World Briefing | Europe: Greece: Oligarch Under Arrest Expected to Be Moved to Prison

A Greek magistrate on Friday ordered that the oligarch Lavrentis Lavrentiadis, who was arrested Thursday on charges of embezzlement and fraud, be remanded to custody after visiting the 40-year-old businessman in an Athens hospital. Mr. Lavrentiadis, the former majority stakeholder in Proton Bank, which is alleged to have issued $900 million in bad loans to keep other businesses afloat, is the focus of an investigation that has highlighted concerns about deep-rooted corruption and crony capitalism in Greece. He was admitted to the hospital on Thursday night after citing health problems when the police visited his home in an affluent Athens suburb. Mr Lavrentiadis was expected to be transferred to the capital’s high-security Korydallos prison on Saturday after his request to be admitted to a psychiatric hospital was turned down and he spent Friday night in police custody.

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The New Old Age Blog: Hospital Alarms Fail to Prevent Injury, Study Finds

When it comes to protecting older people from falls, it can take a long time to figure out what helps and sometimes an even longer time to take action against things that were supposed to help but don’t.

A case in point: the so-called safety rails on hospital and nursing home beds. Their hazards, as The New Old Age reported more than two years ago, are well documented. They are intended to keep sick, drugged or confused people from climbing or falling out of bed. What they actually do is make falls more dangerous; they also trap patients between the rails and the mattress until they asphyxiate, causing hundreds of deaths annually.

The Consumer Product Safety Commission is finally investigating these hazards, with findings due soon.

Alarms — sensors that alert aides or nurses when someone at risk of falling attempts to get out of bed or up from a chair or toilet — sound better, right? Lots of health care facilities thought so.

Use of these alarms has increased “over the past 10 or 15 years as the problems of physical restraints and bed rails became better known,” said Ronald Shorr, who directs geriatric research at the V.A. Medical Center in Gainesville, Fla. “This was the next wave in fall prevention.”

The trouble is, hospital bed alarms don’t appear to reduce falls, according to the study that Dr. Shorr just published in The Annals of Internal Medicine.

Lots of patients, of all ages, fall in hospitals, and about a quarter of those falls cause injuries. They also cost hospitals money, because Medicare will no longer reimburse facilities for treating injuries from falls that in theory shouldn’t have happened.

Though there aren’t statistics on the number of systems, it is rare these days to find a large hospital that doesn’t use alarms, in some cases built right into the beds.

Yet “their efficacy hadn’t been established,” Dr. Shorr told me in an interview. The few studies that reported reduced falls from alarms were small, lacked control groups, or didn’t continue for very long. Dr. Shorr and his colleagues set out to remedy those shortcomings.

Over 18 months, they documented falls among patients in 16 medical and surgical units, with a combined 349 beds, at Methodist Healthcare-University Hospital in Memphis, Tenn. Half those units were randomly designated “usual care.” In the other eight, the “intervention” units, Dr. Shorr and study coordinator Michelle Chandler held repeated education sessions to explain the alarms — in this case, flexible pads made by Bed-Ex and widely-used — and demonstrate their use in beds and on chairs and commode seats.

Ms. Chandler visited the intervention units daily — the staff started calling her “Mrs. Falls” — and even brought fresh alarm pads and help set them up to encourage their use.

The intervention worked, in that those units used the alarms far more often. But when the researchers tallied up the falls among the 27,672 patients (half of them over age 63) in these units — controlling for many variables, including not only demographic factors but staffing levels and psychotropic drug regimens — they found the alarms had no significant effect.

Patients in the units that used alarms more heavily fell just as often as patients in the control units that used alarms much less frequently. (The numbers: 5.62 falls per 1,000 patient-days, a measure of how many people spent how long in the hospital, versus 4.56 falls in the control units, not a statistically significant difference.)

There were no fewer injuries in the more-alarmed units, nor any less use of physical restraints.

There were likely higher costs, though. A Bed-Ex monitor and cables cost about $350 at the time, and each disposable sensor pad cost $23.

Why didn’t the alarms help? Dr. Shorr hypothesized that the staff developed what he called alarm fatigue. “How many times a week do you hear a car alarm go off?” he asked. “You become desensitized.”

But it is also possible, he said, that when the alarms sounded and the nurses scampered, “the patients who weren’t alarmed fell more often.”

