Well: The Benefits of Exercising Outdoors

While the allure of the gym — climate-controlled, convenient and predictable — is obvious, especially in winter, emerging science suggests there are benefits to exercising outdoors that can’t be replicated on a treadmill, a recumbent bicycle or a track.

You stride differently when running outdoors, for one thing. Generally, studies find, people flex their ankles more when they run outside. They also, at least occasionally, run downhill, a movement that isn’t easily done on a treadmill and that stresses muscles differently than running on flat or uphill terrain. Outdoor exercise tends, too, to be more strenuous than the indoor version. In studies comparing the exertion of running on a treadmill and the exertion of running outside, treadmill runners expended less energy to cover the same distance as those striding across the ground outside, primarily because indoor exercisers face no wind resistance or changes in terrain, no matter how subtle.

The same dynamic has been shown to apply to cycling, where wind drag can result in much greater energy demands during 25 miles of outdoor cycling than the same distance on a stationary bike. That means if you have limited time and want to burn as many calories as possible, you should hit the road instead of the gym.

But there seem to be other, more ineffable advantages to getting outside to work out. In a number of recent studies, volunteers have been asked to go for two walks for the same time or distance — one inside, usually on a treadmill or around a track, the other outdoors. In virtually all of the studies, the volunteers reported enjoying the outside activity more and, on subsequent psychological tests, scored significantly higher on measures of vitality, enthusiasm, pleasure and self-esteem and lower on tension, depression and fatigue after they walked outside.

Of course, those studies were small-scale, short-term — only two walks — and squishy in their scientific parameters, relying heavily on subjective responses. But a study last year of older adults found, objectively, that those who exercised outside exercised longer and more often than those working out indoors. Specifically, the researchers asked men and women 66 or older about their exercise habits and then fitted them all with electronic gadgets that measured their activity levels for a week. The gadgets and the survey showed that the volunteers who exercised outside, usually by walking, were significantly more physically active than those who exercised indoors, completing, on average, about 30 minutes more exercise each week than those who walked or otherwise exercised indoors.

Studies haven’t yet established why, physiologically, exercising outside might improve dispositions or inspire greater commitment to an exercise program. A few small studies have found that people have lower blood levels of cortisol, a hormone related to stress, after exerting themselves outside as compared with inside. There’s speculation, too, that exposure to direct sunlight, known to affect mood, plays a role.

But the take-away seems to be that moving their routines outside could help reluctant or inconsistent exercisers. “If outdoor activity encourages more activity, then it is a good thing,” says Jacqueline Kerr, a professor at the University of California, San Diego, who led the study of older adults. After all, “despite the fitness industry boom,” she continues, “we are not seeing changes in national physical activity levels, so gyms are not the answer.”

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Euro Watch: Manufacturers Survey Points to New Downturn in Euro Zone

LONDON — Hopes the euro zone might emerge from recession soon were dealt a blow on Thursday, as surveys showed the downturn in the region’s businesses worsened unexpectedly this month — especially in France.

The data came a day before the European Commission is due to announce interim economic forecasts for the 27-nation bloc, including which countries did not meet E.U. budget deficit targets.

European stock indexes were lower, following sharp declines in Asian benchmarks, and the euro slipped against the dollar. Analysts attributed the declines to nervousness about economic growth, especially following indications Wednesday that the U.S. Federal Reserve is divided on maintaining stimulus measures.

Economists had expected that the Markit Flash Eurozone Services PMI, a business survey and one of the earliest monthly indicators of economic activity, would add to tentative signs that a recovery is in the offing.

But the indicator fell in February to 47.3 from 48.6, marking a year below the 50 threshold for growth and confounding expectations for a rise to 49.0 from more than 30 analysts polled by Reuters, none of whom forecast such a poor reading.

Markit said the schism between Germany and France — the two biggest economies in the euro zone — was now at its widest since the survey started in 1998.

While companies in Germany sustained a healthy rate of growth, French services companies are in the midst of their worst slump since early 2009, when the financial crisis and subsequent recession were doing their worst.

