Baby Born with Heart Outside Her Chest Goes Home from Hospital

By Dahvi Shira

01/24/2013 at 06:40 PM EST

Ashley and Audrina Cardenas

Three-month-old Audrina Cardenas is a survivor.

The infant, delivered on Oct. 15 with a rare genetic deformity called "ectopia cordis," was born with part of her heart outside of her body. Following a successful surgery in November, Cardenas finally left the hospital on Wednesday.

At the time of her procedure, the Texas Children's Hospital in Houston released a statement explaining, "A multidisciplinary team of surgeons saved Audrina's life during a miraculous six-hour, open-heart surgery where they reconstructed her chest cavity to make space for the one-third of her heart that was outside of her body."

Cardenas's mother Ashley told ABCNews.com that she knew about her daughter's condition when she was 16 weeks pregnant.

"They gave me the option to terminate the pregnancy [or] continue with the pregnancy and do something called comfort care at the time of delivery, where instead of doing anything painful to her or do surgery, they let you spend as much time with her until she passes, or opt for a high-risk surgery to help repair the heart," Ashley Cardenas said.

Although she's been released from the hospital, Audrina will still be on oxygen and use a feeding tube, according to her mom, who spoke to HLN affiliate KTRK.

With Audrina wearing a pink chest shield made by doctors, Ashley said, "She doesn't have the sternum. She doesn't have anything over her heart besides the skin and a little muscle that they put over, so this is very important for her to wear. Especially for a car seat, the straps go right on her heart, and if she didn't have anything hard, it would damage her heart."

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Penalty could keep smokers out of health overhaul

WASHINGTON (AP) — Millions of smokers could be priced out of health insurance because of tobacco penalties in President Barack Obama's health care law, according to experts who are just now teasing out the potential impact of a little-noted provision in the massive legislation.

The Affordable Care Act — "Obamacare" to its detractors — allows health insurers to charge smokers buying individual policies up to 50 percent higher premiums starting next Jan. 1.

For a 55-year-old smoker, the penalty could reach nearly $4,250 a year. A 60-year-old could wind up paying nearly $5,100 on top of premiums.

Younger smokers could be charged lower penalties under rules proposed last fall by the Obama administration. But older smokers could face a heavy hit on their household budgets at a time in life when smoking-related illnesses tend to emerge.

Workers covered on the job would be able to avoid tobacco penalties by joining smoking cessation programs, because employer plans operate under different rules. But experts say that option is not guaranteed to smokers trying to purchase coverage individually.

Nearly one of every five U.S. adults smokes. That share is higher among lower-income people, who also are more likely to work in jobs that don't come with health insurance and would therefore depend on the new federal health care law. Smoking increases the risk of developing heart disease, lung problems and cancer, contributing to nearly 450,000 deaths a year.

Insurers won't be allowed to charge more under the overhaul for people who are overweight, or have a health condition like a bad back or a heart that skips beats — but they can charge more if a person smokes.

Starting next Jan. 1, the federal health care law will make it possible for people who can't get coverage now to buy private policies, providing tax credits to keep the premiums affordable. Although the law prohibits insurance companies from turning away the sick, the penalties for smokers could have the same effect in many cases, keeping out potentially costly patients.

"We don't want to create barriers for people to get health care coverage," said California state Assemblyman Richard Pan, who is working on a law in his state that would limit insurers' ability to charge smokers more. The federal law allows states to limit or change the smoking penalty.

"We want people who are smoking to get smoking cessation treatment," added Pan, a pediatrician who represents the Sacramento area.

Obama administration officials declined to be interviewed for this article, but a former consumer protection regulator for the government is raising questions.

"If you are an insurer and there is a group of smokers you don't want in your pool, the ones you really don't want are the ones who have been smoking for 20 or 30 years," said Karen Pollitz, an expert on individual health insurance markets with the nonpartisan Kaiser Family Foundation. "You would have the flexibility to discourage them."

Several provisions in the federal health care law work together to leave older smokers with a bleak set of financial options, said Pollitz, formerly deputy director of the Office of Consumer Support in the federal Health and Human Services Department.

First, the law allows insurers to charge older adults up to three times as much as their youngest customers.

Second, the law allows insurers to levy the full 50 percent penalty on older smokers while charging less to younger ones.

