WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

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Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

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Online:

WHO report: http://bit.ly/YDCXcb

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India Ink: What They Said: Budget 2013-14

Finance Minister Palaniappan Chidambaram presented the Union budget in Parliament on Thursday morning. Reactions were mixed from analysts who felt that while the finance minister had delivered a satisfactory budget given the country’s economic climate, more could have been done to attract foreign investment.

Prime Minister Manmohan Singh, speaking with Doordarshan News:

Given the challenges facing our economy, the finance minister has done a commendable job. India needs to create jobs for our growing labor force to the extent of about 10 million persons every year. To do that, we need to accelerate the tempo of our growth. We need, as the 12th Five-Year Plan has mentioned eloquently, a growth rate of about 8 percent. This is a growth rate which is consistent with our underlying potential. We have to get there. Although this is a difficult journey — it cannot be accomplished in a single year – but the finance minister has taken important steps to reverse the pessimistic view with regard to investment climate, with regard to the growth potential and possibilities of our economy.

The finance minister has laid out a road map. There is plenty of food for every ministry to chew upon. And each one of our ministries has to ask itself this question: If India needs an 8 percent growth rate, growth which is at the same time inclusive and sustainable, what is it that each ministry should do? The finance minister has, I think, mentioned these challenges. It is up to the collective wisdom of my Council of Ministers to convert these challenges into opportunities to accelerate the tempo of growth, to make it more inclusive, to make it more sustainable.

Dinesh Thakkar, chairman and managing director at Angel Broking in Mumbai:

The government’s reform momentum had been so strong since September that there were expectations of some exciting measures in the budget too. That was not the case, but it does not mean the budget was a disappointment. The finance minister has been seriously committed to bringing down the fiscal deficit, and he has delivered on that front, as he did not announce any major populist measure and largely maintained stability in tax policies, save for some tweaking for higher income brackets and corporates. In my view, there were no major positive or negative triggers for the markets or any particular sectors, and I think what the market will look forward to is the reform agenda being continued by the government outside the budget, in the coming Parliament sessions, for which the momentum still looks very much on track.

Anuj Puri, chairman and country head of Jones Lang LaSalle India:

We did not expect this budget to be a game-changer. The realities of the Indian economic situation need to viewed in context with the factors that drive it, not least of all the global economic situation. There is no escaping the fact that the business which comes to India from the European Union and the U.S. has a trickle-down effect on key economic drivers in India, and the Finance Ministry does not control these factors. The Union budget can only hope to address factors within its control.

This was a moderately encouraging budget in general, but tepid for the Indian real estate sector. There has been no proposal on certain key expectations from the real estate sector. These include implementation of the real estate regulator and the Land Acquisition Act. All said and done, Indian real estate will continue to struggle with its larger hurdles. While the affordable housing category has been rightly given due attention, aspects relating to improved transparency and corporate governance within the sector have been largely ignored.

That said, the budget has shown commitment to improving communication on taxation and regulatory policies. This should give more comfort to offshore real estate investors who have been bogged down by the political inertia and therefore unsure of India as an investment destination in the recent past.

Partha Iyengar, country manager for research, India, at Gartner:

The big overarching focus on growth by the finance minister is the fundamental “feel good” factor in this budget. Given the fact that one can argue that a lot of the weakness in the Indian economy is what I call a “sentimental recession,” his strong statement that there is no ground for “doom and gloom” heading into the new year.

The big specific positives of the budget are that he has focused both in terms of the letter and spirit of the budget on the key planks of growth for India and health of every industry, including IT, which is infrastructure, education, skills development and incentives for the growth of domestic manufacturing. Some of the other positive areas are support for entrepreneurship, the M.S.M.E. [micro, small and medium enterprises] sector, both in terms of financial and overall support. The recognition that the overseas “trust deficit” in terms of a comfort level on India’s investment climate has to be addressed is also welcome.

However, the budget is only a directional statement, and the challenge for India historically and even currently is in the execution of the statement of intent outlined in the budget. This has been India’s Achilles’ heel, in that bold pronouncements in the budget never see the light of day or are not implemented as effectively as they can or should be. So it was disappointing to not see any statements on what the government would do to ensure mechanisms and oversight to ensure speedy and efficient implementation of these programs. Overall, a 7/10 score for the budget.

