Setback for first malaria vaccine in African trial

LONDON (Reuters) – The world’s first potential malaria vaccine proved only 30 percent effective in African babies in a crucial trial, calling into question whether it can be a useful weapon in the fight against the deadly disease.

The surprisingly poor result for the vaccine, which GlaxoSmithKline has been developing for three decades, leaves several years of work ahead before a protective malaria shot could be ready for countries that desperately need one.

Malaria, a mosquito-borne parasitic disease, kills hundreds of thousands a year, mainly babies in Africa, and scientists say an effective vaccine is key to hopes to eradicate it.

Philanthropist Bill Gates, who helped fund the GSK vaccine’s development, said further research was now needed to see whether and how it might be used.

“The efficacy came back lower than we had hoped, but developing a vaccine against a parasite is a very hard thing to do,” he said in a statement.

Results from the final-stage trial with 6,537 babies aged six to 12 weeks showed the vaccine provided “modest protection”, reducing episodes of the disease by 30 percent compared to immunisation with a control vaccine, researchers said on Friday.

That efficacy rate a year after vaccination is less than half the 65 percent in an earlier trial in babies which analysed protection rates after six months. It is also a lot less than the 50 percent rate seen in five to 17 month-olds.

Vaccinating babies, rather than toddlers, is the preferred option, since the new vaccine could then be added to other routine infant immunisations. A separate programme for older children would involve a lot of extra costs.

Eleanor Riley, a professor of immunology at the London School of Hygiene and Tropical Medicine said the results showed that GSK’s vaccine, called RTS,S or Mosquirix, is potentially useful, but “not the complete solution”.

“The slightly lower than expected efficacy will … affect the cost-benefit analysis that health providers and funders will have to undertake before deciding whether the vaccine represents the best use of limited financial resources,” she said.

NOT GIVING UP

Despite the setback, Britain’s top drugmaker said it would push ahead with developing RTS,S and GSK Chief Executive Andrew Witty said it could be an important tool in fighting malaria.

“We’ve been at this for 30 years, and we’re certainly not going to give up now,” he told reporters on a conference call.

GSK does not expect to make any profit from the vaccine, which would only be sold in poor countries.

Witty reiterated a promise that if RTS,S is ultimately approved for market, it would be priced at cost of manufacture plus a 5 percent margin, and the margin would be reinvested by GSK in malaria research.

Given the target market, it is governments and international groups that will fund the vaccine’s roll-out, and they now need more positive data before deciding whether it is worth buying.

“We will have to have more information to give us a clearer idea as to how useful this vaccine will be,” said Seth Berkley, CEO of the GAVI Alliance, which funds bulk-buy vaccination programmes for poorer nations.

In particular, Berkley told Reuters he wanted to see longer-term data, including the effect of booster shots, and an analysis of how the vaccine performed in different settings.

Details of the malaria trial, which is Africa’s largest ever clinical trial involving almost 15,500 children in seven countries, were presented at a medical meeting in Cape Town and published online by the New England Journal of Medicine.

Witty said he would have liked to have seen efficacy rates of around 50 percent in infants, but stressed that more data would become available before the trial ends in 2014 which may throw more light on why rates of success are so variable.

“It may open up a more customised approach to how this potential vaccine gets used,” he said.

Malaria is caused by a parasite carried in the saliva of mosquitoes. It is endemic in more than 100 countries worldwide and infected around 216 million people in 2010, killing around 655,000 of them, according to the World Health Organisation.

Control measures such as insecticide-treated bed nets, indoor spraying and anti-malaria drugs have helped cut cases and deaths significantly in recent years, but scientists say it will take an effective vaccine and many more years work to wipe out malaria.

Scientists around the world are working on other potential malaria vaccines but RTS,S is by far the furthest ahead in development.

Medications/Drugs News Headlines – Yahoo! News

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Obama: U.S. voted for tax hikes on rich

President Barack Obama makes remarks on the "fiscal cliff" in the East Room of the White House (Kevin Lamarque …Claiming a mandate from his election romp over Mitt Romney, President Barack Obama announced Friday that he had invited Congressional leaders to the White House next week for talks on how to steer the battered economy away from a "fiscal cliff." Obama said he was open to compromise with Republicans—but that any final deal needed to raise taxes on the richest Americans.