My own 2 cents: If an alarm sounds when someone stirs, is any hospital or nursing home so well-staffed that someone can materialize within seconds? Does a staff become less vigilant when patients have alarms and are presumed – wrongly, it seems – to be safer?

Nursing homes also frequently use alarms, and while this hospital data might not apply in another setting, Dr. Shorr said his findings made him skeptical about their effectiveness there, too.

So we probably shouldn’t feel reassured about our elders’ safety when they are in a hospital, alarms or no alarms. Even younger people, recovering from surgery and feeling the effects of anesthesia or sedatives, can and do fall.

“The more eyes on your loved one, the better,” said Dr. Shorr. “And it’s best if they’re your eyes.”

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Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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The New Old Age Blog: Hospital Alarms Fail to Prevent Injury, Study Finds

When it comes to protecting older people from falls, it can take a long time to figure out what helps and sometimes an even longer time to take action against things that were supposed to help but don’t.

A case in point: the so-called safety rails on hospital and nursing home beds. Their hazards, as The New Old Age reported more than two years ago, are well documented. They are intended to keep sick, drugged or confused people from climbing or falling out of bed. What they actually do is make falls more dangerous; they also trap patients between the rails and the mattress until they asphyxiate, causing hundreds of deaths annually.

The Consumer Product Safety Commission is finally investigating these hazards, with findings due soon.

Alarms — sensors that alert aides or nurses when someone at risk of falling attempts to get out of bed or up from a chair or toilet — sound better, right? Lots of health care facilities thought so.

Use of these alarms has increased “over the past 10 or 15 years as the problems of physical restraints and bed rails became better known,” said Ronald Shorr, who directs geriatric research at the V.A. Medical Center in Gainesville, Fla. “This was the next wave in fall prevention.”

The trouble is, hospital bed alarms don’t appear to reduce falls, according to the study that Dr. Shorr just published in The Annals of Internal Medicine.

Lots of patients, of all ages, fall in hospitals, and about a quarter of those falls cause injuries. They also cost hospitals money, because Medicare will no longer reimburse facilities for treating injuries from falls that in theory shouldn’t have happened.

Though there aren’t statistics on the number of systems, it is rare these days to find a large hospital that doesn’t use alarms, in some cases built right into the beds.

Yet “their efficacy hadn’t been established,” Dr. Shorr told me in an interview. The few studies that reported reduced falls from alarms were small, lacked control groups, or didn’t continue for very long. Dr. Shorr and his colleagues set out to remedy those shortcomings.

Over 18 months, they documented falls among patients in 16 medical and surgical units, with a combined 349 beds, at Methodist Healthcare-University Hospital in Memphis, Tenn. Half those units were randomly designated “usual care.” In the other eight, the “intervention” units, Dr. Shorr and study coordinator Michelle Chandler held repeated education sessions to explain the alarms — in this case, flexible pads made by Bed-Ex and widely-used — and demonstrate their use in beds and on chairs and commode seats.

Ms. Chandler visited the intervention units daily — the staff started calling her “Mrs. Falls” — and even brought fresh alarm pads and help set them up to encourage their use.

The intervention worked, in that those units used the alarms far more often. But when the researchers tallied up the falls among the 27,672 patients (half of them over age 63) in these units — controlling for many variables, including not only demographic factors but staffing levels and psychotropic drug regimens — they found the alarms had no significant effect.

Patients in the units that used alarms more heavily fell just as often as patients in the control units that used alarms much less frequently. (The numbers: 5.62 falls per 1,000 patient-days, a measure of how many people spent how long in the hospital, versus 4.56 falls in the control units, not a statistically significant difference.)

There were no fewer injuries in the more-alarmed units, nor any less use of physical restraints.

There were likely higher costs, though. A Bed-Ex monitor and cables cost about $350 at the time, and each disposable sensor pad cost $23.

Why didn’t the alarms help? Dr. Shorr hypothesized that the staff developed what he called alarm fatigue. “How many times a week do you hear a car alarm go off?” he asked. “You become desensitized.”

But it is also possible, he said, that when the alarms sounded and the nurses scampered, “the patients who weren’t alarmed fell more often.”

My own 2 cents: If an alarm sounds when someone stirs, is any hospital or nursing home so well-staffed that someone can materialize within seconds? Does a staff become less vigilant when patients have alarms and are presumed – wrongly, it seems – to be safer?

Nursing homes also frequently use alarms, and while this hospital data might not apply in another setting, Dr. Shorr said his findings made him skeptical about their effectiveness there, too.

