Drone Pilots Found to Get Stress Disorders Much as Those in Combat Do

U.S. Air Force/Master Sgt. Steve Horton

Capt. Richard Koll, left, and Airman First Class Mike Eulo monitored a drone aircraft after launching it in Iraq.

The study affirms a growing body of research finding health hazards even for those piloting machines from bases far from actual combat zones.

“Though it might be thousands of miles from the battlefield, this work still involves tough stressors and has tough consequences for those crews,” said Peter W. Singer, a scholar at the Brookings Institution who has written extensively about drones. He was not involved in the new research.

That study, by the Armed Forces Health Surveillance Center, which analyzes health trends among military personnel, did not try to explain the sources of mental health problems among drone pilots.

But Air Force officials and independent experts have suggested several potential causes, among them witnessing combat violence on live video feeds, working in isolation or under inflexible shift hours, juggling the simultaneous demands of home life with combat operations and dealing with intense stress because of crew shortages.

“Remotely piloted aircraft pilots may stare at the same piece of ground for days,” said Jean Lin Otto, an epidemiologist who was a co-author of the study. “They witness the carnage. Manned aircraft pilots don’t do that. They get out of there as soon as possible.”

Dr. Otto said she had begun the study expecting that drone pilots would actually have a higher rate of mental health problems because of the unique pressures of their job.

Since 2008, the number of pilots of remotely piloted aircraft — the Air Force’s preferred term for drones — has grown fourfold, to nearly 1,300. The Air Force is now training more pilots for its drones than for its fighter jets and bombers combined. And by 2015, it expects to have more drone pilots than bomber pilots, although fighter pilots will remain a larger group.

Those figures do not include drones operated by the C.I.A. in counterterrorism operations over Pakistan, Yemen and other countries.

The Pentagon has begun taking steps to keep pace with the rapid expansion of drone operations. It recently created a new medal to honor troops involved in both drone warfare and cyberwarfare. And the Air Force has expanded access to chaplains and therapists for drone operators, said Col. William M. Tart, who commanded remotely piloted aircraft crews at Creech Air Force Base in Nevada.

The Air Force has also conducted research into the health issues of drone crew members. In a 2011 survey of nearly 840 drone operators, it found that 46 percent of Reaper and Predator pilots, and 48 percent of Global Hawk sensor operators, reported “high operational stress.” Those crews cited long hours and frequent shift changes as major causes.

That study found the stress among drone operators to be much higher than that reported by Air Force members in logistics or support jobs. But it did not compare the stress levels of the drone operators with those of traditional pilots.

The new study looked at the electronic health records of 709 drone pilots and 5,256 manned aircraft pilots between October 2003 and December 2011. Those records included information about clinical diagnoses by medical professionals and not just self-reported symptoms.

After analyzing diagnosis and treatment records, the researchers initially found that the drone pilots had higher incidence rates for 12 conditions, including anxiety disorder, depressive disorder, post-traumatic stress disorder, substance abuse and suicidal ideation.

But after the data were adjusted for age, number of deployments, time in service and history of previous mental health problems, the rates were similar, said Dr. Otto, who was scheduled to present her findings in Arizona on Saturday at a conference of the American College of Preventive Medicine.

The study also found that the incidence rates of mental heath problems among drone pilots spiked in 2009. Dr. Otto speculated that the increase might have been the result of intense pressure on pilots during the Iraq surge in the preceding years.

The study found that pilots of both manned and unmanned aircraft had lower rates of mental health problems than other Air Force personnel. But Dr. Otto conceded that her study might underestimate problems among both manned and unmanned aircraft pilots, who may feel pressure not to report mental health symptoms to doctors out of fears that they will be grounded.

She said she planned to conduct two follow-up studies: one that tries to compensate for possible underreporting of mental health problems by pilots and another that analyzes mental health issues among sensor operators, who control drone cameras while sitting next to the pilots.

“The increasing use of remotely piloted aircraft for war fighting as well as humanitarian relief should prompt increased surveillance,” she said.

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Southern California malls target Asian shoppers

The arrival of the Lunar New Year this month seems to have sparked an epiphany for area shopping centers: Asian and Asian American consumers have a growing pile of money and want to spend it where they're welcome.

So in the Year of the Snake, malls around the Southland are hustling harder to make themselves more appealing to the demographic.

