Gun Shop Owners Report Spike in Sales as Enthusiasts Fear Possible New Laws

Larry Deklinski/The News-Item, via Associated Press

Linda Kahler with customers at Kahler’s Gun Shop in Helfenstein, Pa., where the business has been crowded the past few days.

Rainier Arms, a gun dealer in Auburn, Wash., receives great Yelp reviews for its responsiveness. But a call to the dealer on Friday led to a full voice mail box, and an e-mail to its sales team drew this automatic response: “Thank you for contacting Rainier Arms for your AR-15 needs.  Due to an overwhelming response to the latest political climate, we are experiencing longer-than-normal response times.”

At Bud’s Gun Shop in Maryland, a message on the Web site said that customer service was “completely overwhelmed” and it discouraged customers from calling or e-mailing.

And on GunBroker.com, an Oracle .223 that normally retails for around $650 had been bid up to $1,175 with three days left in the auction.

With gun-control legislation getting more serious discussion than it has in years, gun sales are spiking as enthusiasts stock up in advance of possible restrictions.

Gun sales have been increasing over the past five years, with marked increases around the 2008 and 2012 elections, and after mass shootings like the one in Aurora, Colo., and now in Newtown, Conn.

“The largest factor by far is fears over a potential change in gun laws — that’s what’s driving most guns enthusiasts or even first-time buyers to go buy a gun,” said Nima Samadi, senior guns and ammunition analyst for the research firm IBISWorld.

There is increasing demands for guns in the United States. Last year, the Federal Bureau of Investigation conducted 16.45 million background checks for firearm sales through the National Instant Criminal Background Check System, a 14 percent jump from the previous year. In the first 11 months of this year, the bureau conducted 16.8 million background checks, a record since the system’s founding in 1998.

Since the shootings at Sandy Hook Elementary School in Newtown, though, a few companies associated with gun sales have backed away. Cerberus Capital Management put the company that makes the Bushmaster, a gun used in the shootings, up for sale on Tuesday, saying, “The Sandy Hook tragedy was a watershed event that has raised the national debate on gun control to an unprecedented level.”

Dick’s Sporting Goods temporarily ceased selling all guns in its location closest to Newtown, and has also put a hold on sales of so-called modern sporting rifles, which include semiautomatic guns, nationwide.

And Deseret Digital Media, which owns KSL.com, a Web site that has been criticized by Mayor Michael R. Bloomberg for allowing unregulated gun sales, said it was suspending classified advertisements for guns.

Elsewhere, though, consumers are hurrying to buy guns, leading to some models being out of stock, warnings of shipping and customer-service delays, and significant premiums on assault rifles.

“We are seeing a total madhouse of buying everything in sight,” said Bob Irwin, owner of the Gun Store, a Las Vegas shooting range and retailer. Thursday, he said, was the largest sales day in the history of the store, which has been open for 30 years. “We have not only a run on the guns, but a run on ammunition.”

Mr. Irwin has begun limiting how much of some types of ammunition customers can buy, and he has canceled employees’ days off to handle the demand.

Walmart, the largest retailer of guns and ammunition in the United States, indicated that several semiautomatic guns were out of stock at locations across the country. Kory Lundberg, a spokesman, said the company was not sold out of guns altogether, but had low inventory in some situations. Walmart carries guns in about half its stores, and about one-third carry so-called modern sporting rifles, the category including the Bushmaster and other AR-15 weapons.

Other retailers around the country were selling out of guns and accessories. On Friday on ImpactGuns.com, the Bushmaster .223 was out of stock. Davidson’s, a supplier to gun retailers, placed a notice on its Web site that said it was seeing “unprecedented demand,” and at MidwayUSA.com, more than 100 parts for AR-15 guns were out of stock and on back order.

On AR15.com, a gun-enthusiast Web site, a user posted that a barrel for a gun disappeared from an online shopping cart overnight, and is now on back order. Another user, named warplg8654, responded, “Dealers can’t keep anything in stock for what I think are obvious reasons given the current political climate.”

When a user called JazzFan asked whether paying a $100 premium for a Stag Model 3 was a good deal, another user said that seemed “reasonable with all of the panic buying.”

Gavin Gear, the founder of the enthusiast site Northwest Gun, said gun owners were feeling “apprehension.”

“People are trying to think ahead, and if they want to own a particular firearm and they think it’s going to be outlawed or restricted, they’re more likely to buy now,” he said.

Read More..

The Daughter of a Sick Woman Falls Prey to a Craigslist Scam

Sitting side by side on their living room sofa, Patricia Morales and her daughter, Katherine, could be any mother-daughter duo. Both have dark hair, dark eyes and welcoming, infectious smiles.

Librado Romero/The New York Times

Patricia Morales, 62, at home in the Bronx. Her treatment for ailments like rheumatoid arthritis and hepatitis C led to depression.

2012-13 Campaign

Previously recorded:

$3,375,394

Recorded Wednesday:

182,251

*Total:

$3,557,645

Last year to date:

$3,320,812

*Includes $709,856 contributed to the Hurricane Sandy relief efforts.

For the past 100 years, The New York Times Neediest Cases Fund has provided direct assistance to children, families and the elderly in New York. To celebrate the 101st campaign, an article will appear daily through Jan. 25. Each profile will illustrate the difference that even a modest amount of money can make in easing the struggles of the poor.