So we probably shouldn’t feel reassured about our elders’ safety when they are in a hospital, alarms or no alarms. Even younger people, recovering from surgery and feeling the effects of anesthesia or sedatives, can and do fall.

“The more eyes on your loved one, the better,” said Dr. Shorr. “And it’s best if they’re your eyes.”

---

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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IHT Rendezvous: Damien Hirst Leaves Gagosian

Less than a year after the Gagosian Gallery gave Damien Hirst all 11 of its spaces around the world to show his spot paintings, word comes that the bad-boy British artist will no longer be represented by Gagosian, where he has shown on and off for 17 years.

“We wish him continued success for the future,’’ a statement issued by the gallery, confirming his sudden departure, said.

On Thursday, Science Ltd., Mr. Hirst’s company, told the Financial Times that the gallery owner  “Larry Gagosian and Damien have reached an amicable decision to part company,” adding that the artist would continue his relationship with the White Cube Gallery in London.  But the question remains whether Mr. Hirst will look for another gallery to show his work in New York, where he has a large number of big collectors.

Mr. Hirst has never been known for being monogamous, at least not when it comes to gallery representation. White Cube in London has also handled his work for years. In 2008 he snubbed both galleries, when Sotheby’s in London sold 223 of his new artworks. The sale, which was held just as the financial markets were heading for disaster, included dead animals – sharks, zebras, piglets and even a calf – floating in giant glass tanks of formaldehyde; cabinets filled with diamonds; and cigarette butts.  And paintings – spin paintings, dot paintings, paintings with butterflies pinned under glass. More than 21,000 visitors flocked to Sotheby’s on New Bond Street to see the work before the sale, which brought $200.7 million.

Ever the showman, he caused a sensation in 2007 at White Cube’s gallery in Mayfair when he showed a human skull cast in platinum and covered with 8,601 diamonds.  At the time the gallery said the artwork cost $23.5 million to make. During the five weeks that summer when it was on display in a small, blackened room at White Cube’s Mason’s Yard Space, crowds lined up with free timed tickets in hand to ogle the piece.  A nearby shop was doing a brisk business selling skull T-shirts and other Hirstian memorabilia. The skull was reportedly bought by a consortium of investors that included the artist himself. (It isn’t the first time he has invested in his own work.  Mr. Hirst and Jay Jopling, the owner of White Cube, bought about 12 works from Charles Saatchi, former advertising magnate, in 2003 for around $15 million.)

Over the years Mr. Hirst has amassed a large fortune.  The Sunday Times of London has called him the world’s richest artist, with a fortune estimated at about $346 million.

He is not the only artist to stray from Gagosian.  Last week while the contemporary art world converged on Miami Beach for the giant art fair there, David Zwirner, the Chelsea dealer, confirmed that in May he is planning to do a show of new paintings and sculptures by Jeff Koons, another superstar artist represented by Mr. Gagosian. Like Mr. Hirst, Mr. Koons has never shown any gallery loyalty. For decades he has also exhibited his work at the Sonnabend Gallery in Chelsea. Last week Rebecca Sternthal, a director of Gagosian who works with Mr. Koons said that Gagosian “still represents Jeff Koons.  He works closely with us and with Sonnabend.  In the past he has had shows in different galleries but we are still actively working with him and with his studio.’’

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Talks on Telecommunications Treaty Falter

DUBAI — Once-in-a-generation talks on a global telecommunications treaty were perched on the verge of collapse Thursday, with delegates seemingly unable to break an impasse over the most sensitive issue: whether to include the Internet in the document.

The United States was poised to withdraw support for the negotiations, being carried out under the auspices of a U.N. agency called the International Telecommunications Union, according to two people briefed on the situation who insisted on anonymity because of the delicacy of the talks. Several countries in Europe and elsewhere were expected to join the United States. A spokesman for the U.S. delegation declined to comment.

The United States insists that the Internet should not be included in the treaty, which deals with technical matters like connecting international telephone calls, because that could lead to curbs on free speech. A bloc of other countries, led by Russia, China and the host nation, the United Arab Emirates, has argued that the Internet should be mentioned in the treaty because Internet traffic travels through telecommunications networks.

The goal of the talks was to revise a document that was last updated in 1988, when the Internet was in its early stages. With more than 190 nations represented, agreement was never going to be easy, but the telecommunications union had insisted that it would operate by consensus when possible.

