France to stay in Mali until stability restored

BAMAKO/DUBAI (Reuters) - France pledged on Tuesday to keep troops in Mali until stability returned to the West African country, raising the specter of a long campaign against al Qaeda-linked rebels who held their ground despite a fifth day of air strikes.

Paris has poured hundreds of soldiers into Mali and carried out 50 bombing raids since Friday in the Islamist-controlled northern half of the country, which Western and regional states fear could become a base for terrorist attacks in Africa and Europe.

Defense Minister Jean-Yves Le Drian said that, despite French air support, Malian forces had not been able to dislodge Islamist fighters from the central Malian town of Konna or Diabaly, just 350 km (220 miles) northeast of Bamako.

A column of French armored vehicles rolled northward from the dusty riverside capital of Bamako towards rebel lines on Tuesday, the first major northward deployment of ground troops. A military official declined to comment on their objective.

Thousands of African soldiers are due to take over the offensive, but regional armies are scrambling to accelerate the operation, which was initially not expected for months and has been brought forward by France's surprise bombing campaign aimed at stopping a rebel advance on a strategic town last week.

President Francois Hollande, on a visit to the United Arab Emirates during which he sought Gulf states' financial backing for the African-led mission, suggested France would retain a major role in its former colony for months to come.

"We have one goal. To ensure that when we leave, when we end our intervention, Mali is safe, has legitimate authorities, an electoral process and there are no more terrorists threatening its territory," Hollande told a news conference.

Paris has said it plans to deploy 2,500 soldiers to bolster the Malian army and work with the intervention force provided by West African states.

West African defense chiefs met in Bamako on Tuesday to approve plans for speeding up the deployment of 3,300 regional troops, foreseen in a United Nations-backed intervention plan.

Nigeria pledged to deploy soldiers within 24 hours, and Belgium said it was sending transport planes and helicopters to help, but West Africa's armies need time to become operational.

Mali's north, a vast and inhospitable area of desert and rugged mountains the size of Texas, was seized last year by an Islamist alliance combining al Qaeda's north African wing AQIM with splinter group MUJWA and the home-grown Ansar Dine rebels.

Any delay in following up on the French air bombardments of Islamist bases and fuel depots with a ground offensive could allow the insurgents to slip away into the desert and mountains, regroup and counter-attack.

The rebels, who French officials say are mobile and well armed, have shown they can hit back, dislodging government forces from Diabaly on Monday.

Residents said the town was still under Islamist control on Tuesday despite a number of air strikes that shook houses.

An eye witness near Segou, to the south, told Reuters he had seen 20 French Special Forces soldiers driving toward Diabaly.

In Konna, whose seizure on Thursday sparked French involvement, residents said Islamist fighters were camped just outside town. Army troops had also withdrawn after entering the town on Saturday.

Malians have largely welcomed the French intervention, having seen their army suffer a series of defeats by the rebels.

"With the arrival of the French, we have started to see the situation on the front evolve in our favor," said Aba Sanare, a resident of Bamako.

QUESTIONS OVER READINESS

Aboudou Toure Cheaka, a senior regional official in Bamako, said the West African troops would be on the ground in a week.

The original timetable for the 3,300-strong U.N.-sanctioned African force - to be backed by western logistics, money and intelligence services - did not initially foresee full deployment before September due to logistical constraints.

Senegal, Burkina Faso, Niger, Nigeria and Guinea have all offered troops. Col. Mohammed Yerima, spokesman for Nigeria's defense ministry, said the first 190 soldiers would be dispatched within 24 hours.

But Nigeria, which is due to lead the mission, has already cautioned that even if some troops arrive in Mali soon, their training and equipping will take more time.

Sub-Saharan Africa's top oil producer, which already has peacekeepers in Sudan's Darfur and is fighting a bloody and difficult insurgency at home against Islamist sect Boko Haram, could struggle to deliver on its troop commitment of 900 men.

