Most countries offer the Pill over-the-counter

NEW YORK (Reuters Health) - Unlike women in the U.S., Canada and much of Europe, most women in the world can access the birth control pill without a prescription, according to a new study.
As medical organizations and other groups push to ease the prescription requirements for the Pill in the U.S. and elsewhere, "we can start to use this information to... get a sense of the safety of women having access to this method where no prescription is required," said Kari White, who studies birth control at the University of Alabama in Birmingham.
The Pill is generally considered safe, said White, who was not involved in the new work, and some studies have shown that, without a doctor's input, women can accurately screen themselves for risk factors to steer away from using the Pill if it's not appropriate for them.
Earlier this year, the American College of Obstetricians and Gynecologists, a leading group of women's doctors, endorsed the idea of making the birth control pill available without a prescription (see Reuters Health report of November 20, 2012 here: http://reut.rs/UH0Zz9).
In a survey of government health officials, pharmaceutical companies, family planning groups, medical providers and other experts in 147 countries Dr. Daniel Grossman, of Ibis Reproductive Health in Oakland, California, and his colleagues found that women in the U.S. and 44 other countries need a prescription to get birth control pills.
The group reported in the medical journal Contraception that while another 56 countries had laws requiring prescriptions, in practice women could access the contraception over-the-counter.
Thirty-five countries legally allowed access to oral contraceptives over-the-counter, and 11 countries allowed over-the-counter access as long as the woman is screened to ensure that she is a good candidate.
"The patterns we saw were interesting," said Grossman. "Higher income countries - western Europe, Australia, Japan and North America - generally require a prescription."
Grossman told Reuters Health he couldn't explain why these patterns have emerged.
"Perhaps in places like China and India that have pills available over-the-counter formally without a prescription might be consistent with strong national family planning programs," he speculated.
Dr. Ward Cates, of FHI 360, a research organization in Durham, North Carolina, said the lack of a prescription requirement might also reflect a general approach to making health care more accessible in countries where it is less available.
In some countries, "healthcare tends to be more fragmented and healthcare oversight tends to be more fragmented. Therefore the availability of products tends to percolate to outlets that tend to be more accessible to the public," said Cates, who was not part of the study.
Grossman said it will be useful for countries looking to ease restrictions on birth control access to look to the experiences of these countries.
"Will this information about the availability of pills being over-the-counter in other countries influence policy here? Probably not," Grossman told Reuters Health.
"But I do think it helps to put it in perspective that this is not something revolutionary."
SOURCE: http://bit.ly/S51BnH Contraception, online December 10, 2012.
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Annual Pap tests? For some in U.S., old habits die hard

CHICAGO (Reuters) - An increasing number of younger women in the United States are delaying their first Pap test for cervical cancer until after they reach 21, reflecting new U.S. guidelines, health officials said on Thursday.
But 60 percent of U.S. women who have had a total hysterectomy and no longer have a cervix are still getting the tests, a sign that old habits may die hard, experts said.
Although an annual Pap test was once the standard of care, most professional groups including the American Cancer Society, the American College of Obstetricians and Gynecologists, and the U.S. Preventive Services Task Force, a government-backed panel, now recommend that most women get tested every three to five years, and that younger women delay their first test until 21.
And these same three groups agree that screening is unnecessary for most women who have had a total hysterectomy - the removal of the uterus and cervix - for non-cancerous reasons. Likewise, women over 65 who have had years of negative tests no longer need to be screened.
The guidelines are meant to curb overscreening, which increases the risk of unnecessary surgery and preterm birth in younger women, and adds unnecessary cost to the care of women over 65 who have never had a problem Pap and those who have had their cervix removed.
In light of the changes, two teams at the U.S. Centers for Disease Control and Prevention analyzed Pap test data from 2000 to 2010 to see how well doctors were adjusting to the call for less frequent screening.
They found the number of women aged 18 to 21 who had never been screened doubled, rising to 47.5 percent in 2010. The team also found that in 2010, women age 30 and older were less likely to report having a Pap test in the last three years.
And while Pap testing fell among women who had a hysterectomy, dropping to 60 percent in 2010 from 73 percent in 2000, the number still reflects significant overtreatment.
Meg Watson, an epidemiologist with CDC's Division of Cancer Prevention and Control, said there are some women who need to continue screening after a hysterectomy, including those whose surgery was done to remove cancers. But that number is small.
"We feel that this would still be a minority of women, and it should not be the 60 percent that we're seeing now," she said.
CDC researchers said the guideline changes are recent, but the trends do reflect a shift toward adhering to them.
TEST 'DEEPLY ENTRENCHED'
Dr. David Chelmow, a professor of obstetrics and gynecology at Virginia Commonwealth University Medical Center, who helped write the latest ACOG guidelines, concedes that it makes little sense to continue to give regular Pap smears to so many women who already have had a hysterectomy.
"It's tough to get cervical cancer without a cervix," he said.
Chelmow said widespread cervical cancer screening has significantly reduced cervical cancer rates in the United States, which have fallen by 70 percent in the last four decades.
The practice of annual Pap tests is "deeply, deeply entrenched," he said.
Although overscreening adds to health costs and unneeded worry and procedures for everyone, overscreening young women may carry even greater risks because treatments can weaken the cervix and hamper a young woman's chances of carrying a child full term, said Watson of the CDC.
Cervical cancer is a slow-growing cancer caused by exposure to certain strains of the human papillomavirus (HPV), a common sexually transmitted disease that causes precancerous abnormalities of the cervix.
In women under 21, HPV infection is very common, but cancer itself is "vanishingly rare," occurring at a rate of about one in 1 million, Chelmow said.
Cervical cancer is the second most common cancer in women worldwide, with about 500,000 new cases and 250,000 deaths each year, according to the World Health Organization.
In the United States, about 12,000 women developed new cases of cervical cancer last year, and 4,220 women died from their cancer, according to the American Cancer Society.
Most deaths occur in women who were infrequently screened or were not screened at all.
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Julia Roberts to star in HBO film on early AIDS epidemic

LOS ANGELES (Reuters) - Julia Roberts will star as a paraplegic physician treating patients early in the AIDS epidemic in the stage-to-screen adaptation of the Tony Award-winning drama "The Normal Heart," U.S. cable television network HBO said on Friday.
"The Normal Heart," set to air on HBO in 2014, tells the story of the dawning of the epidemic in 1980s New York.
Oscar-winner Roberts plays Dr. Emma Brookner, who treats several early patients infected with the HIV virus that causes AIDS. Co-star Mark Ruffalo plays Ned Weeks, an eyewitness to how the disease ravaged the city's gay community.
The film will be directed by "Glee" creator Ryan Murphy and was adapted by the play's author, Larry Kramer, an early advocate for AIDS prevention and care.
"Ryan has assembled an extraordinary cast to bring Larry Kramer's landmark theatrical achievement to the screen for the first time, and we couldn't be more thrilled to bring this important film to HBO," Michael Lombardo, HBO's president of programming, said in a statement.
"The Normal Heart" debuted on stage in 1985 in New York and was revived on Broadway in 2011, winning the Tony Award for best revival.
The movie version was originally envisioned as big screen release before HBO took it up as a television film.
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Presidents of Sudan, South Sudan to meet Friday