Desert Hills Premium Outlets, Ontario Mills and the Outlets at Orange are partnering on a "Snaking through Southern California" initiative to lure Chinese shoppers to their malls. Simon Property Group, which owns the centers, says it's attempting to market to Asian consumers with multilingual messaging and Lunar New Year decorations.

Many stores in South Coast Plaza now have Asian employees to cater to the influx of moneyed tourists from China, Japan and South Korea who flock to the upscale mall. The center also has a language-assistance program and maps in Asian languages.

Westfield Santa Anita in Arcadia, a city where more than half the population is Asian/Asian American, is hosting its first-ever Lunar New Year festival Saturday afternoon. Free activities include a lion dance, Chinese calligraphy demonstrations and a Year of the Snake photo booth for families.

The San Gabriel Valley center hung a 120-foot, 600-pound red-and-gold dragon installation above its indoor carousel. Decorators brought in a Chinese pagoda as well as kumquat trees for good luck.

Even after the holiday, Westfield plans to continue tweaking the Santa Anita mall -- currently home to Nordstrom, AMC Theatres, Macy’s and more -- to better suit its Asian American clientele.

This summer, Hai Di Lao, a hot-pot restaurant chain based in China's Sichuan province, is to open its first U.S. location at the center. Beijing-based eatery Meizhou Dongpo is also scheduled to move in, in early 2014.

The mall already offers some store directories in Chinese.

The revamps could have a major economic payoff. Government projections peg 2013 as a record year for Chinese tourism to the United States. A report from Nielsen this past fall showed Asian American buying power surging over $1 trillion within five years, from $718.4 billion in 2012.

ALSO:

Asian tourists flock to South Coast Plaza

U.S. wine exports hit record, China sales up 18%

Asian American consumers: Nearing $1 trillion in buying power

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Gunfire and deadly crash rattle the Las Vegas Strip

LAS VEGAS — A spectacular predawn crash on the Strip — triggered when bullets fired from a black Range Rover peppered a Maserati — hit this resort city right between the eyes. In the end, three people were dead and a major intersection under lockdown during a three-state manhunt for the shooters, leaving even casino veterans used to the extraordinary scratching their heads.

The mayhem was sparked, witnesses told police, by a quarrel early Thursday at a hotel valet stand.

The two vehicles left the Aria resort hotel and were heading north on Las Vegas Boulevard at 4:20 a.m., an hour when the casino marquees shine brightly but the gambling thoroughfare is largely empty. At Harmon Avenue, occupants inside the Range Rover opened fire on the Maserati, police said.

The silver-gray sports car, which was struck several times, sped into the intersection at Flamingo Road, ramming a Yellow cab. The taxi exploded, killing the driver and a passenger. Four other vehicles in the intersection were also involved in the crash and explosion, but officers offered no details.

"Omg Omg Omg that car just blew up!" one witness tweeted shortly after the crash, posting a photo of the wreckage. "God Bless their Souls! Omg!"

The driver of the Maserati died later at a hospital, police said. A passenger in the vehicle received minor injuries and was being interviewed by investigators. At least three others were also injured.

Police in Nevada, California, Arizona and Utah were on alert for the distinctive black Range Rover SUV, described as having dark-tinted windows, black rims and out-of-state paper dealer plates.

"We are going to pursue these individuals and prosecute them," Clark County Sheriff Doug Gillespie said at an afternoon news conference. "This act was totally unacceptable. It's not just tragic but unnecessary — the level of violence we see here in Las Vegas and across America."

Authorities had not publicly identified the dead. But a Las Vegas television station late Thursday identified the taxi driver as Michael Boldon, 62, who the station said had recently moved here from Michigan to care for his 93-year-old mother.

The victim's son, who drives a limousine, told Fox News 5 that he last talked with his father after 3 a.m., and later called his cellphone shortly after the crash to warn him to avoid the Strip. But there was no answer.

The station also identified the driver of the Maserati as Ken Cherry, a rap artist from Oakland who also is known as "Kenny Clutch." The station quoted family members identifying Cherry as the driver. An Internet video of a Cherry song called "Stay Schemin" shows two men in a vehicle on the Strip.

Police had more questions than answers.

"It began with a dispute at a nearby hotel and spilled onto the streets," said Capt. Chris Jones of the Las Vegas Police Robbery and Homicide Division.

The morning's events threw the Strip into disarray all day. The gambling boulevard's busiest and best-known intersection was cordoned off by yellow police tape until nightfall, keeping traffic and curious pedestrians away from the carnage. Even skywalks were blocked off.

