No sympathy for Armstrong on social media

LONDON (Reuters) – Lance Armstrong’s televised doping confession has done nothing to restore his shattered reputation, a study of responses posted to the Twitter social media site showed.

“What was particularly noticeable in our analysis of the Armstrong revelation was the sheer lack of sympathy out there,” said Charlie Dundas of sports market research company Repucom.

“The tone of the discussion around the Oprah Winfrey interview highlighted the level of disappointment and anger that exists. It’s clear the public are far from ready to forgive Lance Armstrong,” he added.

In the interview, Armstrong admitted to using performance-enhancing drugs on his way to his seven Tour de France titles. The Texan also said he hoped a lifetime ban would one day be lifted to allow him to compete in events like marathons.

The Armstrong interview generated 1.9 million Twitter posts between January 14-20, Repucom said. America accounted for more than a quarter of these, with Australia the second most active nation on the site.

(Writing by Keith Weir, editing by Mark Meadows)

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Michelle Obama again picks designer Wu for inaugural gown

WASHINGTON (Reuters) – It was one of the biggest questions of Monday’s inaugural celebrations: not what would President Barack Obama say, but what would his wife, Michelle Obama, wear?

The first lady cemented her reputation as an international style trend-setter with her choice of a Jason Wu red sleeveless ball gown in the evening, and a striking business-style blue navy coat and dress for the ceremonial daytime events.

It was a huge win for U.S. designer Wu making one of his ball gowns her choice for a second straight inauguration.

The first lady appeared for her first dance of the night with the president at the Commander-in-Chief’s Ball for U.S. service members in a ruby-colored chiffon and full-length velvet gown custom made by the New York-based designer.

Her shoes were from the London-based Malaysian-Chinese designer Jimmy Choo, and she wore a diamond-embellished ring handmade by jeweler Kimberly McDonald of New York.

Michelle Obama helped make Wu a household name by choosing a white chiffon gown he designed for the balls celebrating her husband’s first inauguration in 2009. Wu, now 30, has since had significant commercial success, but his creations in the two inaugurations has won him a place in U.S. fashion history.

Dressing the first lady, a Harvard-trained lawyer known for her style, can be a huge boost for a fashion designer or retail chain.

Praised for wearing high-end designers as well as pieces from mass-market stores, the first lady has won over fashion critics in her four years in the White House.

“Icon’s a big word and it sometimes gets over used, but I think if we’re going to use it, we can use it now,” said Steven Kolb, chief executive of the Council of Fashion Designers of America, adding, “What makes her a real icon is the work that she does and the woman that she is.”

Dresses, sweaters, shoes and belts she has worn have sold out at retailers from designer showrooms to mass market chains including Gap Inc., J. Crew and Target Corp., for which Wu has designed low-priced fashions.

Earlier on Monday, the first lady wore a navy coat and dress by designer Thom Browne, inspired by the fabric of a man’s silk tie.

Her belt and gloves were from J.Crew, a chain that is a fixture in U.S. shopping malls; the necklace and earrings were designed by Cathy Waterman. The suede boots were by Reed Krakoff, as was the short blue cardigan she wore to a celebratory lunch in the Capitol.

BIG-TICKET INDUSTRY

Best known for men’s clothing, Browne boasts a string of design awards, most recently, a prestigious National Design Award for fashion from the Cooper-Hewitt National Design Museum in New York, which is part of the Smithsonian Institution.

“She likes well-tailored clothes, so the inspiration was doing something that looked tailored and structured and fitted through the body and somewhat A-line for the skirt and the dress,” Browne told the Los Angeles Times.

Style mavens credit the 49-year-old first lady with changing the way American women put together their outfits, and, by patronizing U.S. designers, bolstering a multibillion-dollar industry.

A 2010 study from New York University’s Stern School of Business found that a single appearance by the first lady can generate $ 14 million in value for a company.

Famed for her toned arms, Obama set a trend for sleeveless tops. Her cardigans and belted dresses have prompted many working women to switch from blazers and suits in the workplace.

“Michelle looks good however, wherever, whatever she does. Michelle looks good in her sleeping gown,” said Sharon Johnson, a therapist who came from Baltimore to watch the inauguration, and joked that she is still looking for the green leather gloves Obama wore on Inauguration Day four years ago.