Last year donors contributed $7,003,854, which was distributed to those in need through seven New York charities.

The Youngest Donors

If your child or family is using creative techniques to raise money for this year’s campaign, we want to hear from you. Drop us a line on Facebook or talk to us on Twitter.

But the ties that bind them go beyond their genes, beyond the bodies they were born with.

“It’s called a neck ring. It’s a silver curved barbell, one inch,” Katherine, 20, said as she swept aside her shoulder-length black hair to show the piercing in the back of her neck, a show of solidarity with her mother. She had it done when she was 16. “I wanted to know what it felt like for my mom.”

Her mother then turned around and outlined with her finger two lengthy scars that run down her back.

“I’ve had a lot of physical problems,” Ms. Morales, 62, said. Shaking her head at her daughter’s piercing, she added, “I’ve had rods put in my upper and lower spine, but I could never do that.”

The rods were surgically planted to treat herniated discs, the result of having a cruel combination of osteoporosis, hepatitis C, fibromyalgia and rheumatoid arthritis. Ms. Morales contracted hepatitis C from a blood transfusion she received in 1972 after the birth of her only son, she said.

“I didn’t even know about it until 10 years ago,” she said. “My liver blood count was a little high.”

Since the diagnosis, Ms. Morales, a former schoolteacher, has ridden the arduous highs and lows common to patients with hepatitis C. Her treatments for the disease, which debilitates the liver over time, have included pills and injections that can cause depression. Ms. Morales, a single parent, found an unforgiving salve in alcohol.

“I was depressed; I was totally drunk,” she said. “I didn’t want to live anymore.”

Then, about a year ago, she reached a turning point when visiting her hepatitis C specialist.

“I was 210 pounds,” she said. “The doctor said: ‘You have to stop drinking. You have to lose weight.’ ”

To help combat the depression, her doctor referred her to Jewish Association Serving the Aging, a beneficiary agency of UJA-Federation of New York, one of the organizations supported by The New York Times Neediest Cases Fund. She began weekly counseling sessions with a social worker and started taking an antidepressant medication. The federation drew about $600 from the fund in May so that Ms. Morales could buy a mattress.

“I had a horrible bed,” she said. “I felt like I was sleeping on rocks, and with rods in my back, I was waking up every hour.”

After several months of therapy and starting a diet, Ms. Morales was on her way to losing 60 pounds. Today, she weighs 148.

Light was starting to show itself again when the family took an unexpected financial hit this summer. While taking time off from attending Hostos Community College, Katherine Morales looked for work on Craigslist.

“I saw my mom, and I realized I needed to get a job,” Katherine said shyly. “This guy asked me to be his personal assistant, and he asked me to wire money.”

Offering $400 a week, the man requested help transferring almost $2,000 from what he said was his wife’s account. He transferred the money to Katherine’s account, asking her to wire it to a bank account in Malaysia.

Shortly after she wired the money, the bank froze the account, which Katherine and her mother shared. It was then that Katherine realized she had been the victim of a scam. The money transferred into her account turned out to have been stolen, and she was responsible for repaying it.

Katherine went to detectives immediately with more than 20 pages of evidentiary e-mails, but found that she was unable to file a complaint.

“They told me it wasn’t enough,” she said. “These things happen all the time.”

They lost almost $2,000.

Ms. Morales lives on a fixed income. She receives just over $700 a month from Social Security and $200 month in food stamps. The rent for the apartment she shares with her daughter in the Throgs Neck neighborhood of the Bronx is $230, and Ms. Morales has a monthly combined phone and cable bill of $140. Ms. Morales has a son, but he is unable to help the family.

Falling behind on her bills, Ms. Morales turned once again to JASA for help paying a combined phone and cable bill of nearly $200, a grant the agency drew from the Neediest Cases Fund.

“It was terrible, because my intention was to help my mom,” said Katherine, who has since found a part-time job at a vitamin shop.

Ms. Morales has been feeling much better, but she is nervous about an appointment with her hepatitis C specialist in January.

“I’m taking things one day at a time, but I’m looking forward to someone taking care of me,” she said. “I want to live a little bit longer, but not that long.”

“Why are you putting a time limit on it?” Katherine said, jokingly. “Seventy’s the new 20!” she added, nudging her mother in the side. “Remember, the doctor said you wouldn’t live past your late 50s, but you did.”

Read More..

The Daughter of a Sick Woman Falls Prey to a Craigslist Scam

Sitting side by side on their living room sofa, Patricia Morales and her daughter, Katherine, could be any mother-daughter duo. Both have dark hair, dark eyes and welcoming, infectious smiles.

Librado Romero/The New York Times

Patricia Morales, 62, at home in the Bronx. Her treatment for ailments like rheumatoid arthritis and hepatitis C led to depression.

2012-13 Campaign

Previously recorded:

$3,375,394

Recorded Wednesday:

182,251

*Total:

$3,557,645

Last year to date:

$3,320,812

*Includes $709,856 contributed to the Hurricane Sandy relief efforts.

For the past 100 years, The New York Times Neediest Cases Fund has provided direct assistance to children, families and the elderly in New York. To celebrate the 101st campaign, an article will appear daily through Jan. 25. Each profile will illustrate the difference that even a modest amount of money can make in easing the struggles of the poor.