And finally, government tax credits that will be available to help pay premiums cannot be used to offset the cost of penalties for smokers.

Here's how the math would work:

Take a hypothetical 60-year-old smoker making $35,000 a year. Estimated premiums for coverage in the new private health insurance markets under Obama's law would total $10,172. That person would be eligible for a tax credit that brings the cost down to $3,325.

But the smoking penalty could add $5,086 to the cost. And since federal tax credits can't be used to offset the penalty, the smoker's total cost for health insurance would be $8,411, or 24 percent of income. That's considered unaffordable under the federal law. The numbers were estimated using the online Kaiser Health Reform Subsidy Calculator.

"The effect of the smoking (penalty) allowed under the law would be that lower-income smokers could not afford health insurance," said Richard Curtis, president of the Institute for Health Policy Solutions, a nonpartisan research group that called attention to the issue with a study about the potential impact in California.

In today's world, insurers can simply turn down a smoker. Under Obama's overhaul, would they actually charge the full 50 percent? After all, workplace anti-smoking programs that use penalties usually charge far less, maybe $75 or $100 a month.

Robert Laszewski, a consultant who previously worked in the insurance industry, says there's a good reason to charge the maximum.

"If you don't charge the 50 percent, your competitor is going to do it, and you are going to get a disproportionate share of the less-healthy older smokers," said Laszewski. "They are going to have to play defense."

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Online:

Kaiser Health Reform Subsidy Calculator — http://healthreform.kff.org/subsidycalculator.aspx

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S&P rises for seventh day but 1,500 too steep a climb

NEW YORK (Reuters) - The smallest of gains gave the Standard & Poor's 500 its seventh straight winning day on Thursday, but the index failed to hold above the 1,500 line, restrained by Apple's worst day in more than four years.

Apple Inc slid 12.4 percent to $450.50 a day after it posted revenue that missed Wall Street's forecast as iPhone sales were poorer than expected.

The sharp drop wiped out nearly $60 billion in Apple's market capitalization to less than $423 billion, leaving the company vulnerable to losing its status as the most valuable U.S. company to second-place ExxonMobil , at $416.5 billion.

The S&P 500, however, managed to hit its longest winning streak since October 2006.

"The market has sent the message it is no longer driven by the whims of Apple," said Ken Polcari, director of the NYSE floor division at O'Neil Securities in New York.

The S&P 500 briefly traded above 1,500 for the first time since December 12, 2007, but failed to hold above it, indicating that momentum is waning and a pullback is in the charts.

"If the market had a little bit more excitement to it, momentum players would have jumped after it broke through 1,500. Investors know the market is a little bit ahead of itself," Polcari said.

Economic data helped buoy equities as U.S. factory activity grew the most in nearly two years in January and new claims for jobless benefits dropped to a five-year low last week, giving surprisingly strong signals on the economy's pulse.

At the same time, Chinese manufacturing grew this month at the fastest pace in about two years, while data suggesting German growth picked up boosted hopes for a euro-zone recovery.

"PMI in Asia, Europe, and obviously, here in the United States, is moving in the right direction, and that's stuff people should be excited about," Polcari said.

The Dow Jones industrial average <.dji> rose 46 points or 0.33 percent, to 13,825.33 at the close. The S&P 500 <.spx> inched up just 0.01 of a point, or 0 percent, to finish at 1,494.82. The Nasdaq Composite <.ixic> dropped 23.29 points or 0.74 percent, to end at 3,130.38, with most of that loss on Apple's slide.

The broader Russell 2000 index <.rut> also hit a milestone as it closed above 900 points for the first time.

Video streaming service Netflix Inc surprised Wall Street with a quarterly profit after it added nearly 4 million customers in the United States and abroad. Netflix shares surged 42.2 percent to $146.86, its biggest percentage jump ever.

Earnings have helped drive the stock market's recent rally. Thomson Reuters data through early Thursday showed that of the 133 S&P 500 companies that have reported earnings so far, 66.9 percent have exceeded expectations - above the 65 percent average over the past four quarters.

About 6.8 billion shares changed hands on the New York Stock Exchange, the Nasdaq and NYSE MKT, below the daily average during January 2012 of about 6.93 billion shares.

Roughly five issues rose for every four that fell on both the NYSE and Nasdaq.