ADDIS ABABA, Ethiopia (AP) — Ethiopia's Ministry of Foreign Affairs says the presidents of Sudan and South Sudan, two countries which were at the brink of all-out war last year, are to meet Friday in Ethiopia's capital.
Spokesman Dina Mufti said Thursday that Ethiopia is optimistic the meeting will advance stalled peace deals.
Sudan President Omar al-Bashir and South Sudan President Salva Kiir signed deals in September to restart the south's oil industry. South Sudan's oil flows through Sudan's pipelines, bringing in revenue for both countries. The south shut down its oil industry last year after accusing Sudan of stealing its oil. Disagreements on the implementation of the September deal persist.
Ethiopian Prime Minister Hailemariam Desalegn and African Union mediators are expected to push the two leaders for a rapid implementation of the September deals.
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Ethiopian police says Qaida terror cell arrested

ADDIS ABABA, Ethiopia (AP) — Ethiopia's spy agency says that security forces have arrested 15 people alleged to be members of a terror cell linked with al-Qaida.
The spy agency says military training manuals, videos and weapons were seized from the suspects. The agency announced the arrests late Wednesday.
Authorities said the suspects were trained by al-Shabab militants in neighboring Somalia and Kenya. They alleged the group was planning to launch attacks based in Ethiopia's Somali and Harara regions.
On Tuesday the country's federal high court convicted 10 people on similar terror charges.
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AP names Torchia as bureau chief in South Africa

JOHANNESBURG (AP) — Christopher Torchia, The Associated Press bureau chief in Turkey who has reported from five continents, has been appointed chief of bureau for AP for southern Africa.
The appointment was announced Thursday by Africa Editor Andrew Selsky.
"Torchia is one of the best foreign correspondents in the business and has the experience and talent to deliver fascinating stories from this important and diverse region," Selsky said.
As southern Africa bureau chief, Torchia, 45, will oversee coverage of South Africa, Zimbabwe, Mozambique, Botswana, Namibia, Zambia, Angola, Madagascar, Lesotho, Swaziland and Malawi. He will be based in Johannesburg and report directly to Selsky.
He joined the AP in Albany, the New York state capital, in 1989 after a stint at The Albuquerque Journal in New Mexico. He moved to the AP's Boston bureau and the international editing desk in New York, and then transferred to Colombia in 1994, covering drug cartels and rebel and paramilitary groups.
He was posted to Indonesia during the Asian economic crisis that helped oust President Suharto in 1998 and served as bureau chief in South Korea and Singapore, reporting on events including the North Korean nuclear standoff and the Indian Ocean tsunami in 2004. In late 2006, he moved to Istanbul, where he drove coverage of Turkey's rising diplomatic and economic profile and contributed to reporting on the Mideast and on the Arab spring uprisings and Syria's civil war.
He also has reported frequently from Iraq and Afghanistan, covering the 2006 execution of Saddam Hussein in Baghdad, among other stories.
Torchia holds a bachelor of arts degree from Yale University. He is the co-author of "How Koreans Talk" and "Indonesian Slang: Colloquial Indonesian at Work."
An American, Torchia lived in South Africa as a youth. His father, Andrew Torchia, a foreign correspondent for AP before retiring in 1994, also served as AP's bureau chief in Johannesburg in the 1980s.
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Nigeria airline in June crash resumes flights

LAGOS, Nigeria (AP) — The Nigerian airline involved in a June crash that killed at least 163 people resumed domestic flights Thursday, even though officials acknowledge they still don't know what brought the aircraft down and that the families of the dead still haven't received insurance settlements.
Government authorities cleared Dana Air to again fly the same type of planes involved in the crash, despite public outrage over the disaster in a nation with a long history of airplane tragedies. Meanwhile, passengers still nervously board flights, even though the country's aviation industry remains mired in financial problems and is governed by lax oversight.
Smiling staffers stood Thursday at empty check-in and ticket counters at a domestic wing of Murtala Muhammed International Airport in Lagos, as only a few passengers paid for seats on its 4:20 p.m. flight Thursday to Nigeria's capital, Abuja. The private airline planned to have a flight Friday morning carrying local celebrities, government officials and journalists to the capital and back as a sign that the carrier was again open for business, said Tony Usidamen, a Dana spokesman.
The carrier was offering tickets as cheap as 14,400 naira ($90) one-way to the capital, about half the price of its competitors, as a means of luring back passengers. However, Usidamen said the carrier planned a limited flight schedule for the coming weeks and acknowledged it would be a while before its flights were full again.
"It's going to take time to publicize the resumption of flights and to regain the public's confidence," the spokesman told The Associated Press.
On June 3, a Dana Air MD-83 twin-engine jet crashed in a crowded neighborhood on the outskirts of Lagos, killing all 153 people onboard and at least 10 on the ground, authorities have said. The pilots told air traffic controllers that the plane lost power to both engines just before the crash. The reason for the power loss remains unclear. Crash investigators in Nigeria have said the flight data recorder on the plane melted in the ensuing fire.
Dana will fly its remaining stock of five MD-83s, airplanes built by McDonnell Douglas, which was later bought by Boeing Co. The aircraft series is a mainstay of airlines around the world, with a large number still flown by American Airlines, owned by AMR Corp. Joe Obi, a spokesman for Nigeria's Aviation Minister Stella Oduah, pointed to that when asked if authorities had any concerns about Dana continuing to fly that model.
"Until we are sure what caused the crash, we can't make a decision on the MD-83," Obi told the AP.
Federal officials have given Dana Air a two-month window to complete insurance payments to the bereaved, Obi said. That could prove difficult, as Usidamen said the airline's insurers have made full payments to only five families of victims so far. Usidamen blamed the delays on families not getting needed documents from probate courts.
Nigeria has suffered a series of plane crashes over the last decades, with authorities never offering clear explanations for why the disasters happened. Obi said Nigeria's government planned to immediately publicize the cause of the Dana crash as soon as it knew, but the government has previously declined to publish the causes of other crashes.
Other airlines in Nigeria, Africa's most populous nation, have collapsed or faced dire financial straits over the last year.
Air Nigeria, the nation's second-largest carrier, collapsed in September amid allegations of financial mismanagement. Arik Air Ltd., the country's largest and perceived safest carrier, recently halted domestic flights after its management alleged Oduah had a financial interest in seeing the airline fail. The carrier later resumed its flights, but raised its prices as authorities halted other smaller carriers from flying due to financial and safety issues.
Air travel, despite its perils, represents the quickest way for those who can afford it to travel across Nigeria, a nation twice the size of California and with decrepit and dangerous roads. However, experts say Nigerian aviation authorities remain overworked and safety regulations are laxly enforced in a nation where bribery is an epidemic.
The Dana Air crash represented the worst airline disaster in the country since Sept. 27, 1992, when a military transport plane crashed into a swamp shortly after takeoff from Lagos and killed all 163 people onboard. The worst air disaster in Nigeria happened in 1973, when a Jordanian Boeing 707 crashed at Nigeria's Kano international airport and killed 176 people.
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C. African Republic leader fires son from post