“Her beauty is so far inside, and shines so far outside,” Johnson said.

When Michelle Obama held the Bible for her husband during his official swearing-in on Sunday, she wore a dark blue dress by Reed Krakoff, the creative director for the Coach leather goods company, who has become a fashion designer.

On Sunday night, she wore a sleeveless black sequined dress by Michael Kors to an inaugural reception for supporters.

At that reception, President Obama weighed in on what he termed the most “significant” event of the inaugural weekend, his wife’s hotly discussed new hairstyle.

“I love her bangs,” Obama said. “She looks good. She always looks good.”

Interest in Michelle Obama’s clothing has extended to the outfits worn by her two daughters. On Monday, the White House said Malia, 14, was wearing a J.Crew ensemble and Sasha, 11, wore a Kate Spade coat and dress.

Obama is a far bigger influence on U.S. fashion than most of her predecessors. Laura Bush favored suits by Oscar de la Renta and Hillary Clinton, the U.S. Secretary of State, is best known for wearing a range of brightly colored pants suits.

Even stylish Jackie Kennedy wore mostly European designers.

Obama’s fashion choices have not always been applauded. Some Americans were angry when she wore a red gown from a British label – Alexander McQueen – to a 2011 state dinner for China’s president.

Kolb dismissed such concerns, noting that fashion is a global business and that U.S. designers are thrilled when, for example, Kate Middleton, the wife of Britain’s Prince of Wales, wears their clothing.

“At the end of the day, we get up in the morning and we look in our closet and we have to feel good about what we put on,” he said.

At the end of the inaugural festivities, Michelle Obama’s outfits and accompanying accessories will go to the National Archives.

(Additional reporting by Jeff Mason, Steve Holland and Alina Selyukh; Editing by Alistair Bell and Christopher Wilson)

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The Week: A Roundup of This Week’s Science News

“Science,” a colleague once said at a meeting, “is a mighty enterprise, which is really rather quite topical.” He was so right: as we continue to enhance our coverage of the scientific world, we always aim to keep the latest news front and center.

His observation seemed like a nice way to introduce this column, which will highlight the week’s developments in health and science news and glance at what’s ahead. This past week, for instance, the mighty enterprise of science addressed itself to such newsy topics as the flu (there’s still time to get vaccinated!), and mental illness and gun control.

In addition to the big-headline stories that invite wisdom from scientists, each week there is a drumbeat of purely scientific and medical news that emerges from academic journals, fieldwork and elsewhere. These developments, from the quirky to the abstruse, often make their way into the daily news cycle, depending on the strength of the research behind them. (Well, that’s how we judge them, anyway.)

Many discoveries are hard to unravel. “In a way, science is antithetical to everything that has to do with a newspaper,” the same colleague observed. “You couldn’t imagine anything less consumer-friendly.”

Let’s aim to fix that. Below, a selection of the week’s stories.

DEVELOPMENTS

Health

Strange, but Effective

People with a bacterial infection called Clostridium difficile — which kills 14,000 Americans a year — have a startling cure: a transplant of someone else’s feces into their digestive system, which introduces good bacteria that the gut needs to fight off the bad. For some people, antibiotics don’t fix this problem, but an infusion of diluted stool from a healthy person seems to do the trick.

Genetics

Dig We Must

Hillery Metz and Hopi Hoekstra/Harvard University

Evolutionary biologists at Harvard took a tiny species of deer mice, known for building elaborate burrows with long tunnels, and bred it with another species of deer mice, which builds short-tunneled burrows. Comparing the DNA of the original mice with their offspring, the biologists pinpointed four regions of genetic code that help tell the mice what kind of burrow to construct.

Aerospace

Launch, Then Inflate

Uncredited/Bigelow Aerospace, via Associated Press

NASA signed a contract for an inflatable space habitat — roughly pineapple-shaped, with walls of floppy cloth — that will ideally be appended to the International Space Station in 2015. NASA aims to use the pod to test inflatable technology in space, but the company that builds these things, Bigelow Aerospace, has bigger ambitions: think of a 12-person apartment and laboratory in the sky, with two months’ rent at north of $26 million.