Girish Vanvari, co-head of tax at KPMG:

This budget is along anticipated lines, given the economic scenario in the country. There is a stable tax regime. There is no weird tax introduced; nothing much has been tinkered with. The expenditure outlays of the government have not gone down and so the government is not going to stop spending, which means continued growth.

There is a tax on the super-rich with income above 10 million, but this will only affect about 42,000 people and not impact the larger base. Also, the tax is only a 10 percent surcharge and only effective for one year. In this situation, we have limited choices to manage the fiscal deficit, and the budget is quite good given the situation. It is generally an investor-friendly budget because the crux of this budget is growth. Without growth, the fiscal deficit will not be able to be constrained.

Sujan Hajra, chief economist and executive director at Anand Rathi Financial Services in Mumbai:

Given the macroeconomic climate – slowing growth, stable inflation, high fiscal deficit and current account deficit – this is the best budget that could be rolled out in these circumstances. The overarching priority in this budget is to affect some level of fiscal consolidation, and that has been delivered, having kept the fiscal deficit to 5.2 percent for this year.  The other priority for this budget is to induce financial saving and investment, and many measures have been introduced towards that, such as special incentives for over 1 billion rupees investment, a boost to infrastructure investment, particularly in the power and road sector, widening the scope for investing in mutual funds and the inflation index bond.

Despite this being the last full budget before the next election, the budget has largely resisted taking measures of overt populism. The two largely populist measures taken are the Food Security Act and the Direct Benefit Transfer, and none of these involve any major outlay. The subsidy component of the budget has been reduced rather than increased.

Also there has been some kind of benefit for the bottom of the pyramid with tax benefits for the lowest tax bracket and benefits on housing interest payment for the lower end of the spectrum.

Nobody can term this as a dream budget, but it is trying to address macro concerns and bring about some sort of revival in growth.

Chandrajit Banerjee, director general of the Confederation of India Industry, a trade group:

It is a very well thought through and analytical budget and not a political budget. It is a growth-oriented budget, where the focus on investment has been kept high.

Jaijit Bhattacharya, director for South Asia at Hewlett-Packard:

The IT and electronics manufacturing industry was looking forward to budgetary support to the government’s stated policy of promoting IT & electronics manufacturing in India. But this has not been done in this budget.

Dipen Shah, head of private client group, research, Kotak Securities:

The finance minister has projected a fiscal deficit in line with what he had promised, and it is far better than what the situation was when he had come in. To that extent, he has presented a responsible budget. We believe that the budget focuses rightly on higher investments, which can lead to better growth rates in the future. Several initiatives have been announced in the infrastructure sector. Followup action, in terms of removing infrastructure bottlenecks, will be needed and will go a long way in helping the government achieve the growth targets.

Nishith Desai, managing partner at Nishith Desai Associates, a research-based international law firm:

The budget brings some relief but not much excitement – in particular for foreign investors. It was expected that the finance minister would introduce new tax rates and this did not happen. We expected that estate duty would be reintroduced and this was not done. It was expected that there would be a whole host of new indirect taxes, and that was not done to a large extent. Therefore, it was not the draconian budget expected in the current macroeconomic situation. Only the super-rich have been charged a 10 percent surcharge, which is not too much of a burden, in my view.

However, we expected some big bang reforms for bringing foreign investment to India, which did not happen. The finance minister started by saying that foreign investment is “imperative,” but that imperative was soon lost. There was no assurance made to guarantee a stable regulatory environment and that there would not be any more retroactive amendments in general. It was expected that the finance minister would address cases that involve the offshore transfer of shares like Vodafone so that there could be some certainty, but this was not done.

I believe the finance minister will have to present another round of liberalization and reforms to attract foreign investment. I think that he has tried to please everybody, which is not a bad thing. But at the same time, if you look at this from the viewpoint of attracting the foreign investment necessary for growth – that has not happened.