The U.S. delegation was apparently angered by developments in the wee hours Wednesday, when Russia and its allies succeeded in winning approval, by a mere show of hands, for a resolution that the United States and its supporters had interpreted as calling for the telecommunications union to gain important regulatory powers over the Internet.

Currently, the Internet is governed by a loose grouping of mostly private-sector organizations, rather than by governments. But at least one of these organizations, the Internet Corporation for Assigned Names and Numbers, operates under a contract from the U.S. government.

A resolution is not officially part of the treaty wording, and Russia and its allies had previously attempted to include a similar clause in the draft of the treaty. But under a compromise, it agreed this week to withdraw that proposal and settle for a resolution instead. Even that, however, does not appear to have been satisfactory to the United States and its supporters.

Delegations have also been divided over issues like cybersecurity and proposals that telecommunications companies should receive payment for carrying Internet traffic.

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Another Look at a Drink Ingredient, Brominated Vegetable Oil

James Edward Bates for The New York Times

Sarah Kavanagh, 15, of Hattiesburg, Miss., started an online petition asking PepsiCo to change Gatorade’s formula.

Sarah Kavanagh and her little brother were looking forward to the bottles of Gatorade they had put in the refrigerator after playing outdoors one hot, humid afternoon last month in Hattiesburg, Miss.

But before she took a sip, Sarah, a dedicated vegetarian, did what she often does and checked the label to make sure no animal products were in the drink. One ingredient, brominated vegetable oil, caught her eye.

“I knew it probably wasn’t from an animal because it had vegetable in the name, but I still wanted to know what it was, so I Googled it,” Ms. Kavanagh said. “A page popped up with a long list of possible side effects, including neurological disorders and altered thyroid hormones. I didn’t expect that.”

She threw the product away and started a petition on Change.org, a nonprofit Web site, that has almost 200,000 signatures. Ms. Kavanagh, 15, hopes her campaign will persuade PepsiCo, Gatorade’s maker, to consider changing the drink’s formulation.

Jeff Dahncke, a spokesman for PepsiCo, noted that brominated vegetable oil had been deemed safe for consumption by federal regulators. “As standard practice, we constantly evaluate our formulas and ingredients to ensure they comply with federal regulations and meet the high quality standards our consumers and athletes expect — from functionality to great taste,” he said in an e-mail.

In fact, about 10 percent of drinks sold in the United States contain brominated vegetable oil, including Mountain Dew, also made by PepsiCo; Powerade, Fanta Orange and Fresca from Coca-Cola; and Squirt and Sunkist Peach Soda, made by the Dr Pepper Snapple Group.

The ingredient is added often to citrus drinks to help keep the fruit flavoring evenly distributed; without it, the flavoring would separate.

Use of the substance in the United States has been debated for more than three decades, so Ms. Kavanagh’s campaign most likely is quixotic. But the European Union has long banned the substance from foods, requiring use of other ingredients. Japan recently moved to do the same.

“B.V.O. is banned other places in the world, so these companies already have a replacement for it,” Ms. Kavanagh said. “I don’t see why they don’t just make the switch.” To that, companies say the switch would be too costly.

The renewed debate, which has brought attention to the arcane world of additive regulation, comes as consumers show increasing interest in food ingredients and have new tools to learn about them. Walmart’s app, for instance, allows access to lists of ingredients in foods in its stores.

Brominated vegetable oil contains bromine, the element found in brominated flame retardants, used in things like upholstered furniture and children’s products. Research has found brominate flame retardants building up in the body and breast milk, and animal and some human studies have linked them to neurological impairment, reduced fertility, changes in thyroid hormones and puberty at an earlier age.

Limited studies of the effects of brominated vegetable oil in animals and in humans found buildups of bromine in fatty tissues. Rats that ingested large quantities of the substance in their diets developed heart lesions.

Its use in foods dates to the 1930s, well before Congress amended the Food, Drug and Cosmetic Act to add regulation of new food additives to the responsibilities of the Food and Drug Administration. But Congress exempted two groups of additives, those already sanctioned by the F.D.A. or the Department of Agriculture, or those experts deemed “generally recognized as safe.”

The second exemption created what Tom Neltner, director of the Pew Charitable Trusts’ food additives project, a three-year investigation into how food additives are regulated, calls “the loophole that swallowed the law.” A company can create a new additive, publish safety data about it on its Web site and pay a law firm or consulting firm to vet it to establish it as “generally recognized as safe” — without ever notifying the F.D.A., Mr. Neltner said.