“If it wasn’t for Germany, these would be really dire readings,” said Chris Williamson, chief economist at Markit. “At least the German economy is still helping to keep the euro zone afloat in some respects.”

He said the latest survey pointed to the euro zone economy shrinking 0.2 percent to 0.3 percent in the first quarter, following an estimated 0.4 percent contraction at the end of last year.

A Reuters poll of economists last week suggested the economy would merely stagnate this quarter.

By far the most worrying aspect of the data released Thursday was the dismal performance of French companies.

Mr. Williamson said the data for France were more befitting a struggling “peripheral” euro zone economy like Spain or Italy, rather than the “core” status that France traditionally shares with Germany.

By contrast, Germany has enjoyed a good start to the year. German investor morale soared to its highest level in nearly three years this month, according to the ZEW research institute, while the federal statistics office said on Tuesday that employment hit its highest level in the fourth quarter since reunification.

Still, there are limits to what German prosperity can do for the rest of the region, blighted by harsh budget austerity and rising joblessness.

The latest Markit survey suggests that the “positive contagion” noted by the European Central Bank president, Mario Draghi, in January may be more in hope than expectation.

New orders at euro zone service sector companies — which include banks, information technology companies, hotels and restaurants — declined at a faster rate this month, with the index sinking sharply to 46.0 from 48.4 in January.

The survey also dashed optimism that the slump in euro zone factories would ease further in February, as the manufacturing index barely moved, to 47.8 from 47.9 in January.

Output fell at a faster rate, although new export orders brought at least a glimmer of hope, as the index rose to 51.7 in February from 49.5 - its first above-50 reading since June 2006.

The composite index, which combines both the services and manufacturing surveys, fell to 47.3 in February from 48.6 in January.

Companies cut more jobs, although not as quickly as in January, when layoffs rose at the fastest pace in more than three years.

In afternoon trading in Europe the Euro Stoxx 50, a barometer of euro zone blue chips, was down 1.75 percent. National benchmarks were down by more than 1 percent, with the MIB in Milan down 2.42 percent.

In Asia, the Nikkei 225-stock index closed down 1.39 percent, and the Hang Seng index in Hong Kong fell 1.72 percent.

The euro was at $1.3207, down from $1.3340 late Wednesday in New York.

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IHT Rendezvous: True or False? The Tussle Over Ping Fu's Memoir

Did Ping Fu, a prominent Chinese-American businesswoman and author of a recent memoir, “Bend, not Break,” make up her horrible experiences during the 1966-76 Cultural Revolution in order to gain United States citizenship? Did they help her become an American by claiming political asylum?

That’s what her critics, many of them fellow Chinese-Americans, say. It’s an accusation that can stick. As a recent New York Times investigation showed, claiming persecution has spawned an immigration industry involving lawyers prepping clients to make false asylum claims.

As I write in my Letter from China this week, Ms. Fu is being accused of making up a lot of things in her memoir. She’s also a successful entrepreneur: the U.S. government honored Ms. Fu, the founder of the software company Geomagic (in the process of being sold to 3D Systems), with a “2012 Outstanding American by Choice” award.

Ms. Fu is on the board of the White House’s National Advisory Council on Innovation and Entrepreneurship, and is a member of the National Council on Women in Technology, according to the Web site of the U.S. Citizenship and Immigration Services.

Ms. Fu, who says in her memoir she was “quietly deported” to the U.S. in 1984 for writing about female infanticide while still a college student, denies the accusations. But until now she hadn’t explained in public how she became an American.

In an interview with the International Herald Tribune, she said, apparently for the first time, the reason she kept quiet was she was trying to protect her first husband, an American, whom she does not mention in her memoir. The marriage took place while she was living in California, she said.

