Kerry: "We know" Assad ordered Syria chemical attack, "what are we going to do about it?"

London Secretary of State John Kerry's frustration was visible Monday after days of lobbying other nations to support President Obama's call for punitive military strikes against the Syrian government.

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Speaking to reporters in London at the tail end of a foreign trip which saw him take the U.S. government's case to both friends and foes at the G-20 summit in Russia and in Europe, Kerry reiterated the Obama administration's absolute certainty in its own evidence that Syrian President Bashar Assad was behind an Aug. 21 chemical weapons attack in the Damascus suburbs.

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"We know that his regime gave orders to prepare for a chemical attack," said Kerry. "We know by tracing it physically where the rockets came from and where they landed," he added, saying still-secret intelligence showed rockets being fired from regime-controlled areas into the opposition held eastern Ghouta suburbs.

"The evidence is powerful, and the question for all of us is what are we going to do about it," said Kerry.

The White House has shared its evidence with U.S. lawmakers, but it's unclear who else has seen the satellite imagery and heard the intercepted phone calls which make President Obama and his cabinet so certain Assad ordered the attack.

Russia, a close ally to the Assad regime, has said its own analysis of earlier alleged chemical weapons attacks in Syria suggested the rebels fighting against Assad had used deadly chemical agents, including sarin gas.

Russian Foreign Minister Sergey Lavrov welcomes his Syrian counterpart Walid Muallem, left, prior to talks in Moscow, Sept. 9, 2013.

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Russian Foreign Minister Sergey Lavrov, speaking Monday in Moscow alongside his Syrian counterpart Walid Muallem, called on the U.S. to focus its attention and efforts on an expected round of diplomacy and negotiations in Geneva, "and not into preparations for military action."

"We believe in a peaceful settlement to the conflict, but if strikes happen, we would have a different stance," warned Lavrov, suggesting the window for a diplomatic solution to the crisis could actually close if the U.S. went ahead with strikes.

Kerry argued the contrary in London, saying negotiations were not possible with an Assad regime that he said felt it could carry out attacks like the one in Ghouta "with impunity".

Assad himself has given his first television interview since Obama sought congressional approval for strikes in Syria, telling "CBS This Morning" co-host Charlie Rose on Sunday that the U.S. and its allies should "expect every action" in retaliation to a strike.

On Monday, Kerry dismissed the Assad regime's repeated denials that it was to blame for the Ghouta attack.

"This is a man without credibility," Kerry said of the Syrian president.

The Secretary of State stressed that "we're not talking about war" with the plans for an "unbelievably limited" strike on Syrian military targets. "We're not going to war."

Asked by CBS News correspondent Margaret Brennan whether there was any way, at this stage, for Assad to stop an attack by the U.S., Kerry said the Syrian leader "could turn over every single bit of his chemical weapons to the international community in the next week. Turn it over. All of it. Without delay, and allow a full and total accounting before that, but he isn't about to do it and it can't be done."

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Today’s headlines about tamoxifen

Today’s headlines

You may have spotted headlines today claiming that women’s ‘failure’ to take the drug tamoxifen is costing ‘hundreds of lives every year’ in deaths from breast cancer.

The headlines come from research published in the British Journal of Cancer, funded by Breast Cancer Campaign. The researchers, based in Glasgow, looked at the medical records of 1263 breast cancer patients, to see how many completed their prescribed course of tamoxifen.

The authors found that nearly four out of 10 women on the study completed less than 80 per cent of their prescription. Among women whose cancer came back, such ‘low adherers’ tended to have their cancer come back sooner.

The authors, who also looked at a range of other data on the women, calculated that if all of them were to have completed their prescription it would save several hundred lives, and save the NHS around £30 million.

So, what should we make of this finding? Are we to ‘blame’ women – as the tone of some news reports implied – for costing the NHS money by their ‘failure’ to take the drug? Or is it, as so often the case, a bit more complicated than that?

As many readers will doubtless be aware, tamoxifen is a drug used in the prevention and treatment of breast cancer. It works by blocking the action of the hormone oestrogen, and is usually given to women after treatment for breast cancer, to try to prevent their cancer from coming back.