BANGUI, Central African Republic (AP) — Facing an insurgency by a new rebel coalition, the president of Central African Republic consolidated military power under his control Thursday after dismissing his own son as acting defense minister along with his army chief of staff.
President Francois Bozize said in a decree read on state radio late Wednesday that he was taking over the position held by his son, Jean Francis Bozize as neighboring countries sent troops to help.
Hundreds of soldiers from Chad, Republic of Congo, Gabon and Cameroon have been in arriving this week in this desperately poor, landlocked country where rebels have seized 10 towns in a month's time.
Rebel spokesman Col. Djouma Narkoyo reiterated Thursday that they were holding their position at the transportation hub of Sibut pending negotiations in Gabon. They have apparently made no further advance toward the capital since taking the town on Dec. 29.
"Our position today is that we respect the decision of the Economic Community of Central African States," he said by satellite phone. "That's why we are staying in Sibut and are not advancing."
In New York, France's U.N. Ambassador Gerard Araud said there will be a meeting in Libreville, Gabon on Jan. 8 to promote a political solution to the crisis, mediated by President Denis Sassou Nguesso of the Republic of Congo.
"The goal is to have a political agreement in Libreville, a national unity government ... and eventually a peaceful settlement," he told reporters after a closed-door briefing to the U.N. Security Council Thursday on the latest developments in the Central African Republic by U.N. political chief Jeffrey Feltman.
Araud said the African Union and regional groups are in the lead and have been very active, and the Security Council is supporting them and will likely issue a press statement Friday. He said France planned to circulate the text to the 14 other council members on Thursday evening.
"They have stopped the rebels, and they have ideas about a national unity government," Araud said of the AU and regional groups. "So everything will be discussed in the meeting in Libreville on the 8th, and after the meeting in Libreville we'll see whether the U.N. has to do something."
Residents in the capital of Bangui said Bozize's decision to fire his own son was not surprising given the recent military losses. But some noted Bozize may be making his moves too late.
"It's coming too late because the security of our country is already in the hands of rebels," said Jean Nestor Kongbu as he watched fishermen cast their nets in the Obangui River that separates Central African Republic from Congo. ... They say they won't advance, but the government could provoke the rebels or the rebels could provoke the government. They need to negotiate for the Central African people."
The sudden military reorganization also suggests that Bozize's regime may be weakening, said Thierry Vircoulon, the project director for Central Africa at the International Crisis Group.
"If he is dismissing his own son, it means he is getting more and more isolated," Vircoulon said.
Jennifer Cooke, director of the Africa program at the Washington-based Center for Strategic and International Studies, said people see Bozize "as a losing ticket right now."
"People are losing confidence in him and he has every reason to be a bit paranoid right now watching the disintegration of the country," she said.
The United Nations called for talks between the government and rebels and the Security Council scheduled closed consultations on the Central African Republic on Thursday afternoon.
The rebels have indicated they will participate in upcoming talks in Gabon but are also insisting that Bozize go. The president says he will not leave before finishing his term in 2016.
Bozize himself took power in 2003 following a rebellion with the help of Chadian forces. He later went on to win elections in 2005 and 2011, though the opposition and international observers have called the votes deeply flawed.
The rebels behind the latest challenge to Bozize's rule are made up of four separate groups all known by their French acronyms — UFDR, CPJP, FDPC and CPSK. They are collectively known as Seleka, which means alliance in the local Sango language, but have previously fought one another. In September 2011, fighting between the CPJP and the UFDR left at least 50 people dead in the town of Bria and more than 700 homes destroyed.
Just 70 miles (112 kilometers) to the south of Sibut, government and regional forces are fortifying the town of Damara, where truckloads of Chadian troops patrol with rocket-propelled grenades and other weapons.
Gen. Jean Felix Akaga, who heads the regional force known as FOMAC, says a push on Damara, 45 miles (75 kilometers) north of the capital, would be "a declaration of war" on the 10 Central African states.
"For us, Damara is the red line that the rebels cannot cross," Akaga said Wednesday. "If they attack Damara, we will attack.
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US rate on 30-year mortgage rises to 3.71 pct.

WASHINGTON (AP) — Average rates on fixed mortgages rose this week, the first increase in seven weeks. But mortgage rates remain near historic lows, boosting prospects for home sales this year.
Mortgage buyer Freddie Mac said Thursday that the average rate on the 30-year loan increased to 3.71 percent. That's up from 3.67 percent last week, the lowest since long-term mortgages began in the 1950s.
The average rate on the 15-year mortgage, a popular refinancing option, rose to 2.98 percent. That's up from 2.94 percent last week, also a record low.
The rate on the 30-year loan has been below 4 percent since early December. Low rates are a key reason the housing industry is showing modest signs of a recovery this year.
In April, sales of both previously occupied homes and new homes rose near two-year highs. Builders are gaining more confidence in the market, breaking ground on more homes and requesting more permits to build single-family homes later this year.
Low rates could also provide some help to the economy if more people refinance. When people refinance at lower rates, they pay less interest on their loans and have more money to spend.
Still, the pace of home sales remains well below healthy levels. Economists say it could be years before the market is fully healed.
Many people are still having difficulty qualifying for home loans or can't afford larger down payments required by banks. Some would-be home buyers are holding off because they fear that home prices could keep falling.
The economy is growing only modestly and job creation slowed sharply in April and May. U.S. employers created only 69,000 jobs in May, the fewest in a year.
Mortgage rates have been dropping because they tend to track the yield on the 10-year Treasury note. Uncertainty about how Europe will resolve its debt crisis has led investors to buy more Treasury securities, which are considered safe investments. As demand for Treasurys increase, the yield falls.
To calculate average rates, Freddie Mac surveys lenders across the country on Monday through Wednesday of each week.
The average does not include extra fees, known as points, which most borrowers must pay to get the lowest rates. One point equals 1 percent of the loan amount.
The average fee for 30-year loans was 0.7 point, unchanged from last week. The fee for 15-year loans also was unchanged at 0.7 point.
The average rate on one-year adjustable rate mortgages slipped to 2.78 percent from 2.79 percent last week. The fee for one-year adjustable rate loans was 0.5, up from 0.4.
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US fixed mortgage rates fall to new record lows

