6 ways to tweet yourself out of a job

Hate your job? Want to leave without giving two weeks notice? Thanks to Twitter, it’s never been easier to get fired, says Rob Lammie at Mental Floss

Step 1: Drunk tweet
As any Spring Break partier knows, drinking impairs your judgment. It seems to have also impaired the judgment of Major League pitcher-turned-sports-radio-host Mike Bacsik, who put on quite a show during a San Antonio Spurs and Dallas Mavericks NBA game in April 2010. While watching the game, Bacsik bragged that he was “About 12 deep and some shots.” He proceeded to unleash a string of insults aimed at NBA commissioner David Stern, accused the refs of fixing the game, and even threatened to blow up the NBA’s offices. But the one that really got people riled up came after the Mavericks lost the game, when Bacsik tweeted: 

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@MikeBacsik: “Congrats to all the dirty mexicans in San Antonio.”

After sobering up, Bacsik deleted the offending tweets and issued an apology. But it was too little, too late. Numerous people complained to his radio station, which first suspended Bacsik and later fired him. After his dismissal, he told ESPN Dallas, “When you tweet like that, it’s not a playful, harmless thing… I’m very sorry and will try my best for my actions to speak louder than my tweets.”

Step 2: Break the law (or just anger your governor)
Twitter has become a great tool for politicians to connect to the voting public. Former Mississippi Governor Haley Barbour, for one, has really embraced the technology as a way to share his opinions and views. For example, in December 2009, he sent out a tweet saying:

 @HaleyBarbour: “Glad the Legislature recognizes our dire fiscal situation. Look forward to hearing their ideas on how to trim expenses.”

Jennifer Carter, one of his Twitter followers who worked for the University of Mississippi Medical Center (UMC), read this message and offered up a suggestion on how Governor Barbour could personally save the taxpayers money:

“Schedule regular medical exams like everyone else instead of paying UMC employees overtime to do it when clinics are usually closed.” 

This “Oh, snap!” moment referred to an incident that had occurred three years earlier, when the governor requested the medical center open on a Saturday, when they were normally closed, and bring in a staff of 15-20 people who were paid overtime to administer his annual check-up. This happened before Carter worked for UMC and she was simply repeating what she had been told by other employees. 

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The governor’s office tracked down Carter and made a formal complaint to UMC, saying Carter had violated the Health Insurance Portability and Accountability Act, a privacy law that states no employee of a medical facility can reveal any information about a person’s “protected health information.” Some argued that Carter didn’t violate HIPAA, since she didn’t actually give out any information about the health of the governor. However, others believe that simply saying the governor had even visited a doctor is a violation. 

Semantics aside, UMC administrators said it was a violation, so they suspended Carter for three days without pay and strongly suggested she resign to avoid further disciplinary action, which she did.

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Step 3: Have an NSFW lifestyle
St. Louis-based blogger “The Beautiful Kind” had been writing online about her polyamorous sex life for years. Knowing that not everyone would agree with her chosen lifestyle, she was always very careful about maintaining her anonymity, especially when it came to the workplace. So when she signed up for Twitter, she wanted to be anonymous there as well. She thought that, thanks to the similarities between the two, it was like signing up for an online message board — you supplied your real name to the website privately, but could choose to be known publicly by your username only. But when she logged in for the first time and saw that, not only did it show her username (@TBK365), but also her real name on her profile, she immediately went back and removed it. 

Thinking she was now safely anonymous, she used Twitter to promote her blog and to discuss sexually explicit topics with her followers. However, when her boss at the non-profit group where she worked was told by upper management to do a Google search of all employees, TBK’s Twitter account information — with her real name still associated — came up on the Twitter tracking site topsy.com.

The next day, TBK was called into her boss’ office and fired on the spot. Afterwards, her former boss sent her a letter saying, “While I know you are a good worker and an intelligent person, I hope you try to understand that our employees are held to a different standard. When it comes to private matters, such as one’s sexual explorations and preferences, our employees must keep their affairs private.” Because Missouri is an at-will employment state, meaning employers can fire someone for just about any reason, TBK was SOL.

Step 4: Question company policy
When California Pizza Kitchen (CPK) traded in their standard white shirts for black ones, employee Tim Chantarangsu wasn’t happy with the change. So he tweeted @calpizzakitchen his opinion:

@traphik: “black button ups are the lamest s**t ever!!!”

He didn’t expect anyone to notice or care, but the next day he received a direct message from corporate asking what restaurant he worked for. He knew better than to respond, but they tracked him down anyway and he was fired. They not only referenced his tweet about the shirts, but also an earlier one where he had said he was getting ready to work at “Calipornia Skeetza Kitchen.” 

