point range. They were outscored 12-8 on the fast break, an area that had caused so much concern for Crean that he lost sleep leading up to the game.

"I know people criticize us for our defense, and they say 'If they can't play defense, how good can they really be?'" Oladipo said.

Offensively, the Hoosiers were their usual balanced selves.

Zeller was 8 of 13 from the field with four blocks, one steal and an assist. Oladipo and Sheehey were both 8 of 12 from the field. Senior guard Jordan Hulls was 5 of 8, including three 3-pointers, and finished with 13 points, eight assists and two steals.

"It's cool," Oladipo said when asked about beating a program like North Carolina this handily. "I mean, we've been working really hard and you guys know as well as I know that this program, well not last year, but over the last couple of years was really struggling and we wanted to get it back to where it belongs, which is on top. So to get a win like that, it's a humbling experience."

The best thing about this game for North Carolina may be the end of its run against teams from the Hoosier State.

A week ago, North Carolina trailed by 29 points in the second half before falling 82-71 to two-time national runner-up Butler.

On Tuesday, it was almost an instant replay.

Indiana closed the first half fast, started the second half fast and spent the rest of the game pulling away. The Hoosiers' biggest lead, 83-51, came with 4:22 left in the game.

Dexter Strickland led the Tar Heels with 14 points, Marcus Paige had 11 and James Michael McAdoo had 10 points and nine rebounds for North Carolina, which was missing sophomore guard P.J. Hairston, who stayed home with a sprained left knee.

There was a bigger problem, though. North Carolina couldn't figure out how to contain Zeller, one of this season's favorites to be the national player of the year.

"Boy, I would love to watch them play if it wasn't against my team," Williams said. "You look down the lineup and Cody Zeller, he's family to begin with, he's really a load to handle, and two other guys that I didn't even hear of when they were in high school, they just kicked our rear ends."

The game pitting two of the country's most storied programs — which have combined for 10 national titles and 3,767 wins — had been billed as one of this season's showcase events. For 16 minutes, it lived up to the hype.

Zeller changed everything with two flurries.

By setting high picks and drawing post players outside, it opened up the lanes for his cutting and slashing teammates who wasted no time exploiting the holes in the Carolina defense, using a 15-6 run at the end of the first half to take a 46-37 halftime lead.

The Hoosiers were only getting started.

"If you let them dictate and control the pace of the game, they're going to win," Crean said. "So we had to control and dictate the pace of the game, and to do that, we had to run."

But in the second half, the Hoosiers were out to prove something else — that they could defend.

Over the first 8½ minutes, North Carolina managed only three points, the tip-in and a free throw.

Zeller and Oladipo, meanwhile, combined for seven points in the opening 13-0 blitz that put Indiana ahead 59-37, and North Carolina never challenged again as the Hoosiers won their 34th consecutive home game in November against a team that was supposed to cause havoc.

"It's a huge statement," Sheehey said. "We prepared for this game for a couple of weeks now and that's about it. You saw the score. We played hard, we played well, we played together and when we do that, stuff is going to happen."

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Recipes for Health: Spinach and Turkey Salad — Recipes for Health

Andrew Scrivani for The New York Times

Turkey or chicken transforms this classic spinach salad (minus the bacon) into a light main dish, welcome after Thanksgiving and before the rest of the holiday season feasting begins.

2 cups (12 ounces) shredded cooked turkey, chicken breast or chicken breast tenders

1 6-ounce bag baby spinach

6 white or cremini mushrooms, thinly sliced

1 cup cooked wild rice

2 tablespoons chopped walnuts

1 to 2 hard boiled eggs (to taste), finely chopped (optional)

2 tablespoons chopped chives

1 to 2 tablespoons chopped fresh herbs such as parsley, tarragon or marjoram

For the dressing:

2 tablespoons fresh lemon juice

1 tablespoon red wine vinegar, tarragon vinegar or sherry vinegar

1 teaspoon Dijon mustard

Salt and freshly ground pepper

1 small garlic clove, pureed

1/3 cup extra virgin olive oil

2 tablespoons plain low-fat yogurt

1. Combine all of the salad ingredients in a large salad bowl. Whisk together the lemon juice, vinegar, Dijon mustard, salt, pepper, garlic, olive oil and yogurt. Toss with the salad just before serving.