 Fixed U.S. mortgage rates fell again to new record lows, providing prospective buyers with more incentive to brave a modestly recovering housing market.
Mortgage buyer Freddie Mac said Thursday that the average on the 30-year loan dropped to 3.62 percent. That's down from 3.66 percent last week and the lowest since long-term mortgages began in the 1950s.
The average rate on the 15-year mortgage, a popular refinancing option, slipped to 2.89 percent, below last week's previous record of 2.94 percent.
The rate on the 30-year loan has fallen to or matched record low levels in 10 of the past 11 weeks. And it's been below 4 percent since December.
Cheap mortgages have provided a lift to the long-suffering housing market. Sales of new and previously occupied homes are up from the same time last year. Home prices are rising in most markets. And homebuilders are starting more projects and spending at a faster pace.
The number of people who signed contracts to buy previously occupied homes rose in May, matching the fastest pace in two years, the National Association of Realtors reported last week. That suggests Americans are growing more confident in the market.
Low rates could also provide some help to the economy if more people refinance. When people refinance at lower rates, they pay less interest on their loans and have more money to spend. Many homeowners use the savings on renovations, furniture, appliances and other improvements, which help drive growth.
Still, the pace of home sales remains well below healthy levels. Many people are still having difficulty qualifying for home loans or can't afford larger down payments required by banks.
And the sluggish job market could deter some would-be buyers from making a purchase this year. The U.S. economy created only 69,000 jobs in May, the fewest in a year. The unemployment rate rose to 8.2 percent last month, up from 8.1 percent in April.
The government reports Friday on June employment.
Mortgage rates have been dropping because they tend to track the yield on the 10-year Treasury note. A weaker U.S. economy and uncertainty about how Europe will resolve its debt crisis have led investors to buy more Treasury securities, which are considered safe investments. As demand for Treasurys increase, the yield falls.
To calculate average rates, Freddie Mac surveys lenders across the country on Monday through Wednesday of each week.
The average does not include extra fees, known as points, which most borrowers must pay to get the lowest rates. One point equals 1 percent of the loan amount.
The average fee for 30-year loans was 0.8 point, up from 0.7 percent last week. The fee for 15-year loans also was 0.7 point, unchanged from the previous week.
The average rate on one-year adjustable rate mortgages fell to 2.68 percent, down from 2.74 percent last week. The fee for one-year adjustable rate loans rose to 0.5 point, up from 0.4 point.
The average rate on five-year adjustable rate mortgages was unchanged at 2.79 percent. The fee stayed at 0.6 point.
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W.Va. teachers to attend 'Finance University'

CHARLESTON, W.Va. (AP) — West Virginia University's business school is teaming up with the state auditor's office and a nonprofit economic literacy group called the West Virginia Jump$start Coalition to present a conference for educators to learn personal finance — and how to teach it to their students.
This year's Finance University is the 10th annual event for middle- and high-school teachers. It will be held Monday through Friday at the Charleston Conference Center.
Conference organizers say that participants will take a course to prepare for teaching their students personal-finance topics, including credit-card use, saving and investing, insurance, retirement plans, and more. Fifteen financial experts also are expected to give presentations.
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Average on 30-year US mortgage stays at 3.55 pct.

The average rate on the 30-year fixed mortgage held steady this week, staying slightly above the lowest level on record. Low mortgage rates have aided a modest housing recovery.
Mortgage buyer Freddie Mac said Thursday that the rate on the 30-year loan was unchanged at 3.55 percent. In July, the rate fell to 3.49 percent, the lowest since long-term mortgages began in the 1950s.
The average on the 15-year fixed mortgage, a popular refinancing option, slipped to 2.85 percent, down from 2.86 percent last week. That's above the record low of 2.80 percent.
Cheap mortgages have helped lift the housing market. Sales of new and previously occupied homes are well above last year's levels. Low rates have also allowed people to refinance, which lowers monthly mortgage payments and helps boosts consumer spending.
Home prices are increasing more consistently this year, largely because the supply of homes has shrunk while sales have risen. And the number of Americans who owe more on their mortgages than their homes are worth declined in the second quarter.
Still, the housing market has a long way back. Home sales are below healthy levels. And many people are still having difficulty qualifying for home loans or can't afford larger down payments required by banks.
Mortgage rates are low because they tend to track the yield on the 10-year Treasury note. A weaker U.S. economy and uncertainty about how Europe will resolve its debt crisis have led investors to buy more Treasury securities, which are considered safe investments. As demand for Treasurys increase, the yield falls.
To calculate average rates, Freddie Mac surveys lenders across the country on Monday through Wednesday of each week.
The average does not include extra fees, known as points, which most borrowers must pay to get the lowest rates. One point equals 1 percent of the loan amount.
The average fee for 30-year loans was 0.6 point, down from 0.7 point last week. The fee for 15-year loans was changed at 0.6.
The average rate on one-year adjustable rate mortgages was steady at 2.61 percent. The fee for one-year adjustable rate loans also was unchanged, at 0.4 point.
The average rate on five-year adjustable rate mortgages fell to 2.72 percent from 2.75 percent. The fee declined to 0.6 point from 0.7.
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Ahead of the Bell: Weekly mortgage rates

WASHINGTON (AP) — Loan buyer Freddie Mac reports Thursday on whether mortgage rates are continuing to hold near recent low rates.
Last week the average rate on the 30-year fixed mortgage held steady at 3.55 percent, slightly above the record low of 3.49 percent that was reached in July. Meanwhile, the average rate on the 15-year fixed mortgage, a popular refinancing option, dipped to 2.85 percent from 2.86 percent.
Cheap mortgages have helped the housing market recover this year. Sales of new and previously occupied homes are well above last year's levels.
Home prices are increasing more consistently this year, largely because the supply of homes has shrunk while sales have risen. And the number of Americans who owe more on their mortgages than their homes are worth declined in the second quarter.
Still, the housing market has a long way back. Home sales are below healthy levels. And many people are still having difficulty qualifying for home loans or can't afford larger down payments required by banks.
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Hillary Clinton released from the hospital

Secretary of State Hillary Rodham Clinton has been released from a New York hospital after being treated for a blood clot, the State Department announced on Wednesday.
"Her medical team advised her that she is making good progress on all fronts, and they are confident she will make a full recovery," State Department spokesman Philippe Reines said in a statement. A date has not been set for her to return to work.
Clinton was admitted to the hospital on Sunday for treatment of a blood clot related to a concussion she suffered after fainting in December. Her doctors said the clot was located "in the space between the brain and the skull behind the right ear," and she was treated with blood thinners.
Clinton is expected to step down as secretary of state this month. President Barack Obama has named Massachusetts Sen. John Kerry to succeed her.
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Runaway Alaska oil rig dragged two tugs for miles