"This was a central question during the election," the president said in brief remarks in the East Room of the White House. "It was debated over and over again, and on Tuesday night we found out that a majority of Americans agree with my approach.

"Our job now is to get a majority in congress to reflect the will of the American people," Obama said. "I'm not wedded to every detail of my plan. I'm open to compromise. I'm open to new ideas. I'm committed to solving our fiscal challenges. But I refuse to accept any approach that isn't balanced."

The president, who did not take questions on Friday, campaigned in part on a plan that would extend most of the Bush-era tax cuts, but allow them to expire for individuals making more than $200,000 or families pulling in $250,000. Republicans have said they want to prolong all of those rate reductions.

Obama said, as he has all year, that this means both sides agree on extending the middle-class reductions—and that doing so should not require "long negotiations or drama. ... Let's extend the middle-class tax cuts right now. Let's do that right now." (Republicans have resisted; extending those rates would reduce the party's leverage on tax hikes affecting the wealthy).

Republican Speaker John Boehner, speaking shortly before the president's appearance, said he was looking to Obama "to lead" and that he had a short, "cordial" conversation with the president earlier this week about ways to avoid the so-called fiscal cliff.

"I think we both understand that trying to find a way to avert the fiscal cliff is important for this country," Boehner said. "And I'm hopeful that productive conversations can begin soon so we can forge an agreement that can pass the Congress."

Boehner reiterated his opposition to raising tax rates as part of that deal, even on high-income earners, and says he sees the negotiations as a way to overhaul the tax code and the way the federal government pays for entitlement programs like Social Security and Medicare. (Boehner's emphasis on tax rates suggests a possible opening for a compromise that focuses on raising revenue by closing loopholes, which is also a part of Obama's plan).

Obama said he was "encouraged" by the speaker's comments.

The so-called "fiscal cliff" refers to a series of tax increases and deep spending cuts scheduled to occur Jan. 1, 2013 if Obama and his Republican foes fail to reach a deal. They include the expiration of a payroll tax cut and the Bush-era reductions in tax rates, the end of some unemployment benefits, and draconian reductions in domestic and military spending triggered because of the failure of the Congressional "Super Committee" to find $1.2 trillion in deficit reduction over 10 years.

Just how bad would it be if the president and House Republicans held hands and took the country over the cliff, Thelma & Louise style (or maybe à la Homer Simpson)?

The non-partisan Congressional Budget Office, Washington's gold standard for such analysis, warned in a report released Thursday that the consequences could be dire, including a drop in Gross Domestic Product of 0.5 percent in 2013, and a rise in unemployment to 9.1 percent by the end of next year.

The CBO report also noted that extending Bush-era tax cuts for individuals making under $200,000 per year or families making below $250,000—while letting the reductions on higher-income Americans expire—would boost the economy by 1 ¼ percent by the end of 2013. This reflects Obama's preferred course. Extending the tax cuts for the wealthiest Americans, noted the report, "would have a relatively small effect on output for dollar of budgetary cost."

"The American people understand that we're going to have differences and disagreements in the months to come. They get that," Obama said. "But on Tuesday, they said loud and clear that they won't tolerate dysfunction, they won't tolerate politicians who view compromise as a dirty word—not when so many Americans are still out of work."

"What the American people are looking for is cooperation, they're looking for consensus, they're looking for common sense. Most of all they want action," the president said. "I intend to deliver for them in my second term, and I expect to find willing partners in both parties to make that happen.

"So let's get to work."

Chris Moody contributed to this report.

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Ghana building collapse traps dozens, kills 1

ACCRA, Ghana (AP) — A five-story shopping center built earlier this year in a bustling suburb of Ghana‘s capital collapsed Wednesday, killing at least one person and leaving several dozen people trapped in the rubble, authorities and eyewitnesses said.

Rescue crews used cranes to try and remove debris from the top of the building amid fears that machinery sifting through the wreckage could injure trapped survivors. Crowds of bystanders gathered as rescuers sifted through cement and glass.

The fatality at the Melcom Shopping Center at Achimota, a suburb of Accra, was confirmed by Public Affairs Officer of the Ghana Fire Service Billy Anaglate. “We are still working to find out the fate of others who may be trapped under,” he said.