“I had a first marriage and that’s how I got my green card,” she said by telephone. She married on Sept. 1, 1986 and divorced three years later. Until now she had kept silent because of a “smear” campaign against her online, mostly by fellow Chinese who accuse her of lying, which extended to real-life harassment, she said: “They smear my name, they try to get my daughter’s name on the Internet, they sent people to Shanghai to surround my family and to Nanjing to harass my neighbors.” She said the accusers, who are “angry” for reasons she doesn’t really understand, contacted U.S. immigration authorities to challenge her award and her citizenship, as well as shareholders of 3D Systems to warn them she was a “liar,” and not to buy Geomagic. Her second husband, Herbert Edelsbrunner, whom she has since divorced, received many “hate e-mails,” she said. “I just don’t want to hurt innocent people.”

If a first, unpublicized marriage might lay to rest one contentious issue, there are others. Some were the result of exaggeration or unclear communication with her ghostwriter, MeiMei Fox of Los Angeles, she said.

In the interview, she volunteered an example of an error: a widely criticized account of the ‘‘period police,’’ the authorities who checked a woman’s menstrual cycle to ensure she wasn’t pregnant in the early days of the one-child policy. To stop women substituting others’ sanitary pads for inspection, they were sometimes required to use their own finger to show blood. Through a misunderstanding with Ms. Fox, Ms. Fu said this was portrayed as the use of other people’s fingers — an invasion of the woman’s body.

Ms. Fox “wrote it wrong,’’ she said. ‘‘I corrected it three times but it didn’t get corrected.’’ Women used their own finger to show blood, she said, but the mistake went into print anyway.

In general, Ms. Fox may have ‘‘just made some searches on the Internet that maybe weren’t correct,’’ Ms. Fu said.

Chiefly the errors involved use of the words ‘‘all, never, any,’’ that generalized unacceptably, Ms. Fu said. And, ‘‘She doesn’t know China’s geography,’’ she said.

At the beginning of her memoir, Ms. Fu writes of being kidnapped by a Vietnamese-American on arrival in the U.S. state of New Mexico and locked in his apartment to care for his very young children, whose mother had left, in a bizarre incident. A spokeswoman at the Albuquerque Police Department’s Records Office, where the alleged kidnapping took place, said she could not locate such an incident in their records. Asked about it, Ms. Fu repeated that she did not press charges as, fresh from China, she was terrified of all police, “So I don’t know how they keep records, if there is no criminal charges or record.”

And in an e-mail to me, she admitted she made mistakes about a magazine she said she helped edit, called Wugou, or “No Hook,” produced in 1979 by students at her college, then called the Jiangsu Teacher’s College (later it changed its name to Suzhou University, she said.) It was not that magazine but another one, This Generation, that was taken to a meeting in Beijing of student magazine writers from around the country, she wrote in the e-mail. “A good case that shows everyone’s memory can be wrong,” she wrote.

But bigger questions about the scale of the online vitriol from parts of the Chinese and Chinese-American community remain. “I really haven’t known China for 20-something years, and it didn’t occur to me that what I wrote would generate so much anger,” she said. In the last years, “as China got stronger, nationalistic views got stronger,” she said, making a “civil conversation” about disagreements apparently harder.

Additional reporting by Cindy Hao in Seattle.

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Armstrong facing Wednesday deadline with USADA

AUSTIN, Texas (AP) — Lance Armstrong is facing a Wednesday deadline to decide whether he will meet with U.S. Anti-Doping Agency officials and talk with them under oath about what he knows about performance-enhancing drug use in cycling.

The agency has said Armstrong's cooperation in its cleanup effort is the only path open to Armstrong if his lifetime ban from sports is to be reduced.

Armstrong has given mixed signals about whether he plans to talk with USADA officials. Armstrong attorney Tim Herman previously suggested Armstrong would not meet with USADA before the agency's original Feb. 6 deadline. The two sides then agreed to give Armstrong another two weeks to work out an interview with investigators.

Armstrong previously denied using performance-enhancing drugs, but in January admitted doping to win seven Tour de France titles.