(Editing by Jan Paschal)

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St. Gallen Journal: Swiss City Fears for Cultural Legacy in Wake of a Bank’s Fall

Daniel Auf der Mauer for The New York Times

Bach concerts sponsored by the bank Wegelin were sometimes held at the St. Laurentius church in St. Gallen.

ST. GALLEN, Switzerland — Given the modest size of its offices, a trim neo-Classical building off the marketplace, it is easy to underestimate the imprint of the bank once called Wegelin on this compact Swiss city.

It is not just that it was the oldest bank in Switzerland, founded by local textile merchants in 1741. Its senior managing partner, Konrad Hummler, was the son of a former mayor, chairman of the board of the Neue Zürcher Zeitung, the Zurich daily that is the country’s leading newspaper, and the prolific author of columns in which he often denounced the business practices of bigger Swiss banks, like UBS.

But most important, Wegelin, which closed its doors this month, was a significant sponsor of cultural institutions in the area. Among its projects, in 2006 Mr. Hummler, a passionate music lover and amateur violinist, established the Johann Sebastian Bach Foundation, with the goal of financing the performance and recording of the entire vocal works of the German composer, more than 200 cantatas, a task expected to last more than 20 years.

Moreover, the bank was dedicated to preserving the architectural substance of the town. In 2007, Wegelin paid almost $2 million for a significant part of the late Gothic convent of St. Catherine, a former nunnery with a soaring chapel and vaulted cloister that was in considerable disrepair. It then underwrote a painstaking restoration of the chapel with its 19th-century organ, and other portions of the buildings. The idea was to use them eventually for performances of Bach’s works and other music.

The bank and Mr. Hummler also had close ties to the local business school, and at any given time several dozen students might be employed in its training programs.

Now, all this is jeopardized. Last year, Wegelin was charged in the United States with illegally helping American citizens avoid taxes. Under the shock of these charges, Wegelin was split up and its valuable assets placed with another local bank, Raiffeisen. Its bad assets remained with Wegelin, though its name was changed to Notenstein Privatbank, for a medieval guild in St. Gallen.

Wegelin executives eventually pleaded guilty before a court in New York to helping Americans avoid taxes on $1.2 billion of assets between 2002 and 2010, and agreed to pay restitution and fines of almost $60 million. Entering the plea, one of Mr. Hummler’s closest associates, Otto Bruderer, told the court that Wegelin had always believed it was in compliance with Swiss law, adding that “such conduct was common in the Swiss banking industry.”

The news shook St. Gallen. “It was extremely surprising,” said Leonie Schwendimann, who runs a small bookshop across from St. Laurentius, the Protestant church where Bach concerts sponsored by the bank are occasionally held.

Ms. Schwendimann, who often attended the concerts and was a friend of Rudolf Lutz, the baroque specialist who directed the series, voiced concern for their future. “It would be a great loss,” she said. Of the bank’s disappearance, she added, “You have to take care of your business.”

It seemed only coincidental that posters around town advertised the latest piece at the town theater, a sharp critique of the financial world by the Swiss playwright Urs Widmer titled “The End of Money,” featuring a full-length photograph of a banker with donkey’s ears.

Madeleine Herzog, responsible for culture in the city government, called the bank’s restoration of St. Catherine’s convent “exemplary.” But she was concerned about the future without Wegelin. “It was planned for the buildings to be used for cultural events, but that lies now in the responsibility of the bank’s new owners,” she said. “What their concrete plans are, what the future of the Bach cycle is,” she said, “that is not known.”

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Women have caught up to men on lung cancer risk

Smoke like a man, die like a man.

U.S. women who smoke today have a much greater risk of dying from lung cancer than they did decades ago, partly because they are starting younger and smoking more — that is, they are lighting up like men, new research shows.

Women also have caught up with men in their risk of dying from smoking-related illnesses. Lung cancer risk leveled off in the 1980s for men but is still rising for women.

"It's a massive failure in prevention," said one study leader, Dr. Michael Thun of the American Cancer Society. And it's likely to repeat itself in places like China and Indonesia where smoking is growing, he said. About 1.3 billion people worldwide smoke.

The research is in Thursday's New England Journal of Medicine. It is one of the most comprehensive looks ever at long-term trends in the effects of smoking and includes the first generation of U.S. women who started early in life and continued for decades, long enough for health effects to show up.