While slot machines beeped and card games continued inside casinos around the accident scene — including the Bellagio, Caesars Palace and Paris Las Vegas — hotel bell captains were fielding questions from tourists who had awakened to news of the crash and the Strip shutdown. The alleys and side streets between nearby hotels were clogged with pedestrians who inched along on narrow sidewalks, past delivery doors, many making their own paths between the landscaped bushes and palm trees.

Even casino industry workers were thrown into turmoil. Hotel maids and dealers who finished their midnight shifts after dawn were left without bus service home. "I'm stranded," said Tiruselam Kefyalew, 25, a maid. "What a day to leave my cellphone at home."

Limousine drivers who normally prowl the city's gambling core improvised detours. Some said the police blockade would cost them $500 or more in lost business and tips.

"Most people understand, but you have your complainers," said Jim DeSanto, a limo driver who waited for fares outside Bally's casino. "Those people will complain, even when everything is perfect."

Well after noon, guests peered out nearby hotel windows and others leaned into the street to glimpse the crime scene.

"Hey, honey, it must have happened right here," one man told his wife as they left Caesars around noon. The tourist, who would only say that he had arrived from Tampa, Fla., the previous evening, had looked out his hotel window at 4:30 to see a vehicle in flames.

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Tyler, Perry lead Songwriters Hall of Fame class

NASHVILLE, Tenn. (AP) — The Songwriters Hall of Fame is saluting 1970s and '80s rock 'n' roll with its 2013 induction class.

Joe Perry and Steven Tyler of Aerosmith and Mick Jones and Lou Gramm of Foreigner will join the hall of fame this year along with the writers of iconic rock hits "Love Is a Battlefield" and "Heartache Tonight." The ceremony will be held June 13 in New York.

Aerosmith and Foreigner will get the attention here, but inductees Holly Knight, JD Souther and Tony Hatch also have distinguished careers that helped define the sound of rock 'n' roll.

Knight wrote anthemic hits "Love Is a Battlefield" and "Invincible" for Pat Benatar and "The Warrior" for Patty Smyth. She also wrote several songs for Tina Turner, including "The Best" and "Better Be Good to Me," that became standards for the star.

Souther, who has a role on the music-inspired television show "Nashville," had a partnership with The Eagles that spawned several hits, including "Heartache Tonight," ''Victim of Love," ''New Kid in Town" and "Best of My Love."

Hatch made his mark during the British invasion, teaming with Petula Clark on hits like "Downtown" and "My Love" that helped shaped the future of pop music.

Perry and Tyler have survived a sometimes contentious relationship to become one of rock's most successful songwriting teams over the last 40 years. The Rock and Roll Hall of Famers, staples of classic rock radio and pop culture icons, are known for hits like "Sweet Emotion," ''Dream On" and "Livin' on the Edge," and released their 15th studio album last year.

Jones and Gramm are contemporaries of Perry and Tyler who also ruled radio for a time, but they sometimes came at it from a different angle. They could lay down a straight-up rocker like "Jukebox Hero" or "Feels Like the First Time." But they also could slow it down with hits like "I Wanna Know What Love Is" and "Cold as Ice" that helped foreshadow the ballad-driven rock of the late '80s.

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Online:

http://songhall.org

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Follow AP Music Writer Chris Talbott: http://twitter.com/Chris_Talbott .

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Well: Ask Well: The Nutrients in Fruits and Veggies

The colorful skin of an apple, grape or tomato is certainly chockfull of nutrients. But by no means are the outer layers of most fruits and vegetables the prime source of their nutrition.

Part of what makes some fruits and vegetables so rich with color – wax and pesticides notwithstanding – are pigments in the skin that have healthful antioxidant properties. Resveratrol, for example, is found in the skin of red grapes and other fruits. But lycopene, one of the pigments that gives tomatoes and bell peppers their deep red color, is distributed throughout.

Indeed, many vitamins and nutrients are found in the skin as well as the flesh. Take apples. According to the United States Department of Agriculture, a large red apple with its skin intact contains about 5 grams of fiber, 13 milligrams of calcium, 239 milligrams of potassium, and 10 milligrams of vitamin C. But remove the skin, and it still contains about 3 grams of fiber, 11 milligrams of calcium, 194 milligrams of potassium, and plenty of its vitamin C and other nutrients.