 The runaway oil rig that ran aground in Alaska on New Year's Eve dragged two vessels trying to control it more than 10 miles toward shore in just over an hour before the crews cut it loose to save themselves in "near hurricane" conditions.
Details were still emerging on Wednesday from the U.S. Coast Guard and Royal Dutch/Shell, the company at the center of a controversial and accident-prone Arctic oil drilling program of which the Kulluk drillship is a vital part.
They paint a frightening picture of the 28,000-tonne, saucer-shaped rig being thrust toward the shore on waves up to 35 feet high driven by winds up to 62 mph, pulling its main towing vessel, the Aiviq, and a tug, the Alert, behind it.
"We are talking about near hurricane-strength conditions," said Darci Sinclair of the Kulluk Tow Incident Unified Command, set up by the U.S. Coast Guard and the companies involved. "Regaining control became extremely challenging."
The unified command said the Kulluk was still aground on Sitkalidak Island in the Gulf of Alaska, but "upright and stable". Updates were available at www.kullukresponse.com.
The 30-year-old Kulluk is operated by Noble Corp and was refitted by Shell for its summer 2012 drilling expedition in the Beaufort Sea off northern Alaska.
Shell spent $4.5 billion preparing for extraction activities there and in the Chukchi Sea further east, but has yet to complete a single well, while facing some embarrassing setbacks.
Headlines that raise questions about the wisdom of drilling so far north in such a environmentally delicate and technically challenging place were not expected so early in 2013, given that activity stopped for the season two months ago.
Any Kulluk damage could threaten Shell's 2013 drilling program because its oil-spill plans require a second rig to be available at all times in case a relief well needs to be drilled to kill the well. That is the Noble-owned Discoverer, which would also be unable to drill without another rig nearby.
David Smith, spokesman at the Bureau of Safety and Environmental Enforcement in Washington DC, said his division would not yet speculate on the summer. The earliest date that the drilling season could have started last year was July 1.
On Tuesday, the U.S. Coast Guard said the Kulluk's hull appeared sound after a few over flights. More were planned on Wednesday, with more than 600 people supporting the response.
"This is a very large and complex response and it is important that the American public and our elected officials understand the dangerous and difficult challenges being faced by the response crews," Rear Admiral Thomas Ostebo, commander of the Coast Guard in Alaska, said in the statement.
The Kulluk was on its way south for the winter. It had been towed east from the Beaufort, and then south through the Bering Strait that separates the northernmost U.S. state from Siberia.
On December 28, about half way to its winter destination in Seattle, and 50 miles south of Kodiak Island in the Gulf of Alaska, engine failure struck the Aiviq - an icebreaker that is less than a year old, and whose name means "Walrus".
The weather was already rough and the Kulluk's 18-strong crew was lifted off, when a doomed four-day battle to keep the Kulluk off the rocks began.
The effort ran into deeper difficulty a few hours after nightfall on December 31, with the shore less than 19 miles away.
Aiviq, one of two vessels attached at the time, lost its line. It was re-attached, and battled on against the elements along with the Alert, but the coastline kept getting closer as the storm pushed all three vessels north-eastwards.
At 8:15 p.m. on Monday (January 1, 0515 GMT), the order came to cut the Kulluk lines to save the Aiviq, the Alert and the crews.
At 8:30 p.m., the lines were cut, and by 8:48, a trajectory map on the unified command website shows, the Kulluk was aground about 1,600 feet from the shore on Sitkalidak Island, near the larger Kodiak Island. The Kulluk, the wind, and the waves had dragged Aiviq and Alert more than 10 miles in just over an hour.
The vessel settled on what one Coast Guard official described as "loose rock and sand".
Noble had no immediate comment. Shell in London has made a series of statements on the progress of the operation, but had nothing to add on Wednesday, and referred calls to the unified command. Shell in Houston could not be reached for comment.
"ONE DISASTER TO THE NEXT"
The spill risk from the drillship is limited to the 143,000 gallons of ultra-low-sulfur diesel and 12,000 gallons of other oil products on board. Still, opponents of Arctic drilling said the accident showed Shell was unable to keep the Arctic safe.
"Shell has lurched from one Arctic disaster to the next, displaying staggering ineptitude every step of the way," Greenpeace campaigner Ben Ayliffe said on Wednesday.
"Were the pristine environment of the frozen north not at risk of an oil spill it would be almost comical. Instead it's tragic," Ayliffe said. "We're moving closer to a major catastrophe in the Arctic and the U.S. government appears unwilling to provide either the needed oversight or emergency backup the company's incompetence requires."
Shell's Arctic campaign has been bedeviled by problems. The Coast Guard briefly detained the Discoverer in December in Seward, Alaska, on safety concerns. A mandatory oil-containment barge, the Arctic Challenger, failed for months to meet requirements for seaworthiness, and a ship mishap resulted in damage to a key piece of equipment intended to cap a blown well.
Asked why the Kulluk was still at sea two months after work stopped, one contract drilling source said the "demobilization" process after drilling can take days or weeks depending on the rig model and its anchoring. It was also possible the weather was rough enough over the last few months to delay transit.
Replacing the Kulluk, if it ends up being badly damaged, would add to the cost of the accident for Shell, which must reimburse the federal and state governments for response costs.
The Discoverer, which it has under a contract with Noble, costs Shell $240,000 per day - or a few-hundred million dollars over the life of the two-year contract. Shell had to spend $292 million upgrading the Kulluk, when was built in 1983 and had been slated to be scrapped before Shell bought it in 2005.
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Fiscal Cliff Compromise: Winners, Losers and Those in Between