The U.S. has more than 35 million smokers — about 20 percent of men and 18 percent of women. The percentage of people who smoke is far lower than it used to be; rates peaked around 1960 in men and two decades later in women.

Researchers wanted to know if smoking is still as deadly as it was in the 1980s, given that cigarettes have changed (less tar), many smokers have quit, and treatments for many smoking-related diseases have improved.

They also wanted to know more about smoking and women. The famous surgeon general's report in 1964 said smoking could cause lung cancer in men, but evidence was lacking in women at the time since relatively few of them had smoked long enough.

One study, led by Dr. Prabhat Jha of the Center for Global Health Research in Toronto, looked at about 217,000 Americans in federal health surveys between 1997 and 2004.

A second study, led by Thun, tracked smoking-related deaths through three periods — 1959-65, 1982-88 and 2000-10 — using seven large population health surveys covering more than 2.2 million people.

Among the findings:

— The risk of dying of lung cancer was more than 25 times higher for female smokers in recent years than for women who never smoked. In the 1960s, it was only three times higher. One reason: After World War II, women started taking up the habit at a younger age and began smoking more.

—A person who never smoked was about twice as likely as a current smoker to live to age 80. For women, the chances of surviving that long were 70 percent for those who never smoked and 38 percent for smokers. In men, the numbers were 61 percent and 26 percent.

—Smokers in the U.S. are three times more likely to die between ages 25 and 79 than non-smokers are. About 60 percent of those deaths are attributable to smoking.

—Women are far less likely to quit smoking than men are. Among people 65 to 69, the ratio of former to current smokers is 4-to-1 for men and 2-to-1 for women.

—Smoking shaves more than 10 years off the average life span, but quitting at any age buys time. Quitting by age 40 avoids nearly all the excess risk of death from smoking. Men and women who quit when they were 25 to 34 years old gained 10 years; stopping at ages 35 to 44 gained 9 years; at ages 45 to 54, six years; at ages 55 to 64, four years.

—The risk of dying from other lung diseases such as emphysema and chronic bronchitis is rising in men and women, and the rise in men is a surprise because their lung cancer risk leveled off in 1980s.

Changes in cigarettes since the 1960s are a "plausible explanation" for the rise in non-cancer lung deaths, researchers write. Most smokers switched to cigarettes that were lower in tar and nicotine as measured by tests with machines, "but smokers inhaled more deeply to get the nicotine they were used to," Thun said. Deeper inhalation is consistent with the kind of lung damage seen in the illnesses that are rising, he said.

Scientists have made scant progress against lung cancer compared with other forms of the disease, and it remains the leading cause of cancer deaths worldwide. More than 160,000 people die of it in the U.S. each year.

The federal government, the Canadian Institutes of Health Research, the Bill and Melinda Gates Foundation, the cancer society and several universities paid for the new studies. Thun testified against tobacco companies in class-action lawsuits challenging the supposed benefits of cigarettes with reduced tar and nicotine, but he donated his payment to the cancer society.

Smoking needs more attention as a health hazard, Dr. Steven A. Schroeder of the University of California, San Francisco, wrote in a commentary in the journal.

"More women die of lung cancer than of breast cancer. But there is no 'race for the cure' for lung cancer, no brown ribbon" or high-profile advocacy groups for lung cancer, he wrote.

Kathy DeJoseph, 62, of suburban Atlanta, finally quit smoking after 40 years — to qualify for lung cancer surgery last year.

"I tried everything that came along, I just never could do it," even while having chemotherapy, she said.

It's a powerful addiction, she said: "I still every day have to resist wanting to go buy a pack."

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Online:

American Cancer Society: http://www.cancer.org

National Cancer Institute: http://www.cancer.gov/cancertopics/tobacco/smoking and http://www.cancer.gov/cancertopics/types/lung

Medical journal: http://www.nejm.org

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

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The Making of Yair Lapid, Israel’s New Power Broker

Oliver Weiken/European Pressphoto Agency

Yair Lapid spoke to reporters in Tel Aviv on Wednesday, a day after his centrist party became the second-largest faction in Parliament.

TEL AVIV — They pitched tents along Rothschild Boulevard and took to the streets in unprecedented numbers, hundreds of thousands demonstrating against the rising costs of gas, apartments, even cottage cheese.