Research has shown that taking tamoxifen for five years after treatment can prevent breast cancer returning, and save lives.

But, like all drugs, it has side effects. Because it works by stopping oestrogen from having its normal effects, it can cause menopause-like symptoms. In some women these can be extremely debilitating, and some women choose to stop taking it.

We spoke to our head information nurse, Martin Ledwick, about what he thought of the findings, and what women should make of them.

“This study highlights the fact that a significant number of women don’t take their tamoxifen – either for as long as they should, or every day as prescribed.  Worryingly, this can make it more likely that their cancers could come back, leading to more treatment and a worse outlook for them,” he told us.

This is an important issue, says Ledwick, and raises lots of questions about whether and how doctors and other healthcare professionals can help and support women to continue with their treatment, or to take it regularly.

However, there’s an important caveat. “The study doesn’t look at why women didn’t take their tamoxifen as prescribed, and doesn’t differentiate between women who stopped taking the drug completely, and those who seemed to take it inconsistently.”

“So to find out how best we can help women to stick to their treatment plan we would need to understand more about why they didn’t in the first place,” Ledwick says.

“Tamoxifen does have side effects, but women have different individual experience of their severity.  Some women find these side effects very hard to bear and perhaps this is one of the reasons why they stop taking tamoxifen.  If women choose to stop taking a drug because of its side effects, it is important that they have made an informed choice,” he says.

But some women in this study took their tamoxifen inconsistently rather than stopping all together.

“It could be that these women forgot from time to time rather than made an active decision not to take it.  Tamoxifen is a drug that we expect women to take long term, so it wouldn’t be surprising that sometimes someone might forget to take it.”

There could be other psychological reasons too.  “Taking a drug every day following treatment for breast cancer might be acting like a daily reminder of their cancer experience for some women, making them less inclined to want to continue taking it,” Ledwick says.

“It’s important that health professionals don’t make women feel they have failed if they find it hard to continue their treatment.  We need to try and find ways of making treatments easier and more bearable,” says Ledwick.

Until we have answers to these outstanding questions it will be hard to develop specific ways to support women taking tamoxifen.

One thing the medical teams can do, says Ledwick, is to make sure women understand the importance of continuing hormone therapy, and explain the risks of not taking it against the benefits of taking it.  Then if any woman chooses to discontinue treatment they will at least have made a fully informed choice.

And researchers need to continue working towards finding treatments that are easier to take and have more manageable side effects.

Media stories about cancer research can often lead to negative feelings, particularly of ‘blame’, in patients and survivors. Today’s headlines may have been alarming for some – particularly women taking (or who have stopped taking) tamoxifen. If this affects you, you can call our nurse team on 0808 800 4040, or visit our Cancer Chat forum to talk to others in a similar situation.

Henry

McCowan C., Wang S., Thompson A.M., Makubate B. & Petrie D.J. (2013). The value of high adherence to tamoxifen in women with breast cancer: a community-based cohort study, British Journal of Cancer, 109 (5) 1172-1180. DOI: 10.1038/bjc.2013.464

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How to make better decisions about retirement income

(MoneyWatch) One of the most important and complex retirement planning decisions you'll make is how to generate reliable, lifetime retirement income from your IRA, 401(k), and retirement savings. This post suggests a methodical approach for sorting out which retirement income generator (RIG) or combination of RIGs might work best for you.

As background for this post, you may want to review my recent post, "3 ways to turn your IRA and 401(k) into a lifetime retirement paycheck," which summarized the three methods of generating retirement income:

Each RIG has its pros and cons, and each RIG generates a significantly different amount of retirement income. As a result, when deciding how to generate your retirement paycheck, it's essential to understand the important tradeoffs you'll face when choosing your specific RIG or combination of RIGs. Some of these tradeoffs focus on the degree of control you want over your retirement savings vs. the certainty that your retirement paycheck will last the rest of your life, no matter how long you live and no matter what happens in the economy.

When deciding how to use your money to generate retirement income, it's important to understand two cold, hard truths: You'll most likely need to make some tradeoffs between the goals described below. And these tradeoffs will have a significant impact on the amount of retirement income you'll receive.