Last year donors contributed $7,003,854, which was distributed to those in need through seven New York charities.

The Youngest Donors

If your child or family is using creative techniques to raise money for this year’s campaign, we want to hear from you. Drop us a line on Facebook or talk to us on Twitter.

But the ties that bind them go beyond their genes, beyond the bodies they were born with.

“It’s called a neck ring. It’s a silver curved barbell, one inch,” Katherine, 20, said as she swept aside her shoulder-length black hair to show the piercing in the back of her neck, a show of solidarity with her mother. She had it done when she was 16. “I wanted to know what it felt like for my mom.”

Her mother then turned around and outlined with her finger two lengthy scars that run down her back.

“I’ve had a lot of physical problems,” Ms. Morales, 62, said. Shaking her head at her daughter’s piercing, she added, “I’ve had rods put in my upper and lower spine, but I could never do that.”

The rods were surgically planted to treat herniated discs, the result of having a cruel combination of osteoporosis, hepatitis C, fibromyalgia and rheumatoid arthritis. Ms. Morales contracted hepatitis C from a blood transfusion she received in 1972 after the birth of her only son, she said.

“I didn’t even know about it until 10 years ago,” she said. “My liver blood count was a little high.”

Since the diagnosis, Ms. Morales, a former schoolteacher, has ridden the arduous highs and lows common to patients with hepatitis C. Her treatments for the disease, which debilitates the liver over time, have included pills and injections that can cause depression. Ms. Morales, a single parent, found an unforgiving salve in alcohol.

“I was depressed; I was totally drunk,” she said. “I didn’t want to live anymore.”

Then, about a year ago, she reached a turning point when visiting her hepatitis C specialist.

“I was 210 pounds,” she said. “The doctor said: ‘You have to stop drinking. You have to lose weight.’ ”

To help combat the depression, her doctor referred her to Jewish Association Serving the Aging, a beneficiary agency of UJA-Federation of New York, one of the organizations supported by The New York Times Neediest Cases Fund. She began weekly counseling sessions with a social worker and started taking an antidepressant medication. The federation drew about $600 from the fund in May so that Ms. Morales could buy a mattress.

“I had a horrible bed,” she said. “I felt like I was sleeping on rocks, and with rods in my back, I was waking up every hour.”

After several months of therapy and starting a diet, Ms. Morales was on her way to losing 60 pounds. Today, she weighs 148.

Light was starting to show itself again when the family took an unexpected financial hit this summer. While taking time off from attending Hostos Community College, Katherine Morales looked for work on Craigslist.

“I saw my mom, and I realized I needed to get a job,” Katherine said shyly. “This guy asked me to be his personal assistant, and he asked me to wire money.”

Offering $400 a week, the man requested help transferring almost $2,000 from what he said was his wife’s account. He transferred the money to Katherine’s account, asking her to wire it to a bank account in Malaysia.

Shortly after she wired the money, the bank froze the account, which Katherine and her mother shared. It was then that Katherine realized she had been the victim of a scam. The money transferred into her account turned out to have been stolen, and she was responsible for repaying it.

Katherine went to detectives immediately with more than 20 pages of evidentiary e-mails, but found that she was unable to file a complaint.

“They told me it wasn’t enough,” she said. “These things happen all the time.”

They lost almost $2,000.

Ms. Morales lives on a fixed income. She receives just over $700 a month from Social Security and $200 month in food stamps. The rent for the apartment she shares with her daughter in the Throgs Neck neighborhood of the Bronx is $230, and Ms. Morales has a monthly combined phone and cable bill of $140. Ms. Morales has a son, but he is unable to help the family.

Falling behind on her bills, Ms. Morales turned once again to JASA for help paying a combined phone and cable bill of nearly $200, a grant the agency drew from the Neediest Cases Fund.

“It was terrible, because my intention was to help my mom,” said Katherine, who has since found a part-time job at a vitamin shop.

Ms. Morales has been feeling much better, but she is nervous about an appointment with her hepatitis C specialist in January.

“I’m taking things one day at a time, but I’m looking forward to someone taking care of me,” she said. “I want to live a little bit longer, but not that long.”

“Why are you putting a time limit on it?” Katherine said, jokingly. “Seventy’s the new 20!” she added, nudging her mother in the side. “Remember, the doctor said you wouldn’t live past your late 50s, but you did.”

Read More..

Instagram Reversal Doesn’t Appease Everyone

Peter DaSilva for The New York Times

Kevin Systrom, right, co-founder of Instagram, with employees in the company office in San Francisco last year.

SAN FRANCISCO — Facebook may have quelled a full-scale rebellion by quickly dumping the contentious new terms of use for Instagram, its photo-sharing service. But even as the social network furiously backpedaled, some users said Friday they were carrying through on plans to leave.

Eric Piermont/Agence France-Presse — Getty Images

Kevin Systrom, Instagram’s co-founder, said the company would complete its plans, then explain its ad policy.

Ryan Cox, a 29-year-old management consultant at ExactTarget, an Indianapolis-based interactive marketing software company, said he had already moved his photos to Flickr, Yahoo’s photo-sharing app, where he could have better control.

Mr. Cox said the uproar this week over whether Instagram owned its users’ photos was “a wake-up call.”

“It’s my fault,” he continued. “I’m smart enough to know what Instagram had and what they could do — especially the minute Facebook acquired them — but I was a victim of naïve optimism.”