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Ask an Expert: Questions About Hearing Loss? A Help Desk

This week’s Ask the Expert features Neil J. DiSarno, who will answer questions about hearing loss. Dr. DiSarno is the chief staff officer for audiology at the American Speech-Language-Hearing Association. From 1998 to 2012 he was chairman of the department of communication sciences and disorders at Missouri State University. Following are the types of questions that Dr. DiSarno is prepared to answer.

Neil J. DiSarno of the American Speech-Language-Hearing Association.

¶My wife has told me she believes I’m not hearing as well as I used to. What sort of specialist should I see and what can I expect?

¶I’ve been told that I should consider using hearing aids. If I decide to, how much better am I likely to hear?

¶I’ve noticed that my 2-year-old granddaughter’s speech is not developing properly. Neither her mother or the pediatrician seem to be concerned, but I suspect there is a problem. What do you suggest?

¶I use hearing aids, but still have great difficulty hearing conversation in restaurants and in large group settings. Is this common and is there something more that I can do to improve my ability to function in those settings?

Please leave your questions in the comments section. Answers will be posted on Wednesday, Feb. 27. (Unfortunately, not all questions may be answered.)

Booming: Living Through the Middle Ages offers news and commentary about baby boomers, anchored by Michael Winerip. You can connect with Michael Winerip on Facebook here. You can follow Booming via RSS here or visit nytimes.com/booming and reach us by e-mail at booming@nytimes.com.

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DealBook: Office Depot and OfficeMax Announce Plans to Merge, After Erroneous Release

10:21 a.m. | Updated

Office Depot and OfficeMax announced plans to merge on Wednesday, just hours after an erroneous news release about the deal surfaced briefly.

Under the terms of the deal, Office Depot said it would issue 2.69 new shares of common stock for each share of OfficeMax. At that level, the transaction would value OfficeMax at $13.50, or roughly $1.19 billion, a premium of more than 25 percent to the company’s closing price last week.

The deal has been anticipated, as the companies face an increasingly difficult competitive environment. Both companies, which are burdened with big real estate footprints, have struggled against lower-priced rivals like Amazon.com and Costco. By uniting, the two companies should be able to reduce costs and better negotiate prices.

“In the past decade, with the growth of the Internet, our industry has changed dramatically,” Neil R. Austrian, chairman and chief executive of Office Depot, said in a statement. “Combining our two companies will enhance our ability to serve customers around the world, offer new opportunities for our employees, make us a more attractive partner to our vendors and increase stockholder value.”

While the deal has been years in the making, it was initially announced prematurely. A news release announcing the merger of the companies was posted on Office Depot’s Web site early on Wednesday morning, but it quickly disappeared.

Several news organizations reported the terms disclosed in the errant news release for Office Depot’s earnings. The details were buried on page four of the release, under the header “Other Matters.”

As the details filtered through the market, shares of the companies jumped. In premarket trading, Office Depot’s stock rose more than 7 percent, while OfficeMax shares were up more than 8 percent.

The episode is reminiscent of other times that companies’ earnings releases were published prematurely. Last fall, Google’s third-quarter earnings were published three hours early, which the technology giant blamed on a mistake by R.R. Donnelley & Sons, the company’s printer.

Representatives for Office Depot and OfficeMax were not immediately available for comment on the erroneous release.

Strategically, the deal makes sense, as the companies face a changing competitive environment.

Combined, the companies reported about $4.4 billion in revenue for their third quarter of 2012; in comparison, Staples disclosed $6.4 billion in revenue for the same period.

Office Depot has also been under pressure from an activist hedge fund, Starboard Value, which sent a letter to the retailer’s board last fall. In it, Starboard called for more cost cuts and a greater focus on higher-margin businesses like copy and print services. With a 14.8 percent stake, Starboard is the company’s biggest investor.

In announcing the deal, the two companies emphasized their new financial heft.

With the merger, the retailers expect to generate $400 million to $600 million in annual cost savings. The combined entity would also have $1 billion in cash, providing additional firepower to invest in the business.