Other officials told The Associated Press that the death toll was likely to rise.

An AP reporter at the scene saw at least one man pulled from the debris, covered in dust and who was then whisked into an ambulance.

A Greater Accra Regional Public Affairs officer, deputy superintendent Freeman Tettey, confirmed that one person died and told the AP that 51 have been rescued and sent to hospitals around the capital.

“I was on my way to the shop when l saw it crumpling down,” Kojo Boadi, an eyewitness, said.

President John Mahama declared the scene a disaster zone and cut short his election campaign in the north of the country to be able to visit the site. The presidential election is scheduled for December.

The five-story store opened in February is part of the Melcom chain owned by Indian immigrant magnate, Bhagwan Khubchandani. His late father arrived in Ghana in 1929 as a 14-year-old to work as a store boy in the-then Gold Coast.

The store sells a variety of cheap, imported household goods and appliances that are popular with working-class Ghanaians.

Africa News Headlines – Yahoo! News

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Exclusive: Google Ventures beefs up fund size to $300 million a year

SAN FRANCISCO (Reuters) - Google will increase the cash it allocates to its venture-capital arm to up to $300 million a year from $200 million, catapulting Google Ventures into the top echelon of corporate venture-capital funds.

Access to that sizeable checkbook means Google Ventures will be able to invest in more later-stage financing rounds, which tend to be in the tens of millions of dollars or more per investor.

It puts the firm on the same footing as more established corporate venture funds such as Intel's Intel Capital, which typically invests $300-$500 million a year.

"It puts a lot more wood behind the arrow if we need it," said Bill Maris, managing partner of Google Ventures.

Part of the rationale behind the increase is that Google Ventures is a relatively young firm, founded in 2009. Some of the companies it backed two or three years ago are now at later stages, potentially requiring larger cash infusions to grow further.

Google Ventures has taken an eclectic approach, investing in a broad spectrum of companies ranging from medicine to clean power to coupon companies.

Every year, it typically funds 40-50 "seed-stage" deals where it invests $250,000 or less in a company, and perhaps around 15 deals where it invests up to $10 million, Maris said. It aims to complete one or two deals annually in the $20-$50 million range, Maris said.

LACKING SUPERSTARS

Some of its investments include Nest, a smart-thermostat company; Foundation Medicine, which applies genomic analysis to cancer care; Relay Rides, a carsharing service; and smart-grid company Silver Spring Networks. Last year, its portfolio company HomeAway raised $216 million in an initial public offering.

Still, Google Ventures lacks superstar companies such as microblogging service Twitter or online bulletin-board company Pinterest. The firm's recent hiring of high-profile entrepreneur Kevin Rose as a partner could help attract higher-profile deals.

Soon it could have even more cash to play around with. "Larry has repeatedly asked me: 'What do you think you could do with a billion a year?'" said Maris, referring to Google chief executive Larry Page.

(Editing by Muralikumar Anantharaman)

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Cancer trials can lack clear information on biopsies

NEW YORK (Reuters Health) – People participating in cancer drug trials aren’t always given the most straightforward explanation of possible risks and benefits from invasive procedures that may be involved, according to a new study.

Biopsies of tumor tissue can help researchers figure out how well a test drug is working – but the invasive, sometimes painful procedures are typically of little benefit to study participants themselves.

The new findings show more than five percent of biopsies in such trials may result in complications, but that informed consent documents spend less time explaining those risks than they do for simple blood draws, which are much less invasive.

“Most of these procedures don’t have any therapeutic value for patients, they are burdensome, they’re painful and they carry risk,” said Jonathan Kimmelman, from the Biomedical Ethics Unit at McGill University in Montreal, Canada.

“Before you do a procedure like that on patients, you really want to have their adequate informed consent,” Kimmelman, who wasn’t involved in the new study, told Reuters Health.

“The only reason (patients) should submit to them is to contribute to science in some way,” and not with the hope the biopsies will help them get better, he said.

For the new study, researchers from the University of Texas MD Anderson Cancer Center in Houston reviewed 57 cancer trials by their institution that involved tumor biopsies for study subjects and were conducted in 2005 through 2010.