Yield: Serves 4 as a main dish

Advance preparation: The salad can be assembled and the dressing mixed several hours before serving. Refrigerate and toss together when ready to serve.

Variation: Add 1 ripe but firm persimmon, peeled, cored and sliced, to the mixture.

Nutritional information per serving: 375 calories; 25 grams fat; 4 grams saturated fat; 5 grams polyunsaturated fat; 15 grams monounsaturated fat; 53 milligrams cholesterol; 14 grams carbohydrates; 2 grams dietary fiber; 119 milligrams sodium (does not include salt to taste); 26 grams protein

Martha Rose Shulman is the author of “The Very Best of Recipes for Health.”

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California Shows Signs of Resurgence

Sam Hodgson/Bloomberg News

Prosperous coastal places like La Jolla, here, are better off than the state as a whole; many inland areas still have high jobless rates.

LOS ANGELES — After nearly five years of brutal economic decline, government retrenchment and a widespread loss of confidence in its future, California is showing the first signs of a rebound. There is evidence of job growth, economic stability, a resurgent housing market and rising spirits in a state that was among the worst hit by the recession.

California reported a 10.1 percent unemployment rate last month, down from 11.5 percent in October 2011 and the lowest since February 2009. In September, California had its biggest month-to-month drop in unemployment in the 36 years the state has collected statistics, from 10.6 percent to 10.2 percent, though the state still has the third-highest jobless rate in the nation.

The housing market, whose collapse in a storm of foreclosures helped worsen the economic decline, has snapped back in many, though not all, parts of the state. Houses are sitting on the market for a shorter time and selling at higher prices, and new home construction is rising. Home sales rose 25 percent in Southern California in October compared with a year earlier.

After years of spending cuts and annual state budget deficits larger than the entire budgets of some states, this month the independent California Legislative Analyst’s Office projected a deficit for next year of $1.9 billion — down from $25 billion at one point — and said California might post a $1 billion surplus in 2014, even accounting for the tendency of these projections to vary markedly from year to year.

A reason for the change, in addition to a series of deep budget cuts in recent years, was voter approval of Proposition 30, promoted by Gov. Jerry Brown to raise taxes temporarily to avoid up to $6 billion in education cuts.

“The state’s economic recovery, prior budget cuts and the additional, temporary taxes provided by Proposition 30 have combined to bring California to a promising moment: the possible end of a decade of acute state budget challenges,” the report said. “Our economic and budgetary forecast indicates that California’s leaders face a dramatically smaller budget problem in 2013-14.”

And 38 percent of Californians say the state is heading in the right direction, according to a survey this month by U.S.C. Dornsife/Los Angeles Times. For most places, that figure would seem dismal. But it is double what it was 13 months ago.

California’s recovery echoes a rebound across much of the country; the state suffered not only one of the longest downturns but also one of the most severe. Economists say the turnaround, should it continue, is a positive harbinger for the nation, given the size and diversity of the state’s economy.

Democrats here have been quick to argue that the improvements in fiscal conditions that the state is now projecting after voters approved the temporary tax increase may embolden other states, and Congress, to raise some taxes rather than turn to a new round of cuts.

Yet California still faces major problems. The economic recovery is hardly uniform. Central California and the Inland Empire — the suburban sprawl east of Los Angeles — continue to stagger under the collapse of the construction market, and some economists wonder if they will ever join the coastal cities on the prosperity train. Cities, most recently San Bernardino, are facing bankruptcy, and public employee pension costs loom as a major threat to the state budget and those of many municipalities, including Los Angeles.

A federal report this month said that by some measures, California has the worst poverty in the nation. The river of people coming west in search of the economic dream, traditionally an economic and creative driver, has slowed to a crawl.

Still, the fear among many Californians that the bottom had fallen out appears to be fading. Economists said they were spotting many signs of incipient growth, including a surge in rental costs in the Bay Area, which suggests an influx of people looking for jobs.

“I think the state is turning a corner,” said Enrico Moretti, a professor of economics at the University of California, Berkeley. He said that the recovery was creating regional lines of economic demarcation — “We are going to see a more and more polarized state,” he said — but that over all, California was emerging from the recession.