About 10,000 chemicals are allowed to be added to foods, about 3,000 of which have never been reviewed for safety by the F.D.A., according to Pew’s research. Of those, about 1,000 never come before the F.D.A. unless someone has a problem with them; they are declared safe by a company and its handpicked advisers.

“I worked on the industrial and consumer products side of things in the past, and if you take a new chemical and put it into, say, a tennis racket, you have to notify the E.P.A. before you put it in,” Mr. Neltner said, referring to the Environmental Protection Agency. “But if you put it into food and can document it as recognized as safe by someone expert, you don’t have to tell the F.D.A.”

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Another Look at a Drink Ingredient, Brominated Vegetable Oil

James Edward Bates for The New York Times

Sarah Kavanagh, 15, of Hattiesburg, Miss., started an online petition asking PepsiCo to change Gatorade’s formula.

Sarah Kavanagh and her little brother were looking forward to the bottles of Gatorade they had put in the refrigerator after playing outdoors one hot, humid afternoon last month in Hattiesburg, Miss.

But before she took a sip, Sarah, a dedicated vegetarian, did what she often does and checked the label to make sure no animal products were in the drink. One ingredient, brominated vegetable oil, caught her eye.

“I knew it probably wasn’t from an animal because it had vegetable in the name, but I still wanted to know what it was, so I Googled it,” Ms. Kavanagh said. “A page popped up with a long list of possible side effects, including neurological disorders and altered thyroid hormones. I didn’t expect that.”

She threw the product away and started a petition on Change.org, a nonprofit Web site, that has almost 200,000 signatures. Ms. Kavanagh, 15, hopes her campaign will persuade PepsiCo, Gatorade’s maker, to consider changing the drink’s formulation.

Jeff Dahncke, a spokesman for PepsiCo, noted that brominated vegetable oil had been deemed safe for consumption by federal regulators. “As standard practice, we constantly evaluate our formulas and ingredients to ensure they comply with federal regulations and meet the high quality standards our consumers and athletes expect — from functionality to great taste,” he said in an e-mail.

In fact, about 10 percent of drinks sold in the United States contain brominated vegetable oil, including Mountain Dew, also made by PepsiCo; Powerade, Fanta Orange and Fresca from Coca-Cola; and Squirt and Sunkist Peach Soda, made by the Dr Pepper Snapple Group.

The ingredient is added often to citrus drinks to help keep the fruit flavoring evenly distributed; without it, the flavoring would separate.

Use of the substance in the United States has been debated for more than three decades, so Ms. Kavanagh’s campaign most likely is quixotic. But the European Union has long banned the substance from foods, requiring use of other ingredients. Japan recently moved to do the same.

“B.V.O. is banned other places in the world, so these companies already have a replacement for it,” Ms. Kavanagh said. “I don’t see why they don’t just make the switch.” To that, companies say the switch would be too costly.

The renewed debate, which has brought attention to the arcane world of additive regulation, comes as consumers show increasing interest in food ingredients and have new tools to learn about them. Walmart’s app, for instance, allows access to lists of ingredients in foods in its stores.

Brominated vegetable oil contains bromine, the element found in brominated flame retardants, used in things like upholstered furniture and children’s products. Research has found brominate flame retardants building up in the body and breast milk, and animal and some human studies have linked them to neurological impairment, reduced fertility, changes in thyroid hormones and puberty at an earlier age.

Limited studies of the effects of brominated vegetable oil in animals and in humans found buildups of bromine in fatty tissues. Rats that ingested large quantities of the substance in their diets developed heart lesions.

Its use in foods dates to the 1930s, well before Congress amended the Food, Drug and Cosmetic Act to add regulation of new food additives to the responsibilities of the Food and Drug Administration. But Congress exempted two groups of additives, those already sanctioned by the F.D.A. or the Department of Agriculture, or those experts deemed “generally recognized as safe.”

The second exemption created what Tom Neltner, director of the Pew Charitable Trusts’ food additives project, a three-year investigation into how food additives are regulated, calls “the loophole that swallowed the law.” A company can create a new additive, publish safety data about it on its Web site and pay a law firm or consulting firm to vet it to establish it as “generally recognized as safe” — without ever notifying the F.D.A., Mr. Neltner said.