In 38 of those trials, a biopsy was mandatory for all participants, often as a way for researchers to tell if the drug in question had worked as intended. In some other cases, biopsies were used as pre-study checks to see if patients had the right type of tumor for a certain targeted drug.

Lead author Dr. Michael Overman and his colleagues found almost all informed consent documents didn’t specifically address the research alternatives to biopsies or the lack of likely benefits for patients themselves. The average document had just 39 words addressing the potential risks from study biopsies, compared to 48 words for blood draws.

In those trials, 576 patients had a total of 745 tumor biopsies – including lung, liver and head and neck biopsies. Thirty-nine of those resulted in complications, such as lung air leaks and bleeding, and six in major complications requiring patients to be hospitalized or to get further surgery, according to findings published Monday in the Journal of Clinical Oncology.

Overman said one of the problems has been that until now, there hasn’t been enough available data for study investigators to give patients a reliable estimate of their chance of a biopsy-related complication.

“The informed consent documents that are used are not always as clear as they could be,” Kimmelman said.

He added that not all cancer studies requiring biopsies are of the highest quality. And some don’t make it into the published scientific literature, where they could potentially help determine if a drug is approved or could guide treatment decisions for future patients.

“I think a lot of patients understandably think that when they’re volunteering for these studies they’re giving tissue for what is cutting-edge science, and sometimes that’s true, but not always,” Kimmelman said.

Both researchers agreed that as more targeted drugs are designed for patients with very specific types of cancer, research biopsies will become increasingly necessary to determine how well those drugs are working on the tumor itself.

“I think giving biopsies is a good thing. I think you learn from it, but you need to do it in an honest fashion,” Overman told Reuters Health.

Especially in early drug studies, the patients involved typically have few established treatment options.

“This is where we should say (to patients), ‘This is an experimental therapy, an experimental biopsy, and you don’t have to do it,’” Overman said.

SOURCE: http://bitly.com/U9NXK1 Journal of Clinical Oncology, online November 5, 2012.

Diseases/Conditions News Headlines – Yahoo! News

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Loughner gets life for deadly Ariz. rampage

TUCSON, Ariz. (AP) — The man who pleaded guilty to a deadly Arizona shooting rampage that wounded former U.S. Rep. Gabrielle Giffords was sentenced to life in prison Thursday.

U.S. District Judge Larry Burns sentenced 24-year-old Jared Lee Loughner for the January 2011 attack that left six people dead and Giffords and others wounded.

Loughner pleaded guilty to federal charges under an agreement that guarantees he will spend the rest of his life in prison without the possibility of parole.

The hearing marked the first time victims — including Giffords — could confront Loughner in court.

Her astronaut husband, Mark Kelly, did all the talking for her, as the couple looked at Loughner and told him how his deadly rampage at the former congresswoman's political meeting had upended her life.

"Her life has been forever changed. Plans she had for our family and her career have been immeasurably altered," Kelly said. "Every day is a continuous struggle to do those things she once was so good at."

Loughner showed no emotion, and looked at the other victims. His mother sobbed nearby.

"Mr. Loughner, you may have put a bullet through her head but you haven't put a dent in her spirit and her commitment to make the world a better place," Kelly said.

Giffords kissed Kelly when he was done. He grabbed her hand and they walked away, with her limping.

Earlier, Loughner told Burns that he will not be speaking at the hearing.

Loughner pleaded guilty three months ago to 19 federal charges under an agreement that guarantees he will spend the rest of his life in prison without the possibility of parole.

Both sides reached the deal after a judge declared that Loughner was able to understand the charges against him. After the shooting, he was diagnosed with schizophrenia and underwent forcible psychotropic drug treatments.

At the hearing, Loughner, who wore dress pants and a dark brown shirt with a tie, heard from his victims.

"We've been told about your demons, about the illness that skewed your thinking," said Susan Hileman, at times visibly shaking, to Loughner. "Your parents, your schools, your community, they all failed you.

"It's all true," Hileman said. "It's not enough."

"You pointed a weapon and shot me three times," she said, staring directly at Loughner. He looked back at her. "And now I walk out of this courtroom and into the rest of my life and I won't think of you again."