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Why Jennifer Aniston Kept Her Hair Down on Oscar Night

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02/26/2013 at 02:30 PM ET

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Her longtime stylist, Living Proof’s Chris McMillan, says the star wanted to stick with what works. “She wanted to keep the makeup natural and the hair natural,” he says in the exclusive clip above. “I think it’s about, at this point, being really comfortable on the red carpet.” Amen!

To hear more on Aniston’s Oscar night look, and to hear McMillan give a how-to on the night’s hot short hairstyles (his faves were Anne Hathaway and Charlize Theron), watch the clip above. Tell us: Did you like Aniston’s natural hair and makeup on Oscar night? 

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Medicare paid $5.1B for poor nursing home care

SAN FRANCISCO (AP) — Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.

The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.

One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.

By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.

"These findings raise concerns about what Medicare is paying for," the report said.

Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.

In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.

In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.

The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.

That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.

Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.

In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.

"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to AP. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."

CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.

Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall nursing home operators are well regulated and follow federal guidelines but added that he could not fully comment on the report's conclusions without having had the chance to read it.

"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.

Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.

"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, NY. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."

Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.

Investigators found the homes didn't always do what was needed to ensure a smooth transition.

In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.

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On the Web:

The OIG report: http://1.usa.gov/VaztQm

The Medicare nursing home database: http://www.medicare.gov/NursingHomeCompare/search.aspx?bhcp=1&AspxAutoDetectCookieSupport=1

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Follow Garance Burke on Twitter at —http://twitter.com/garanceburke.

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Stock futures tick higher ahead of GDP, jobless data

NEW YORK (Reuters) - Stock index futures edged modestly higher on Thursday as investors were reluctant to make big bets following a sharp two-day rally and ahead of a rash of data.

Investors will also be keeping an eye on the debate in Washington over sequestration - U.S. government budget cuts that will take effect starting on Friday if lawmakers fail to reach an agreement on spending and taxes. President Barack Obama and Republican congressional leaders arranged to hold last-ditch talks to prevent the cuts, but expectations were low that any deal would be produced.

Major indexes posted their biggest daily gains since early January on Wednesday, putting the S&P 500 back above the closely watched level of 1,500. Over the past two sessions, the index has gained 1.9 percent, lifted by strong data and comments from Federal Reserve Chairman Ben Bernanke that showed continued support for the Fed's stimulus policy.

Wall Street has largely resisted predictions it would undergo a correction, with the S&P up 6.3 percent so far this year and the Dow Jones industrial average within striking distance of an all-time high. While markets suffered steep losses earlier this week on concerns over European debt, they have since recovered and are flat on the week.

Revised gross domestic product data is expected to show that the U.S. economy grew 0.5 percent in the fourth quarter, rather than contracted 0.1 percent as initially estimated. The data is due at 8:30 a.m. (1330 GMT)

Weekly jobless claims, also on tap for 8:30 a.m., are seen dipping by 2,000 to 360,000 in the latest week, while the February Chicago PMI is seen dipping to 54.3 from 55.6 last month.

Those reports come in the wake of strong pending home sales data Wednesday and a proxy for business spending plans that was more robust than expected, which added to the positive tone in markets.

S&P 500 futures rose 2.7 points and were above fair value, a formula that evaluates pricing by taking into account interest rates, dividends and time to expiration on the contract. Dow Jones industrial average futures added 16 points and Nasdaq 100 futures rose 4.5 points.

J.C. Penney Co Inc shares slumped 15 percent to $18.01 in premarket trading a day after it reported a steep drop in sales, prompting the department store to overhaul its pricing strategy.

Groupon Inc also reported revenue that missed expectations, sending shares down 26 percent to $4.41 before the bell.

Salesforce.com Inc and Gap Inc are on tap to report results later Thursday.

With 93 percent of the S&P 500 companies having reported results so far, 69.5 percent have beaten profit expectations, compared with a 62 percent average since 1994 and 65 percent over the past four quarters, according to Thomson Reuters data.

Fourth-quarter earnings for S&P 500 companies are estimated to have risen 6.2 percent, according to the data, above a 1.9 percent forecast at the start of the earnings season.

Tim Cook, chief executive of Apple Inc , acknowledged widespread disappointment Wednesday in the performance of the tech titan's stock, which is down 16.5 percent so far this year, but urged investors to take a long-term view on the company.