Little did they know that Chantarangsu is kind of a big deal on another social website, YouTube. Under the name TimothyDeLaGhetto2, Chantarangsu has hundreds of thousands of subscribers, accounting for over 10,500,000 views of his videos at the time. Of course he made a YouTube video telling his Twitter story and it has been viewed well more than 100,000 times. Shortly after the incident, he asked his followers to bombard CPK’s Twitter account with RTs (re-tweets) of his offending message, which they were more than happy to oblige.

Step 5: Make a celebrity look bad
During his five years on the job, Jon Barrett-Ingels had served a lot of celebrities as a waiter at Barney Greengrass, an upscale restaurant in Beverly Hills. One day, Jane Adams, star of the HBO series Hung, came in and had lunch to the tune of $ 13.44. Unfortunately, when the bill came, Adams realized she had left her wallet in the car. Ingels knew who she was, so he told her she could run out and grab it and come back. The actress left, but didn’t return. Instead, someone from her agency called the next day and paid the bill. However, they didn’t leave a tip. Ingels had recently signed up for Twitter and so, his sixth tweet to his 40 followers said:

@PapaBarrett: Jane Adams, star of HBO series “Hung” skipped out on a $ 13.44 check. Her agent called and payed the following day. NO TIP!!!” 

Over the next few weeks, Ingels started using Twitter to send out a few harmless observations about celebrities that came in to eat — mainly what they ordered or what they looked like that day. Then, out of the blue, Jane Adams came back to the restaurant. According to Ingels’ blog, she was clearly upset and begrudgingly slapped $ 3 on the bar for Ingels as a tip. Surprised, Ingels told the actress she really didn’t have to do that, but her gesture was appreciated. She allegedly replied with, “My friend read about it on Twitter!” before storming off. Adams complained about the tweet to management, so someone from Barney’s corporate started following Ingels on Twitter to see what he was up to. After reading his celebrity tweets, it didn’t take long before they gave him the boot.

Step 6: Don’t get hired in the first place
If you’ve followed steps 1 – 5 and you still have a job, here’s the ultimate way to make sure Twitter will keep you from gainful employment.

When recent college grad Skye Riley heard back from Cisco, the computer networking giant, about her job application, one of her first instincts was to tweet about it. Unfortunately, this is what she tweeted:

@theconnor: Cisco just offered me a job! Now I have to weigh the utility of a fatty paycheck against the daily commute to San Jose and hating the work.

The unfortunate part? An employee of Cisco, Tim Levad, came across her post while doing a Twitter search for Cisco. He replied to her by saying:

@timmylevad: Who is the hiring manager. I’m sure they would love to know that you will hate the work. We here at Cisco are versed in the web.

Riley’s story was the tweet heard round the world. It became a hot topic on tech blogs for weeks afterwards, with writers calling it the “Cisco Fatty” incident. She later claimed that the tweet was taken out of context — that part of her message was referring to a well-paid internship she had turned down — but it appears the damage had already been done. While only she and Cisco know what really happened, according to her online resume, she has never worked for the company.

 — Rob Lammie

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Katherine Heigl Goes Holiday Shopping on Black Friday

Caught in the Act

11/24/2012 at 11:45 AM EST

Someone's going to have a happy holiday!

Katherine Heigl was out and about picking up holiday supplies, including wrapping paper and toys, from Party City in Beverly Hills on Black Friday.

The actress, who turns 34 on Saturday, was shopping with husband Josh Kelley.

It will be a special holiday for the couple, who will celebrate for the first time with daughter Adalaide Marie Hope, who arrived in April. They also have a daughter Naleigh, who turned 4 on Thanksgiving Day.

"Hope you all had a wonderful Thanksgiving!" Heigl Tweeted. "I'm so thankful for my friends, my girls, and my fantastic family, and all of you of course!"

What's on your holiday list? Send us pics of the items you've been dreaming about, and your photos might appear on PEOPLE.com!

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AP PHOTOS: Simple surgery heals blind Indonesians

PADANG SIDEMPUAN, Indonesia (AP) — They came from the remotest parts of Indonesia, taking crowded overnight ferries and riding for hours in cars or buses — all in the hope that a simple, and free, surgical procedure would restore their eyesight.

Many patients were elderly and needed help to reach two hospitals in Sumatra where mass eye camps were held earlier this month by Nepalese surgeon Dr. Sanduk Ruit. During eight days, more than 1,400 cataracts were removed.