Back on the genteel boulevard on Wednesday, many of those middle-class protesters from 2011 said they had taken their grievances to the ballot box the day before, helping to catapult Yair Lapid, a suave, handsome journalist-turned-populist-politician, into Israel’s newest power broker.

“He spoke out the strongest about how everything in this country is upside down,” said Elad Shoshan, 28, who works with computers and rents an apartment on a cheaper street off the boulevard.

Echoing his candidate’s mantra, Roni Klein, 52, an accountant, said, “My wife and I work, and still it is very hard for us to finish the month.”

Mr. Lapid’s new, centrist Yesh Atid party shocked the political establishment by winning 19 of Parliament’s 120 seats, becoming Israel’s second-largest faction and a crucial partner for Prime Minister Benjamin Netanyahu, whose relatively poor showing left him scrambling to form a stable coalition.

While Mr. Netanyahu remains all but assured of serving a third term — Mr. Lapid said Wednesday that he would not unite with Arab lawmakers to stop him — Yesh Atid’s ascendance promises to shift the government’s focus to pocketbook concerns despite the pressing foreign policy issues Israel faces.

Mr. Lapid’s campaign hardly challenged Mr. Netanyahu’s policies on the Iranian nuclear threat, the tumult in the Arab world or the Israeli-Palestinian conflict. This was the first election in memory in which such existential security issues were not emphasized, as a growing majority of Israelis see them as too tough to tackle. Even Mr. Netanyahu barely spoke about Iran, his raison d’être.

Instead, voters and analysts alike said Mr. Lapid had captured the hearts of Israel’s silent majority with his personal charm and a positive, inclusive message that harnessed the everyday frustrations that fueled the huge social justice protests in 2011.

One pollster found that about 40 percent of Mr. Lapid’s supporters defined themselves as right-leaning, and in Israel’s coalition system, many saw his success as a tactical move by voters not to oust Mr. Netanyahu but to nudge him to broaden the agenda.

On Wednesday, the prime minister embraced Mr. Lapid’s platform, promising a government “as broad as possible” that would bring change on three fronts: affordable housing, government reform and forcing ultra-Orthodox Jews to “share the burden” of military service and taxes.

Some saw the results as a victory for secular Jews at a time of conflict with the ultra-Orthodox over resources and religious pluralism. Mr. Lapid’s stronghold was here in coastal Tel Aviv and its bourgeois suburbs, where he won about 1 in 4 votes cast, and Modiin, a fast-growing bedroom community halfway between here and Jerusalem.

Tamar Hermann, a political scientist and vice president of Israel’s Open University, called Mr. Lapid “the epitome of the Israeli dream” and described his voters as “the mainstream of the mainstream.”

“This is the kind of voting you can take your kids to and teach them a lesson in civic fulfillment without taking any risks,” Professor Hermann said. “They are complaining, but this is a kind of the zeitgeist, not real agony, not real suffering, not real dissatisfaction with the basic cornerstone of the system. It’s just polishing here and there.”

The election results were widely seen as a rebuke to the status quo, but not necessarily a call for change in approach to contentious questions like what to do about the Palestinians. While Mr. Lapid has called for a return to negotiations, he shares Mr. Netanyahu’s skepticism about the lack of a partner, saying this week, “I don’t think the Arabs want peace.” He opposes division of Jerusalem and made his foreign policy speech in Ariel, a sprawling Jewish settlement 12 miles into the West Bank that the Palestinians see as problematic for the viability of their state.

“The majority of Israelis came to the conclusion that there will be no new Middle East,” Mr. Lapid said over cappuccino here last month. “What we want is not a happy marriage, but a decent divorce.”

Instead, the change voters were seeking was more about the nature of politics itself.

Irit Pazner Garshowitz contributed reporting.

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PEOPLE's Music Critic: Why We're Upset About Beyoncé's Lip-Synching Drama

By Chuck Arnold

01/22/2013 at 08:40 PM EST

Did she lip-synch or didn't she?

That's the question surrounding Beyoncé after reports surfaced that she didn't sing "The Star-Spangled Banner" live at yesterday's presidential inauguration.

A spokesperson for the U.S. Marine Band, which backed the pop diva at the ceremony, said Tuesday that Mrs. Jay-Z decided to use a previously recorded vocal track before delivering the national anthem, but later on another spokesperson, this one for the Pentagon, said there was no way of knowing whether the 16-time Grammy winner was guilty of lip-synching or not.