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Egypt’s President Said to Limit Scope of Judicial Decree

Tara Todras-Whitehill for The New York Times

Egyptians at a burned-out school in Cairo on Monday before the funeral of an activist who was injured in a clash and died Sunday.

CAIRO — With public pressure mounting, President Mohamed Morsi appeared to pull back Monday from his attempt to assert an authority beyond the reach of any court. His allies in the Muslim Brotherhood canceled plans for a large demonstration in his support, signaling a chance to calm an escalating battle that has paralyzed a divided nation.

After Mr. Morsi met for hours with the judges of Egypt’s Supreme Judicial Council, his spokesman read an “explanation” on television that appeared to backtrack from a presidential decree placing Mr. Morsi’s official edicts above judicial scrutiny — even while saying the president had not actually changed a word of the statement.

Though details of the talks remained hazy, and it was not clear whether the opposition or the court would accept his position, Mr. Morsi’s gesture was another demonstration that Egyptians would no longer allow their rulers to operate above the law. But there appeared little chance that the gesture alone would be enough to quell the crisis set off by his perceived power grab.

Protesters remained camped in Tahrir Square, and the opposition was moving ahead with plans for a major demonstration on Tuesday.

The presidential spokesman, Yasser Ali, said for the first time that Mr. Morsi had sought only to assert pre-existing powers already approved by the courts under previous precedents, not to free himself from judicial oversight.

He said that the president meant all along to follow an established Egyptian legal doctrine suspending judicial scrutiny of presidential “acts of sovereignty” that work “to protect the main institutions of the state.” The judicial council had said Sunday that it could bless aspects of the decree deemed to qualify under the doctrine.

Mr. Morsi had maintained from the start that his purpose was to empower himself to prevent judges appointed by former President Hosni Mubarak from dissolving the constituent assembly, which is led by his fellow Islamists of the Muslim Brotherhood’s Freedom and Justice Party. The courts have already dissolved the Islamist-led Parliament and an earlier constituent assembly, and the Supreme Constitutional Court was widely expected to rule against this one next week.

But the text of the original decree had exempted all presidential edicts from judicial review until the ratification of a constitution, not just those edicts related to the assembly or justified as “acts of sovereignty.”

Legal experts said that the spokesman’s explanations of the president’s intentions, if put into effect, would amount to a revision of the decree Mr. Morsi issued last Thursday. But lawyers said that the verbal statements alone carried little legal weight.

How the courts would apply the doctrine remained hard to predict. And Mr. Morsi’s opposition indicated it was holding out for far greater concessions, including the breakup of the whole constituent assembly.

Speaking at a news 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 withdrawal of Mr. Morsi’s new powers was only the first step toward the opposition’s goal of “the withdrawal of the legitimacy of Morsi’s presence in the presidential palace.” Completely withdrawing the edict would be “a minimum,” he said.

Khaled Ali, a human rights lawyer and former presidential candidate, pointed to the growing crowd of protesters camped out in Tahrir Square for a fourth night. “The one who did the action has to take it back,” Mr. Ali said.

Moataz Abdel Fattah, a political scientist at Cairo University, said Mr. Morsi was saving face during a strategic retreat. “He is trying to simply say, ‘I am not a new pharaoh; I am just trying to stabilize the institutions that we already have,’ ” he said. “But for the liberals, this is now their moment, and for sure they are not going to waste it, because he has given them an excellent opportunity to score.”

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HTC confirms 5-inch ‘Deluxe’ smartphone won’t launch in Europe

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Newton leads Panthers past Eagles 30-22

PHILADELPHIA (AP) — They were two words on a sponsor's banner draped behind the Philadelphia Eagles' postgame podium: Imagine. Change.

For disgusted Eagles fans, that's all they can do, especially with coach Andy Reid still running the show. They won't have to imagine much longer.

After 14 seasons, one Super Bowl appearance, and, now a dreadful losing streak, the countdown to the end of Reid's tenure is hitting high gear in Philadelphia. Owner Jeffrey Lurie already has said that an 8-8 record would be "unacceptable" this year.

The Eagles would have to finish 5-0 just to get there after Cam Newton threw for two touchdowns and ran for two more to lead the Carolina Panthers to a 30-22 victory over the Philadelphia Eagles on Monday night.