The ink was still wet on Congress' fiscal-cliff fix Wednesday morning when Americans started lumping themselves into the winners and losers circles.
And like a Venn diagram of politics, the circles overlapped with many dubbing themselves as part-loser, part-winner. Compromise is one way to view it: While Congress compromised over who qualified as wealthy, families across the country saw comprise in their own lives: Sure, they're spared income-tax increases, but they hand over that juicy 2-percentage-point payroll tax cut.
Most Americans will reap the boons of the compromise: a continuation of the Bush-era tax cuts for those making less than $400,000, more unemployment benefits for those who need them, help for small businesses, and extensions of the Child Tax Credit, the Earned Income Tax Credit and college tuition breaks.
But it's Congress' failure to renew the cut in payroll taxes that garnered attention Wednesday. Those taxes, which fund Social Security, will again sap pocketbooks like they did prior to 2011.
Yahoo News asked Americans to pinpoint how the legislative deal will affect their families' short-term planning and long-term goals. How will the increase in payroll taxes hit their bottom line? What particular portions of the legislation impact them most?
"There are clearly winners and losers here," S.W. Hampson, a New Orleans filmmaker, wrote Wednesday in a first-person perspective. "Winners: The unemployed. Losers: Individuals making $400,000 per year and couples making $450,000 per year. The Biggest Loser: Me, the working man."
Hampson, 29, says he will see about an $800 decrease in take-home pay in 2013 because of the increase in payroll taxes. In the long-term, he'll be more frugal while paying off student loans, keeping a roof over his head and putting food on the table. In the short-term, he says he'll cancel a modest trip to visit family. Ending these economy-boosting tax breaks doesn't add up to him.
"Those extra few dollars a week mean a lot to me as a person working paycheck to paycheck. It isn't like that money is going into savings; it is money I would be spending, hence stimulating the economy," Hampson says.
Finding his expendable income sliced in half, he took to Twitter, telling his followers: "Bureaucratic red tape is eventually replaced by legislative duct tape…until the whole thing falls apart. #USProblems #DC'Solutions'"
Fiscal-cliff effects could've been worse
In Omaha, Neb., Amber Weinacht is more equivocal.
The 35-year-old single mother of three children, ages 14, 11 and 6, says she's counting on the $1,000-per-child tax credits to curb expenses. But the legislation will take around $32 more from her paycheck monthly for Social Security benefits.
"That is a week's worth of gas, or an entire month's supply of milk for my family," Weinacht writes. "Yearly, this adds up to about $350. I cringe when I think of where our family budget will take cuts. It is already mighty lean."
Still, the tax credits, coupled with tax breaks for her residential-cleaning business, make the deal seem not so sour.
"I am hoping that things will even out at the end of the year. I will still be getting the same amount on my tax returns that I am getting now, which is a nice safety net for my family to look forward to. All in all, I guess the deal doesn't seem so bad," Weinacht says.
Fiscal cliff deal gets a 'C' in my book, or ledger
John A. Tures is a political science professor, so he's naturally graded Congress on its efforts to avoid the fiscal cliff.
For the short-term, Congress earns an A-.
Long-term, it nearly fails, bringing home a D-.
"Watching the fiscal cliff deal debate go down was a lot like political theater, but its conclusion would have consequences for me," the LaGrange, Ga., resident writes. "After all, any deal, or lack of one, would lead to changes in taxes and a potential panic on Wall Street."
In the next few years, he and his family are helped by the income-tax extension, reprieve of Medicare payments to doctors and $2,000 worth of child tax credits. He writes: "Contrary to popular belief, professors don't make anywhere near $400,000, and I'm married to a teacher (our household income is way below $450,000), so those tax cuts sticking around help."
But the long-term future isn't so rosy: "One of the biggest shortcomings was the lack of deficit reform. By not cutting spending, and allowing low tax rates to stick around, the fiscal cliff deal could add to the overall debt by $4 trillion. This doesn't affect families like me immediately, but such debt is unsustainable. If it leads to future tax hikes, massive cuts in Social Security, Medicare, and the elimination of college tuition tax breaks and Pell Grants, the short-term success the deal has for my family won't be worth it. Hopefully, the new Congress will have more appetite for long-term spending reforms, keeping more of what we need, and less of what we don't."
Legislation's Medicare provisions a relief
For Marla Mayes' parents, rescuing Medicare payments to doctors may literally be life-saving.
Mayes' parents suffer from a variety of conditions: renal kidney failure, diabetes, high blood pressure, lung cancer and more. Had Congress not reached the fiscal cliff compromise, Medicare payments to doctors could have been cut by nearly 27 percent.
"Most of Dad's doctors were going to drop him," Mayes, who works as an unpaid caregiver for her folks in Merritt Island, Fla., writes. "Most of my folks' doctors already have big office signs stating they are not accepting any new Medicare patients."
Without the Medicare provisions extended, she could forget about a second opinion and likely not a first one. When her 79-year-old father had dialysis problems, a second surgeon spotted a tumor on his lung in an x-ray. Immediate surgery and a biopsy followed.
"I can't fathom trying something like that if the fiscal cliff deal had not passed," Mayes says.
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Senior trapped in Mississauga, Ont., nursing home elevator for more than a day

BRAMPTON, Ont. - Officials are investigating after an elderly woman was trapped in an elevator at her Mississauga, Ont., nursing home for more than 24 hours.
Peel Region chair Emil Kolb said Wednesday in a statement that the senior was trapped in the elevator at the Malton Village Long Term from the evening of Dec. 23 until early Christmas morning.
Kolb says the woman had been out with her family on Dec. 23 and was dropped off at the front door that evening, but staff thought she was staying with family when she didn't return to her room.
It's believed she became trapped in the elevator between floors on her way to her room and it no one realized that she was missing until 24 hours later.
A search was begun and she was finally found in the malfunctioning elevator, was treated at the scene by paramedics and taken to hospital for evaluation.
Kolb says she returned to the centre on Christmas Day by dinnertime and although she is recovering well, she remains under close observation.
Kolb called the incident "very distressing" and said it was "very unhappy news on what should be one of the most joyous (days) of the year."
"My distress was certainly far less than that of the resident and her family," he added.
"We consider this an extremely serious failure," Kolb said.
The Ministry of Health and Long Term Care was advised of the incident and Kolb said regional officials are co-operating fully with the investigation.
He said action has already been taken to ensure residents on leave from the centre are accounted for on their return, including requiring that families and residents sign in and out of the centre.
"No resident or family should ever have to experience such an event again," Kolb said.
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McConnell: Fiscal cliff deal not great, but it shields Americans from tax hike

Editor's note: This op/ed is by Senate Republican Leader Mitch McConnell, R-Ky.
The first day of a new Congress always represents a fresh start. This year, it also presents a perfect opportunity to tackle the single-greatest challenge facing our nation: reining in the out-of-control federal spending that threatens to permanently alter our economy and dim the prospects and opportunities of future generations of Americans.
Earlier this week, I helped negotiate an imperfect solution aimed at avoiding the so-called “fiscal cliff.” If I had my way taxes would not have gone up on anyone, but the unavoidable fact was this if we had sat back and done nothing taxes would have gone up dramatically on every single American, and I simply couldn’t allow that to happen.
By acting, we’ve shielded more than 99% of taxpayers from a massive tax hike that President Obama was all-too willing to impose. American families and small businesses that would have seen painfully smaller paychecks and profits this month have been spared. Retirement accounts for seniors won’t be whittled down by a dramatic increase in taxes on investment income. And many who’ve spent a lifetime paying taxes on income and savings won’t be slammed with a dramatically higher tax on estates.
Was it a great deal? No. As I said, taxes shouldn’t be going up at all. Just as importantly, the transcendent issue of our time, the spiraling debt, remains completely unaddressed. Yet now that the President has gotten his long-sought tax hike on the “rich,” we can finally turn squarely toward the real problem, which is spending.
Predictably, the President is already claiming that his tax hike on the “rich” isn’t enough. I have news for him: the moment that he and virtually every elected Democrat in Washington signed off on the terms of the current arrangement, it was the last word on taxes. That debate is over. Now the conversation turns to cutting spending on the government programs that are the real source of the nation’s fiscal imbalance. And the upcoming debate on the debt limit is the perfect time to have that discussion.
We simply cannot increase the nation’s borrowing limit without committing to long overdue reforms to spending programs that are the very cause of our debt.
The only way to achieve the balance the President claims to want is by cutting spending. As he himself has admitted, no amount of tax hikes or revenue could possibly keep up with the amount of money Washington is projected to spend in the coming years. At some point, high taxes become such a drag on the economy that the revenue stalls.
While most Washington Democrats may want to deny it, the truth is, the only thing we can do to solve the nation’s fiscal problem is to tackle government spending head on — and particularly, spending on health care programs, which appear to take off like a fighter jet on every chart available that details current trends in federal spending.
The President may not want to have a fight about government spending over the next few months, but it’s the fight he is going to have, because it’s a debate the country needs. For the sake of our future, the President must show up to this debate early and convince his party to do something that neither he nor they have been willing to do until now. Over the next two months they need to deliver the same kind of bipartisan resolution to the spending problem we have now achieved on revenue — before the 11th hour.
When it comes to spending, the time has come to rise above the special interest groups that dominate the liberal wing of the Democratic Party in Washington and act, without drama or delay. The President likes to say that most Americans support tax hikes on the rich. What he conveniently leaves out is that even more Americans support cuts. That’s the debate the American people really want. It’s a debate Republicans are ready to have. And it’s the debate that starts today, whether the President wants it or not.
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Heads roll on Black Monday as seven coaches fired