The patients camped out, sleeping side-by-side on military cots, eating donated food while fire trucks supplied water for showers and toilets. Many who had given up hope of seeing again left smiling after their bandages were removed.

"I've been blind for three years, and it's really bad," said Arlita Tobing, 65, whose sight was restored after the surgery. "I worked on someone's farm, but I couldn't work anymore."

Indonesia has one of the highest rates of blindness in the world, making it a target country for Ruit who travels throughout the developing world holding free mass eye camps while training doctors to perform the simple, stitch-free procedure he pioneered. He often visits hard-to-reach remote areas where health care is scarce and patients are poor. He believes that by teaching doctors how to perform his method of cataract removal, the rate of blindness can be reduced worldwide.

Cataracts are the leading cause of blindness globally, affecting about 20 million people who mostly live in poor countries, according to the World Health Organization.

"We get only one life, and that life is very short. I am blessed by God to have this opportunity," said Ruit, who runs the Tilganga Eye Center in Katmandu, Nepal. "The most important of that is training, taking the idea to other people."

During the recent camps, Ruit trained six doctors from Indonesia, Thailand and Singapore.

Here, in images, are scenes from the mobile eye camps:

Read More..

AP PHOTOS: Simple surgery heals blind Indonesians

PADANG SIDEMPUAN, Indonesia (AP) — They came from the remotest parts of Indonesia, taking crowded overnight ferries and riding for hours in cars or buses — all in the hope that a simple, and free, surgical procedure would restore their eyesight.

Many patients were elderly and needed help to reach two hospitals in Sumatra where mass eye camps were held earlier this month by Nepalese surgeon Dr. Sanduk Ruit. During eight days, more than 1,400 cataracts were removed.

The patients camped out, sleeping side-by-side on military cots, eating donated food while fire trucks supplied water for showers and toilets. Many who had given up hope of seeing again left smiling after their bandages were removed.

"I've been blind for three years, and it's really bad," said Arlita Tobing, 65, whose sight was restored after the surgery. "I worked on someone's farm, but I couldn't work anymore."

Indonesia has one of the highest rates of blindness in the world, making it a target country for Ruit who travels throughout the developing world holding free mass eye camps while training doctors to perform the simple, stitch-free procedure he pioneered. He often visits hard-to-reach remote areas where health care is scarce and patients are poor. He believes that by teaching doctors how to perform his method of cataract removal, the rate of blindness can be reduced worldwide.

Cataracts are the leading cause of blindness globally, affecting about 20 million people who mostly live in poor countries, according to the World Health Organization.

"We get only one life, and that life is very short. I am blessed by God to have this opportunity," said Ruit, who runs the Tilganga Eye Center in Katmandu, Nepal. "The most important of that is training, taking the idea to other people."

During the recent camps, Ruit trained six doctors from Indonesia, Thailand and Singapore.

Here, in images, are scenes from the mobile eye camps:

Read More..

Global shares gain as global economic outlook improves

LONDON (Reuters) - World share markets extended a week-long rally on Thursday as manufacturing surveys in China and the United States boosted confidence in global growth and euro zone data at least did not worsen the already weak outlook for that region.

The euro hit a three high against the dollar on optimism that a funding deal for debt-crippled Greece will ultimately be agreed - and despite data indicating the region's economy is on course for its deepest recession since early 2009.

"The driving factors behind euro/dollar are that the global macroeconomic backdrop seems to be improving and people are pricing out the tail risk on Greece," said Arne Lohmann Rasmussen, head of currency research at Danske Bank.

The euro rose 0.4 percent to $1.2880, its highest since November 2.

The view there will be a deal to help Athens was bolstered on Wednesday when German Chancellor Angela Merkel said after the failure of the latest talks, that an agreement was possible when euro zone ministers meet again on Monday.

The hopes for a Greek deal, combined with the better economic data and a growing view that a solution can be found to the U.S. fiscal crisis, lifted the MSCI world equity index 0.4 percent to 326 points, putting it on track for its best week since mid-September.

Europe's FTSE Eurofirst 300 index rose 0.4 percent to a two-week high of 1,101.70 points, with London's FTSE 100, Paris's CAC-40 and Frankfurt's DAX between 0.3 and 0.7 percent higher.

However, trading was subdued, with U.S. markets closed for the Thanksgiving holiday.

CHINA BOOST

Confidence in the global economic outlook got its biggest boost from the HSBC flash Manufacturing Purchasing Managers Index (PMI) for China, which pointed to an expansion in activity after seven consecutive quarters of slowdown.