Some victims, including Giffords, welcomed the plea deal as a way to move on. It spared victims and their families from having to go through a potentially lengthy and traumatic trial and locks up the defendant for life.

Christina Pietz, the court-appointed psychologist who treated Loughner, had warned that although Loughner was competent to plead guilty, he remained severely mentally ill and his condition could deteriorate under the stress of a trial.

When Loughner first arrived at a Missouri prison facility for treatment, he was convinced Giffords was dead, even though he was shown a video of the shooting. He eventually realized she was alive after he was forcibly medicated.

It's unknown whether Pima County prosecutors, who have discretion on whether to seek the death penalty against Loughner, will file state charges against him. Stephanie Coronado, a spokeswoman for Pima County Attorney Barbara LaWall, said Wednesday that no decision had been made.

It's unclear where Loughner will be sent to serve his federal sentence. He could return to a prison medical facility like the one in Springfield, Mo., where he's been treated for more than a year. Or he could end up in a prison such as the federal lockup in Florence, Colo., that houses some of the country's most notorious criminals, including Oklahoma City bombing conspirator Terry Nichols and "Unabomber" Ted Kaczynski.

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Canada firms to capitalize on nuclear trade with India

NEW DELHI (Reuters) – Canadian firms will be able to export uranium and nuclear reactors to India for the first time in almost four decades under an agreement between the two nations, their prime ministers said, but more work is needed to implement the deal.

Once implemented, the agreement will end a ban on nuclear cooperation Canada imposed in 1976 after India secretly exploded its first nuclear bomb in 1974, commonly called the “Smiling Buddha”, using material from a Canadian-built reactor in India.

“Being able to resolve these issues and move forward is, we believe, a really important economic opportunity for an important Canadian industry, part of the energy industry, that should pay dividends in terms of jobs and growth for Canadians down the road,” Canadian Prime Minister Stephen Harper said on Tuesday on a visit to New Delhi.

A negotiator with the Canadian Nuclear Safety Commission (CNSC), speaking on condition of anonymity because of the delicacy of the talks, said that what remained was a careful legal review of the language; translation into French and Hindi; and then a signing.

This is not expected to take very long, he said. The two sides have set up a joint committee to liaise on nuclear issues, but he said it would not be negotiating.

India aims to lift its nuclear capacity to 63,000 MW in the next 20 years by adding nearly 30 reactors. The country currently operates 20 mostly small reactors at six sites with a capacity of 4,780 MW, or 2 percent of its total power capacity, according to the Nuclear Power Corporation of India Limited.

Canada’s ambassador to India, Stewart Beck, said on Monday his country wanted to be able to track all nuclear material, but that India felt it only needed to report to the International Atomic Energy Agency (IAEA).

It was not clear who made concessions in the talks and how effective the safeguards would be to ensure that Canadian material did not get used again for making nuclear weapons.

However, the CNSC official said India would now be required to notify Canada of any transfers to a third country and trade could only go to facilities that are safeguarded by the IAEA.

PROBABLY BEATING AUSTRALIA

Harper said the CNSC had worked to “achieve all of our objectives in terms of non-proliferation”.

Canada is in a race against Australia, its strategic ally but a commercial rival in the uranium business. Australia is also trying to nail down safeguards under which it too could sell uranium to India.

“We are effectively ahead of the Australians,” the CNSC official said, noting however that Russia and Kazakhstan were already supplying into India.

Opening up the Indian market would be a big help to Canada’s Cameco Corp, which is the world’s largest publicly traded uranium producer but which recently cut its long-term output targets due to the Fukushima disaster.

“Anytime we can reduce the roadblocks to selling our product around the world is always helpful,” Cameco chief executive Tim Gitzel told Reuters in Canada. “It opens a new market for us with the appropriate safeguards in place. So this is good news.”

Another potential beneficiary is Canadian engineering firm SNC Lavalin Group Inc, which bought the government’s commercial nuclear division, which designed the Candu reactor that is in use in numerous countries.

“As far as the sales of reactors goes, we would normally now request that Canada be accorded the same treatment as the Russians, the French and the Americans and that a site be designated in India for the implementation of at least a twin- unit Candu nuclear power station,” SNC Lavalin International President Ronald Denom, part of Harper’s delegation in India, told Reuters.