One senior government adviser in Nigeria said the Mali deployment was stretching the country's military.

"The whole thing's a mess. We don't have any troops with experience of those extreme conditions, even of how to keep all that sand from ruining your equipment. And we're facing battle-hardened guys who live in those dunes," said the adviser, who asked not to be named.

FRENCH LINING UP SUPPORT

France, which has repeatedly said it has abandoned its role as policeman of its former African colonies, said on Monday that the U.S., Canada, Denmark and Germany had also offered logistical support.

Fabius has said Gulf Arab states would help the Mali campaign, while Belgium said on Tuesday it would send two C130 transport planes and two medical helicopters following a request from Paris.

A meeting of donors for the operation was expected to be held in Addis Ababa at the end of January.

Security experts have warned that the multinational intervention in Mali, couched in terms of a campaign by governments against "terrorism", could provoke a jihadist backlash against France and the West, and African allies.

U.S. officials have warned of links between AQIM, Boko Haram in Nigeria and al Shabaab Islamic militants fighting in Somalia.

Al Shabaab, which foiled a French effort at the weekend to rescue a French secret agent it was holding hostage, urged Muslims around the world to rise up against what it called "Christian" attacks against Islam.

"Our brothers in Mali, show patience and tolerance and you will win. War planes never liberate a land," Sheikh Ali Mohamud Rage, al Shabaab's spokesman, said on a rebel-run website.

U.S. officials said Washington was sharing information with French forces in Mali and considering providing logistics, surveillance and airlift capability.

"We have made a commitment that al Qaeda is not going to find any place to hide," U.S. Defense Secretary Leon Panetta told reporters as he began a visit to Europe. Panetta later said the U.S. had no plans to send troops to Mali.

One U.S. military source said the haphazard nature of French involvement reminded him of the U.S. entry into Afghanistan.

"I don't know what the French endgame is for this," the source said. "Air strikes are fine, but pretty soon you run out of easy targets. Then what do you do? What do you do when they head up into the mountains?"

(Additional reporting by Elizabeth Pineau and Raissa Kasolowsky in Abu Dhabi; Felix Onuah in Abuja and Tim Cocks in Lagos; Abdi Sheikh in Mogadishu; Michelle Nichols Louis Charbonneau at the United Nations; Richard Valdmanis in Dakar; Joe Bavier in Abidjan; Jan Vermeylen in Brussels; Writing by Pascal Fletcher, Daniel Flynn and David Lewis; editing by Richard Valdmanis, Giles Elgood and Will Waterman)

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Lance's Doping Drama Explained in 5 Clicks

Before the cyclist tells all to Oprah Winfrey, see how multiple allegations got his Tour de France titles revoked

Credit: AP

Updated: Friday Aug 24, 2012 | 02:30 PM EDT
By: Kiran Hefa

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Vegas woman who couldn't stop growing dies at 34

LAS VEGAS (AP) — As a teenager growing up in Las Vegas, Tanya Angus strutted along fashion runways. She was 5 feet 8 inches, and people told her she had a perfect body.

But at the time of her death Monday, the 34-year-old Angus stood 7 feet 2 inches and weighed about 400 pounds. She was a victim of a rare disorder called acromegaly — or gigantism — that wouldn't let her stop growing.

"'Mom, I don't know why I got it,'" Karen Strutynski recalled her daughter saying. "'But I guess God decided that I could handle it.'"

Handle it she did — by appearing on television specials and in the news, by being vulnerable about a condition that left her face misshapen and gave her chronic growing pains.

Acromegaly is a disorder in which there is too much growth hormone in the body. It's spurred by a non-cancerous tumor that grows on the pituitary gland, and causes growth of bones and organs.

The disorder affected just about everything for Angus. She couldn't pull even the largest of shirts over her head, because she couldn't fit through the collar. She needed specially made shoes, and jewelers stretched her rings to size 20.