“We are excited to bring together two companies intent on accelerating innovation for our customers and better differentiating us for success in a dynamic and highly competitive global industry,” Ravi K. Saligram, chief executive of OfficeMax, said in a statement. “We are confident that there will be exciting new opportunities for employees as part of a truly global business.”

Each company will have an equal number of directors on the board of the combined retailer. Before the deal closes, OfficeMax will pay a special dividend of $1.50 a share to its shareholders.

OfficeMax was advised by JPMorgan Chase and the law firms Skadden, Arps, Slate, Meagher & Flom and Dechert. Office Depot was counseled by Simpson Thacher & Bartlett, while its board was advised by the Peter J. Solomon Company, Morgan Stanley and Kirkland & Ellis. Perella Weinberg Partners provided financial advice to the board’s transaction committee.

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For His Second Act, Japanese Premier Plays It Safe, With Early Results

Toru Hanai/Reuters

Prime Minister Shinzo Abe, whose policies have sent the Tokyo stock market up, will visit Washington this week.

TOKYO — Since taking office less than two months ago, Japan’s outspokenly hawkish new prime minister, Shinzo Abe, has been in what some political analysts are calling “safe driving mode.” He has carefully avoided saying or doing anything to provoke other Asian nations, while focusing instead on wooing voters with steps to revive the moribund domestic economy.

So far, his approach seems to be working. His plans for public-works projects, stimulus measures called “Abenomics,” have sent the Tokyo stock market surging along with Mr. Abe’s own approval rating, which is now at 71 percent, according to the latest poll by Yomiuri Shimbun. On Friday, he will seek to build on his strong start when he meets President Obama at a Washington summit meeting aimed at improving relations with the United States, which regards Japan as its most important ally in Asia.

Mr. Abe, 58, has said he wants to be what Japan has not seen in almost a decade: a steady-handed leader who lasts long enough in office to actually get things done. Analysts say his success hinges on whether he can lead his Liberal Democratic Party to victory in upper house elections in July, and end the split Parliament that undermined many of his predecessors.

What is less clear is what he will do if he wins that election. One trait that makes Mr. Abe a bit of an enigma, some analysts say, is that he seems to have two sides: the realist and the right-wing ideologue. In analysts’ view, if he does jettison some of his current caution, for instance by trying to revise Japan’s antiwar Constitution to allow a full-fledged military instead of its current Self-Defense Force, he risks provoking a standoff with China over disputed islands, and possibly isolating Japan in a region still sensitive to its early-20th-century militarism.

“In his first six weeks, he has done everything he can to show he is a moderate,” said Andrew L. Oros, director of international studies at Washington College in Chestertown, Md. “But after July, he might feel he has a freer rein to do things that he thinks are justified.”

Part of the problem, Mr. Oros and others say, is that Mr. Abe faces conflicting political pressures. His base in the governing party’s most conservative wing expects bold steps to end what it sees as Japan’s overly prolonged displays of contrition for World War II. But he must also convince the broader public that he is a coolheaded, competent steward of a declining nation that also depends on China for its economic future.

There is also the ghost of his past failure. The last time he was prime minister, six years ago, he stepped down amid criticism that he had been “clueless” for having pursued a nationalistic agenda of revising the Constitution and history textbooks, and for not doing more to reduce unemployment and spur the economy.

This time, Mr. Abe is acting with the determined carefulness of a man given a second chance. He has focused on extricating Japan from its recession with steps that have quickly buoyed the country’s economy, the world’s third-largest. Since being named prime minister after his party’s election victory in December, Mr. Abe has promised $215 billion in public works spending to create jobs and promote growth.

He has also publicly pressured the central bank, the Bank of Japan, to move more aggressively to end years of corrosive price declines known as deflation — threatening, for example, to amend the law on the bank’s independence if it does not reach its target of 2 percent inflation. The bank’s governor, Masaaki Shirakawa, announced this month that he would step aside to allow Mr. Abe to appoint a new chief who will work more closely with the government by pumping more money into the economy to prompt banks to lend more and companies to spend more.