Biology

What’s Green and Flies?

Jodi Rowley/Australian Museum

National Geographic reported on an Australian researcher working in Vietnam who discovered a great-looking new species of flying frog. Described as having flappy forearms (the better for gliding), the three-and-a-half-inch-long frog likes to “parachute” from tree to tree, Jodi Rowley, an amphibian biologist at the Australian Museum in Sydney, told the magazine. She named it Helen’s Flying Frog, for her mother.

Privacy

That’s Joe’s DNA!

People who volunteer their genetic information for the betterment of science — and are assured anonymity — may find that their privacy is not a slam dunk. A researcher who set out to crack the identities of a few men whose genomes appeared in a public database was able to do so using genealogical Web sites (where people upload parts of their genomes to try to find relatives) as well as some simple search tools. He was trying to test the database’s security, but even he did not expect it to be so easy.

Genetics

An On/Off Switch for Disease

Geneticists have long puzzled over what it is that activates a disease in one person but not in another — even in identical twins. Now researchers from Johns Hopkins and the Karolinska Institute in Sweden who studied people with rheumatoid arthritis have identified a pattern of chemical tags that tell genes whether to turn on or not. In rheumatoid arthritis, the immune system attacks the body, and it is thought the tags enable the attack.

Planetary Science

That Red Planet

Everybody loves Mars, and we’re all secretly hoping that NASA’s plucky little rover finds evidence of life there. Meanwhile, a separate NASA craft — the Mars Reconnaissance Orbiter, which has been looping the planet since 2006 — took some pictures of a huge crater that looks as if it once held a lake fed by groundwater. It is too soon to say if the lake held living things, but NASA’s news release did include the happy phrase “clues to subsurface habitability.”

COMING UP

Animal Testing

Retiring Chimps

Emily Wabitsch/European Pressphoto Agency

A lot of people have strong feelings about the use of chimpanzees in biomedical and behavioral experiments, and the National Institutes of Health has been listening. On Tuesday, the agency is to release its recommendations for curtailing chimp research in a big way. This will be but a single step in a long process and it will apply only to the chimps the agency owns, but it may well stir big reactions from many constituencies.

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Bank of Japan Moves to Fight Deflation

TOKYO — The Bank of Japan set an ambitious 2 percent inflation target and pledged to ease monetary policy “decisively” by introducing open-ended asset purchases, following intense pressure from the country’s audacious new prime minister, Shinzo Abe, who has made beating deflation a national priority.

In a joint statement Tuesday with the government, the central bank said it was doubling its inflation target to 2 percent and said it would “pursue monetary easing and aim to achieve this target at the earliest possible time.”

The Bank of Japan also said that it intended to purchase assets indefinitely, promising to stick to a program that has allowed the bank to pump funds into the Japanese economy, even with interest rates at virtually zero. The bank’s board voted to keep its benchmark rate at a range of zero to 0.1 percent.

Mr. Abe immediately hailed the bank’s moves, telling the Bank of Japan governor, Masaaki Shirakawa, that the measures were “groundbreaking,” according to Kyodo News. Analysts, however, said the details of the bank’s policy were less impressive than the headlines and said they had expected more.

The central bank, for example, will only begin its open-ended asset purchases in 2014, and estimates that its asset purchase fund will increase by just 10 trillion yen in 2014, remaining unchanged after that. With such a paltry increase, it was unlikely Japan would achieve 2 percent inflation, analysts said. The consumer price index for 2012 fell 0.5 percent, according to government statistics.

The Bank of Japan’s announcement “will likely disappoint those who expected the policy board to answer Abe’s call for a ‘different kind of B.O.J. policy,’ or significantly ramp up its pace of easing,” Izumi Devalier, an economist with HSBC, said in a note to clients.

“This means pressure will remain in place for the B.O.J. to ease policy further, as the 2 percent inflation target remains ever out of reach,” Ms. Devalier and her colleagues said.

Masaaki Kanno, Japan economist for JPMorgan, also called the details of the asset purchase program disappointing. “That said, this is not the end of the game,” he said. “We should expect further easing” including an increase in asset purchases as well as purchases of longer-term assets, once Gov. Shirakawa’s term is up in April and a successor is appointed, Mr. Kanno said.