Newton, who hadn't played up to his sensational rookie season, showed no signs of a sophomore slump against Philadelphia's porous pass defense. He finished 18 of 28 for 306 yards and had a passer rating of 125 in a matchup of teams with the worst records in the NFC.

Newton was only the latest player to shine against an Eagles (3-8) team about all out of hope. The Eagles haven't won since beating the defending Super Bowl champion New York Giants to go 3-1, a skid that has put Reid's job in real jeopardy. Unless Lurie has an implausible change of heart, Reid's run is about over, an inglorious end for the coach who led the Eagles to five conference championship games.

Lurie ducked out of a pregame press conference for the team's Hall of Fame before he could take questions from reporters. Reid said he hasn't discussed his job status with his boss.

"I'm not worried about all of the other things," Reid said. "I'm worried about winning football games and making sure I get my players coached up to where we do a better job with that."

As Philadelphia's seventh straight loss came to a close, some fed-up fans held up a banner that read, "Jeff This Is On You."

While Lurie surely joins Reid in taking a share of the blame for this ugly season, the players have been awful.

"I feel bad for Andy because he's in a horrible situation in a town that is critical, and rightly so," tight end Brent Celek said. "If I was the fans, I'd be mad, too. I don't see Andy as the problem. I see it as us."

Their latest problem was an inability to solve Newton.

Newton, the No, 1 overall pick in 2011, lived up to the hype by throwing for 4,051 yards with 21 TD passes and 14 TDs on the ground in his first year. He entered this game with only nine TD passes and four TDs rushing, a major disappointment for Panthers fans.

But Newton outshined rookie seventh-round pick Nick Foles in his Monday night debut.

Newton had a 24-yard TD toss over the middle to a wide-open Gary Barnidge for a 7-3 lead. He connected with Brandon LaFell on a 43-yard pass to make it 14-3 later in the first quarter. LaFell was wide open on the play, taking advantage of another breakdown in coverage in the secondary.

Newton led a 95-yard drive to open the third quarter, finishing it off with a 1-yard leap to give the Panthers a 21-15 lead. Newton hit Louis Murphy for a 55-yard gain on a second-and-11 from Carolina's 16.

"I think my best game is still to come," Newton said. "I'm still focused on getting better each and every week."

Carolina (3-8) went ahead 24-22 early in the fourth quarter on Graham Gano's 23-yard field goal.

"It's been a long time in coming," Panthers coach Ron Rivera said. "Lots of people contributed and made plays. Real proud of what we did and the things we did to give ourselves a chance to win."

Bryce Brown set an Eagles' rookie record with 178 yards rushing, including TD runs of 65 and 5 yards. Brown, filling in for injured running back LeSean McCoy, surpassed Correll Buckhalter's rookie mark of 134 yards rushing in his first start since his senior year at Wichita East High School in 2008. Brown also lost two fumbles, including one in Panthers' territory.

Foles was so-so in his second straight start for Michael Vick, who sat out with a concussion. Foles was 16 of 21 for 119 yards.

"The most important thing for me was for us to get the win and that didn't happen tonight," Brown said. "I felt like a lot of that had to do with my two turnovers. It really, really cost us."

After Gano's field goal put them up for good, the Panthers finally stopped Brown when it mattered most, stuffing him on a fourth-and-1 to take over on downs at their 40. Newton led them downfield, running in from the 2 to make it 30-22. Gano, signed last week, missed the extra point. But Brandon Boykin fumbled after a 44-yard kickoff return, the Panthers recovered and held the ball the final 4:29.

The Panthers have shown they're better than their record. They have lost six games by less than a touchdown, including a 2-point loss at Atlanta and a 1-point loss at Chicago.

"It's a huge stage, Monday Night Football, on the road," tackle Jordan Gross said. "It was just big for us and big for the guys on the team who haven't experienced something like this."

For the Eagles, it was simply the latest loss in a season stuffed with them. The Linc was quiet and empty except for some boos when busted coverage led to another Carolina TD. They fled for the exits once the Panthers took over for the final time.

Dwindling fan support is one thing. Losing it from Lurie is quite another for Reid.

"He's as competitive as anybody and he wants to win games," Reid said. "That's what he's in this business for."