Should it matter? Let's remember that Whitney Houston, in what is widely considered one of the best renditions of "The Star-Spangled Banner" of all time, didn't sing it live either at the 1991 Super Bowl.

There are all sorts of technical reasons why it can be challenging to perform a song as difficult as this on such a large scale, and there are many extenuating circumstances that could have played a role in any decision to lip-synch. Certainly no one is questioning whether Beyoncé – who, in removing her earpiece midway through, may have been experiencing audio problems – has the chops to sing it.

Lip-synching – or at least singing over pre-recorded vocal tracks – has long been acceptable for dance-driven artists like Madonna, Janet Jackson and Britney Spears, whose emphasis on intense, intricate choreography makes it hard to execute the moves fans have come to expect while also singing live. Huffing and puffing into the microphone or barely projecting for the sake of keeping it real just isn't gonna cut it. Of course, there have been other instances – such as Ashlee Simpson's 2004 Saturday Night Live debacle – where faking it crossed the line.

Surely there wouldn't be the same controversy about Beyoncé had she been hoofing across the stage performing "Single Ladies (Put a Ring on It)" on one of her tour stops. But this was the presidential inauguration, the national anthem, and there was no choreography involved.

Some things have to remain sacred, and for "the land of the free and the home of the brave," this was one of them.

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Flu season fuels debate over paid sick time laws

NEW YORK (AP) — Sniffling, groggy and afraid she had caught the flu, Diana Zavala dragged herself in to work anyway for a day she felt she couldn't afford to miss.

A school speech therapist who works as an independent contractor, she doesn't have paid sick days. So the mother of two reported to work and hoped for the best — and was aching, shivering and coughing by the end of the day. She stayed home the next day, then loaded up on medicine and returned to work.

"It's a balancing act" between physical health and financial well-being, she said.

An unusually early and vigorous flu season is drawing attention to a cause that has scored victories but also hit roadblocks in recent years: mandatory paid sick leave for a third of civilian workers — more than 40 million people — who don't have it.

Supporters and opponents are particularly watching New York City, where lawmakers are weighing a sick leave proposal amid a competitive mayoral race.

Pointing to a flu outbreak that the governor has called a public health emergency, dozens of doctors, nurses, lawmakers and activists — some in surgical masks — rallied Friday on the City Hall steps to call for passage of the measure, which has awaited a City Council vote for nearly three years. Two likely mayoral contenders have also pressed the point.

The flu spike is making people more aware of the argument for sick pay, said Ellen Bravo, executive director of Family Values at Work, which promotes paid sick time initiatives around the country. "There's people who say, 'OK, I get it — you don't want your server coughing on your food,'" she said.

Advocates have cast paid sick time as both a workforce issue akin to parental leave and "living wage" laws, and a public health priority.

But to some business owners, paid sick leave is an impractical and unfair burden for small operations. Critics also say the timing is bad, given the choppy economy and the hardships inflicted by Superstorm Sandy.

Michael Sinensky, an owner of seven bars and restaurants around the city, was against the sick time proposal before Sandy. And after the storm shut down four of his restaurants for days or weeks, costing hundreds of thousands of dollars that his insurers have yet to pay, "we're in survival mode."

"We're at the point, right now, where we cannot afford additional social initiatives," said Sinensky, whose roughly 500 employees switch shifts if they can't work, an arrangement that some restaurateurs say benefits workers because paid sick time wouldn't include tips.

Employees without sick days are more likely to go to work with a contagious illness, send an ill child to school or day care and use hospital emergency rooms for care, according to a 2010 survey by the University of Chicago's National Opinion Research Center. A 2011 study in the American Journal of Public Health estimated that a lack of sick time helped spread 5 million cases of flu-like illness during the 2009 swine flu outbreak.

To be sure, many employees entitled to sick time go to work ill anyway, out of dedication or at least a desire to project it. But the work-through-it ethic is shifting somewhat amid growing awareness about spreading sickness.

"Right now, where companies' incentives lie is butting right up against this concern over people coming into the workplace, infecting others and bringing productivity of a whole company down," said John A. Challenger, CEO of employer consulting firm Challenger, Gray & Christmas.

Paid sick day requirements are often popular in polls, but only four places have them: San Francisco, Seattle, Washington, D.C., and the state of Connecticut. The specific provisions vary.