Since last year, when Mr. Abe was still opposition leader, he has urged the central bank to do more to end deflation, the all-around fall in prices, profit and incomes that has plagued Japan’s economy since the late 1990s. He stepped up the pressure on the bank after a landslide victory by his Liberal Democratic Party in parliamentary elections in December, which catapulted him to office for the second time since a short-lived stint in 2006-07.

Mr. Abe’s call for the Bank of Japan to increase the monetary supply, among other things, has weakened the yen, a boon to the competitiveness of exporters, which make up much of Japan’s growth. Earlier this month, Mr. Abe also announced a 12 trillion yen emergency stimulus, providing even more tailwind for the Japanese economy. That bright outlook has pushed the Nikkei stock index 20 percent higher since mid-November, when Mr. Abe first campaigned on his expansionary platform.

Mr. Abe’s critics, however, warn that the central bank, which will buy up more government bonds as part of its asset purchase program, will become a printing press for profligate government spending — spending that carries great risks for a country whose public debt is already twice the size of its economy. Critics also say that before flooding a broken system with money, Japan must first tackle structural problems that hurt economic efficiency.

Mr. Abe maintains that deflation will undermine any efforts to grow, and that the government and central bank must act together to get prices rising again. But in a nod to critics, the joint statement said the government would also promote “all possible decisive policy actions for reforming the economic structure” and establish “a sustainable fiscal structure.”

“I believe we are firmly on the path toward bold monetary easing,” Mr. Abe told reporters following the bank’s announcement.

Mr. Shirakawa, who has long argued that the bank alone cannot spark inflation or economic growth, called on the government to do its part to bolster the Japanese economy.

“Various actors need to put in considerable effort along with the Bank of Japan,” Mr. Shirakawa told a press conference late Tuesday. “Those efforts are going to have to be quite drastic,” he said.

Market reaction was mixed. The Nikkei index average rose 0.8 percent in anticipation of the bank’s announcement, before giving up its gains to end 0.4 percent lower, at 10,709.93. The index has risen over 20 percent, however, since Mr. Abe started his monetarist push. The dollar briefly rose above 90 yen, near the 2-year high of 90.25 it hit on Monday, but had slipped to 88.67 yen late afternoon in Tokyo.

Yields on 10-year Japanese government bonds were largely unchanged, with a benchmark issue ending trading at 0.730 percent, down 0.005 percentage points from Monday’s close.

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Republican allies advocate for immigration reform

WASHINGTON — Traditional pillars of the Republican base, such as police groups, evangelical pastors and the U.S. Chamber of Commerce, have begun to push skeptical GOP lawmakers to change federal immigration laws to allow most of the nation's 11 million illegal immigrants to apply for legal status.

The issue has long been fought mostly between Republicans and Democrats. But the fate of a potential immigration overhaul may be determined by battles erupting inside the GOP.

"Now it's conservatives versus conservatives over how much immigration reform should happen," said Alex Nowrasteh, an immigration expert at the Cato Institute, a libertarian think tank in Washington that has advanced a free-market argument for opening up the immigration system.

President Obama has vowed to revise immigration laws early in his second term, but Republican support would be necessary to pass any significant legislation in the GOP-held House.

Some national Christian organizations, law enforcement officials and business leaders have begun coordinating a national campaign to convince voters that immigration reform can be consistent with conservative values. Gathering in Washington last week, leaders of several groups said the goal is to help Republicans in Congress who fear being voted out of office if they support legal status for illegal immigrants.

Republican strategists have dubbed the emerging coalition "Bibles, badges and business." And opponents are gearing up their own lobbying machinery in favor of restricting immigration.

"It is unfortunate that these groups have abandoned the base to support immigration reform that is not in the best interest of Americans," said Rosemary Jenks, director of government relations for NumbersUSA, a Virginia-based advocacy group that lobbies to reduce immigration levels and grades members of Congress. "We have 20 million Americans unemployed who can't find jobs."