“Naïve optimism” is as good a term as any for the emotion that people feel as they put their private lives onto social networks.

Companies like Google, Twitter, Yelp and Facebook offer themselves as free services for users to store and share their most intimate pictures, secrets, messages and memories. But to flourish over the long term, they need to seek new ways to market the personal data they accumulate. They must constantly push the envelope, hoping users either do not notice or do not care.

So they sell ads against the content of an e-mail, as Google does, or transform a user’s likes into commercial endorsements, as Facebook does, or sell photographs of your adorable 3-year-old, which is what Instagram was accused of planning this week.

“The reality is that companies have always had to make money,” said Miriam H. Wugmeister, chair of Morrison Foerster’s privacy and data security group.

Even as Instagram was pulling back on its changed terms of service on Thursday night, it made clear it was only regrouping. After all, Facebook, as a publicly held corporation, must answer to Wall Street’s quarterly expectations.

“We are going to take the time to complete our plans, and then come back to our users and explain how we would like for our advertising business to work,” Kevin Systrom, Instagram’s youthful co-founder, wrote on the company’s blog.

Instagram’s actions angered many users who were already incensed over the company’s decision earlier this month to cut off its integration with Twitter, a Facebook rival, making it harder for its users to share their Instagram photos on Twitter.

Users were apprehensive that the new terms of service meant that data on their favorite things would be shared with Facebook and its advertisers. Users also worried that their photos would become advertising.

Instagram is barely two years old but has 100 million users. Last spring, Facebook announced plans to buy it in a deal that was initially valued at $1 billion. The deal was closed in September for a somewhat smaller amount.

For some users, Mr. Systrom’s apology and declaration that “Instagram has no intention of selling your photos, and we never did” was sufficient.

National Geographic, which suspended its account in the middle of the uproar, held a conference call with members of Facebook’s legal and policy teams. Afterward, the magazine, which has 658,000 Instagram followers, said it would resurrect its account.

Also mollified was Noah Kalina, who took wedding photographs earlier this year for Mark Zuckerberg, the founder of Facebook. In a widely circulated post on Twitter, Mr. Kalina said the new terms of service were “a contract no professional or nonprofessional should ever sign.” His advice: “Walk away.”

On Friday, the photographer said he had walked back. “It’s nice to know they listened.”

Kim Kardashian, the most followed person on Instagram, said on Tuesday that she “really loved” the service — note the past tense — and that the new rules were not “fair.” She had yet to update her 17 million Twitter followers on Friday, but since she is pushing her True Reflection fragrance it is a safe bet that she has forgiven and forgotten.

Read More..

Philippines Passes Law on Enforced Disappearances

MANILA, Philippines (AP) — Philippine President Benigno Aquino III has signed a law imposing up to life imprisonment for state agents convicted of being involved in enforced disappearances, the first major human rights legislation under his nearly 3-year-old government.

Presidential spokesman Edwin Lacierda says Aquino signed the law late Friday, two months after it was passed by Congress.

The human rights group Karapatan says more than 1,000 political activists and suspected supporters have disappeared since the 1972-1986 Ferdinand Marcos dictatorship, including more than 200 under Aquino's predecessor, Gloria Macapagal Arroyo. It has documented 12 cases of enforced disappearance under Aquino.

U.S.-based Human Rights Watch says the new law is the first to criminalize enforced disappearances in Asia and challenged Aquino to "move quickly to enforce" it.

Read More..

Boehner Tax Plan in House Is Pulled, Lacking Votes

Brendan Hoffman for The New York Times

Speaker John A. Boehner of Ohio leaving a meeting Thursday with fellow House Republicans on talks over the “fiscal cliff.”

WASHINGTON — Speaker John A. Boehner’s effort to pass fallback legislation to avert a fiscal crisis in less than two weeks collapsed Thursday night in an embarrassing defeat after conservative Republicans refused to support legislation that would allow taxes to rise on the most affluent households in the country.

House Republican leaders abruptly canceled a vote on the bill after they failed to rally enough votes for passage in an emergency meeting about 8 p.m. Within minutes, dejected Republicans filed out of the basement meeting room and declared there would be no votes to avert the “fiscal cliff” until after Christmas. With his “Plan B” all but dead, the speaker was left with the choice to find a new Republican way forward or to try to get a broad deficit reduction deal with President Obama that could win passage with Republican and Democratic votes.

What he could not do was blame Democrats for failing to take up legislation he could not even get through his own membership in the House.

“The House did not take up the tax measure today because it did not have sufficient support from our members to pass,” Mr. Boehner said in a statement that said responsibility for a solution now fell to the White House and Senator Harry Reid, Democrat of Nevada, the majority leader. “Now it is up to the president to work with Senator Reid on legislation to avert the fiscal cliff.”

The stunning turn of events in the House left the status of negotiations to head off a combination of automatic tax increases and significant federal spending cuts in disarray with little time before the start of the new year.

At the White House, the press secretary, Jay Carney, said the defeat should press Mr. Boehner back into talks with Mr. Obama.

“The president will work with Congress to get this done, and we are hopeful that we will be able to find a bipartisan solution quickly that protects the middle class and our economy,” he said.