He also said it should open up the market to service the existing reactors in India.

Harper also said Canada welcomed foreign investment, after the country temporarily blocked Malaysian state oil firm Petronas’ C$ 5.17 billion ($ 5.19 billion) bid for gas producer Progress Energy Resources on October 20.

Late on Friday, Canada extended to December 10 its review of a $ 15.1 billion bid made in July by China’s CNOOC Ltd for Canadian energy producer Nexen Inc.

“Those decisions have to be taken looking at the global evolving economy in which we operate,” Harper said.

($ 1 = C$ 0.9965)

(Additional reporting by Julie Gordon in Toronto; Additional writing by Frank Jack Daniel; Editing by Jonathan Thatcher and Michael Roddy)

Canada News Headlines – Yahoo! News

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Apple's shares slide 4 percent to five-month low

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A Minute With: Taylor Lautner finding new dawn after “Twilight”

LOS ANGELES (Reuters) – As dusk sets on the “Twilight” saga with the final film, actor Taylor Lautner is looking at a new dawn for the next stage in his career.

Lautner, 20, shot to fame after being cast as werewolf Jacob Black in the “Twilight” films, entangled in a torrid love triangle with Kristen Stewart‘s Bella Swan and Robert Pattinson‘s vampire Edward Cullen. He became a household name and pin-up for his clean-cut good looks and shirtless scenes.

In “Breaking Dawn – Part 2,” out in U.S. theaters on November 16, Lautner’s character finds new love, albeit unusual, and indulges his comedic side as the story comes to an end.

Lautner spoke to Reuters about leaving Jacob and his cast mates behind, and why the final film may leave fans in tears.

Q: What’s different about Jacob in “Breaking Dawn – Part 2″?

A: “He’s always been so stressed and emotional and things aren’t going his way and there was a huge weight lifted off his shoulders in this one, huge. It was nice to play that side of Jacob where he could sit back and relax and have a smile on his face and crack a few funny jokes every now and then.”

Q: Jacob finds his soul mate in Bella and Edward’s daughter Renesmee from the moment she is born. Was it challenging to balance his affection for her without coming across creepy?

A: “It was a challenge, and it is so complicated, but really nobody understands it more than Stephenie Meyer who created it. I was picking her brain all day long about it. She basically told me over and over again, ‘Taylor, stop trying to overthink it, stop trying to take it different places … It’s a life-long bond between two people, that’s it.’ In the movie, (Renesmee) is 10 years old, it’s much more of a protector relationship right now, and of course the relationship will grow but we don’t explore that, but it was important for me to keep it simple.”

Q: What are you going to miss most about your character and the franchise?

A: “These characters have never stopped changing throughout the entire franchise, and that’s what I love about Jacob. Jacob himself has grown up so much and gone through so many hurdles and it was a fantastic character to play. For me, it’ll be tough to say goodbye to spending time with people that I love. We’ve grown so close over the past few years. Our relationships will go on past this but to not have that excuse to spend day after day together while filming or promoting will be different.”

Q: “Twilight” fans are not just interested in your characters, they’re also interested in your personal lives. The past summer has seen a lot of attention on Robert and Kristen’s relationship. How do you handle that level of scrutiny?

A: “It’s unlike anything else because when we do talk about the movies, 90 percent of the time people want to know more about ourselves than the characters and what’s going on. I guess that just comes with a fan base like this, it comes with the job and you try and not let it affect you too much, but I have no complaints … The scrutiny, is it unfortunate? Yeah, but you just got to make your way around it and think about things more.”

Q: Do you feel protective of your cast members?

A: “Yes, I definitely do, we’re so close by this point, I think that it’s hard not to.”

Q: What do you hope “Twilight” fans take away from “Breaking Dawn – Part 2″?

A: “I just hope they’re happy and they’re proud because we really do make these movies for them. They’re the reason we are able to make them, their support is unreal and we’re so proud of this last one. This last one specifically wraps it up so nicely, it’s an amazing movie. During the movie, it’ll keep you on the edge of your seat but by the end, I think more than a few of the fans will be in tears.”

Q: Post-Twilight, where do you want to take your career to, what roles would you like to explore? I hear you have a cameo in the comedy “Grown Ups 2″?