The Chinese data followed a report on Wednesday showing U.S. manufacturing grew in November at its quickest pace in five months, indicating strong economic growth in the fourth quarter.

"There are questions over whether the Chinese economy is really that bad or if the U.S. will take a long time to recover, but we are getting signs that the situation is not as bad as assumed," said Peter Braendle, head of European equities at Zurich-based Swisscanto Asset Management.

PMI data on the manufacturing and services sectors in Europe's two biggest economies, Germany and France, added to the better tone, revealing that conditions had not worsened in November, though both economies are still contracting.

However, the PMI numbers for the wider euro zone remain extremely weak, pointing to the recession-hit region shrinking by about 0.5 percent in the current quarter - its sharpest contraction since the first quarter of 2009.

"The weak PMI outturn for November is a major disappointment in light of the increases in the German and French PMI surveys, and suggest the recession on the euro zone's periphery is gathering further pace," said ING economist Martin van Vliet.

BOND DEMAND

In the fixed-income markets, the improving tone enabled Spain to sell 3.88 billion euros ($4.97 billion) of new government bonds on Thursday, even though it has already raised enough funds for this year's needs.

The average yield on the three-year bonds in the auction was 3.617 percent, compared with 3.66 percent at a sale earlier in November and a 2012 average of 3.79 percent.

Ten-year Spanish yields were 6 basis points lower on the day at 5.67 percent, having traded above 6 percent at the start of the week.

"It's a clear reflection that sentiment in Spain has improved markedly," RIA Capital Markets bond strategist Nick Stamenkovic said, adding that the market was expecting Madrid to ask for an international bailout early next year.

Expectations Greece will soon get more cash set Greek yields on course for their 10th consecutive daily fall. The February 2023 bond yield dropped to 16.16 percent, its lowest since it was issued during a debt restructuring in March.

COMMODITIES STEADY

Commodity prices had some support from the improving outlook for world demand, but the prospect of only modest global growth in 2013 kept the gains in check.

Three-month copper on the London Metal Exchange rose 0.6 percent to $7,735.25 a metric tonne, and spot gold inched up to $1,730.30 an ounce.

Oil prices were more mixed as the ceasefire between Israel and Gaza's Hamas rulers on Thursday eased concerns over the impact the unrest might have had on supply from the region, offsetting support from the prospect of more Chinese oil demand.

Brent slipped 7 cents to $110.90 a barrel, while U.S. crude was up 2 cents at $87.40.

($1 = 0.7801 euros)

(Additional reporting by Jessica Mortimer and Marius Zaharia; Editing by Will Waterman and Alastair Macdonald)

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Israel and Hamas Maintain Cease-Fire, After Push by the U.S. and Egypt

CAIRO — A cease-fire agreed to under intense Egyptian and American pressure between Israel and the Palestinian militant group Hamas to halt eight days of bloody conflict seemed to be holding on Thursday, averting a full-scale Israeli ground invasion of the Gaza Strip without resolving the underlying disputes.

With Israeli forces still massed on the Gaza border, a tentative calm in the fighting descended after the agreement was announced on Wednesday night. Some of the tens of thousands of Israeli reservists called up during the conflagration appeared to be making preparations on Thursday to redeploy away from staging areas along the Gaza border where the Israeli military had mounted a buildup of armor and troops.

The success of the truce will be an early test of how Egypt’s new Islamist government might influence the most intractable conflict in the Middle East.

In southern Israel, the target of more than 1,500 rockets fired from Gaza over the past week, wary residents began to return to routine. But schools within a 25-mile radius of the Palestinian enclave remained closed and thousands of soldiers, mobilized for a possible ground invasion, remained along the Gaza border. The military said that a decision regarding the troop deployment would be made after an assessment of the situation later Thursday.

A rocket alert sounded at the small village of Nativ Haasara near the border with Gaza on Thursday morning, sending residents skeptical from the start about the cease-fire running for shelter. The military said the alert had been a false alarm.

In Gaza, traffic returned to streets that had been deserted, stores and markets opened and workers began the huge task of cleaning up the debris left by days of aerial and naval bombardment. Thousands of Palestinians demonstrated in Gaza in support of the cease-fire as the Hamas leadership emerged from the fighting claiming victory.

Israel Radio said a dozen rockets were fired from Gaza in the first few hours of the cease-fire, but Israeli forces did not respond. In the rival Twitter feeds that offered a cyberspace counterpoint to the exchanges of airstrikes and rockets, the Israel Defense Forces said they had achieved their objectives while the armed Al Qassam Brigades in Gaza said Israeli forces had “raised the white flag.”