The refusal of a band of House Republicans to allow income tax rates to rise on incomes over $1 million came after Mr. Obama scored a decisive re-election victory campaigning for higher taxes on incomes over $250,000. Since the November election, the president’s approval ratings have risen, and opinion polls have shown a strong majority not only favoring his tax position, but saying they will blame Republicans for a failure to reach a deficit deal.

With a series of votes on Thursday, the speaker, who faces election for his post in the new Congress next month, had hoped to assemble a Republican path away from the cliff. With a show of Republican unity, he also sought to strengthen his own hand in negotiations with Mr. Obama. The House did narrowly pass legislation to cancel automatic, across-the-board military cuts set to begin next month, and shift them to domestic programs.

But the main component of “Plan B,” a bill to extend expiring Bush-era tax cuts for everyone with incomes under $1 million, could not win enough Republican support to overcome united Democratic opposition. Democrats questioned Mr. Boehner’s ability to deliver any agreement.

“I think this demonstrates that Speaker Boehner has a real challenge,” said Representative Steny H. Hoyer of Maryland, the No. 2 House Democrat. “He hasn’t been able to cut any deal, make any agreement that’s balanced. Even if it’s his own compromise.”

Representative Rick Larsen of Washington accused Republicans of shirking their responsibility by leaving the capital. “The Republicans just picked up their toys and went home,” he said.

Futures contracts on indexes of United States stock listings and shares in Asia fell sharply after Mr. Boehner conceded that his bill lacked the votes to pass.

The point of the Boehner effort was to secure passage of a Republican plan, then demand that the president and the Senate to take up that measure and pass it, putting off the major fights until early next year when Republicans would conceivably have more leverage because of the need to increase the federal debt limit. It would also allow Republicans to claim it was Democrats who had caused taxes to rise after the first of the year had no agreement been reached.

That strategy lay in tatters after the Republican implosion.“Some people don’t know how to take yea for an answer,” said Representative Charlie Dent of Pennsylvania, a Republican who supported the measure and was open about his disappointment with his colleagues.

Opponents said they were not about to bend their uncompromising principles on taxes just because Mr. Boehner asked.

“The speaker should be meeting with us to get our views on things rather than just presenting his,” said Representative Justin Amash of Michigan, who recently lost a committee post for routinely crossing the leadership.

Jeremy W. Peters contributed reporting.

Read More..

About New York: One Boy’s Death Moves State to Action to Prevent Others

Prompted by the death of a 12-year-old Queens boy in April, New York health officials are poised to make their state the first in the nation to require that hospitals aggressively look for sepsis in patients so treatment can begin sooner. Under the regulations, which are now being drafted, the hospitals will also have to publicly report the results of their efforts.

The action by New York has elated sepsis researchers and experts, including members of a national panel who this month formally recommended that the federal government adopt standards similar to what the state is planning.

Though little known, sepsis, an abnormal and self-destructive immune response to infection or illness, is a leading cause of death in hospitals. It often progresses to severely low blood pressure, shock and organ failure.

Over the last decade, a global consortium of doctors, researchers, hospitals and advocates has developed guidelines on early identification and treatment of sepsis that it says have led to significant drops in mortality rates. But first hints of the problem, like a high pulse rate and fever, often are hard for clinicians to tell apart from routine miseries that go along with the flu or cold.

“First and foremost, they need to suspect sepsis,” Dr. Mitchell M. Levy, a professor at Brown University School of Medicine and a lead author of a paper on the latest sepsis treatment guidelines to be published simultaneously next month in the United States in a journal, Critical Care Medicine, and in Europe in Intensive Care Medicine.

“It’s the most common killer in intensive care units,” Dr. Levy said. “It kills more people than breast cancer, lung cancer and stroke combined.”

If started early enough, the treatment, which includes antibiotics and fluids, can help people escape from the drastic vortex of sepsis, according to findings by researchers working with the Surviving Sepsis Campaign, the global consortium. The tactics led to a reduction of “relative risk mortality by 40 percent,” Dr. Levy said.

Although studies of 30,000 patients show that the guidelines save lives, “the problem is that many hospitals are not adhering to them,” said Dr. Clifford S. Deutschman, director of the sepsis research program at the Perelman School of Medicine at the University of Pennsylvania and the president of the Society of Critical Care Medicine.

About 300 hospitals participate in the study, and the consortium has a goal of having 10,000. “The case is irrefutable: if you take these sepsis measures, and you build a program to help clinicians and hospitals suspect sepsis and identify it early, that will mean more people will survive,” Dr. Levy said.

At a symposium in October, the New York health commissioner, Dr. Nirav R. Shah, said that he would require state hospitals to adopt best practices for early identification and treatment of sepsis. Gov. Andrew M. Cuomo intends to make it a major initiative in 2013, said Josh Vlasto, a spokesman for the governor. “The state is taking unprecedented measures to prevent and effectively treat sepsis in health care facilities across the state and is looking at a wide range of additional measures to better protect patients,” Mr. Vlasto said.

In April, Rory Staunton, a sixth grader from Queens, died of severe septic shock after he became infected, apparently through a cut he suffered while playing basketball. The severity of his illness was not recognized when he was treated in the emergency room at NYU Langone Medical Center. He was sent home with a diagnosis of an ordinary bellyache. Hours later, alarming laboratory results became available that suggested he was critically ill, but neither he nor his family was contacted. For an About New York column in The New York Times, Rory’s parents, Ciaran and Orlaith Staunton, publicly discussed their son’s final days. Their revelations prompted doctors and hospitals across the country to seek new approaches to heading off medical errors.