 Heads continued to roll for under-achieving head coaches across the National Football League as the Philadelphia Eagles' Andy Reid, Buffalo Bills' Chan Gailey and Cleveland Browns' Pat Shurmur were all fired on what has become known as Black Monday.
The unemployment ranks swelled even further later on Monday with the Chicago Bears' Lovie Smith, Kansas City Chiefs' Romeo Crennel, San Diego Chargers' Norv Turner and Arizona Cardinals' Ken Whisenhunt also getting the axe to bring the total to seven teams with head coaching vacancies.
The 5-11 Browns, who closed out the season on Sunday with a 24-10 loss to the Pittsburgh Steelers, were among the first to begin house cleaning by announcing Shurmur and general manager Tom Heckert had been relieved of their duties.
The news was quickly followed by the 6-10 Bills confirming they had sacked Gailey and the 4-12 Eagles announcing Reid was being relieved of his duties after 14 years in charge.
Reid's departure had been widely expected but still came as shock to many after a mostly successful tenure in Philadelphia leading the Eagles to six NFC East titles, five NFC championship games and a Super Bowl appearance in 2004.
His 140 victories are a franchise record and rank 22nd on the all-time NFL coaching list.
But a bitterly disappointing 2012 campaign that ended in a 42-7 loss to the New York Giants on Sunday signaled to owner Jeffrey Lurie that is was time for a change.
"Andy Reid won the most games of any head coach in Eagles' history and he is someone I respect greatly and will remain friends with for many years to come," said Lurie in a statement. "But, it is time for the Eagles to move in a new direction.
"Andy leaves us with a winning tradition that we can build upon and we are very excited about the future."
UNEXPECTED FIRING
If there was a surprise it came in Chicago where Smith was sacked despite guiding his team to a respectable 10-6 record and narrowly missing out on a playoff berth.
In nine seasons in Chicago, Smith posted a record of 81-63 in leading the team to an NFC championship and Super Bowl appearance in 2006.
But in five of the past six seasons, the Bears have failed to make the playoffs and after a sparkling 7-1 start to the 2012 campaign stumbled down the stretch to again miss out on the post-season.
After a league worst 2-14 season, that earned the Chiefs the number one pick in 2013 draft, it came as no surprise that Kansas City would be looking for a new head coach.
It was a difficult season on and off the field for Crennel, who watched the losses pile up then looked on as linebacker Jovan Belcher shot himself dead at the team's training facility after killing his girlfriend.
San Diego fired both coach Turner and general manager A.J. Smith after the team went 7-9 and missed the playoffs for the third consecutive season.
Arizona also removed its coach and general manager with Rod Graves dismissed along with coach Whisenhunt.
The Cardinals started the season 4-0 but won only one other game as quarterback problems beleaguered the team.
Black Monday began with the Jacksonville Jaguars announcing they had fired general manager Gene Smith and was followed by the New York Jets dumping GM Mike Tannenbaum.
The Jets, however, ended the speculation swirling around Rex Ryan by confirming the under-fire head coach would be back next season.
"Rex Ryan will remain the head coach of our football team. I believe that he has the passion, the talent, and the drive to successfully lead our team," said Jets owner Woody Johnson on the team's website.
After a tumultuous 6-10 season, overshadowed by a quarterbacking controversy around the use of incumbent Mark Sanchez and polarizing Tim Tebow, Ryan was widely expected to pay for the Jets under-achieving results with his job.
With Ryan back for next season the speculation will now center on the futures of Sanchez and Tebow in New York.
The Jets' sputtering offense ranked 30th among 32 teams, generating an average of just 299 yards per game.
Changes had been expected in Jacksonville after the toothless Jaguars finished the season tied with the Chiefs for the NFL's worst record (2-14).
"Now it is time for the Jacksonville Jaguars to begin a new chapter," new owner Shahid Khan said in a statement. "We're not looking back.
"I've made it clear from Day One that we pledge nothing less than to deliver the first Super Bowl championship to Jacksonville.
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Ryan stays as Jets coach, GM Tannenbaum fired