"There's nothing made for giants," her mother explained.

Some people judged her daughter, Strutynski said, believing she used a wheelchair because she lacked the discipline to keep her weight down. What they didn't know is that she ate one meal a day, and her medications caused her face to swell.

"People were very cruel until she went into the media," Strutynski said.

After television appearances, Angus became an advocate for those with the disease, corresponding with people from some 60 countries to help them get the treatment they needed.

She saw her mission as helping others get diagnosed before it was too late and the disease got out of control, her mother said.

An autopsy is pending, but Strutynski said it appears Angus died after catching a cold and developing a tear in her big heart.

Her mother plans to keep up Angus' website and continue corresponding with patients struggling to deal with the disease.

"We can't let it end. It's just too important," Strutynski said, her voice cracking. "We can't just let it die with Tanya."

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Dow, S&P 500 inch up with retailers but Apple drags again

NEW YORK (Reuters) - The Dow and S&P 500 edged higher on Tuesday after stronger-than-expected retail data, though tech heavyweight Apple dragged on the market for a third day.

Apple was the biggest weight on both the S&P 500 and Nasdaq 100 <.ndx> after reports on Monday of cuts to orders for iPhone parts. Shares declined 3.2 percent to $485.92 and closed below $500 for the first time since February.

Retail stocks advanced after a government report showing retail sales rose more than expected in December was seen as a favorable sign for fourth-quarter growth. A separate report showed manufacturing activity in New York state contracted for the sixth month in a row in January.

"A little better-than-expected news on retail sales once again reinforces that the consumer remains alive and reasonably well," said Mark Luschini, chief investment strategist at Janney Montgomery Scott in Philadelphia, which manages about $54 billion in assets.

Among retailers, American Eagle Outfitters Inc gained 4.8 percent to $20.58 and Gap Inc rose 3.4 percent to $32.46. The Morgan Stanley retail index <.mvr> advanced 1.5 percent.

Express Inc surged 23.8 percent to $17.40 after the apparel retailer raised its fourth-quarter and full year 2012 outlook.

The Dow Jones industrial average <.dji> was up 27.57 points, or 0.20 percent, at 13,534.89. The Standard & Poor's 500 Index <.spx> was up 1.66 points, or 0.11 percent, at 1,472.34. The Nasdaq Composite Index <.ixic> was down 6.72 points, or 0.22 percent, at 3,110.78.

Apple's stock has lost about 7 percent in the last three sessions and is down 8.7 percent since the start of the year.

"It's tough to discern exactly what's putting the pressure on it. But at the end of the day, its influence, considering it's still 3 1/2 to 4 percent of the S&P 500 index, is being felt," Luschini said.

"I attribute (it) to just some of the bloom coming off of the rose. They haven't necessarily done anything wrong, as much as others have caught up."

Also keeping investors on edge is the looming debt ceiling debate. On Monday, President Barack Obama rejected any negotiations with Republicans over raising the U.S. debt ceiling. The United States could default on its debt if Congress does not increase the borrowing limit.

Resolving the debt ceiling is more a question of how than if. Investors don't expect a U.S. default, but they are also wary of another eleventh-hour agreement like the one in August 2011.

An expected lackluster earnings season, too, kept investors from taking aggressive bets. Analyst estimates for the quarter have fallen sharply since October. S&P 500 earnings growth is now seen up just 1.8 percent from a year ago, Thomson Reuters data showed.

Homebuilder Lennar reported a sharp rise in quarterly profit, but the stock declined 0.8 percent to $40.68 on worries that growth in orders was slowing.

Dell Inc shares added to Monday's gains, ending up 7.2 percent to $13.17 after sources said talks to take the computer maker private are in an advanced stage.

On the down side, shares of Facebook dropped 2.7 percent to $30.10. The company unveiled a "graph search" feature that CEO Mark Zuckerberg said would help its billion-plus users sort through content within the social network and its content feeds.