But conservative views on immigration are changing. Recent polling shows a majority of Republican voters would support a plan that simultaneously tightens border security, requires employers to check the immigration status of new hires and creates a path to legal status for immigrants who have paid a fine and back taxes.

"The whole economy is suffering because we can't grow without immigration," said Carlos Gutierrez, former secretary of Commerce under President George W. Bush. He has helped create a political action committee to fund Republican congressional campaigns and "give cover to people who come out and admit they are for immigration reform," he said.

In coming months, the U.S. Chamber of Commerce will try to convince local chapters that businesses will benefit from laws that make it easier for non-Americans to obtain work visas, and allow illegal immigrants to apply for permanent legal status, said Randel Johnson, a senior vice president for the chamber in Washington.

"We have time to build this right," Johnson said. Chamber officials are working with labor unions and other groups to help craft possible provisions for an immigration bill in May or June, he said.

The chamber has favored new laws for more than a decade, he said, but the organization is starting a more aggressive campaign to build public support.

"In the past, we didn't do what we needed," Johnson said. "Evangelicals bring another wrinkle to help us persuade Republicans to bring a bill."

A national network of evangelical pastors will encourage congregations to read 40 biblical passages about how to treat foreigners and to discuss how Scripture can inform the debate on immigration.

Called the "'I Was a Stranger' Challenge," the campaign is supported by several major Christian groups, including Sojourners, the National Assn. of Evangelicals and the Southern Baptist Convention. Many oppose abortion and gay marriage.

"I see this as a biblical justice and compassion issue," said Bill Hamel, president of the Evangelical Free Church of America, based in Minneapolis.

Hamel said he would encourage more than 1,000 churches affiliated with his organization to pray about immigration, and would meet his congressman, John Kline (R-Minn.), who has sought to lower immigration levels, to urge him to change his stance.

Some Republican law enforcement officials have joined the effort.

The lack of federal action on immigration has complicated the work of local police, said Gregory F. Zoeller, the Republican attorney general of Indiana. "It takes their eye off the ball of maintaining the safety of the people of Indiana," he said.

"Republicans need to change now because the country is changing," said Nowrasteh, the immigration expert at the Cato Institute. "It is self preservation as well."

brian.bennett@latimes.com

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Notre Dame hoax tip was emailed: Deadspin.com editor

CHICAGO (Reuters) – The tip that led to the revelation that one of the most widely recounted U.S. sports narratives of the past year was a hoax came to the editors of an online sports blog as many of their news tips do: an unsolicited email.

That email led Deadspin.com assignment editor Timothy Burke on the hunt of a story that exposed the heart-wrenching tale of standout Notre Dame linebacker Manti Te’o's dead girlfriend as a fabrication, Burke said on CNN on Thursday.

Te’o sprang to national prominence last fall when the senior co-captain was seen heroically leading the Fighting Irish to an underdog victory against the Michigan State Spartans within days of learning his grandmother had died. Moreover, it was widely reported, Te’o's girlfriend had died of leukemia just hours after his grandmother’s death.

From that point, Te’o's narrative was a prominent feature in coverage of the team, which has a dedicated following and whose games are televised nationally each week.

Notre Dame went on to an undefeated regular season, culminating in a berth in the national championship game, which the Fighting Irish lost to the Alabama Crimson Tide on January 7.

“We got an email last week at Deadspin.com that said ‘Hey, there’s something real weird about Lennay Kekua, Manti Te’o's allegedly dead girlfriend. You guys should check it out,’” Burke said.

The email prompted Burke and co-author Jack Dickey to begin searching online for background on Kekua. “So we start Googling the name Lennay Kekua. We can’t find any evidence of this person that wasn’t attached to stories about her being Manti Te’o's dead girlfriend.”

Their investigation led about a week later to a 4,000-word expose, published Wednesday under the headline “Blarney,” that painstakingly debunked the story of Kekua’s existence. The story went viral online.

Within hours of its publication, officials at Notre Dame, one of the most powerful institutions in college football and U.S. collegiate athletics overall, held a hastily organized press conference to assert that Te’o had been duped in a hoax perpetrated by a friend of his.