“Mr. Abe has clearly learned the lessons of his past failure,” said Norihiko Narita, a political scientist at Surugadai University, near Tokyo. “And the biggest lesson is that voters care more about the economy.”

This article has been revised to reflect the following correction:

Correction: February 19, 2013

An earlier version of this article referred incorrectly to a request for a meeting in January that the Obama administration declined. Prime Minister Shinzo Abe was proposing traveling to the United States; the Japanese did not ask President Obama to visit.

This article has been revised to reflect the following correction:

Correction: February 19, 2013

An earlier version of this article misspelled part of the name of the Japanese newspaper whose latest poll gave Mr. Abe an approval rating of 71 percent. It is Yomiuri Shimbun, not Shimbum.

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Pistorius says no intentions to kill girlfriend

PRETORIA, South Africa (AP) — Oscar Pistorius told a packed courtroom Tuesday that he shot his girlfriend to death by mistake, thinking she was a robber. The prosecutor called it premeditated murder.

The double amputee said in an affidavit read by his lawyer at his bail hearing that he felt vulnerable because he did not have on his prosthetic legs when he pumped bullets into the locked bathroom door. Then, Pistorius said in the sworn statement, he realized that model Reeva Steenkamp was not in his bed.

"It filled me with horror and fear," he said.

He put on his prosthetic legs, tried to kick down the door, then bashed it in with a cricket bat to find Steenkamp, 29, shot inside. He said he ran downstairs with her, but "She died in my arms."

Prosecutor Gerrie Nel on Tuesday charged the 26-year-old athlete and Olympian with premeditated murder, alleging he took the time to put on his legs and walk some seven meters (yards) from the bed to the bathroom door before opening fire. A conviction of premeditated murder carries a mandatory sentence of life in jail.

The Valentine's Day shooting death has shocked South Africans and many around the world who idolized Pistorius for overcoming adversity to become a sports champion, competing in the London Olympics last year in track besides being a Paralympian. Steenkamp was a model and law graduate who made her debut on a South African reality TV program that was broadcast on Saturday, two days after her death.

The magistrate ruled that Pistorius faces the harshest bail requirements available in South African law.

Nel told the court that Pistorius fired into the door of a small bathroom where Steenkamp was cowering after a shouting match. He fired four times and three bullets hit Steenkamp, the prosecutor said.

"She couldn't go anywhere. You can run nowhere," prosecutor Nel argued. "It must have been horrific."

Pistorius sobbed softly as his lawyer, Barry Roux, insisted the shooting was an accident and that there was no evidence to substantiate a murder charge.

"Was it to kill her, or was it to get her out?" he asked about the broken-down door. "We submit it is not even murder. There is no concession this is a murder."

He said the state had provided no evidence that the couple quarreled nor offered a motive.

Nel rebutted: "The motive is 'I want to kill.'"

There were affadavits from friends of Pistorius and Steenkamp read out by defense lawyer Roux in the bail hearing.

The statements described a charming, happy couple. The night before the killing, they said, Pistorius and Steenkamp had canceled separate plans to spend the night before Valentine's Day together at his home.

As details emerged at the dramatic court hearing in the capital, Steenkamp's body was being cremated Tuesday at a memorial service in the south-coast port city of Port Elizabeth. The family said members had arrived from around the world. Six pallbearers carried her coffin, draped with a white cloth and covered in white flowers, into the church for the private service.

June Steenkamp, the mother, said the family wants answers.

"Why? Why my little girl? Why did this happen? Why did he do this?" she said in an interview published Monday in The Times newspaper.

Outside the court, several dozen singing women protested against domestic violence and waved placards urging Pistorius be refused bail. "Pistorius must rot in jail," one placard said.