(Editing by Bernadette Baum)

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India Ink: Revisiting the Horror in Sri Lanka

NEW DELHI — In the series of photographs shot in 2009, the bare-chested boy is first shown seated on a bench watching something outside the frame. Then he is seen having a snack. In the third image he is lying on the ground with bullet holes in his chest. The photographs, which were released last week by the British broadcaster Channel 4, appear to document the final moments in the life of 12-year-old Balachandran Prabhakaran, the youngest son of the slain founder of the Liberation Tigers of Tamil Eelam, Velupillai Prabhakaran.

The images are from the documentary film “No Fire Zone,” which tells the story of Sri Lanka’s violent suppression of Mr. Prabhakaran’s equally violent revolution, which had come very close to securing a separate state for the Tamil minority of Sri Lanka. After 26 years of civil war between the Tamils, who are chiefly Hindus, and the Sinhalese majority, who are chiefly Buddhists, the Sri Lankan state won decisively in 2009. Human rights activists say that hundreds of Tamil fighters, political leaders and their families, including Mr. Prabhakaran and his family, did not die in action but were executed. They estimate that more than 40,000 Tamil civilians died in the final months of the war.

Within its borders, the Sri Lankan government appears to wink at its Sinhalese population to accept their congratulations for ending the war, but it maintains a righteous indignation when the world accuses its army of planned genocide.

“No Fire Zone” includes video footage and photographs shot on mobile phones by Tamil survivors and Sinhalese soldiers that were somehow leaked. The film’s director, Callum Macrae, told me that it will be screened at the 22nd session of the U.N. Human Rights Council, now under way in Geneva, where the United States plans to introduce a resolution asking Sri Lanka to investigate the allegations of war crimes by its army.

It is not clear what such a resolution will achieve because Sri Lanka’s powerful president, Mahinda Rajapaksa, who has a rustic swagger about him and a manly black mustache, is the triumphant face of Sri Lanka’s victory in the war. The Sri Lankan Army is unambiguously under his control. Whatever the worth of the resolution, India is expected to support it more enthusiastically than it did a similar resolution last March.

Over the years, the shape and location of Sri Lanka have inspired several Indian cartoonists to portray the island nation as a tear drop beneath India’s peninsular chin. This is an illogical depiction of Sri Lanka’s trauma because a tear drop is not sorrowful; it is a consequence of someone’s sorrow. Some caricatures that appeared in the late 1980s and early 1990s, however, showed the Indian peninsula weeping and Sri Lanka as the consequent tear drop. This imagery had a stronger logic. India’s history with Sri Lanka is, in a way, about a bumbling giant being hurt by a cunning dwarf.

Under the late Prime Minister Indira Gandhi, the type of strategists who imagine they are great Machiavellian characters, and love to add the prefix “geo” to “politics” to feel good about their advisory jobs, ensured that India armed and financed the Tamil rebels. In 1984, when she was assassinated and her son Rajiv Gandhi took over as prime minister, Sri Lanka was engaged in a full-fledged civil war. Now, India wanted to play gracious giant in the region and bring peace to Sri Lanka. In 1987, it sent troops to achieve that end. It was a disastrous move, and resulted in the deaths of nearly 1,200 Indian soldiers and thousands of Tamil fighters. In an act of vengeance, Mr. Prabhakaran made his greatest strategic blunder: ordering the assassination of Rajiv Gandhi.

On the early morning of May 22, 1991, as the news spread through Madras (now Chennai) by phone and radio, I saw people run out of their homes in some kind of delirium to pick up the newspapers from their porches. The city had just woken up to the improbable fact that a suicide bomber had killed Mr. Gandhi the previous night in a small town not far from Chennai. Until then, the southern state of Tamil Nadu, whose capital is Chennai, was a haven for the Tamil Tigers. Bound by a common language, the masses of Tamil Nadu felt a deep compassion for the struggle of Sri Lankan Tamils. But Mr. Gandhi’s assassination was seen by them as an act of war against India. The chief minister of Tamil Nadu at the time, Muthuvel Karunanidhi, who was accused of being a friend of the Tigers, went around Chennai in an open-roof van, standing with his palms joined in apology. That was not good enough. In the 1991 Tamil Nadu assembly elections, his party won only two seats.