The girlfriend, who called herself Kekua and claimed to be a Stanford University graduate, was merely an online persona who “ingratiated herself with Manti and then conspired with others to lead him to believe she had tragically died of leukemia,” university spokesman Dennis Brown said in a statement.

Notre Dame Athletic Director Jack Swarbrick said the university learned of the hoax from Te’o on December 26. Te’o answered questions forthrightly and private investigators uncovered several things that pointed to Te’o being a victim in the case, Swarbrick said.

Deadspin’s Burke said he remains skeptical of this being a hoax perpetrated on Te’o rather than by Te’o.

“Ask yourself why and what incentive a person would have to execute such a lengthy, time-consuming and expensive con that would involve multiple people and essentially consume his entire life just to screw around with a guy that he knows?” Burke said on CNN.

Deadspin.com said the woman whose photograph was frequently shown on TV and in news reports about Kekua was actually a young California woman who had never met or communicated with Te’o. The website declined to identify her by name.

On Thursday, TV newsmagazine “Inside Edition” said the woman in the photograph was a 23-year-old marketing professional in Los Angeles named Diane O’Meara. Inside Edition, which is syndicated by CBS Television Distribution, said O’Meara was a former classmate of one of Te’o's friends. It Aredid not give the friend’s name.

In the expose published Wednesday, Deadspin.com said a friend of Te’o's named Ronaiah Tuiasosopo was “the man behind” the hoax.

Outside Tuiasosopo’s home in Palmdale, California on Thursday, a member of his family who did not identify himself told reporters, “Please, we have no comment. Please respect that.”

The Te’o hoax is the latest black eye Notre Dame’s legendary football program has suffered in recent years.

In 2011, the school was fined $ 42,000 by an Indiana agency over the death of football videographer Declan Sullivan, 20, who died in October 2010 after a hydraulic lift he was using to record practice toppled over in high winds.

In 2010, Elizabeth “Lizzy” Seeberg, a freshman at nearby St. Mary’s College, killed herself ten days after accusing a Notre Dame football player of sexual battery. Her family began questioning the campus police department’s reluctance to gather evidence and a 15-day delay in interviewing the accused.

After a federal investigation into the matter, the school agreed to revise its policies on sexual misconduct.

(Additional reporting by Dan Burns, Dana Feldman, David Bailey and Mary Wisniewski.; Editing by Vicki Allen, Greg McCune and Andrew Hay)

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Michelle Obama wears bangs, Krakoff to swearing-in

WASHINGTON (AP) — Michelle Obama showed off her new bangs and a royal blue dress and cardigan by American designer Reed Krakoff at Sunday’s swearing-in ceremony.

The first lady and daughter Malia matched President Barack Obama‘s blue suit, also complementing the Blue Room of the White House, where the small ceremony took place. Younger daughter Sasha, however, went her own way: She wore a lacy pink dress with a gold, wide-width, high-waisted belt — a style her mother helped popularize — and gold shoes.

It’s not the first time Mrs. Obama chose a design by Krakoff. She previously has worn a gown and jacket by the designer, who also is the president and executive creative director of Coach, Inc. She has carried one of his tote bags, too.

Her hairdo, however, is a change — and it has been the subject of online chatter since its debut on Thursday in a photo taken at the White House.

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Well: A Check on Physicals

“Go Beyond Your Father’s Annual Physical. Live Longer, Feel Better”

This sales pitch for the Princeton Longevity Center’s “comprehensive exam” promises, for $5,300, to take “your health beyond the annual physical.” But it is far from certain whether this all-day checkup, and others less inclusive, make a meaningful difference to health or merely provide reassurance to the worried well.

Among physicians, researchers and insurers, there is an ongoing debate as to whether regular checkups really reduce the chances of becoming seriously ill or dying of an illness that would have been treatable had it been detected sooner.

No one questions the importance of regular exams for well babies, children and pregnant women, and the protective value of specific exams, like a Pap smear for sexually active women and a colonoscopy for people over 50. But arguments against the annual physical for all adults have been fueled by a growing number of studies that failed to find a medical benefit.

Some experts note that when something seemingly abnormal is picked up during a routine exam, the result is psychological distress for the patient, further testing that may do more harm than good, and increased medical expenses.