Another example is the sweet potato. The U.S.D.A. says that a 100-gram serving of sweet potato cooked with its skin contains 2 grams of protein, 3 grams of fiber, and 20 milligrams of vitamin C. But the same sized serving of sweet potato without skin that has been boiled — a process that further leaches away some of its nutrients — still boasts 1.4 grams of protein, 2.5 grams of fiber, and 13 milligrams of vitamin C.

You can lose the skin, in other words, without losing all the benefits.

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Stocks open higher following a two-day decline

Strong earnings results from big U.S. companies offered investors a whiff of hope Friday. Stocks rose after a two-day slump, but remained on track for their worst week this year.

Hewlett-Packard drove the Dow Jones industrial average higher a day posting fiscal first-quarter earnings that beat the forecasts of analysts and the company itself. The results came as relief after months of bad news for the computer maker. Its stock rose $1.36, or 8 percent, to $18.46.

American International Group Inc. helped boost the Standard & Poor's 500 index after saying its fourth-quarter operating results exceeded forecasts. The company's net loss was $4 billion, mainly because of claims related to Superstorm Sandy, in the first full quarter after it finished repaying its $182 billion government bailout. Its stock rose $1.39, or 4 percent, to $38.67.

The Dow Jones industrial average was up 42 points at 13,922 in the first 45 minutes of trading. The Standard & Poor's 500 index rose six to 1,508. The Nasdaq composite index rose 14 to 3,145.

All three indexes remain down for the week. The S&P 500 is on track for its first weekly loss of the year.

Stocks plunged Wednesday afternoon after minutes from the Federal Reserve's latest policy meeting spooked investors. The minutes revealed disagreement at the Fed about how long to keep buying bonds in an effort to boost the economy. The slide continued Thursday.

Many analysts believe that the Fed's bond-buying and resulting low interest rates have driven this year's stock rally, which has lifted indexes to their highest levels since the 2008 financial crisis.

Among the other corporate news moving markets:

— Abercrombie & Fitch sank after a key sales metric declined in the all-important holiday quarter. Its stock fell $2.27, or 5 percent, to $46.78.

— WebMD Health Corp. soared after the health website operator reported better-than-expected revenue and an optimistic outlook for 2013. The stock rose $3.85, or 24 percent, to $20.15.

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Bulgari shows off Liz Taylor's gems

It isn't easy sometimes to be an ordinary person in Los Angeles, so near to and yet so far from the city's glamorous events.

You hear about the grand Oscar parties, but you will never be invited. The award ceremony may be taking place minutes from where you live, but you watch it at home, on TV, in your sweat pants — and you might as well be in Dubuque.

Rodeo Drive too can make you feel like a scrap on the cutting room floor. As you stroll the wide and immaculate sidewalks of Beverly Hills' iconic shopping street, you pass by boutiques you'd feel self-conscious walking into. In the windows are baubles and trinkets you could never in three lifetimes afford.

Which is why it is rather nice to be invited to make a private appointment at the house of Bulgari, the fine Italian jeweler that opened its doors in 1884.

Elizabeth Taylor loved Bulgari jewels. Richard Burton, whose torrid affair with her began during the filming of "Cleopatra" in Rome, accompanied her often to the flagship shop on the Via Condotti. He liked to joke that the name Bulgari was all the Italian she knew.

So it is fitting that starting Oscar week, the jeweler is celebrating the Oscar-winning star with an exhibit of eight of her most treasured Bulgari pieces.

They are heavy on diamonds and emeralds — of rare size, gleam and value.

And Bulgari knows their value well.

After Taylor's death, it reacquired some of the gems at a Christie's auction. One piece, an emerald-and-diamond brooch that also can be worn as a pendant, sold for $6,578,500 — breaking records both for sales price of an emerald and for emerald price per carat ($280,000).

That brooch, whose centerpiece is an octagonal step-cut emerald weighing 23.44 carats, was Burton's engagement present to Taylor. He followed it upon their marriage (his second, her fifth) with a matching necklace whose 16 Colombian emeralds weigh in at 60.5 carats. Bulgari bought the necklace back too, for $6,130,500.

They are in the exhibit, along with Burton's engagement ring to Taylor and a delicate brooch — given to her by husband No. 4, Eddie Fisher — whose emerald and diamond flowers were set en tremblant so that they gently fluttered as Taylor moved.

The jewels are not for sale.