Milwaukee voters approved a sick time requirement in 2008, but the state Legislature passed a law blocking it. Philadelphia's mayor vetoed a sick leave measure in 2011; lawmakers have since instituted a sick time requirement for businesses with city contracts. Voters rejected a paid sick day measure in Denver in 2011.

In New York, City Councilwoman Gale Brewer's proposal would require up to five paid sick days a year at businesses with at least five employees. It wouldn't include independent contractors, such as Zavala, who supports the idea nonetheless.

The idea boasts such supporters as feminist Gloria Steinem and "Sex and the City" actress Cynthia Nixon, as well as a majority of City Council members and a coalition of unions, women's groups and public health advocates. But it also faces influential opponents, including business groups, Mayor Michael Bloomberg and City Council Speaker Christine Quinn, who has virtually complete control over what matters come to a vote.

Quinn, who is expected to run for mayor, said she considers paid sick leave a worthy goal but doesn't think it would be wise to implement it in a sluggish economy. Two of her likely opponents, Public Advocate Bill de Blasio and Comptroller John Liu, have reiterated calls for paid sick leave in light of the flu season.

While the debate plays out, Emilio Palaguachi is recovering from the flu and looking for a job. The father of four was abruptly fired without explanation earlier this month from his job at a deli after taking a day off to go to a doctor, he said. His former employer couldn't be reached by telephone.

"I needed work," Palaguachi said after Friday's City Hall rally, but "I needed to see the doctor because I'm sick."

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Associated Press writer Susan Haigh in Hartford, Conn., contributed to this report.

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Follow Jennifer Peltz at http://twitter.com/jennpeltz

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Banks, commodity stocks lift S&P 500 to five-year high

NEW YORK (Reuters) - Bank and commodity shares led the benchmark Standard & Poor's 500 Index to a fresh five-year closing high on Tuesday on hopes that the global economy continues to mend.

Travelers' shares climbed after the insurer's results and lifted the Dow Jones industrial average to a new five-year closing high.

On Friday, both the Dow and the S&P 500 ended at five-year highs after the quarterly earnings season got off to a solid start. On Monday, the U.S. stock market was closed in observance of the Martin Luther King, Jr., holiday.

In Tuesday's session, the market also gained on signals that Republican leaders in the U.S. House of Representatives aim on Wednesday to pass a bill to extend the U.S. debt limit by nearly four months to May 19. The White House welcomed the move, saying it would remove uncertainty about the issue.

Investors, however, were cautious ahead of an increase in earnings reports and as the S&P 500 rose for a fifth straight session.

Jack de Gan, chief investment officer of Harbor Advisory Corp, in Portsmouth, New Hampshire, said better economic numbers in the United States and China, as well as more stabilization in Europe, were driving buyers into sectors associated with economic growth.

"Any (bearish) news could turn us down for a day or so," he said, referring to the recent string of gains.

Freeport-McMoRan Copper & Gold led gains in the materials sector after it reported a 16 percent rise in fourth-quarter profit on higher production. Shares gained 4.6 percent to $35.19.

The Dow Jones industrial average <.dji> rose 62.51 points, or 0.46 percent, to 13,712.21 at the close. The S&P 500 <.spx> gained 6.58 points, or 0.44 percent, to 1,492.56. The Nasdaq Composite <.ixic> added 8.47 points or 0.27 percent, to 3,143.18.

Tuesday's session marked the highest closes for both the Dow and the S&P 500 since December 2007.

Technology shares underperformed as concerns about Apple's ability to continue to grow at hyper speed and a weak outlook from Intel Corp diminished optimism about the sector's prospects. The S&P technology index <.splrct> added 0.16 percent for the day. In comparison, the S&P energy sector index <.spny>, the S&P financials index <.spsy> and the S&P basic materials index <.splrcm> each gained 0.9 percent.

But Google shares rose 4.8 percent to above $736 in extended-hours trading after the world's No. 1 search engine reported a jump in fourth-quarter revenue. Shares of IBM added more than 4 percent to trade above $204 after the world's largest technology services company reported earnings and revenue that beat estimates.

"We expected Q4 for many tech vendors would be weak because we were expecting a lot of companies sitting on their wallets until it became clear what was going to become of the fiscal cliff," Forrester analyst Andrew Bartels said about IBM.