About 10,000 chemicals are allowed to be added to foods, about 3,000 of which have never been reviewed for safety by the F.D.A., according to Pew’s research. Of those, about 1,000 never come before the F.D.A. unless someone has a problem with them; they are declared safe by a company and its handpicked advisers.

“I worked on the industrial and consumer products side of things in the past, and if you take a new chemical and put it into, say, a tennis racket, you have to notify the E.P.A. before you put it in,” Mr. Neltner said, referring to the Environmental Protection Agency. “But if you put it into food and can document it as recognized as safe by someone expert, you don’t have to tell the F.D.A.”

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Gadgetwise Blog: Tip of the Week: Webmail Attachments Made Easy

The “Attach a file” button in the window of your open Web-based mail message may make it seem like you have to navigate around your hard drive to find the file you want to send, but appearances might be deceiving.

In some Web browsers, both Yahoo Mail and Google’s Gmail allow you to drag files from your computer’s desktop right into the message window to upload them as file attachments. Yahoo has additional information on attachment management and Google has an illustrated example for Gmail.

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Russian Envoy Says Syrian Leader Is Losing Control

MOSCOW — Russia’s top envoy for the Middle East said Thursday that Bashar al-Assad’s government is losing both control and territory to rebel forces, and said “unfortunately, it is impossible to exclude a victory of the Syrian opposition” — the most clear indication to date that Russia sees Mr. Assad, a longtime strategic ally, as headed for defeat.

“We must look squarely at the facts, and the trend now suggests that the regime and the government in Syria are losing more and more control and more and more territory,” said Deputy Foreign Minister Mikhail Bogdanov, in remarks to Russia’s Public Chamber that were carried by Russian wire services.

Mr. Bogdanov also said that Russia is preparing to evacuate its citizens — a complex task, since for decades, Russian women have married Syrian men sent to study in Russia and returned home with them to raise families. It was the first time an official at Mr. Bogdanov’s level had announced plans for an evacuation, and it sent a message to Damascus that Russia no longer holds out hope that the government can prevail.

Russia is eager to protect its strategic interests in Syria, like a naval facility at the port of Tartus, and has been meeting frequently with opposition delegations, presumably laying the groundwork for a possible transition. In his remarks to the Public Chamber, a Kremlin advisory group, Mr. Bogdanov said he believed that half the Russian citizens living in Syria support the rebels.

“Moreover, some of the people coming here as part of opposition coalitions have Russian passports,” he said.

Russia has cast its stance on Syria as a principled stand against Western-led interventions — a passionate topic for President Vladimir V. Putin, who feels Russia was deceived into supporting a no-fly zone in Libya that served as cover for a military campaign. In recent days, Moscow has been adamant that its fundamental position has not changed.

For many months, the Russian authorities have resisted Western pressure on Moscow to persuade the Syrian leader to step down. Though Russia has said it supports the creation of a transitional government, it has been at odds with the West on whether Mr. Assad — and Iran — would have a voice in it. Mr. Bogdanov said on Thursday that Russia’s stance has been deliberately distorted in the Western news media, an effort “intended to weaken our influence” in the Middle East, and that third-party governments have strengthened rebel forces by providing weaponry.

“Massive supply of modern armaments have pushed the Syrian rebels to stake their hopes on force,” leading to “an acceleration of the spiral of violence,” he said.

Leonid Medvedko, a political analyst who covered Syria for Soviet news services, said officials have so far been reluctant to declare an evacuation of Russian citizens “because there are technical questions, political questions — because it will mean we are fully giving up Syria.”

“It is a humanitarian step, but each humanitarian step has a political meaning,” he said.

From the first, Russia has taken the view that Mr. Assad’s departure would usher in a long and chaotic process of fragmentation in Syria, and most experts this week said they were braced for the beginning of that process. Mr. Medvedko, the former journalist, said he expected Syria to cleave into four parts that would be home to distinct ethnic and religious groups, much as Yugoslavia did in the 1990s.

Fyodor Lukyanov, the editor of Russia in Global Affairs and head of an influential policy group, said that even if Mr. Assad leaves the country, his countrymen will keep fighting.

“The prevailing view is that it will be complete and desperate chaos,” said Mr. Lukyanov. “To remove Assad will not mean settlement of the Syrian conflict. You can remove him — I don’t know in which way — but what will you do to 300,000 Alawites? They will be fighting for their lives, not for power anymore.”