In addition, Commissioner Shah in New York convened a symposium on sepsis, which included presentations from medical experts and Rory’s parents.

At the end of the meeting, Dr. Shah said that he had listened to all the statistics on the prevalence of the illness, and that one had stuck in his memory: “Twenty-five percent,” he said — the portion of the Staunton family lost to sepsis.

He said he would issue new regulations requiring hospitals to use best practices in identifying and treating sepsis, actions that, he said, he was taking “in honor of Rory Staunton.”

The governor’s spokesman, Mr. Vlasto, said that “the Staunton family’s advocacy has been essential to creating a strong public will for action.”

Dr. Levy said New York’s actions were “bold, pioneering and grounded in good scientific evidence,” adding, “The commissioner has taken the first step even before the federal government.”

Dr. Deutschman said that initiatives like those in New York were needed to overcome resistance among doctors. “You’re talking about a profession that has always prided itself on its autonomy,” he said. “They don’t like to be told that they’re wrong about something.”

The availability of proven therapies should move treatment of sepsis into a new era, experts say, comparing it to how heart attacks were handled not long ago. People arriving in emergency rooms with chest pains were basically put to bed because not much could be done for them, said Dr. Kevin J. Tracey, the president of the Feinstein Institute for Medical Research at North Shore-Long Island Jewish Health System. Dr. Tracey, a neurosurgeon, has made major discoveries about the relationship between the nervous system and the runaway immune responses of sepsis.

If physicians and nurses were trained to watch for sepsis, as they now routinely do for heart attacks, many of its most dire problems could be headed off before they got out of control, he said. The Stauntons have awakened doctors and nurses to the possibility of danger camouflaged as a stomach bug.

“We are with sepsis where we were with heart attack in the early 1980s,” Dr. Tracey said.

“If you don’t think of it as a possibility, this story can happen again and again. This case could change the world.”

E-mail: dwyer@nytimes.com

Twitter: @jimdwyernyt

Read More..

About New York: One Boy’s Death Moves State to Action to Prevent Others

Prompted by the death of a 12-year-old Queens boy in April, New York health officials are poised to make their state the first in the nation to require that hospitals aggressively look for sepsis in patients so treatment can begin sooner. Under the regulations, which are now being drafted, the hospitals will also have to publicly report the results of their efforts.

The action by New York has elated sepsis researchers and experts, including members of a national panel who this month formally recommended that the federal government adopt standards similar to what the state is planning.

Though little known, sepsis, an abnormal and self-destructive immune response to infection or illness, is a leading cause of death in hospitals. It often progresses to severely low blood pressure, shock and organ failure.

Over the last decade, a global consortium of doctors, researchers, hospitals and advocates has developed guidelines on early identification and treatment of sepsis that it says have led to significant drops in mortality rates. But first hints of the problem, like a high pulse rate and fever, often are hard for clinicians to tell apart from routine miseries that go along with the flu or cold.

“First and foremost, they need to suspect sepsis,” Dr. Mitchell M. Levy, a professor at Brown University School of Medicine and a lead author of a paper on the latest sepsis treatment guidelines to be published simultaneously next month in the United States in a journal, Critical Care Medicine, and in Europe in Intensive Care Medicine.

“It’s the most common killer in intensive care units,” Dr. Levy said. “It kills more people than breast cancer, lung cancer and stroke combined.”

If started early enough, the treatment, which includes antibiotics and fluids, can help people escape from the drastic vortex of sepsis, according to findings by researchers working with the Surviving Sepsis Campaign, the global consortium. The tactics led to a reduction of “relative risk mortality by 40 percent,” Dr. Levy said.

Although studies of 30,000 patients show that the guidelines save lives, “the problem is that many hospitals are not adhering to them,” said Dr. Clifford S. Deutschman, director of the sepsis research program at the Perelman School of Medicine at the University of Pennsylvania and the president of the Society of Critical Care Medicine.

About 300 hospitals participate in the study, and the consortium has a goal of having 10,000. “The case is irrefutable: if you take these sepsis measures, and you build a program to help clinicians and hospitals suspect sepsis and identify it early, that will mean more people will survive,” Dr. Levy said.

At a symposium in October, the New York health commissioner, Dr. Nirav R. Shah, said that he would require state hospitals to adopt best practices for early identification and treatment of sepsis. Gov. Andrew M. Cuomo intends to make it a major initiative in 2013, said Josh Vlasto, a spokesman for the governor. “The state is taking unprecedented measures to prevent and effectively treat sepsis in health care facilities across the state and is looking at a wide range of additional measures to better protect patients,” Mr. Vlasto said.

In April, Rory Staunton, a sixth grader from Queens, died of severe septic shock after he became infected, apparently through a cut he suffered while playing basketball. The severity of his illness was not recognized when he was treated in the emergency room at NYU Langone Medical Center. He was sent home with a diagnosis of an ordinary bellyache. Hours later, alarming laboratory results became available that suggested he was critically ill, but neither he nor his family was contacted. For an About New York column in The New York Times, Rory’s parents, Ciaran and Orlaith Staunton, publicly discussed their son’s final days. Their revelations prompted doctors and hospitals across the country to seek new approaches to heading off medical errors.