Volume was roughly 5.8 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with the 2012 average daily closing volume of about 6.45 billion.

Advancers outpaced decliners on the NYSE by about 17 to 12 and on the Nasdaq by about 13 to 11.

(Additional reporting by Chuck Mikolajczak; Editing by Kenneth Barry and Nick Zieminski)

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Mali Islamists counter attack, promise France long war

BAMAKO/PARIS (Reuters) - Al Qaeda-linked Islamist rebels launched a counteroffensive in Mali on Monday after four days of French air strikes on their northern strongholds, seizing the central town of Diabaly and promising to drag France into a brutal Afghanistan-style war.

France, which has poured hundreds of troops into the capital Bamako in recent days, carried out more air strikes on Monday in the vast desert area seized last year by an Islamist alliance grouping al Qaeda's north African wing AQIM alongside Mali's home-grown MUJWA and Ansar Dine militant groups.

"France has opened the gates of hell for all the French," said Oumar Ould Hamaha, a spokesman for MUJWA, which has imposed strict sharia, Islamic law, in its northern fiefdom of Gao. "She has fallen into a trap which is much more dangerous than Iraq, Afghanistan or Somalia," he told Europe 1 radio.

Paris is determined to shatter Islamist domination of the north of its former colony, an area many fear could become a launchpad for terrorism attacks on the West and a base for coordination with al Qaeda in Yemen, Somalia and North Africa.

The French defense ministry said it aimed to deploy 2,500 soldiers in the West African state to bolster the Malian army and work with a force of 3,300 West African troops from the immediate region foreseen in a U.N.-backed intervention plan.

The United States, which has operated a counter-terrorism training program in the region, said it was sharing information with French forces and considering providing logistics, surveillance and airlift capability.

"We have a responsibility to go after al Qaeda wherever they are," Defense Secretary Leon Panetta told reporters heading with him on a week-long tour of European capitals.

As French aircraft bombarded mobile columns of Islamist fighters, other fighters launched a counter-attack to the southwest of recent clashes, dislodging government forces from the town of Diabaly, just 350 km (220 miles) northeast of Bamako. French and Malian troops attempting to retake the town were battling Islamists shouting 'Allahu akbar', residents said.

The rebels infiltrated the town overnight from the porous border region with Mauritania, home to AQIM camps housing well-equipped and trained foreign fighters. A spokesman for Ansar Dine said its fighters took Diabaly, working with AQIM members.

Dozens of Islamist fighters died on Sunday when French rockets hit a fuel depot and a customs house being used as a headquarters. The U.N. said an estimated 30,000 people had fled the fighting, joining more than 200,000 already displaced.

France, which has repeatedly said it has abandoned its role as the policeman of its former African colonies, convened a U.N. Security Council meeting for Monday to discuss the Mali crisis.

The European Union announced it would hold an extraordinary meeting of its foreign ministers in Brussels this week to discuss speeding up a EU training mission to help the Malian army and other direct support for the Bamako government.

French Foreign Minister Laurent Fabius said France would do everything to ensure that regional African troops were deployed quickly to follow up on the French military action, which was launched to block a push southwards by the Islamist rebels.

"ORGANISED AND FANATICAL"

"We knew that there would be a counter-attack in the west because that is where the most determined, the most organized and fanatical elements are," French Defense Minister Jean-Yves Le Drian told France's BFM TV.

France has said its sudden intervention on Friday, responding to an urgent appeal from Mali's president, stopped the Islamists from seizing the dusty capital of Bamako.

President Francois Hollande says Operation Serval - named after an African wildcat - is solely aimed at supporting the 15-nation West African bloc ECOWAS which received U.N. backing in December for a military intervention to dislodge the rebels.

Hollande's robust intervention has won plaudits from Western leaders and has also shot down domestic criticism which portrayed him as spineless and indecisive.