After more than a week of nights punctuated by the crash of bombardment and the sound of outgoing missiles, reporters in Gaza said the night had been quiet.

At the same time, Israeli security forces said on Thursday that they detained 55 Palestinian militants in the West Bank after earlier confrontations. The army said the detentions were designed to “continue to maintain order” and to “prevent the infiltration of terrorists into Israeli communities.”

The United States, Israel and Hamas all praised Egypt’s role in brokering the cease-fire as the antagonists pulled back from violence that had killed more than 150 Palestinians and five Israelis over the past week. The deal called for a 24-hour cooling-off period to be followed by talks aimed at resolving at least some of the longstanding grievances between the two sides.

Gazans poured into the streets declaring victory against the far more powerful Israeli military. In Israel, the public reaction was far more subdued. Many residents in the south expressed doubt that the agreement would hold, partly because at least five Palestinian rockets thudded into southern Israel after the cease-fire began.

The one-page memorandum of understanding left the issues that have most inflamed the tensions between the Israelis and the Gazans up for further negotiation. Israel demands long-term border security, including an end to Palestinian missile launching over the border. Hamas wants an end to the Israeli embargo.

The deal demonstrated the pragmatism of Egypt’s new Islamist president, Mohamed Morsi, who balanced public support for Hamas with a determination to preserve the peace with Israel. But it was unclear whether the agreement would be a turning point or merely a lull in the conflict.

The cease-fire deal was reached only through a final American diplomatic push: Secretary of State Hillary Rodham Clinton conferred for hours with Mr. Morsi and the United Nations secretary general, Ban Ki-moon, at the presidential palace here. Hanging over the talks was the Israeli shock at a Tel Aviv bus bombing on Wednesday — praised by Hamas — that recalled past Palestinian uprisings and raised fears of heavy Israeli retaliation. After false hopes the day before, Western and Egyptian diplomats said they had all but given up hope for a quick end to the violence.

David D. Kirkpatrick reported from Cairo, and Jodi Rudoren from Gaza. Reporting was contributed by Fares Akram from Gaza, Isabel Kershner and Ethan Bronner from Jerusalem, Mayy El Sheikh from Cairo, Rick Gladstone from New York, and Alan Cowell from Paris.

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Fitch cuts Sony, Panasonic debt ratings to “junk” status

TOKYO (Reuters) – Ratings agency Fitch downgraded the debt ratings of Japan’s Sony Corp and Panasonic Corp to “junk” status citing weakness in their consumer electronics and TV operations, further diminishing the luster of the once-great Japanese brands.

The cut to below investment grade, the first by a ratings firm, comes as the floundering Japanese tech giants face weak demand and fierce competition from Apple Inc and Samsung Electronics.

A strong yen and bumps in China, where growth has slowed and Japanese goods have been targeted in sometimes violent protests recently, have also weighed on their earnings.

The two companies, along with Sharp Corp, racked up combined losses of $ 20 billion last year, leading them to axe jobs, sell assets and close facilities.

“Both Sony and Panasonic are struggling to generate operating profits, but each is restructuring and I don’t envision the current situation continuing,” said Masahi Oda, Chief Investment Officer at Sumitomo Mitsui Trust Bank.

“A collapse of their core business would be a problem, but we are not at the point yet, and to me Fitch looks too negative,” Oda added.

Fitch downgraded Sony by three notches to BB-minus from BBB- minus, saying meaningful recovery will be slow. The move came after Sony, the maker of PlayStation game consoles and Vaio laptops, last week announced plans to raise 150 billion yen ($ 1.82 billion) through the sale of convertible bonds.

“Fitch believes that continuing weakness in the home entertainment and sound and mobile products and communications segments will offset the relatively stable music and pictures segments and improvement in the devices segment which makes semiconductors and components,” it said in statement.

In a separate statement, Fitch cut Panasonic to BB from BBB-minus, a two-notch downgrade, citing weakened competitiveness in its TVs and display panels as well as weak cash generation from its operations. It has a negative outlook on both the companies.

The downgrade sent Sony’s five-year credit default swaps (CDS), insurance-like contracts against debt default or restructuring, 5 basis points wider to 382.5/402.5 basis points.

Panasonic’s CDS for the same maturity were quoted at 295/315 basis points, 15 basis points wider than in Thursday morning Asian trade.

Standard & Poor’s rates the two consumer electronics makers at BBB, the second lowest of the investment grade, while Moody’s Investors Service has Baa3 on them, the lowest of the high-grade category.