But now, the plight of the Sri Lankan Tamils has returned as a passionate political issue in Tamil Nadu. Mr. Karunanidhi is too old to stand anymore but even as a patriarch who uses a wheelchair, he is a useful ally of the Indian National Congress party, which heads the national government. He has often demanded that the accomplices of Mr. Gandhi’s assassin now on death row in India be pardoned, and that President Rajapaksa be tried on war crimes charges. Last year, when the United States introduced a resolution against Sri Lanka, India was reluctant to back it for strategic reasons, including that it has commercial interests in Sri Lanka, which China is fast grabbing. But Mr. Karunanidhi and public sentiment in Tamil Nadu finally persuaded the Indian government to support it.

In a few days, when the United States introduces its new resolution against Sri Lanka, the brute forces of politics and practicality will ensure that the Indian government led by the Congress party, whose leader is Sonia Gandhi, will join other nations in asking Sri Lanka to explain how exactly it eliminated the organization that made her a widow.

Manu Joseph is editor of the Indian newsweekly Open and author of the novel “The Illicit Happiness of Other People.”

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Jennifer Aniston & Justin Theroux's Wedding Planning Underway

02/27/2013 at 07:50 AM EST

She conquered the Oscars, and now Jennifer Aniston is preparing for another very big day.

The actress, 44, is in the process of planning her wedding to screenwriter-actor Justin Theroux, 41 – and she has already checked off some major tasks on her to-do list, including choosing wedding bands, setting a date and narrowing down dresses.

Just don't expect the wedding, which is likely to take place soon after Aniston wraps her current film in Connecticut on March 8, to be a lavish production.

"It will be a small affair with their closest friends," a source close to Aniston tells PEOPLE in this week's cover story.

In the meantime, the bride-to-be is enjoying life with her future groom.

"Jen seems more confident than ever," says the source, "and they've become a great team."

For much more on Aniston and Theroux's wedding plans, their romantic Oscar night and look inside their relationship, pick up this week's issue of PEOPLE

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Advanced breast cancer edges up in younger women

CHICAGO (AP) — Advanced breast cancer has increased slightly among young women, a 34-year analysis suggests. The disease is still uncommon among women younger than 40, and the small change has experts scratching their heads about possible reasons.

The results are potentially worrisome because young women's tumors tend to be more aggressive than older women's, and they're much less likely to get routine screening for the disease.

Still, that doesn't explain why there'd be an increase in advanced cases and the researchers and other experts say more work is needed to find answers.

It's likely that the increase has more than one cause, said Dr. Rebecca Johnson, the study's lead author and medical director of a teen and young adult cancer program at Seattle Children's Hospital.

"The change might be due to some sort of modifiable risk factor, like a lifestyle change" or exposure to some sort of cancer-linked substance, she said.

Johnson said the results translate to about 250 advanced cases diagnosed in women younger than 40 in the mid-1970s versus more than 800 in 2009. During those years, the number of women nationwide in that age range went from about 22 million to closer to 30 million — an increase that explains part of the study trend "but definitely not all of it," Johnson said.

Other experts said women delaying pregnancy might be a factor, partly because getting pregnant at an older age might cause an already growing tumor to spread more quickly in response to pregnancy hormones.

Obesity and having at least a drink or two daily have both been linked with breast cancer but research is inconclusive on other possible risk factors, including tobacco and chemicals in the environment. Whether any of these explains the slight increase in advanced disease in young women is unknown.

There was no increase in cancer at other stages in young women. There also was no increase in advanced disease among women older than 40.

Overall U.S. breast cancer rates have mostly fallen in more recent years, although there are signs they may have plateaued.

Some 17 years ago, Johnson was diagnosed with early-stage breast cancer at age 27, and that influenced her career choice to focus on the disease in younger women.

"Young women and their doctors need to understand that it can happen in young women," and get checked if symptoms appear, said Johnson, now 44. "People shouldn't just watch and wait."