Under pressure from Paris, regional states have said they hope to send in their forces this week. Military chiefs from ECOWAS nations will meet in Bamako on Tuesday but regional powerhouse Nigeria, which is due to lead the mission, has cautioned that training and deploying troops will take time.

Two decades of peaceful elections had earned Mali a reputation as a bastion of democracy in turbulent West Africa but that image unraveled after a military coup in March left a power vacuum for MNLA Tuareg rebels to seize the desert north.

MUJWA, an AQIM splinter group drawing support from Arabs and other ethnic groups, took control of Gao, the main city of the north, from the Tuaregs in June, shocking Mali's liberal Muslim majority with amputation of hands for theft under sharia.

Malian Foreign Minister Tyeman Coulibaly said the situation had become "untenable" in the north. "Every day, we were hearing about feet and hands being cut off, girls being raped, cultural patrimony being looted," he told the French weekly Paris Match.

ISLAMISTS DESTROY TIMBUKTU SHRINES

Last week's drive toward Bamako appeared to have been led by Ansar Dine, founded by renegade Tuareg separatist commander Iyad ag Ghali in his northern fiefdom of Kidal.

The group has said that the famed shrines of ancient desert trading town Timbuktu - a UNESCO world heritage site - were un-Islamic and idolatrous. Much of the area's religious heritage has now been destroyed, sparking international outrage.

France's intervention raises the threat for eight French hostages held by al Qaeda allies in the Sahara and for 30,000 French expatriates living in neighboring, mostly Muslim states.

Concerned about reprisals at home, France has tightened security at public buildings and on public transport.

However, top anti-terrorist judge, Marc Trevidic, played down the imminence of the risk, telling French media: "They're not very organized right now ... It could be a counter attack later on after the defeat on the ground. It's often like that."

Military analysts warn that if French action was not followed up by a robust deployment of ECOWAS forces, with logistical and financial support from NATO, then the whole U.N.-mandated Mali mission was unlikely to succeed.

"The French action was an ad-hoc measure. It's going to be a mess for a while, it depends on how quickly everyone can come on board," said Hussein Solomon, a professor at the University of the Free State, South Africa.

(Additional reporting by Emmanuel Jarry, Brian Love and Catherine Bremer in Paris, Justyna Pawlak and Adrian Croft in Busssels and Louis Charbonneau in New York; writing by Daniel Flynn; editing by Pascal Fletcher)

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Study Shows Gender Bias in Wikipedia, Linux

Today in the age of the “brogrammer,” whose frat boy tendencies are glorified and sought after by cutting-edge online startups, women in tech often find themselves objectified and excluded — especially in communities like Wikipedia and open-source software, where women make up even less of the population (around 13 percent and 1 percent, respectively) than in more mainstream technical fields.

That was one of the facts Joseph Reagle, an assistant professor at Northeastern University, drew on for his study about “Free culture and the gender gap.” He discovered that just because a community (like Wikipedia) says that it’s open doesn’t mean that it isn’t hostile to women.

Free for all?

The “Free Encyclopedia” Wikipedia’s claim to fame is that anyone can edit and contribute to it. To keep errors from cropping up, it has policies that let anyone flag part of an article for review, and allow trusted editors to decide how to present something.

The process by which those editors decide, however, is often highly combative and alienating to women, who “are socialized to not be competitive and avoid conflict” according to Reagle. Sue Gardner, the Executive Director of the Wikimedia Foundation (the project behind Wikipedia), wrote a list of “Nine Reasons Women Don’t Edit Wikipedia,” in which she noted Wikipedia’s “fighty” and “contentious” culture, where loud and assertive people drive others out regardless of their competence.

“Otherwise commendable features”

Reagle found that Wikipedia’s values of radical freedom and openness actually led to a culture that is more closed off to women. He noted that “implicit” power structures existed, even in the absence of formal ones; and that imposing few restrictions on how people treat each other can lead to “a chaotic culture of undisciplined vandals,” which disenfranchises women from participation just as surely as if there were rules against women participating.