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The New Old Age Blog: The Gift of Reading

This is the year of the tablet, David Pogue of The Times has told us, and that may be good news for seniors who open holiday wrappings to find one tucked inside. They see better with tablets’ adjustable type size, new research shows. Reading becomes easier again.

This may seem obvious — find me someone over 40 who doesn’t see better when fonts are larger — but it’s the business of science to test our assumptions.

Dr. Daniel Roth, an eye specialist and clinical associate professor at the Robert Wood Johnson Medical School in New Brunswick, N.J., offered new evidence of tablets’ potential benefits last month at the annual meeting of the American Academy of Ophthalmology.

His findings, based on tests conducted with 66 adults age 50 and over: older people read faster (a mean reading speed of 128 words per minute) when using an iPad, compared to a newspaper with the same 10-point font size (114 words per minute).

When the font was increased to 18 points — easy to do on an iPad — reading speed increased to 137 words per minute.

“If you read more slowly, it’s tedious,” Dr. Roth said, explaining why reading speed is important. “If you can read more fluidly, it’s more comfortable.”

What makes the real difference, Dr. Roth theorizes, is tablets’ illuminated screen, which heightens contrast between words and the background on which they sit.

Contrast sensitivity — the visual ability to differentiate between foreground and background information — becomes poorer as we age, as does the ability to discriminate fine visual detail, notes Dr. Kevin Paterson, a psychologist at the University of Leicester, who recently published a separate study on why older people struggle to read fine print.

“There are several explanations for the loss of sensitivity to fine detail that occurs with older age,” Dr. Paterson explained in an e-mail. “This may be due to greater opacity of the fluid in the eye, which will scatter incoming light and reduce the quality of the projection of light onto the retina. It’s also hypothesized that changes in neural transmission affect the processing of fine visual detail.”

Combine these changes with a greater prevalence of eye conditions like macular degeneration and diabetic retinopathy in older adults, and you get millions of people who cannot easily do what they have done all their lives — read and stay connected to the world of ideas, imagination and human experience.

“The No. 1 complaint I get from older patients is that they love to read but can’t, and this really bothers them,” Dr. Roth said. The main option has been magnifying glasses, which many people find cumbersome and inconvenient.

Some words of caution are in order. First, Dr. Roth’s study has not been published yet; it was presented as a poster at the scientific meeting and publicized by the academy, but it has not yet gone through comprehensive, rigorous peer review.

Second, Dr. Roth’s study was completed before the newest wave of tablets from Microsoft, Google, Samsung and others became available. The doctor made no attempt to compare different products, with one exception. In the second part of his study, he compared results for the iPad with those for a Kindle. But it was not an apples to apples comparison, because the Kindle did not have a back-lit screen.

This section of his study involved 100 adults age 50 and older who read materials in a book, on an iPad and on the Kindle. Book readers recorded a mean reading speed of 187 words per minute when the font size was set at 12; Kindle readers clocked in at 196 words per minute and iPad readers at 224 words per minute at the same type size. Reading speed improved even more drastically for a subset of adults with the poorest vision.

Again, Apple’s product came out on top, but that should not be taken as evidence that it is superior to other tablets with back-lit screens and adjustable font sizes. Both the eye academy and Dr. Roth assert that they have no financial relationship with Apple. My attempts to get in touch with the company were not successful.

A final cautionary note should be sounded. Some older adults find digital technology baffling and simply do not feel comfortable using it. For them, a tablet may sit on a shelf and get little if any use.

Others, however, find the technology fascinating. If you want to see an example that went viral on YouTube, watch this video from 2010 of Virginia Campbell, then 99 years old, and today still going strong at the Mary’s Woods Retirement Community in Lake Oswego, Ore.

Ms. Campbell’s glaucoma made it difficult for her to read, and for her the iPad was a blessing, as she wrote in this tribute quoted in an article in The Oregonian newspaper:

To this technology-ninny it’s clear
In my compromised 100th year,
That to read and to write
Are again within sight
Of this Apple iPad pioneer

Caregivers might be delighted — as Ms. Campbell’s daughter was — by older relatives’ response to this new technology, a potential source of entertainment and engagement for those who can negotiate its demands. Or, they might find that old habits die hard and that their relatives continue to prefer a book or newspaper they can hold in their hands to one that appears on a screen.

Which reading enhancement products have you used, and what experiences have you had?

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