“Part of the problem of looking for abnormalities in perfectly well people is that rather a lot of us have them,” Dr. Margaret McCartney, a Scottish physician, wrote in The Daily Mail, a British newspaper. “Most of them won’t do us any harm.”

She cited the medical saga of Brian Mulroney, former prime minister of Canada. A CT scan performed as part of a checkup in 2005 revealed two small lumps in Mr. Mulroney’s lungs. Following surgery, he developed an inflamed pancreas, which landed him in intensive care. He spent six weeks in the hospital, then was readmitted a month later for removal of a cyst on his pancreas caused by the inflammation.

The lumps on his lungs, by the way, were benign. But what if, you may ask, Mr. Mulroney’s lumps had been cancer? Might not the discovery during a routine exam have saved his life?

Logic notwithstanding, the question of benefits versus risks from routine exams can be answered only by well-designed scientific research.

Defining the value of a routine checkup — determining who should get one and how often — is especially important now, because next year the Affordable Care Act will add some 30 million people to the roster of the medically insured, many of whom will be eligible for government-mandated preventive care through an annual exam.

Dr. Ateev Mehrotra of the University of Pittsburgh School of Medicine, who directed a study of annual physicals in 2007, reported that an estimated 44.4 million adults in the United States undergo preventive exams each year. He concluded that if every adult were to receive such an exam, the health care system would be saddled with 145 million more visits every year, consuming 41 percent of all the time primary care doctors spend with patients.

There is already a shortage of such doctors and not nearly enough other health professionals — physician assistants and nurse practitioners — to meet future needs. If you think the wait to see your doctor is too long now, you may want to stock up on some epic novels to keep you occupied in the waiting room in the future.

Few would challenge the axiom that an ounce of prevention is worth a pound of cure. Lacking incontrovertible evidence for the annual physical, this logic has long been used to justify it:

¶ If a thorough exam and conversation about your well-being alerts your doctor to a health problem that is best addressed sooner rather than later, isn’t that better than waiting until the problem becomes too troublesome to ignore?

¶ What if you have a potentially fatal ailment, like heart disease or cancer, that may otherwise be undetected until it is well advanced or incurable?

¶ And wouldn’t it help to uncover risk factors like elevated blood sugar or high cholesterol that could prevent an incipient ailment if they are reversed before causing irreparable damage?

Even if there is no direct medical benefit, many doctors say that having their patients visit once a year helps to maintain a meaningful relationship and alert doctors to changes in patients’ lives that could affect health. It is also an opportunity to give patients needed immunizations and to remind them to get their eyes, teeth and skin checked.

But the long-sacrosanct recommendation that everyone should have an annual physical was challenged yet again recently by researchers at the Nordic Cochrane Center in Copenhagen.

The research team, led by Dr. Lasse T. Krogsboll, analyzed the findings of 14 scientifically designed clinical trials of routine checkups that followed participants for up to 22 years. The team found no benefit to the risk of death or serious illness among seemingly healthy people who had general checkups, compared with people who did not. Their findings were published in November in BMJ (formerly The British Medical Journal).

In introducing their analysis, the Danish team noted that routine exams consist of “combinations of screening tests, few of which have been adequately studied in randomized trials.” Among possible harms from health checks, they listed “overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, adverse psychosocial effects due to labeling, and difficulties with getting insurance.”

Furthermore, they wrote, “general health checks are likely to be expensive and may result in lost opportunities to improve other areas of health care.”

In summarizing their results, the team said, “We did not find an effect on total or cause-specific mortality from general health checks in adult populations unselected for risk factors or disease. For the causes of death most likely to be influenced by health checks, cardiovascular mortality and cancer mortality, there were no reductions either.”

What, then, should people do to monitor their health?

Whenever you see your doctor, for any reason, make sure your blood pressure is checked. If a year or more has elapsed since your last blood test, get a new one.

Keep immunizations up to date, and get the screening tests specifically recommended based on your age, gender and known risk factors, including your family and personal medical history.

And if you develop a symptom, like unexplained pain, shortness of breath, digestive problems, a lump, a skin lesion that doesn’t heal, or unusual fatigue or depression, consult your doctor without delay. Seek further help if the initial diagnosis and treatment fails to bring relief.