On Tuesday night, actress Julianne Moore wore the Burton necklace, with pendant attached, at a gala for Bulgari's top clients. At the dinner hour, guests were escorted along a lavender-colored carpet to a nearby rooftop that had been transformed into a Roman terrace.

Those honored guests, of course, got private viewings of Taylor's jewels.

But so did Amanda Perry, a healer from West Hollywood who arrived the next morning for one of the first appointments available to the public.

Someone had emailed news of the collection to the 35-year-old Taylor fan. She walked in off the street Tuesday, when the exhibit was open only to press — and Sabina Pelli, Bulgari's glamorous executive vice president, fresh from Rome, was taking sips of San Pellegrino brought to her on a silver tray between back-to-back interviews that started at 5 a.m.

The camera crews were long gone when Perry came back Wednesday. She had the exhibit, and handsome sales associate Timothy Morzenti of Milan, entirely to herself.

In a black suit, still wearing on his left hand the black glove he dons to handle fine jewels, Morzenti whisked Perry off via a private elevator to the exhibit on the second floor. The jewels stood in vitrines mounted high off the ground. Behind them were photos and a slide show of Taylor, bejeweled.

"Which piece would you like to see first?" Morzenti asked her as a security guard stood by. "I personally love the emerald ring."

Then he proceeded at leisure to explain Bulgari-signature sugar-loaf cuts and trombino ring settings, while tossing in occasional Taylor stories.

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Lady Gaga says she's had hip surgery

NEW YORK (AP) — Lady Gaga says she's had surgery to fix her hip.

The 26-year-old singer posted on her blog late Wednesday that she had hip surgery and it "happened so fast." She canceled her "Born This Way Ball" tour last week.

She thanked her fans in the post, saying they gave her "a lot of strength." Lady Gaga said that as she was wheeled to surgery, she reflected on her fans. She wrote: "Sometimes you are so brave that it terrifies me. I wonder how it's even possible."

Lady Gaga canceled more than 20 dates on the remainder of her tour, which began last April. She originally postponed four dates last week after experiencing difficulties during her concert in Montreal. She explained to fans on Twitter that she'd hurt herself while performing some time ago.

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Online:

http://littlemonsters.com/post/5125a616222766643e00019f

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Well: The Benefits of Exercising Outdoors

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

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

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

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

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

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

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

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Inflation remains tame, but so do gains in earnings

WASHINGTON -- Despite worry in some corners about the Federal Reserve's stimulus efforts stoking inflation, there continues to be little indication that consumer prices are heading higher.

The consumer price index was flat in January for the second month in a row, the Bureau of Labor Statistics reported Thursday. A drop in gas prices and a halt to recent gains in food prices held down the overall index. Compared with a year ago, the consumer price measure for January was up a mild 1.6%.

But that moderate inflation rate will provide little comfort to most consumers. Not only have gas prices jumped in recent weeks, the end of the payroll tax holiday at the start of this year has clipped about $40 from the biweekly paycheck for the average worker.

With that, inflation-adjusted average hourly earnings in January were up just 0.6% from a year ago, the Bureau of Labor Statistics said.

Excluding energy and food, the so-called core measure of consumer prices, which is more closely tracked by the Fed, rose 0.3% in January from December, the highest in 20 months. Higher prices for clothes and shelter accounted for much of that increase, although consumers also paid more for airline fares, medical services and school tuitions in January.

Still, the annual core inflation rate in January held at 1.9% for the third straight month. That is just a notch below the 2% inflation target set by the Fed, which has been pumping money into the financial system to stimulate economic growth and help bring down the high jobless rate.

The Fed's stimulus efforts include the purchase of $85 billion worth of government and mortgage bonds a month, aimed at holding down long-term interest rates to spur investment, spending and hiring. Many economists and policymakers, including some Fed members, are concerned that the central bank's easy-money policies will lead to spiraling inflation down the road.

So far, there’s little sign of that.

"Consumer inflation remains relatively tame, mostly because of persistently subdued economic growth," said Diane Swonk, chief economist at Mesirow Financial in Chicago. "Ongoing constraints on consumer budgets, however, will force a reallocation away from discretionary purchases toward necessities. This will hold overall inflation in check, but remain extremely uncomfortable."

ALSO:

Consumer sentiment bounces back in February

Retail sales growth slows as higher payroll tax resumes

More Fed officials worry about negative effects of stimulus

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