Some people will opt for a retirement income with lifetime guarantees that aren't subject to the risk of poor investment performance. Others might be willing to live with some uncertainty about their investments in exchange for the ability to have some control over and access to their retirement savings, and for the potential to leave a legacy to their children or charities.

Let's look a little deeper at the possible goals you'll set when it comes to your RIGs. I call these the LIFE goals:

Most people want to maximize the amount of their retirement income and satisfy as many of these goals as possible with their RIGs. Unfortunately, you get what you pay for when it comes to addressing these goals. What I mean is, the more of these goals you want to meet, the lower your initial retirement income will be.

When selecting a specific RIG, you'll need to make a trade-off between the LIFE goals and the amount of retirement income you need. For example, a 65-year-old with $500,000 in retirement savings can reasonably expect to generate an annual retirement income of between $15,000 and $30,000, depending on the RIG(s) they use and how many goals they want to address. These net figures correspond to initial annual retirement incomes equaling 3 percent and 6 percent of savings, respectively -- these percentages are often called the "payout rates."

The $15,000 amount meets the most number of LIFE goals and gives you maximum control over your retirement investments. The $30,000 amount addresses the fewest number of LIFE goals and gives you the least control over your retirement investments, but it also maximizes the certainty of your retirement income.

Here's a slide from one of the retirement planning workshops that I show participants to help them rate how important each of the LIFE goals are for them.

Deciding which goals are most important to you will help you develop your strategy for generating retirement income. Many people may decide that a combination of RIGs might best meet their circumstances, giving them the advantages of each while mitigating the disadvantages of each.

Stay tuned for my next post, which describes how the various RIGs meet the different LIFE goals.

This post is an edited excerpt from my recent book, Money for Life: Turn Your IRA and 401(k) Into a Lifetime Retirement Paycheck.

Steve Vernon On Twitter » >> View all articles

For more than 35 years, consulting actuary Steve Vernon helped large employers design and manage their retirement programs. Now he's a Research Scholar for the Stanford Center on Longevity, where he helps collect, direct, and disseminate research that will improve the financial security of seniors. He also delivers retirement planning workshops and has authored Money for Life: Turn Your IRA and 401(k) Into a Lifetime Retirement Paycheck and Recession-Proof Your Retirement Years.

View the original article here

How to make better decisions about retirement income

(MoneyWatch) One of the most important and complex retirement planning decisions you'll make is how to generate reliable, lifetime retirement income from your IRA, 401(k), and retirement savings. This post suggests a methodical approach for sorting out which retirement income generator (RIG) or combination of RIGs might work best for you.

As background for this post, you may want to review my recent post, "3 ways to turn your IRA and 401(k) into a lifetime retirement paycheck," which summarized the three methods of generating retirement income:

Each RIG has its pros and cons, and each RIG generates a significantly different amount of retirement income. As a result, when deciding how to generate your retirement paycheck, it's essential to understand the important tradeoffs you'll face when choosing your specific RIG or combination of RIGs. Some of these tradeoffs focus on the degree of control you want over your retirement savings vs. the certainty that your retirement paycheck will last the rest of your life, no matter how long you live and no matter what happens in the economy.

When deciding how to use your money to generate retirement income, it's important to understand two cold, hard truths: You'll most likely need to make some tradeoffs between the goals described below. And these tradeoffs will have a significant impact on the amount of retirement income you'll receive.

Some people will opt for a retirement income with lifetime guarantees that aren't subject to the risk of poor investment performance. Others might be willing to live with some uncertainty about their investments in exchange for the ability to have some control over and access to their retirement savings, and for the potential to leave a legacy to their children or charities.

Let's look a little deeper at the possible goals you'll set when it comes to your RIGs. I call these the LIFE goals:

Most people want to maximize the amount of their retirement income and satisfy as many of these goals as possible with their RIGs. Unfortunately, you get what you pay for when it comes to addressing these goals. What I mean is, the more of these goals you want to meet, the lower your initial retirement income will be.

When selecting a specific RIG, you'll need to make a trade-off between the LIFE goals and the amount of retirement income you need. For example, a 65-year-old with $500,000 in retirement savings can reasonably expect to generate an annual retirement income of between $15,000 and $30,000, depending on the RIG(s) they use and how many goals they want to address. These net figures correspond to initial annual retirement incomes equaling 3 percent and 6 percent of savings, respectively -- these percentages are often called the "payout rates."