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Media Decoder: News Outlets Take to Washington for Inauguration Coverage

If he squints hard enough, President Obama will be able to see CNN from his perch on the inaugural podium on Monday.

The cable news channel has set up an elaborate studio on the National Mall — one of the four locations where its anchors will be leading coverage of Mr. Obama’s second inaugural celebration.

“The goal is to put our anchors in the middle of all the activity,” said Sam Feist, CNN’s Washington bureau chief. So in the morning, Wolf Blitzer will start out by the Capitol building and Anderson Cooper by the Mall, moving to new spots along the parade route in the afternoon. Other anchors will be at the inaugural balls at night.

The coverage might seem more subdued on other major television networks, reflecting the fact that there is generally less enthusiasm for presidential inaugurations the second time around. Still, the ceremony and the spectacle that accompanies it will take over the networks and news channels beginning with their morning shows, some of which are relocating to Washington for the day.

CBS has built a studio on the Mall beside CNN’s. Its one-year-old morning show, “CBS This Morning,” will be broadcast from there and expand to three hours for the day. NBC’s “Today” show will have all of its hosts in Washington, as well.

ABC’s “Good Morning America” is doing it a bit differently, sending George Stephanopoulos and Josh Elliott to Washington and having the show’s other hosts stay in New York.

The bulk of the festivities will be anchored by the same correspondents who handled election night for their networks. There has been a last-minute change at PBS, though: Judy Woodruff is away from Washington because of a family illness, a spokeswoman said, so the senior correspondent Jeffrey Brown will anchor with Gwen Ifill, instead.

Most Americans will watch the inauguration on television, just as they did in 2009, the first time Mr. Obama was inaugurated. But there will also be a panoply of Web sites live-streaming the event, including that of the Presidential Inauguration Committee.

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Obama's second inauguration a mark of progress in its own right

WASHINGTON — The first time Barack Obama ran, the euphoria that attended his election captivated Kamilah Aquil. Then came his presidency, a bracing reality check.

Hope faded. Not enough changed. But for Aquil, that doesn't make Obama a disappointment.

It does make this second inauguration Monday a landmark she never expected and one she considers even more profound than the first. He's not just the first black president, but a man Americans trusted enough, missteps and all, to give another shot at shepherding our country.

That's one reason Aquil, a Los Angeles County probation officer, was headed for Washington last week with her 13-year-old son, Makhi Garvey.

I met them on the flight from Los Angeles, and questioned her — as I have dozens of black strangers in the last few weeks — about her verdict on Obama, who drew a record turnout of black voters in November, but less enthusiasm than in 2008.

Aquil has heard the grumbling that Obama hasn't done enough to relieve black suffering. She doesn't see it that way. "He puts it out on the table and tries to advocate for the country as a whole," she said. "He can only do so much."

Aquil was born and raised in Compton. She veered off track as a teenager, but an adult she admired steered her "off the path of destruction" and pointed her toward college.

She thinks about that when she sees her son watching President Obama. "It's his influence, who he is as an individual," she says, looking beyond the president's politics to praise his patience, tenacity and balance.

For her, and for millions of African Americans whose votes kept Obama in office, this president's reelection didn't turn on the standard question: Are you better off today than you were four years ago?

It was tied as well to a bigger vision, a sense that their footing is more solid and their children's future brighter because a black man — this particular black man — resides in the White House.

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There have been reams written in the last four years about the ways race complicated the leadership challenges faced by the nation's first black president.

Now, as Obama enters his second term, those themes are already being replayed.

Ben Jealous, head of the National Assn. for the Advancement of Colored People, is as tired of answering the question as I've become of asking. Has Obama delivered for the masses of black people who helped put him in office?

Jealous sighs — its meaning clear in the silence:

Isn't it enough that the man expanded access to healthcare, dispatched Osama bin Laden and steered the nation through the worst recession in 70 years?

"I'm waiting for the article about the white president who disappointed the white people the most," Jealous said.

"How come nobody ever asked that question: How did white people feel about Bill Clinton, about George Bush?"

Because a white president has always been perceived to be the leader of all the people.

Obama's appraisal is muddied by uncertain expectations.

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