Similar dynamics exist in popular open-source software projects like the Linux kernel. Open-source luminaries like Eric Raymond are legendarily combative and hostile to “idiots,” even while they they tolerate abusive personalities who drive female contributors away. Reagle’s study quoted numerous female writers with experience working in Linux and open-source software, who called its community “cliquish and exclusionary” as well as “more competitive and fierce than most areas of programming.”

How to achieve equality

Wikipedia’s new Teahouse page is “a friendly place to help new editors,” which is designed especially to encourage women to participate. Meanwhile, women like Denise Paolucci are creating their own startups like Dreamwidth, which are based on existing open-source programming code. Unlike most “proprietary” code, it’s still free for women to do what they want with it — if they can overcome the obstacles in their way.

Jared Spurbeck is an open-source software enthusiast, who uses an Android phone and an Ubuntu laptop PC. He has been writing about technology and electronics since 2008.

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Britney Spears Steps Out in 'Love' Sweatshirt after Split

By Dahvi Shira

01/14/2013 at 03:50 PM EST

Britney Spears still believes in "love" – at least when it comes to wearing it.

The pop star, 31 – whose failed engagement to Jason Trawick, 41, was announced on Friday – grabbed coffee in L.A. on Monday, sporting a black and white sweatshirt with the four-letter word displayed in large letters across the front.

The former X Factor judge looked casual, wearing shades and her hair in a ponytail.

Once the split was official, a source told PEOPLE, "Britney had a lot of issues with Jason doing his own thing – in business and seeing his friends. In her perfect world he would have been home with her twenty-four/seven, so that was a point of contention; something they were always working on."

But she didn't seem too bent out of shape when she made her outing and grabbed two drinks to go, as she wore a happy grin the whole time.

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Hospitals crack down on workers refusing flu shots

CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.

"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."

Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."

Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.

"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."

For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.

A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.

The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."

The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.

According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.

The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.

Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.

Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.

Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.

Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.

Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.

While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.

Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.

Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.

Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.

"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.

Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.

Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.

Calhoun, the Illinois nurse, says she is unsure of her options.

"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."

__

Online:

R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf

CDC: http://www.cdc.gov

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Apple drags on S&P, Nasdaq; Dell jumps after report

NEW YORK (Reuters) - The S&P 500 and Nasdaq ended lower on Monday as worries over demand for Apple products drove down its shares and as investors braced for earnings disappointments.

But Dell Inc's stock jumped 13 percent to about a five-month high at $12.29, offsetting some of the tech-sector weakness, after Bloomberg reported the No. 3 personal computer maker is in talks with private equity firms to go private.

Tech heavyweight Apple lost 3.6 percent to $501.75 and was the biggest weight on both the S&P 500 and Nasdaq 100 <.ndx> indexes after reports that the company has cut orders for LCD screens and other parts for the iPhone 5 this quarter due to weak demand. The stock earlier hit a session low of $498.51, the first dip below $500 since February 16.

"With Apple, it seems as if the sentiment has shifted from this being the one stock that everybody wanted to own to people beginning to look at it as a company (whose) business is slowing down somewhat," said Eric Kuby, chief investment officer of North Star Investment Management Corp in Chicago.

Adding to investor unease, fourth-quarter earnings kick into high gear this week. Analyst estimates for the quarter have fallen sharply since October, with S&P 500 earnings growth now seen up just 1.9 percent from a year ago, Thomson Reuters data showed.

The Dow Jones industrial average <.dji> was up 18.89 points, or 0.14 percent, at 13,507.32. The Standard & Poor's 500 Index <.spx> was down 1.37 points, or 0.09 percent, at 1,470.68. The Nasdaq Composite Index <.ixic> was down 8.13 points, or 0.26 percent, at 3,117.50.

Apple suppliers also lost ground, with Cirrus Logic off 9.4 percent at $28.62 and Qualcomm down 1 percent at $64.24.