With two of the three major ratings agencies still having the two companies as investment grade, institutional investors won’t face too great a pressure to cut their debt holdings in them, analysts said.

SONY SHARES TUMBLE

Sony shares shed 4.4 percent in Frankfurt on Thursday. The shares ended 1.8 percent higher at 834 yen in Tokyo before the Fitch announcement, trading not too far from their 32-year closing low of 793 yen hit on November 15. Sony stock is down 40 percent so far this year.

Panasonic shares were down 0.6 percent in Frankfurt in low volume. The stock inched up 0.7 percent to close at 407 yen in Tokyo trading, near its 34-year closing low of 385 yen reached on November 13.

Last month, Panasonic cut its forecast and warned it will lose close to $ 10 billion in the year to March, as it writes off billions of yen in tax-deferred assets and goodwill related to its mobile phone, solar panel and small lithium battery businesses.

Ahead of its earnings revision, Panasonic won $ 7.6 billion in loan commitments in October from banks including Sumitomo Mitsui Financial Group and Mitsubishi UFJ Financial Group, a funding backstop it says will help it avoid having to seek capital from credit markets.

Sony made a small operating profit in the July-September quarter, helped by the sale of a non-core chemicals business, and kept its forecast for a full-year profit of $ 1.63 billion.

(Additional reporting by Dominic Lau in Tokyo and Umesh Desai in Hong Kong; Editing by Muralikumar Anantharaman)

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Study finds mammograms lead to unneeded treatment

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.

It's the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call "cancer" are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don't really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it's relatively new to the debate over breast cancer screening.

"We're coming to learn that some cancers — many cancers, depending on the organ — weren't destined to cause death," said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, "once a woman is diagnosed, it's hard to say treatment is not necessary."

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday's New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it's most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment.

Researchers used federal surveys on mammography and cancer registry statistics from 1976 through 2008 to track how many cancers were found early, while still confined to the breast, versus later, when they had spread to lymph nodes or more widely.

The scientists assumed that the actual amount of disease — how many true cases exist — did not change or grew only a little during those three decades. Yet they found a big difference in the number and stage of cases discovered over time, as mammograms came into wide use.

Mammograms more than doubled the number of early-stage cancers detected — from 112 to 234 cases per 100,000 women. But late-stage cancers dropped just 8 percent, from 102 to 94 cases per 100,000 women.

The imbalance suggests a lot of overdiagnosis from mammograms, which now account for 60 percent of cases that are found, Bleyer said. If screening were working, there should be one less patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage, he explained.

"Instead, we're diagnosing a lot of something else — not cancer" in that early stage, Bleyer said. "And the worst cancer is still going on, just like it always was."

Researchers also looked at death rates for breast cancer, which declined 28 percent during that time in women 40 and older — the group targeted for screening. Mortality dropped even more — 41 percent — in women under 40, who presumably were not getting mammograms.

"We are left to conclude, as others have, that the good news in breast cancer — decreasing mortality — must largely be the result of improved treatment, not screening," the authors write.

The study was paid for by the study authors' universities.

"This study is important because what it really highlights is that the biology of the cancer is what we need to understand" in order to know which ones to treat and how, said Dr. Julia A. Smith, director of breast cancer screening at NYU Langone Medical Center in New York. Doctors already are debating whether DCIS, a type of early tumor confined to a milk duct, should even be called cancer, she said.

Another expert, Dr. Linda Vahdat, director of the breast cancer research program at Weill Cornell Medical College in New York, said the study's leaders made many assumptions to reach a conclusion about overdiagnosis that "may or may not be correct."

"I don't think it will change how we view screening mammography," she said.

A government-appointed task force that gives screening advice calls for mammograms every other year starting at age 50 and stopping at 75. The American Cancer Society recommends them every year starting at age 40.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the study should not be taken as "a referendum on mammography," and noted that other high-quality studies have affirmed its value. Still, he said overdiagnosis is a problem, and it's not possible to tell an individual woman whether her cancer needs treated.

"Our technology has brought us to the place where we can find a lot of cancer. Our science has to bring us to the point where we can define what treatment people really need," he said.

___

Online:

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

Screening advice: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Wall Street flat after data, Greek deal delay

NEW YORK (Reuters) - Stocks were flat on Wednesday as consumer sentiment stalled because of growing uncertainty over federal tax and spending plans next year and the absence of a deal by international lenders on emergency aid for Greece

Other U.S. economic data came in as expected, such as initial weekly claims for jobless benefits, depriving the market of any clear direction.