The $15,000 amount meets the most number of LIFE goals and gives you maximum control over your retirement investments. The $30,000 amount addresses the fewest number of LIFE goals and gives you the least control over your retirement investments, but it also maximizes the certainty of your retirement income.

Here's a slide from one of the retirement planning workshops that I show participants to help them rate how important each of the LIFE goals are for them.

Deciding which goals are most important to you will help you develop your strategy for generating retirement income. Many people may decide that a combination of RIGs might best meet their circumstances, giving them the advantages of each while mitigating the disadvantages of each.

Stay tuned for my next post, which describes how the various RIGs meet the different LIFE goals.

This post is an edited excerpt from my recent book, Money for Life: Turn Your IRA and 401(k) Into a Lifetime Retirement Paycheck.

Steve Vernon On Twitter » >> View all articles

For more than 35 years, consulting actuary Steve Vernon helped large employers design and manage their retirement programs. Now he's a Research Scholar for the Stanford Center on Longevity, where he helps collect, direct, and disseminate research that will improve the financial security of seniors. He also delivers retirement planning workshops and has authored Money for Life: Turn Your IRA and 401(k) Into a Lifetime Retirement Paycheck and Recession-Proof Your Retirement Years.

View the original article here

On 50th anniversary of MLK's speech, locals excited about trip to D.C.

On 50th anniversary of MLK's speech, locals excited about trip to D.C.

Martin Luther King Jr. Middle School sixth-grader Malik Washington left Kankakeeon Friday afternoon with 53 others to join a 50th anniversary pilgrimage to Washington, D.C., in remembrance of MLK's famous "I Have a Dream" speech.

Malik said his own dream today is "to be successful." But he was going to Washington "to march for justice ... for Trayvon ... jobs ... I have a dream." Though just 11, he said he thinks racial relations have improved because "we communicate with each other better."

His grandmother, Shawn Love, of Kankakee, said she was making the trip "to take my grandson to this historic moment and to march on Washington for justice. I want to teach my grandson you have to take the positive way to do things in life."

She planned to meet in Washington with two other grandsons from Maryland and her brother, Kankakee native Angelo Bailey, of D.

View the original article here

Source: U.S. postpones meeting with Russia about Syria

Updated 2:25 a.m.

WASHINGTON The U.S. has put off a meeting that had been scheduled for Wednesday in The Hague between senior diplomats from the United States and Russia as Washington mulls its response to what it says was a chemical weapons attack by the regime of President Bashar Assad, a senior State department official tells CBS News.

"Given our ongoing consultations about the appropriate response to the chemical weapons attack in Syria on August 21, we have decided to postpone Under Secretary (Wendy) Sherman and (U.S. Ambassador to Syria) Ambassador (Robert) Ford's meeting with a Russian delegation," the source said.

The meeting was to have taken up plans for an international peace conference aimed at ending Syria's civil war.

"We will work with our Russian counterparts to reschedule the meeting," the official continued. "As we've long made clear - and as the events of August 21 reinforce - it is imperative that we reach a comprehensive and durable political solution to the crisis in Syria. The United States remains fully invested in that process. We will continue working with Russia and other international partners to move towards a transition based on the framework laid out in the Geneva Communique."

Russia regrets the postponement, Deputy Foreign Minister Gennady Gatilov said Tuesday, according to the Reuters news service. Gatilov made clear on Twitter that the U.S. decided unilaterally to postpone the meeting, Reuters says.

Earlier on Monday, U.S. Secretary of State John Kerry said there is "undeniable" evidence of a large-scale chemical weapons attack in Syria, with intelligence strongly pointing to Assad's government and, "This international norm cannot be violated without consequences." Kerry called the use of such weapons a "moral obscenity."

Kerry's tough language marked the clearest justification yet for U.S. military action in Syria, which, if President Barack Obama decides to do so, most likely would involve sea-launched cruise missile attacks on Syrian military targets.

Speaking to reporters at the State Department, Kerry was harshly critical of chemical warfare.