"Given the fact it's Q4 and the cloud of fiscal cliff within it, it's a positive indication that especially tech software will be doing better in the next couple of months."

During the regular session, shares of blue chips Travelers, DuPont

, and Verizon Communications rose following earnings.

Travelers rose 2.2 percent to $77.95, a closing high. DuPont's shares gained 1.8 percent to $47.82. Verizon's stock rose 0.9 percent to $42.94.

Thomson Reuters data through Tuesday morning showed that of the 74 S&P 500 companies that have reported earnings so far, 62.2 percent have topped expectations, roughly even with the 62 percent average since 1994, but below the 65 percent average over the past four quarters.

Overall, S&P 500 fourth-quarter earnings are forecast to have risen 2.6 percent. That estimate is above the 1.9 percent forecast from the start of earnings season, but well below the 9.9 percent fourth-quarter earnings forecast from October 1, the data showed.

U.S.-listed shares of Research in Motion rallied 13 percent to $17.90 a day after its chief executive said the Canadian company may consider strategic alliances with other companies after the launch of devices powered by RIM's new BlackBerry 10 operating system.

About 6.2 billion shares changed hands on the New York Stock Exchange, the Nasdaq and NYSE MKT, below last year's daily average of about 6.45 billion shares.

On the NYSE, advancers outnumbered decliners by a ratio of roughly 9 to 4. On the Nasdaq, five stocks rose for every three that fell.

Signs of improved sentiment toward world growth were also seen in European bond markets. The yield on Portugal's benchmark 10-year note fell below 6 percent for the first time since late 2010 on news that the country was set to tap the bond market this week for the first time since it was bailed out in 2011.

(Reporting by Rodrigo Campos; Additional reporting by Jennifer Saba; Editing by Jan Paschal)

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The Lede Blog: Prince Harry Compares War to PlayStation, and Taliban Are Not Amused

A Taliban spokesman said on Tuesday that Prince Harry must have “mental problems,” following the broadcast of remarks by the royal in which he said that killing militants from an Apache helicopter was similar to playing video games.

As soon as Britain’s Ministry of Defense announced on Monday that Prince Harry had left Afghanistan, ending his four-month deployment there, the British news media rushed to broadcast video of the royal officer at war, which was recorded with his cooperation on the condition that it not be released until his tour was over.

Britain’s Channel 4 News broke into its bulletin on Monday night just minutes after the announcement to broadcast its edit of the footage, which was shot late last year at Camp Bastion in Afghanistan’s Helmand Province by the British Press Association.

A video report from Britain’s Channel 4 News shot during Prince Harry’s recent deployment to Afghanistan.

The Channel 4 News report drew attention to the frequency with which the prince, whose mother was being chased by photographers when she died in a car accident, mentioned his distaste for the British press.

At one stage in the interview, Prince Harry said that he was not troubled by killing militants. “Take a life to save a life,” he said. “If there’s people trying to do bad stuff to our guys, then we’ll take them out of the game.”

In another edit of the footage, posted online by The Guardian, Prince Harry, who is known as Captain Wales in the army, explained that he was glad to have been “pushed forward to the front seat,” the one reserved for the attack helicopter’s gunner. That was, he said, “a joy for me because I’m one of those people that loves playing PlayStation and Xbox, so with my thumbs I like to think I’m probably quite useful — if you ask the guys I thrash them at FIFA the whole time,” referring to a popular video game series.

“This is a serious war, a historic war, resistance for us, for our people,” a Taliban spokesman, Zabiullah Mujahid, told Agence France-Presse in response, “and now this prince comes and compares this war with his games, PlayStation or whatever he calls it.”

But the spokesman added, “We don’t take his comments very seriously, as we have all seen and heard that many foreign soldiers, occupiers who come to Afghanistan, develop some kind of mental problems on their way out.”

In another part of the interview, posted online by The Telegraph, Prince Harry said that his brother, Prince William, was jealous of him. “He’d love to be out here and, to be honest with you, I don’t see why he couldn’t,” Harry said. “No one knows who’s in the cockpit. Yes you get shot at, but, you know, if the guys who are doing the same job as us are being shot at on the ground, then I don’t think there’s anything wrong with us being shot at as well. Yeah, people back home might have issues with that, but we’re not special.”

Video of remarks by Prince Harry about how much his brother would like to serve in Afghanistan.

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