Euro zone finance ministers, the International Monetary Fund and the European Central Bank failed for a second week to agree on how to make Greece's debt sustainable, which is necessary before the next cash infusion can be made to the fiscally beleaguered nation.

European shares edged up as investors looked for signs of progress on a deal before the next meeting of lenders on Monday. The FTSEurofirst 300 <.fteu3> gained 0.2 percent. <.eu/>

"The European situation has been around for so long, there is nothing new there and everybody realizes it is going to be a long-term workout. From some progress over the last couple of months, all of a sudden we've had no progress," said Tim Ghriskey, chief investment officer of Solaris Group in Bedford Hills, New York.

Labor Department data showed initial jobless claims dropped 41,000 to a seasonally adjusted 410,000 in the latest week, in line with expectations though still elevated in the wake of superstorm Sandy.

The S&P 500 had dropped 5.3 percent since Election Day on November 6 because of worries over U.S. fiscal negotiations and continued debt problems in Europe. But over the past three session, the index <.spx> has risen 2.6 percent, boosted by positive rhetoric from Washington on fiscal discussions and a market many viewed as oversold.

Gains made early in the day on Tuesday were mostly erased after Federal Reserve Chairman Ben Bernanke cautioned that the central bank lacked the tools to cushion the U.S. economy from the impact of the "fiscal cliff."

"We are in a bit of a holding period here. Everybody is focused on the fiscal cliff and any indications of a settlement between Congress and the White house and any indications of what that settlement might be," said Ghriskey.

The fiscal cliff is a series of tax hikes and spending cuts which, failing agreement in Congress, will go into effect in the new year and threaten the nation's fragile economic recovery.

The Dow Jones industrial average <.dji> gained 18.46 points, or 0.14 percent, to 12,806.97. The Standard & Poor's 500 Index <.spx> shed 0.33 points, or 0.02 percent, to 1,387.48. The Nasdaq Composite Index <.ixic> lost 0.09 points, or 0.00 percent, to 2,916.59.

Financial information firm Markit said its U.S. "flash," or preliminary, manufacturing Purchasing Managers Index rose to 52.4, its quickest pace in five months, from a three-year low of 51.0 in October.

The Thomson Reuters/University of Michigan's final reading of the overall index on consumer sentiment came in at 82.7, a touch up from 82.6 the month before but down from a preliminary reading of 84.9 released earlier in the month.

Trading is expected to be light ahead of a U.S. holiday Thursday for Thanksgiving.

Deere & Co lost 2.7 percent to $83.66 after the world's largest farm equipment maker, reported a weaker-than-expected quarterly profit.

Salesforce.com Inc jumped 7.3 percent to $156.52 after the business software provider beat Wall Street expectations for the third quarter and maintained its outlook for the rest of the year.

(Editing by Kenneth Barry)

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Fighting Continues as U.S. Seeks Truce in Gaza

JERUSALEM — American efforts to help negotiate a cease-fire between Israel and Palestinian militants in the week-old Gaza rocket battle faced a new obstacle on Wednesday when the first bus bombing in years traumatized Tel Aviv, raising the prospect of a new Israeli retaliation just as Secretary of State Hillary Rodham Clinton was working to achieve even a brief pause in the fighting.

Mrs. Clinton, who rushed to the Middle East late Tuesday in an intensified diplomatic push, conferred with Israeli leaders in Jerusalem and then visited Palestinian leaders in the West Bank before heading to Cairo for talks with the Egyptian president, Mohamed Morsi, whose good relationship with the Hamas government in Gaza has emerged as pivotal to the negotiations. Mrs. Clinton was engaged in intense talks with Mr. Morsi and his aides at Cairo’s presidential offices, officials there said.

The Tel Aviv bus bombing, which wounded at least 21 Israelis in an act that at least two Palestinian militant factions took responsibility for, resurrected fears in Israel of past Palestinian uprisings. It followed Israeli airstrikes overnight and into Wednesday on government buildings in Gaza and suspected smuggling tunnels under Gaza’s Rafah border crossing with Egypt, among other targets.

The back-and-forth attacks emphasized the underlying problems in finding any lasting solution to a conflict rooted in deep-seated hostilities and mistrust between Israelis and Palestinians.

Egyptian and American officials in Cairo said negotiations over a cease-fire, which the Egyptian media and Hamas officials had said was on the verge of completion Tuesday, had been hung up on a number of issues, including Hamas’s demands for unfettered access to Gaza via the Rafah crossing and other steps that would ease Israel’s economic and border control over other aspects of life for the more than one million Palestinian residents of Gaza, which Israel vacated in 2005 after 38 years of occupation.