The Dow fared better than the other two indexes, helped in part by Hewlett-Packard shares, which rose 4.9 percent to $16.95. The stock, which was up early in the session after JPMorgan upgraded its rating on the stock and raised its price target to $21 from $15, added to gains after the Dell report.

Appliance and electronics retailer Hhgregg Inc slumped 5.7 percent to $7.44 after the company cut its same-store sales forecast for the full year.

Earnings reports are due this week from Goldman Sachs , Bank of America , Intel and General Electric , among other companies. Third-quarter reports ended with a gain of just 0.1 percent, the worst for an S&P 500 profit period in three years, according to Thomson Reuters data.

President Barack Obama warned Congress at a news conference on Monday that a refusal to raise the U.S. debt ceiling next month could mean a government shutdown and trigger economic chaos.

Volume was roughly 5.6 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with the 2012 average daily closing volume of about 6.45 billion.

Decliners were about even with advancers on the NYSE while decliners outpaced advancers on the Nasdaq by about 12 to 11.

(Additional reporting by Chuck Mikolajczak; Editing by Kenneth Barry and Nick Zieminski)

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France bombs Islamist strongholds deep in north Mali

BAMAKO/PARIS (Reuters) - French fighter jets pounded Islamist rebel strongholds deep in northern Mali on Sunday as Paris poured more troops into the capital Bamako, awaiting a West African force to dislodge al Qaeda-linked insurgents from the country's north.

The attacks on Islamist positions near the ancient desert trading town of Timbuktu and Gao, the largest city in the north, marked a decisive intensification on the third day of the French mission, striking at the heart of the vast area seized by rebels in April.

France is determined to end Islamist domination of northern Mali, which many fear could act as a base for attacks on the West and for links with al Qaeda in Yemen, Somalia and North Africa.

Defense Minister Jean-Yves Le Drian said France's sudden intervention on Friday had prevented the advancing rebels from seizing Bamako. He vowed that air strikes would continue.

"The president is totally determined that we must eradicate these terrorists who threaten the security of Mali, our own country and Europe," he told French television.

Residents and rebel leaders had reported air raids early on Sunday in the towns of Lere and Douentza in central Mali, forcing Islamists to withdraw. As the day progressed, French jets struck targets further to the north, including near the town of Kidal, the epicenter of the rebellion.

In Gao, a dusty town on the banks of the Niger river where Islamists have imposed an extreme form of sharia law, residents said French jets pounded the airport and rebel positions. A huge cloud of black smoke rose from the militants' camp in the city's north, and pick-up trucks ferried dead and wounded to hospital.

"The planes are so fast you can only hear their sound in the sky," resident Soumaila Maiga said by telephone. "We are happy, even though it is frightening. Soon we will be delivered."

Paris said four Rafale jets flew from France to strike rebel training camps, logistics depots and infrastructure around Gao with the aim of weakening the rebels and preventing them from returning southward.

"We blocked the terrorists' advance and from today what we've started to do is to destroy the terrorists' bases behind the front line," French Foreign Minister Laurent Fabius told LCI television.

France has deployed about 550 soldiers to Mali under "Operation Serval" -- named after an African wildcat -- split between Bamako and the town of Mopti, 500 km (300 miles) north.

In Bamako, a Reuters cameraman saw more than 100 French troops disembark on Sunday from a military cargo plane at the international airport, on the outskirts of the capital.

The city's streets were calm, with the sun streaking through the dusty air as the seasonal Harmattan wind blew from the Sahara. Many cars had French flags draped from the windows to celebrate Paris's intervention.

"We thank France for coming to our aid," said resident Mariam Sidibe. "We hope it continues till the north is free."

AFRICAN TROOPS EXPECTED

More than two decades of peaceful elections had earned Mali a reputation as a bulwark of democracy, but that image unraveled in a matter of weeks after a military coup in March which left a power vacuum for the Islamist rebellion.