26 Photos

"By any standard, it is inexcusable and - despite the excuses and equivocations that some have manufactured - it is undeniable," said Kerry, the highest-ranking U.S. official to confirm the attack in the Damascus suburbs that activists say killed hundreds of people.

Mr. Obama was still deciding how to respond to the use of deadly gases, officials said. The White House said last year that type of warfare would cross a "red line." But the U.S., along with allies in Europe, appeared to be laying the groundwork for the most aggressive response since Syria's civil war began more than two years ago.

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Source: U.S. postpones meeting with Russia about Syria

Updated 2:25 a.m.

WASHINGTON The U.S. has put off a meeting that had been scheduled for Wednesday in The Hague between senior diplomats from the United States and Russia as Washington mulls its response to what it says was a chemical weapons attack by the regime of President Bashar Assad, a senior State department official tells CBS News.

"Given our ongoing consultations about the appropriate response to the chemical weapons attack in Syria on August 21, we have decided to postpone Under Secretary (Wendy) Sherman and (U.S. Ambassador to Syria) Ambassador (Robert) Ford's meeting with a Russian delegation," the source said.

The meeting was to have taken up plans for an international peace conference aimed at ending Syria's civil war.

"We will work with our Russian counterparts to reschedule the meeting," the official continued. "As we've long made clear - and as the events of August 21 reinforce - it is imperative that we reach a comprehensive and durable political solution to the crisis in Syria. The United States remains fully invested in that process. We will continue working with Russia and other international partners to move towards a transition based on the framework laid out in the Geneva Communique."

Russia regrets the postponement, Deputy Foreign Minister Gennady Gatilov said Tuesday, according to the Reuters news service. Gatilov made clear on Twitter that the U.S. decided unilaterally to postpone the meeting, Reuters says.

Earlier on Monday, U.S. Secretary of State John Kerry said there is "undeniable" evidence of a large-scale chemical weapons attack in Syria, with intelligence strongly pointing to Assad's government and, "This international norm cannot be violated without consequences." Kerry called the use of such weapons a "moral obscenity."

Kerry's tough language marked the clearest justification yet for U.S. military action in Syria, which, if President Barack Obama decides to do so, most likely would involve sea-launched cruise missile attacks on Syrian military targets.

Speaking to reporters at the State Department, Kerry was harshly critical of chemical warfare.

26 Photos

"By any standard, it is inexcusable and - despite the excuses and equivocations that some have manufactured - it is undeniable," said Kerry, the highest-ranking U.S. official to confirm the attack in the Damascus suburbs that activists say killed hundreds of people.

Mr. Obama was still deciding how to respond to the use of deadly gases, officials said. The White House said last year that type of warfare would cross a "red line." But the U.S., along with allies in Europe, appeared to be laying the groundwork for the most aggressive response since Syria's civil war began more than two years ago.

View the original article here

On 50th anniversary of MLK's speech, locals excited about trip to D.C.

On 50th anniversary of MLK's speech, locals excited about trip to D.C.

Martin Luther King Jr. Middle School sixth-grader Malik Washington left Kankakeeon Friday afternoon with 53 others to join a 50th anniversary pilgrimage to Washington, D.C., in remembrance of MLK's famous "I Have a Dream" speech.

Malik said his own dream today is "to be successful." But he was going to Washington "to march for justice ... for Trayvon ... jobs ... I have a dream." Though just 11, he said he thinks racial relations have improved because "we communicate with each other better."

His grandmother, Shawn Love, of Kankakee, said she was making the trip "to take my grandson to this historic moment and to march on Washington for justice. I want to teach my grandson you have to take the positive way to do things in life."

She planned to meet in Washington with two other grandsons from Maryland and her brother, Kankakee native Angelo Bailey, of D.

View the original article here

Parents in Brick upset about move of special education students

BRICK — A school district plan to move about 60 special education students to the Osbornville Elementary School from their neighborhood schools has drawn the ire of some parents who think it will have a negative impact on their children?s education.

Marjory Towey said she was shocked when she heard her 7-year old daughter, a special education student, would attend the Osbornville Elementary School in September. Her daughter now attends the Emma Havens Young Elementary School.