South Africa has some of the world's worst rates of violence against females and the highest rate in the world of women killed by an intimate partner, according to a study by the Medical Research Council. Another council study estimates a child or woman is raped every four minutes. While homicide rates have dropped, the number of women killed by current or former partners has increased, said the council's Professor Rachel Jewkes. At least three women are killed by a partner every day in the country of 50 million, she said.

Steenkamp campaigned actively against domestic violence and had tweeted on Twitter that she planned to join a "Black Friday" protest by wearing black in honor of a 17-year-old girl who was gang-raped and mutilated two weeks ago.

What "she stood for, and the abuse against women, unfortunately it's gone right around and I think the Lord knows that statement is more powerful now," her uncle and the family spokesman Mike Steenkamp said after her memorial.

He said the family had planned a big get-together at Christmas but that had not been possible. "But we are here today as a family and the only one who's missing is Reeva," he said, breaking down and weeping.

Pistorius was born without fibula bones and had them amputated when he was 11 months.

The man known as the Blade Runner because of his running prostheses has lost several valuable sponsorships estimated to be worth more than $1 million a year.

On Tuesday, the athlete was ousted from a pro-gay campaign being launched in Cape Town, organizers said. In a video axed from the campaign, Pistorius says "You don't have to worry. You don't have to change. Take a deep breath and remember, 'It will get better.'"

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Associated Press writer Michelle Faul contributed from Johannesburg and AP photographer Schalk van Zuydam from Port Elizabeth.

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Well: Susan Love's Illness Gives New Focus to Her Cause

During a talk last spring in San Francisco, Dr. Susan Love, the well-known breast cancer book author and patient advocate, chided the research establishment for ignoring the needs of people with cancer. “The only difference between a researcher and a patient is a diagnosis,” she told the crowd. “We’re all patients.”

It was an eerily prescient lecture. Less than two months later, Dr. Love was given a diagnosis of acute myelogenous leukemia. She had no obvious symptoms and learned of her disease only after a checkup and routine blood work.

“Little did I know I was talking about myself,” she said in an interview. “It was really out of the blue. I was feeling fine. I ran five miles the day before.”

Dr. Love, a surgeon, is best known as the author of the top-selling “Dr. Susan Love’s Breast Book” (Da Capo Press, 2010) now in its fifth edition. She is also president of the Dr. Susan Love Research Foundation, which focuses on breast cancer prevention and research into eradicating the disease. But after decades of tireless advocacy on behalf of women with breast cancer, Dr. Love found herself in an unfamiliar role with an unfamiliar disease.

“There is a sense of shock when it happens to you,” she said. “In some ways I would have been less shocked if I got breast cancer because it’s so common, but getting leukemia was a world I didn’t know. Even when you’re a physician, when you get shocking news like this you sort of forget everything you know and are scared the same as everybody else.”

Because Dr. Love’s disease was caught early, she had a little time to seek second opinions and choose her medical team. She chose City of Hope in Duarte, Calif., because of its extensive experience in bone marrow transplants. At 65, Dr. Love was startled to learn she was considered among the “elderly” patients for this type of leukemia.

She was admitted to the hospital and underwent chemotherapy. Because her blood counts did not rebound after the treatment, her stay lasted a grueling seven weeks.

She went home for just two weeks, and then returned to the hospital for a bone-marrow transplant, with marrow donated by her younger sister, Elizabeth Love De Garcia, 53, who lives in Mexico City.

Although the transplant itself was uneventful, the next four weeks were an ordeal. Dr. Love developed pain and neuropathy from the chemotherapy drugs. Dr. Love’s wife, Dr. Helen Cooksey; daughter, Katie Love-Cooksey, 24; and siblings offered round-the-clock support. Ms. Love-Cooksey slept in the hospital every night. “I wasn’t very articulate during that time, but I always had my family there,” Dr. Love said. “They were great advocates for me.”

The transplant “is quite an amazing thing,” Dr. Love said. Her blood type changed from O positive to B positive, the same type as her sister. She also has inherited her sister’s immune system, and a lifelong allergy to nickel has disappeared. “I can wear cheap jewelry now,” she said. She returned to work last month.