A: “It was great to do (comedy), just hop in and show a different side, do something fun and work with somebody like Adam (Sandler). But now I’m looking forward to doing something different from that. There are a few projects that I’m very excited about that are extremely challenging and dramatic and would be tough.”

(Reporting By Piya Sinha-Roy, editing by Jill Serjeant and Patricia Reaney)

Movies News Headlines – Yahoo! News

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Obama win clears health law hurdle, challenges remain

WASHINGTON (Reuters) – President Barack Obama‘s re-election eliminates the possibility of a wholesale repeal of his signature healthcare reform law, but leaves questions about how many of the changes will be implemented as the national focus shifts to tackling the U.S. debt and deficit.

The 2010 Patient Protection and Affordable Care Act, the biggest overhaul of the $ 2.8 trillion U.S. healthcare system since the 1960s, aims to extend health coverage to more than 30 million uninsured Americans beginning in January 2014.

Republican challenger Mitt Romney had vowed to repeal the law if elected, calling it a costly government expansion despite the fact that the reforms are based on healthcare legislation he signed as governor of Massachusetts.

“There’s sort of an immediate acceptance that this law will stay in place in some meaningful way,” said Chris Jennings, a top healthcare adviser to former Democratic President Bill Clinton. “It’s sort of like a big barrier has been removed.”

Shares in hospitals and insurers that cater to Medicaid, the government insurance for the poor, rose slightly on Wednesday as markets expected the reform laws to be enacted. But health insurers with large employer-based businesses were off slightly, as the health reform law sets limits on their profits and mandates on coverage.

Obama still faces challenges in Congress. Republicans who retained control of the House of Representatives are expected to press for healthcare reform concessions, including delaying and 7scaling back a planned expansion of Medicaid, during negotiations to cut the federal deficit later this month.

But Julie Barnes, director of healthcare policy at the Bipartisan Policy Center, said Tuesday’s victory should give the president added leverage to set the healthcare segment of any deficit-cutting compromise largely on his own terms.

“President Obama has the opportunity to make bold leadership moves toward a bipartisan compromise on healthcare and the economy,” she said. “He has the standing to demand that each party see the investment all Americans have in reforming our broken healthcare system.”

DID MEDICARE HELP OBAMA?

In a related issue, Obama’s staunch defense of Medicare, the healthcare program for the elderly and disabled, may have helped his re-election, giving him an edge in close states including Ohio, Pennsylvania, Iowa, New Hampshire and Nevada.

Obama and his allies vigorously attacked Romney’s plan to convert the popular program that provides guaranteed benefits to one that gives beneficiaries a fixed payment to help them purchase their own health coverage.

Polls show older Americans oppose the idea by margins of 2-to-1, though it was unclear to what extent that opposition translated into votes.

Major provisions of the Affordable Care Act call for cooperation from individual U.S. states, including an expansion of Medicaid and the introduction of subsidized health insurance exchanges for individuals to buy their own coverage.

Governors and legislatures in as many as a half-dozen Republican-majority states oppose those plans and can refuse to act on them.

Other states may be ill-prepared for implementation but could begin to take action now that repeal is no longer a threat. States have until November 16 to say whether they intend to set up their own exchanges. Most will need to partner with the federal government to have one ready by 2014.

Soon after Obama emerged the winner, reform advocates called on his administration to encourage state support for Medicaid by assuring governors and legislatures that $ 930 billion in federal funds for financing the expansion will be pumped into struggling state budgets.

“This guarantee is essential for governors as they decide whether their programs should cover more low-income adults. It is therefore crucial that upcoming federal budget decisions give governors clear assurances that this funding is stable and won’t be reduced,” said Ron Pollack of Families USA, a Medicaid advocacy group.

The healthcare law that Republicans deride as “Obamacare” has already survived repeated attacks and emerged mostly intact.

The Supreme Court upheld the reforms in a landmark June ruling, but empowered states to opt out of the planned Medicaid expansion without losing federal funding for current programs.

The reform law is still the subject of about two-dozen lawsuits seeking to overturn a requirement that church-affiliated institutions cover birth control for employees.

(Editing by Michele Gershberg, Marilyn Thompson and David Storey)

Seniors/Aging News Headlines – Yahoo! News

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