?These are special education students who need stability in their surroundings and we feel that the Brick school system has unjustly chosen to move this demographic and has not thought of our children?s best interest,?? said Towey, 40. ?This will be the third school that my daughter has attended in three years. How is that stability???

Some concerned parents attended the township Board of Education meeting July 25 seeking answers to why students are being moved. During the meeting, district officials said the move was an educational move but failed to elaborate. Superintendent Walter Uszenski said he would meet with groups of parents to discuss the issue during the next couple of weeks. Calls to Uszenski on Wednesday were not returned.

Towey said parents were kept in the dark until the last minute about the change.

?The only way that I knew something was going on was when I saw my daughter?s teacher getting transferred to the Osbronville School last month,? Towey said. ?We feel like this was done behind our back. It?s like they kept us out of loop. It?s like they did not want anyone to fight it. It?s so late in the summer, what can be done??

Jennifer Hanley?s son will be a special education first-grader in September. She said moving the students is not right.

?The district did not supply any information to the parents, there is a lot of confusion,? said Hanley, 41. ?We feel our kids are being segregated and being taken away from their neighborhood kids.?

Colleen Collichio, a 36-year-old mother of twin 6-year-old boys, one of whom is autistic, said the change could have long-term effects on the children.

?They (the district) really didn?t give us much information. They claim that the smaller condensed classes will give them more one-on-one academically,? Collichio said. ?Most of these kids on the spectrum are so academically smart, it is the social issue that they need help with to prepare them for independence.?

Since the move was announced, Collichio talked district officials into letting her son stay at Lanes Mills Elementary School. Yet Collichio said she still is upset by the situation.

?Most of us parents accept that our kids won?t go to college but if they can get a job and know how to take care of themselves, know how to communicate to the locals to get through life that is all we want,? Collichio said. ?We would rather them have the social skills to get through life so we don?t have to put them in assisted living or nursing homes when we pass away.?

View the original article here

Parents in Brick upset about move of special education students

BRICK — A school district plan to move about 60 special education students to the Osbornville Elementary School from their neighborhood schools has drawn the ire of some parents who think it will have a negative impact on their children?s education.

Marjory Towey said she was shocked when she heard her 7-year old daughter, a special education student, would attend the Osbornville Elementary School in September. Her daughter now attends the Emma Havens Young Elementary School.

?These are special education students who need stability in their surroundings and we feel that the Brick school system has unjustly chosen to move this demographic and has not thought of our children?s best interest,?? said Towey, 40. ?This will be the third school that my daughter has attended in three years. How is that stability???

Some concerned parents attended the township Board of Education meeting July 25 seeking answers to why students are being moved. During the meeting, district officials said the move was an educational move but failed to elaborate. Superintendent Walter Uszenski said he would meet with groups of parents to discuss the issue during the next couple of weeks. Calls to Uszenski on Wednesday were not returned.

Towey said parents were kept in the dark until the last minute about the change.

?The only way that I knew something was going on was when I saw my daughter?s teacher getting transferred to the Osbronville School last month,? Towey said. ?We feel like this was done behind our back. It?s like they kept us out of loop. It?s like they did not want anyone to fight it. It?s so late in the summer, what can be done??

Jennifer Hanley?s son will be a special education first-grader in September. She said moving the students is not right.

?The district did not supply any information to the parents, there is a lot of confusion,? said Hanley, 41. ?We feel our kids are being segregated and being taken away from their neighborhood kids.?

Colleen Collichio, a 36-year-old mother of twin 6-year-old boys, one of whom is autistic, said the change could have long-term effects on the children.

?They (the district) really didn?t give us much information. They claim that the smaller condensed classes will give them more one-on-one academically,? Collichio said. ?Most of these kids on the spectrum are so academically smart, it is the social issue that they need help with to prepare them for independence.?

Since the move was announced, Collichio talked district officials into letting her son stay at Lanes Mills Elementary School. Yet Collichio said she still is upset by the situation.

?Most of us parents accept that our kids won?t go to college but if they can get a job and know how to take care of themselves, know how to communicate to the locals to get through life that is all we want,? Collichio said. ?We would rather them have the social skills to get through life so we don?t have to put them in assisted living or nursing homes when we pass away.?