NOTES: Neither Vick nor McCoy has been cleared to return to practice. The injury-depleted Eagles lost wide receiver DeSean Jackson (sternum) and defensive tackle Fletcher Cox (tail bone) in the first half. ... The Eagles inducted five-time Pro Bowl cornerback Troy Vincent and longtime front office executive Leo Carlin into the team's Hall of Fame at halftime. ... Brown's 65-yard TD run was the longest for the Eagles since McCoy's 66-yard TD vs NYG on Nov. 1, 2009. ... Buckhalter had 134 yards rushing vs. Arizona on Oct. 7, 2001. ... Newton led the Panthers with 52 yards rushing.

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The New Old Age Blog: New Efforts to Close Hospitals' Revolving Doors

In the past, the only thing a patient was sure to get after a hospital stay was a bill. But as Medicare cracks down on high readmission rates, hospitals are dispatching nurses, transportation, culturally specific diet tips, free medications and even bathroom scales to patients deemed at risk of relapsing.

Robert Wood Johnson University Hospital in New Brunswick, N.J., has nurses visit high-risk patients at their home within two days of leaving the hosital. Teresa De Peralta, a nurse practitioner who runs the program, said they frequently find that patients don’t realize a drug they were prescribed in the hospital does the same thing as one they have already been taking.

“When medications are changed, they don’t want to throw things out, they think it’s a waste,” Ms. De Peralta said. “We actually go through the cupboards and painstakingly write out in big letters what they should be taking during the day.”

Many hospital officials say their efforts to keep patients healthy after discharge have been spurred by new financial penalties Medicare started imposing in October on places with too many readmissions. Increasingly, hospitals are no longer leaving to patients the responsibility for setting up follow-up appointments or filling new prescriptions.

And hospitals are not assuming that personnel in nursing homes and other facilities know how to properly care for their patients and follow the hospital discharge instructions.

Patients taking the wrong dose or mixing medicines that react badly often end up back in the hospital. A survey of 377 elderly patients at Yale-New Haven Hospital, published this year in The Journal of General Internal Medicine, discovered that 81 percent of the patients either didn’t understand what all their prescriptions were for; were prescribed the wrong drug or the wrong dose; were taken off a drug they needed, or never picked up a new prescription.

Dr. Leora Horwitz, the study’s leader, said patients who were called a week after their discharge and were asked what changes to their medication they were supposed to make “overwhelmingly” couldn’t tell them.

A big part of reducing readmissions is making sure that patients understand early warning signs that their health is deteriorating. Sun Health Care Transitions, a foundation-supported program in Sun City, Ariz., gives scales to some patients with congestive heart failure because small weight gains indicate they are retaining water, a sign that their heart isn’t pumping adequately.

“We have them keep a log,” said Jennifer Drago, a Sun Health vice president. “We want them to be looking for a two-pound daily weight gain, or five pounds over the week.”

Patients whose weight creeps up are quickly sent back to their doctor. Debra Richards, director of case management at Banner Del E. Webb Medical Center, one of the hospitals Sun Health is assisting, said, “That program has helped us quite a bit.”

Shady Grove Adventist Hospital in Rockville, Md., has started taking patients’ cultural backgrounds into consideration when doling out advice about maintaining their health. For example, the hospital encourages Salvadoran patients to substitute olive oils for the palm oils their cuisine traditionally calls for, to roast or bake meat instead of frying it and to use sugar substitutes when making horchata, a popular Central American drink.

When Hackensack University Medical Center sent staff members to teach caregivers how to take care of their patients, one place “didn’t even know what a low-salt diet was,” even though that’s a critical part of keeping heart failure patients from retaining fluids, said Dr. Charles Riccobono, chief quality and safety officer at the New Jersey hospital.

Aurora Health Care, a Milwaukee-based health system, now places its own nurse practitioners in several nursing homes to watch over Aurora’s discharged patients. Aurora says readmission rates of those patients have decreased, in some months by as much as half.

Dr. Eric Coleman, a Denver geriatrician whose ideas on reducing readmissions have been adopted by a number of hospitals and Medicare, said that while some hospital changes are “exciting and new,” others are “relabeling old wine in new bottles.”

“Yesterday we had ‘discharge planning’ and today we have a ‘rapid response transition team,’ and content-wise they’re doing the same thing,” Dr. Coleman said. “But it’s a nice thing to report out to the board of trustees.”

Jordan Rau is a reporter for Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

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