In addition, Commissioner Shah in New York convened a symposium on sepsis, which included presentations from medical experts and Rory’s parents.

At the end of the meeting, Dr. Shah said that he had listened to all the statistics on the prevalence of the illness, and that one had stuck in his memory: “Twenty-five percent,” he said — the portion of the Staunton family lost to sepsis.

He said he would issue new regulations requiring hospitals to use best practices in identifying and treating sepsis, actions that, he said, he was taking “in honor of Rory Staunton.”

The governor’s spokesman, Mr. Vlasto, said that “the Staunton family’s advocacy has been essential to creating a strong public will for action.”

Dr. Levy said New York’s actions were “bold, pioneering and grounded in good scientific evidence,” adding, “The commissioner has taken the first step even before the federal government.”

Dr. Deutschman said that initiatives like those in New York were needed to overcome resistance among doctors. “You’re talking about a profession that has always prided itself on its autonomy,” he said. “They don’t like to be told that they’re wrong about something.”

The availability of proven therapies should move treatment of sepsis into a new era, experts say, comparing it to how heart attacks were handled not long ago. People arriving in emergency rooms with chest pains were basically put to bed because not much could be done for them, said Dr. Kevin J. Tracey, the president of the Feinstein Institute for Medical Research at North Shore-Long Island Jewish Health System. Dr. Tracey, a neurosurgeon, has made major discoveries about the relationship between the nervous system and the runaway immune responses of sepsis.

If physicians and nurses were trained to watch for sepsis, as they now routinely do for heart attacks, many of its most dire problems could be headed off before they got out of control, he said. The Stauntons have awakened doctors and nurses to the possibility of danger camouflaged as a stomach bug.

“We are with sepsis where we were with heart attack in the early 1980s,” Dr. Tracey said.

“If you don’t think of it as a possibility, this story can happen again and again. This case could change the world.”

E-mail: dwyer@nytimes.com

Twitter: @jimdwyernyt

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Bits Blog: Instagram Does an About-Face

11:14 p.m. | Updated
SAN FRANCISCO — In the aftermath of the uproar over changes to Instagram’s privacy policy and terms of service earlier this week, the company did an about-face late Thursday.

In a blog post on the company’s site, Kevin Systrom, Instagram’s co-founder, said that where advertising was concerned, the company would revert to its previous terms of service, which have been in effect since October 2010.

“Rather than obtain permission from you to introduce possible advertising products we have not yet developed,” he wrote, “we are going to take the time to complete our plans, and then come back to our users and explain how we would like for our advertising business to work.” Users had been particularly concerned by a clause in Instagram’s policy introduced on Monday that suggested Instagram would share users’ data — like their favorite places, bands, restaurants and hobbies — with Facebook and its advertisers to better target ads.

They also took issue with an update to the company’s terms of service that suggested users’ photos could be used in advertisements, without compensation and even without their knowledge.

The terms of that user agreement said, “You agree that a business or other entity may pay us to display your user name, likeness, photos (along with any associated metadata) and/or actions you take, in connection with paid or sponsored content or promotions, without any compensation to you.”

Following a reaction that included customers defecting to other services, Mr. Systrom told Instagram users on Tuesday that the new policy had been misinterpreted. “It is our mistake that this language is confusing,” he wrote, and he promised an updated agreement.

That statement apparently was not enough. With more people leaving the service, the company, which Facebook bought for $735 million this year, reacted again by returning to the old rules.

Acknowledging those concerns late Thursday, Mr. Systrom wrote: “I want to be really clear: Instagram has no intention of selling your photos, and we never did. We don’t own your photos — you do.”

Mr. Systrom said the company would still be tweaking its privacy policy to quell users’ fears that their photos might pop-up on third-party sites without their consent.

But Mr. Systrom did not clarify how Instagram planned to monetize its service in the future. Facebook is under pressure to make Instagram earn income.

“It’s a free service — they have to monetize somewhere,” said John Casasanta, a principal at Tap Tap Tap, the maker of Camera+, a photo-filter app that has shunned advertising and instead charges users for premium features. “The days of the simple banner ads are gone. Their user data is too valuable.”

It was unclear whether reverting its terms of service would be enough to satisfy high-profile users like National Geographic, which stopped using its Instagram account in light of the moves, or other users who have aired their grievances on Twitter and Facebook.

The controversy has driven traffic and new users to several other photo-sharing applications.

Pheed, an Instagram-like app that gives users the option to monetize their own content by charging followers to see their posts, gained more users than any other app in the United States on Thursday. By Thursday morning, Pheed had jumped to the ninth most downloaded social-networking app in Apple’s iTunes store, just ahead of LinkedIn.

O. D. Kobo, Pheed’s chief executive, said Thursday morning that subscriptions to the service had quadrupled this week and that in the last 24 hours users had uploaded 300,000 new files to the service — more uploads than any other 24-hour-period since Pheed made its debut six weeks ago.

Another runaway success was Flickr, Yahoo’s photo-sharing service, which redesigned its app last week to make it easier to share photos on Twitter. In a stroke of good fortune, it released the app to positive reviews just as Instagram announced it would no longer sync with Twitter, a Facebook rival.