The authors reviewed a U.S. government database of cancer cases from 1976 to 2009. They found that among women aged 25 to 39, breast cancer that has spread to distant parts of the body — advanced disease — increased from between 1 and 2 cases per 100,000 women to about 3 cases per 100,000 during that time span.

The study was published Tuesday in the Journal of the American Medical Association.

About one in 8 women will develop breast cancer in their lifetime, but only 1 in 173 will develop it by age 40. Risks increase with age and certain gene variations can raise the odds.

Routine screening with mammograms is recommended for older women but not those younger than 40.

Dr. Len Lichtenfeld, the American Cancer Society's deputy chief medical officer, said the results support anecdotal reports but that there's no reason to start screening all younger women since breast cancer is still so uncommon for them.

He said the study "is solid and interesting and certainly does raise questions as to why this is being observed." One of the most likely reasons is probably related to changes in childbearing practices, he said, adding that the trend "is clearly something to be followed."

Dr. Ann Partridge, chair of the federal Centers for Disease Control and Prevention's advisory committee on breast cancer in young women, agreed but said it's also possible that doctors look harder for advanced disease in younger women than in older patients. More research is needed to make sure the phenomenon is real, said Partridge, director of a program for young women with breast cancer at the Harvard-affiliated Dana-Farber Cancer Institute.

The study shouldn't cause alarm, she said. Still, Partridge said young women should be familiar with their breasts and see the doctor if they notice any lumps or other changes.

Software engineer Stephanie Carson discovered a large breast tumor that had already spread to her lungs; that diagnosis in 2003 was a huge shock.

"I was so clueless," she said. "I was just 29 and that was the last thing on my mind."

Carson, who lives near St. Louis, had a mastectomy, chemotherapy, radiation and other treatments and she frequently has to try new drugs to keep the cancer at bay.

Because most breast cancer is diagnosed in early stages, there's a misconception that women are treated, and then get on with their lives, Carson said. She and her husband had to abandon hopes of having children, and she's on medical leave from her job.

"It changed the complete course of my life," she said. "But it's still a good life."

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Online:

JAMA: http://jama.ama-assn.org

CDC: http://www.cdc.gov/cancer/breast/index.htm

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India Ink: Narmada Devi, the Housewife from Uttar Pradesh

Why do millions of people, from entire Indian villages to urbane middle managers to foreign tourists, brave the crowds at the Kumbh Mela? During this year’s 55-day pilgrimage, to Allahabad, Uttar Pradesh, an estimated 100 million Hindus and others are expected to take a holy dip in the Ganges River to wash away their sins. India Ink interviewed some of them.

Narmada Devi, 45, a housewife from Varanasi, Uttar Pradesh, was one among them. This is what she had to say.

Why did you come to the Kumbh Mela this year? Is it your first time?

This is my fifth time. I came with family. We had a tough year last year. We wonder if it is because of the sins we have committed. We came here to wash them away.

How have you found it so far?

I love the excitement here. I am also fortunate that I am here on Mauni Amavasya, one of the main royal bathing days. They say that if we manage to take a dip today, we would be internally cleansed.

Describe your journey to the Kumbh. Did you travel alone? How long did it take?

We traveled in a horrible bus from Benaras. It took us longer than it should have. I don’t know how much time we spent on that bus, but it was an awful journey. I threw up the whole time.

Do you consider yourself a religious person?

We are Hindus. We follow Hinduism and worship Hindu gods. We have a pandit, or priest, in our town who we believe in, and we do whatever he asks us to – with respect to our profession, our future, etc. Apart from that, I don’t know what you mean by being religious.

Who do you think is going to win the 2014 election?

We don’t care if it is the Bahujan Samaj Party or the Samajwadi Party. We just want good governance. I can’t tell you how much we have suffered because of bad administration. Higher crime rates, not enough good education for my sons and my husband’s shop was also looted. No authorities came to our rescue.

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Cheers! Hollywood Toasts the Oscars

From Elton John's celebrated bash to Vanity Fair's annual soiree, see how George & Stacy, Adele, Jennifer Lawrence and more marked Hollywood's biggest night

Credit: Kevin Mazur/VF13/WireImage

Updated: Monday Feb 25, 2013 | 11:30 AM EST
By: Kiran Hefa & Kate Hogan

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