Dr. Love has been told her disease is in remission, though her immune system remains compromised and she is more susceptible to infection. So she avoids crowds, air travel and other potential sources of cold and flu viruses.

While Dr. Love has always been a strong advocate for women undergoing cancer treatment, she says her disease and treatment has strengthened her understanding of what women with breast cancer and other types of cancer go through during treatments.

“There are little things like having numb toes or having less stamina to building muscles back up after a month of bed rest,” she said. “There is significant collateral damage from the treatment that is underestimated by the medical profession. There’s a sense of ‘You’re lucky to be alive, so why are you complaining?’ ”

Dr. Love says her experience has emboldened her in her quest to focus on the causes of disease rather than new drugs to treat it.

“I think I’m more impatient now and in more of a hurry,” she said. “I’ve been reminded that you don’t know how long you have. There are women being diagnosed every day. We don’t have the luxury to sit around and come up with a new marketing scheme. We have to get rid of this disease, and there is no reason we can’t do it.”

People who remain skeptical about the ability to eradicate breast cancer should look to the history of cervical cancer, she said. Decades ago, a woman with an abnormal Pap smear would be advised to undergo hysterectomy. Now a vaccine exists that can protect women from the infection that causes most cervical cancers.

“We need to focus more on the cause of breast cancer,” she said. “I’m still very impressed with the fact that cancer of the cervix went from being a disease that robbed women of their fertility, if not their lives, to having a vaccine to prevent it.”

Dr. Love, who wrote a book called “Live a Little!,” said illness has also made her grateful that she didn’t put off her “bucket list” and that she has traveled the world and focused on work she finds challenging and satisfying.

“It just reminds you that none of us are going to get out of here alive, and we don’t know how much time we have,” she said. “I say this to my daughter, whether it’s changing the world or having a good time, that we should do what we want to do. I drink the expensive wine now.”

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Homebuilder Confidence Dips

LOS ANGELES (AP) — Confidence among U.S. homebuilders slipped this month from the 6½ year high it reached in January, with many builders reporting less traffic by prospective customers before the critical spring home-buying season.

The National Association of Home Builders/Wells Fargo builder sentiment index released Tuesday dipped to 46 from 47 in January. It was the first monthly decline in the index since April.

Readings below 50 suggest negative sentiment about the housing market. The last time the index was at 50 or higher was in April 2006, when it was 51. It began trending higher in October 2011, when it was 17.

The latest index, based on responses from 402 builders, comes as the U.S. housing market is strengthening after stagnating for roughly five years after the housing boom collapsed.

Steady job gains and near-record-low mortgage rates have encouraged more people to buy homes. Prices have been rising. In part, that's because the supply of previously occupied homes for sale has thinned to the lowest level in more than a decade. And the pace of foreclosures, while still rising in some states, has slowed sharply on a national basis.

The trends have led homebuilders to increase construction. Last year, builders broke ground on the most new homes in four years.

All told, sales of new homes jumped nearly 20 percent last year to 367,000, the most since 2009. Still, many economists don't foresee a full housing recovery before 2015 at the earliest.

"The index remains near its highest level since May of 2006, and we expect homebuilding to continue on a modest rising trajectory this year," said David Crowe, the NAHB's chief economist.

Even so, builders remain concerned about the sturdiness of the U.S. economy and unemployment, which ticked up to 7.9 percent last month from 7.8 percent in December.

Many builders are facing higher costs for building materials and having trouble obtaining financing for construction. Some also are facing a shortage of workers in markets where residential construction has picked up sharply, such as Texas and Arizona.

An index that measures current sales conditions fell one point to 51. And a gauge of traffic by prospective buyers declined four points to 32 from 36 in January.

But builders' outlook for sales in the next six months improved one point to 50.

Though new homes represent only a fraction of the housing market, they have an outsize impact on the economy. Each home built creates an average of three jobs for a year and generates about $90,000 in tax revenue, according to NAHB statistics.

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