View the original article here

Many women worry about sex after heart attack

After a heart attack, women often worry about the safety of having sex again, and many wish their doctors would talk about the issue more.

So finds a study involving interviews with 17 women who?d survived a heart attack in the past two years. The researchers found that while most rekindled their sex lives within a month of the attack, many also remained fearful about how sex could affect their hearts.

What?s more, few had discussed the issue with their doctors. And when they had, it was the women, not the doctors, who brought the topic up.

?Unfortunately, that?s not surprising,? said Emily Abramsohn, a researcher at the University of Chicago who worked on the study, published online July 24 in the Journal of the American Heart Association.

The women, who averaged 60 years of age, were all part of a larger study following heart attack survivors? health. In that study, only 47 percent of men and 35 percent of women said their doctors had talked to them about resuming their sex lives.

Fears around the cardiac dangers of sex may be unfounded, experts say. Many studies have shown that for most heart attack survivors, sex is a low-risk activity. Less than 1 percent of all heart attacks are triggered during sex, according to the American Heart Association (AHA).

Still, doctors may be unsure about what specific advice to give, said Dr. Suzanne Steinbaum, a cardiologist and director of women and heart disease at Lenox Hill Hospital in New York City.

There are guidelines on the topic, issued just last year from the AHA and the American College of Cardiology. These recommendations offer up some general parameters: Sex is ?reasonable,? for instance, when heart patients can climb two flights of stairs without having chest pain or trouble breathing.

One woman in the new study said her doctor told her just that. The problem, she said, was, ?I couldn?t hardly climb two flights of stairs before I had a heart attack.?

?We need to be able to tell patients more than that,? said Steinbaum, who is also the author of Dr. Suzanne Steinbaum?s Heart Book, which addresses women?s heart health, including sexual activity.

Sex involves emotional and mental well-being, too, Steinbaum noted, and women may have concerns about it even if they feel physically fit. Depression, for instance, is common after a heart attack, and that might affect a woman?s sexual functioning.

?We need to address the emotional and psychosocial issues, too,? Steinbaum said.

Abramsohn agreed that doctors may not know what to say on the subject, and noted that there are also practical obstacles.

In the immediate term, your doctor is concerned with saving your life, she explained. Then, when you?re being discharged from the hospital, the doctor may be focused on your medications or cardiac rehab; any discussion of sexual well-being may get lost.

But it is important for doctors to at least broach the subject, both Abramsohn and Steinbaum said. ?If the doctor brings it up,? Abramsohn said, ?at least the woman will know it?s important to them as well, and that she can talk to her doctor about it.?

The women in this study had suffered a heart attack an average of two years before the interviews. All but one said they?d started having sex again within six months of the heart attack, but ?fear? was common, Abramsohn?s team reports.

Some also said their partners were afraid of hurting them.

So what can women do? ?Know that you?re not alone in having fears surrounding sexual activity,? Abramsohn said. ?And if you are concerned, bring it up with your doctor.?

If you do that but still ?feel you?re not being heard,? Steinbaum said, you can ask for a referral to someone who works with heart patients ? a social worker, psychologist or cardiac rehab nurse, for example.

Cardiac rehab programs, which may be prescribed in the couple of months after a heart attack, involve supervised exercise and counseling on issues like depression and anxiety. A program may not specifically address sexual activity, Steinbaum said, but it may help women feel better, physically and emotionally.

?When you exercise and see that you?re getting stronger, you also gain confidence,? Steinbaum said.

She added that there may also be specific underlying reasons for sexual dysfunction after a heart attack ? not only depression, but medication side effects or abnormal thyroid hormone activity, for example. That?s another reason it?s important to talk about sexual issues with your doctor, Steinbaum pointed out.

?If you don?t feel like you?re getting back to normal after a heart attack,? she said, ?it?s not your fault.?

ON THE WEB: www.heart.org/, the American Heart Association has more on sex and heart disease.

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"Why is it people always get so upset about Affirmative Action but not about legacies? For some..."

Why is it people always get so upset about Affirmative Action but not about legacies? For some reason we’re ok with the historically advantaged having a leg-up over the rest of us, but not the historically disenfranchised.

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