France convened a U.N. Security Council meeting for Monday to discuss Mali. French President Francois Hollande's intervention has won plaudits from leaders in Europe, Africa and the United States but it is not without risks.

It raised the threat level for eight French hostages held by al Qaeda allies in the Sahara and for the 30,000 French expatriates living in neighboring, mostly Muslim states.

Concerned about reprisals, France has tightened security at public buildings and on public transport. It advised its 6,000 citizens to leave Mali as spokesmen for Ansar Dine and al Qaeda's north Africa wing AQIM promised to exact revenge.

In its first casualty of the campaign, Paris said a French pilot was killed on Friday when rebels shot down his helicopter.

Hours earlier, a French intelligence officer held hostage in Somalia by al Shabaab extremists linked to al Qaeda was killed in a failed commando raid to free him.

Hollande says France's aim is simply to support a mission by West African bloc ECOWAS to retake the north, as mandated by a U.N. Security Council resolution in December.

With Paris pressing West African nations to send their troops quickly, Ivory Coast President Alassane Ouattara, who holds the rotating ECOWAS chairmanship, kick-started the operation to deploy 3,300 African soldiers.

Ouattara, installed in power with French military backing in 2011, convened a summit of the 15-nation bloc for Saturday in Ivory Coast to discuss the mission.

"The troops will start arriving in Bamako today and tomorrow," said Ali Coulibaly, Ivory Coast's African Integration Minister. "They will be convoyed to the front."

The United States is considering sending a small number of unarmed surveillance drones to Mali as well as providing logistics support, a U.S. official told Reuters. Britain and Canada have also promised logistical support.

Former French colonies Senegal, Niger and Burkina Faso have all pledged to deploy 500 troops within days. In contrast, regional powerhouse Nigeria, due to lead the ECOWAS force, has suggested it would take time to train and equip the troops.

HOUSE-TO-HOUSE SEARCHES

France, however, appeared to have assumed control of the operation on the ground. Its airstrikes allowed Malian troops to drive the Islamists out of the strategic town of Konna, which they had briefly seized this week in their southward advance.

Calm returned to Konna after three nights of combat as the Malian army crushed any remaining rebel fighters. A senior army official said more than 100 rebels had been killed.

"Soldiers are patrolling the streets and have encircled the town," one resident, Madame Coulibaly, told Reuters by phone. "They are searching houses for arms or hidden Islamists."

Analysts expressed doubt, however, that African nations would be able to mount a swift operation to retake north Mali -- a harsh, sparsely populated terrain the size of France -- as neither the equipment nor ground troops were prepared.

"My first impression is that this is an emergency patch in a very dangerous situation," said Gregory Mann, associate professor of history at Columbia University, who specializes in francophone Africa and Mali in particular.

While France and its allies may be able to drive rebel fighters from large towns, they could struggle to prise them from mountain redoubts in the region of Kidal, 300 km (200 miles) northeast of Gao.

Human Rights Watch said at least 11 civilians, including three children, had been killed in the fighting. A spokesman for Doctors Without Borders in neighboring Mauritania said about 200 Malian refugees had fled across the border to a camp at Fassala and more were on their way.

In Bamako, civilians tried to contribute to the war effort.

"We are very proud and relieved that the army was able to drive the jihadists out of Konna. We hope it will not end there, that is why I'm helping in my own way," said civil servant Ibrahima Kalossi, 32, one of over 40 people who queued to donate blood for wounded soldiers.

(Additional reporting by Adama Diarra, Tiemoko Diallo and Rainer Schwenzfeier in Bamako, Pascal Fletcher in Johannesburg, Joe Bavier in Abidjan, Catherine Bremer, Leila Aboud and John Irish in Paris and Phil Stewart in Washington; Writing by Daniel Flynn; Editing by Will Waterman and Roger Atwood)

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