The Hamas Health Ministry in Gaza said the Palestinian death toll after a week of fighting stood at 140 at noon. At least a third of those killed are believed to have been militants. On the Israeli side, five Israelis have been killed, including one soldier.

Around noon on Wednesday in the Gaza Strip, according to the Hamas government media office, a bomb hit the house of Issam Da’alis, an adviser to Ismail Haniya, the Hamas prime minister. The house had been evacuated. Earlier, a predawn airstrike near a mosque in the Jabaliya refugee camp killed a 30-year-old militant, a spokesman said, and F-16 bombs destroyed two houses in the central Gaza Strip.

There were 23 punishing strikes against the southern tunnels that are used to bring weapons as well as construction material, cars and other commercial goods into Gaza from the Sinai Peninsula.

Within Gaza City, Abu Khadra, the largest government office complex, was obliterated overnight. Businesses were also damaged, including two banks and a tourism office, and electricity cables fell on the ground and were covered in dust.

Separately, a bomb dropped from an F-16 created a 20-foot crater in an open area in a stretch of hotels occupied by foreign journalists. Several of the hotels had windows blown out by the strike around 2 a.m., but no one was reported injured. By morning, the hole in the ground had filled with sludgy water, apparently from a burst pipe, appearing almost like a forgotten swimming hole with walls made of sand and cracked cinder block.

Surveying damage near a government complex, Raji Sourani of the Palestinian Center for Human Rights said Gaza civilians were “in the eye of the storm,” and accused Israel of “inflicting pain and terror” on them. Israeli officials accuse Hamas of locating military sites in or close to civilian areas.

Overnight, as the conflict entered its eighth day, the Israeli military said in Twitter posts that “more than 100 terror sites were targeted, of which approximately 50 were underground rocket launchers.” The targets included the Ministry of Internal Security in Gaza, described as “one of Hamas’s main command and control centers.”

While there was no immediate or formal claim of responsibility for the bus bombing in Tel Aviv, a message on a Twitter account in the name of Al Qassam Brigades, the armed wing of the Hamas authorities in the Gaza Strip, declared: “We told you IDF that our blessed hands will reach your leaders and soldiers wherever they are, ‘You opened the Gates of hell on Yourselves.’ ” The letters I.D.F. refer to the Israel Defense Forces.

On several occasions since the latest conflagration seized Gaza last week, militants have aimed rockets at Tel Aviv, but they have either fallen short, landed in the sea or been intercepted. Hundreds of rockets fired by militants in Gaza have struck other targets.

But the bombing seemed to be the first time in the current fighting that violence had spread directly onto the streets of Tel Aviv.

On Tuesday — the deadliest day of fighting in the conflict — Mrs. Clinton arrived hurriedly in Jerusalem and met with Prime Minister Benjamin Netanyahu of Israel to push for a truce.

Her visit to Cairo on Wednesday to consult with Egyptian officials in contact with Hamas placed her and the Obama administration at the center of a fraught process with multiple parties, interests and demands.

Before leaving for Cairo, Mrs. Clinton visited the West Bank to meet Mahmoud Abbas, the head of the Palestinian Authority, which is estranged from the Hamas rulers of the Gaza Strip and has increasingly strained ties with Israel over a contentious effort to upgrade the Palestinian status at the United Nations to that of a nonmember state. Mrs. Clinton is to meet again with Mr. Netanyahu before heading for Egypt, the reports said.

Mr. Abbas’s faction is favored by the United States, but it is not directly involved in either the fighting in Gaza or the effort in Cairo to end it. Like Israel and much of the West, the United States regards Hamas as a terrorist organization.

The Israelis, who have amassed tens of thousands of troops on the Gaza border and have threatened to invade for a second time in four years to end the rocket fire, never publicly backed the idea of a short break in fighting. They said they were open to a diplomatic accord but were looking for something more enduring.

“If there is a possibility of achieving a long-term solution to this problem through diplomatic means, we prefer that,” Mr. Netanyahu said before meeting with Mrs. Clinton at his office. “But if not, I’m sure you understand that Israel will have to take whatever actions necessary to defend its people.”

Ethan Bronner reported from Jerusalem, and David D. Kirkpatrick from Cairo. Reporting was contributed by Jodi Rudoren and Fares Akram from Gaza; Isabel Kershner from Jerusalem; Alan Cowell from London; Andrea Bruce from Rafah; and Christine Hauser and Rick Gladstone from New York.

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