The day before Instagram announced changes to its terms of service, Flickr’s mobile app was ranked at around 175 in Apple’s overall iTunes app charts. Since that day, the application skyrocketed to the high 20s.

Of course, most of these services are still tiny compared to Instagram, which claims to have more than 100 million members who have uploaded upward of 5 billion photos using its service. And it was unclear if the services’ newfound members had also deleted their Instagram accounts or were merely dabbling in other offerings. But the migration, whether temporary or permanent, was a reminder of the volatility of success and that the fall to bottom can sometimes be as swift as the rise to the top.

Facebook and Instagram declined to say whether they had seen any significant number of account deletions or if they were concerned about losing ground in the photo-sharing market to rivals. Some photo apps took direct aim at Instagram. Camera+ even went so far as to include a snide, holiday-themed reference to Instagram’s stumbles in an app update on Wednesday.

“We’ll never do shady things with your shared pics, because it just isn’t right,” the update noted. “On that note, happy Christmas to all, and to all a good night!”

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Narendra Modi, Polarizing Indian Politician, Gains Power

Reuters

Supporters of the Bharatiya Janata Party waved party flags and lighted firecrackers on Thursday as they celebrated outside a vote-counting center. More Photos »

NEW DELHI — The polarizing leader of the western state of Gujarat, Narendra Modi, inched closer on Thursday to becoming the leading political challenger to India’s dominant Gandhi family by winning a resounding re-election as chief minister.

“My biggest dream is to serve my masses, my people,” Mr. Modi said in a speech before a cheering throng that eventually began to shout “Delhi, Delhi, Delhi,” and then amended that to “P.M., P.M., P.M.,” signaling a hope that he wins the post of prime minister in national elections scheduled for 2014.

Mr. Modi had campaigned in the Gujarati language, but he gave his widely televised victory speech in Hindi — a clear sign that his intended audience extended well beyond his 60 million constituents. His message in the speech, as it has been throughout his campaign, was that he has brought wealth to Gujarat, which lies on the coast of the Arabian Sea, by encouraging economic development. His party won 115 seats in the state legislature. Although a decline of two seats, it is nonetheless a comfortable majority in a house of 182 seats.

Mr. Modi is a prominent politician in the Bharatiya Janata Party, which for years tried to win elections by uniting the country’s Hindu majority — in part by demonizing its Muslim minority. Indeed, shortly after Mr. Modi came to power a decade ago, riots convulsed Gujarat and cost the lives of about 1,000 people, mostly Muslims. Mr. Modi has been accused of not doing enough to stop the riots and of possibly of encouraging them, making him one of the most divisive figures in Indian politics.

He has since sought to broaden his national appeal by softening his overt Hindu nationalism and instead claiming the mantle of good governance and economic growth. In a country where new corruption scandals seem to emerge every month and economic growth has slowed, that message may have broad resonance.

But whether minorities and moderate Hindus in the rest of India will forgive or forget the government failures during the 2002 riots is very much of an open question.

Indeed, some leading members of the Bharatiya Janata Party have resisted Mr. Modi’s rising prominence because they fear that he will cost the party votes among religious minorities.

Nitish Kumar, the powerful chief minister of Bihar in the northeast, has promised to withdraw his support for the Bharatiya Janata Party if it selects Mr. Modi as its prime ministerial candidate for 2014. That would reduce the party’s chances of gaining a majority in the national Parliament, but whether Mr. Kumar would follow through on his threat is uncertain.

Mr. Modi’s role in the 2002 riots has long been a concern for governments in the West. The United States refuses to provide Mr. Modi with a visa.

But as he grows into a national political figure, more Western countries may rethink their refusal to talk with him in an official capacity. In October, Britain ended a 10-year diplomatic boycott of Mr. Modi when its high commissioner met with him for 50 minutes.

India’s religious, caste and regional differences have increasingly splintered the country’s politics. Since Hindus represent 80 percent of the electorate, they could dominate national politics if they managed to overcome the caste differences that divide them. But caste has long been the dominant nexus of Indian politics. The Bharatiya Janata Party has led the national government for only one period, from 1998 to 2004.

Leaders of the party said that Mr. Modi had solidified his place as one of India’s most important politicians, although top party officials refused to speculate on whether he would be its candidate for prime minister in 2014.

“This shows the people’s confidence and trust in the B.J.P. and Narendra Modi’s leadership,” said Dhansukh Bhanderi, a top party official.

Mr. Modi’s opponents played down the importance of his victory. Palaniappan Chidambaram, India’s finance minister and a leader of the governing Indian National Congress Party, said in a televised interview that he thought it had done well on Thursday because Mr. Modi had not managed to expand his political dominance in Gujarat.

In a related political development, it was announced Thursday that the Congress Party had defeated the Bharatiya Janata Party in state assembly elections in Himachal Pradesh, a hilly state in the Himalayas. The victory was an important balm to the Congress Party, which has been buffeted in recent years by corruption allegations and the rise of regional parties.

The election in Himachal Pradesh was between two political leaders who have traded control over the state between them for decades. Virbhadra Singh, 78, of the Congress Party, is now expected to become the state’s chief minister, a post he has already held four times. Prem Kumar Dhumal, 68, will resign after having served two nonconsecutive terms as chief minister.

Hari Kumar contributed reporting from New Delhi, and Haresh Pandya from Rajkot, India.

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