FLORHAM PARK, N.J. (AP) — Mike Tannenbaum pulled out a letter as he stood in front of the New York Jets players for one last time.
It was a farewell address to the group of men he signed, traded for and drafted over the last seven years as the team's general manager. He choked back tears as he read it, and received a round of applause when he was done.
"It was really heartfelt," defensive end Mike DeVito said Monday. "I know Mike, and he'll bounce back."
The Jets fired Tannenbaum after a dismal 6-10 season, but owner Woody Johnson announced that Rex Ryan will be back for a fifth season as the team's coach.
"I believe that he has the passion, the talent, and the drive to successfully lead our team," Johnson said of Ryan in a statement.
The futures of both Tannenbaum and Ryan were unclear after a 28-9 loss to Buffalo on Sunday, a miserable finish to the team's first losing season in Ryan's four years as coach. While it appeared Tannenbaum was a likely goner, it was believed Ryan might also be on shaky ground.
Ryan's scheduled news conference with the media Monday afternoon was postponed amid speculation that there could be several changes on the coaching staff. Offensive coordinator Tony Sparano is expected to be fired after one season, although no coaching moves were immediately made by Johnson after a staff meeting. Defensive coordinator Mike Pettine's status is uncertain after he turned down a contract extension earlier in the year, while special teams coordinator Mike Westhoff retired following Sunday's game.
Johnson started shaking things up early by parting ways with Tannenbaum, who had been with the organization since 1997. Johnson said he has consulted with several "football executives" and also hired a search firm to help aid in finding a new GM. Former Colts vice chairman Bill Polian, 49ers director of player personnel Tom Gamble, Texans director of college scouting Mike Maccagnan, Ravens assistant GM Eric DeCosta and Raiders director of personnel Joey Clinkscales — who was previously a member of New York's front office — could all garner attention from the Jets.
"My goal every year as owner is to build a team that wins consistently," Johnson said. "This year, we failed to achieve that goal. Like all Jets fans, I am disappointed with this year's results. However, I am confident that this change will best position our team for greater success going forward."
The Jets were a team in turmoil from the moment they acquired quarterback Tim Tebow in a trade with Denver last March. The move was made by Tannenbaum and highly criticized by fans and media — and failed in just about every way.
Tebow was brought in as a backup for Mark Sanchez and expected to play a key role in certain offensive schemes. He played sparingly, and spent several weeks out of the lineup with injured ribs.
Meanwhile, Sanchez was having a poor season, the Jets kept losing and Tebow never got a chance to be the No. 1 quarterback.
"I underachieved and didn't play the way I'm capable of playing," Sanchez said. "I want another crack at this thing."
Tebow's time with the Jets began with a splashy news conference, but his one and likely only season ended with the popular backup going out quietly as he wasn't available to the media as the players cleared out their lockers.
Tannenbaum's tenure as the Jets' GM included two trips to the AFC championship game. He had two years left on his contract, but Johnson made the change after the Jets failed to make the playoffs for a second year in a row.
In a statement, Tannenbaum thanked Johnson for "the opportunity of a lifetime" and added that "there are champions on this team that haven't been crowned yet."
Tannenbaum was hired as the team's director of player contract negotiations in 1997, and served in various other roles before replacing Terry Bradway as general manager in 2006.
With a knack for navigating the NFL's salary cap, Tannenbaum was never afraid to make splashy signings or trades — Tebow, Brett Favre, LaDainian Tomlinson, Santonio Holmes and Plaxico Burress, to name a few. He also made his mark on draft day, bringing in some of the team's best players such as Darrelle Revis, Nick Mangold, D'Brickashaw Ferguson and David Harris. But Tannenbaum had more misses than hits in recent drafts, with Vernon Gholston, Vladimir Ducasse and even Sanchez high-round picks that didn't perform as expected.
The trade for Tebow was perhaps the biggest mistake. By acquiring Tebow last March, the Jets brought in a player with immense popularity to provide a spark to the offense — just a matter of days after giving Sanchez a contract extension that included $8.25 million in guarantees for next season. Many fans and media argued that rather than trade for Tebow, Tannenbaum could have addressed some of the Jets' more-pressing needs, such as the offensive line, wide receiver and depth on defense.
The next GM will face an unstable salary cap situation, along with a dozen players scheduled to become unrestricted free agents, including starters Dustin Keller, LaRon Landry, Yeremiah Bell, Shonn Greene and Brandon Moore. Decisions will also have to be made on high-priced and aging veterans such as Calvin Pace and Bart Scott.
Meanwhile, that new GM will also have to work with Ryan, who has two years remaining on his contract and is two years removed from the second of consecutive trips to the AFC championship game.
"I'm excited that Rex is going to be here," Mangold said. "I know he has a passion and a fire for this game and for this team. We have to do a better job on the field, and that starts here shortly."
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Buffalo Bills fire coach Chan Gailey

ORCHARD PARK, N.Y. (AP) — Chan Gailey didn't work out after three losing seasons, leaving the Buffalo Bills looking for their fifth head coach since 2001.
The Bills fired Gailey on Monday after he failed to deliver on his vow to transform a losing franchise into a playoff contender. Gailey's entire staff was fired, too, but the status of general manager Buddy Nix remained uncertain.
Gailey's teams lost twice as many games as they won, going 16-32 over three seasons. The Bills have now posted eight straight losing seasons, and closed with a second straight 6-10 mark after beating the New York Jets 28-9 on Sunday.
"I understand this is a business," said Gailey, who had at least one year left on his contract. "We didn't get the job done."
Gailey spoke for a little over a minute. He declined to take questions, while growing emotional at one point. Among the assistants fired were assistant head coach and defensive coordinator Dave Wannstedt.
"I've been called two other times to get things turned around, was able to do it," Gailey said, referring to previous stops with Dallas (1998-99) and Georgia Tech (2002-07). "We weren't able to get this one done soon enough, and I understand that completely."
It was a disappointing finish for a team that had much higher aspirations. The Bills spent much of the past 14 months securing their best player, re-signing receiver Stevie Johnson and quarterback Ryan Fitzpatrick to lucrative multiyear contracts.
The spending spree reached its peak in March, when they signed defensive end Mario Williams to a six-year, $100 million contract.
"It's always disappointing," said defensive tackle Kyle Williams, one of the only players left in the locker room when the team announced Gailey's firing.
What frustrates Williams more is how the Bills keep making changes without getting any results.
"I get tired of losing," Williams said. "More than anything, I get tired of putting in tons and tons of work. And it's hard sitting here talking to you guys at the end of December feeling like another one kind of slipped through your fingers."
What's next remains unclear. Nix was at the team's facility Monday, but he nor the team provided any indication as to whether he'll be retained.
Gailey's dismissal is a significant setback for Nix. The general manager announced in November that Gailey wasn't going anywhere, because another coaching change would stunt the team's development.
The Bills, however, closed by losing seven of their final 10 games.
Bills owner Ralph Wilson had initially backed Nix's build-through-the-draft approach. Three years ago, the 94-year-old owner said he expected the rebuilding process could take as long as five years.
CEO Russ Brandon has been unhappy with the criticism leveled at the Bills, and how it's translated into poor ticket sales. Buffalo failed to sell out its four final home games.
One option is for the Bills to make a splash in hiring their next head coach, as they attempted in their previous search.
After firing Dick Jauron in November 2009, Wilson expressed a desire to open his checkbook to lure a high-profile coach to Buffalo only to be rebuffed by Mike Shanahan, who instead landed in Washington.
The most high-profile candidates available include coach-turned-broadcaster Jon Gruden and Andy Reid, who was fired by Philadelphia on Monday. Then there's two candidates in the college ranks, Oregon's Chip Kelly and Penn State's Bill O'Brien, who had numerous friends and former colleagues on Gailey's staff.
An offensive specialist, Gailey was unable to spark the Bills popgun attack under Fitzpatrick. The Bills finished 19th in the NFL in yards gained and 21st in points this season. Gailey was faulted for under-utilizing the offense's most dynamic threat, running back C.J. Spiller.
"It's sickening," running back Fred Jackson said, referring to how the Bills failed to play up to expectations. "As players, we had the highest hopes out of everybody. And for us to fall short of that, we don't like it at all. It's depressing."
Ultimately, it was the Bills' porous defense that doomed Gailey.
The Bills allowed 400-plus points in each of the past three seasons, including 435 this year — the second-most in team history. Though Williams' presence improved the pass rush, Buffalo became the NFL's eighth team, and first since the 1986 Jets, to allow 45 points four times in one season.
Fitzpatrick's status is uncertain in part because he's due a $3 million bonus in March. He went 16-29 since taking the starting job three games into the 2010 season.
Fitzpatrick declined to speculate on his future. After speaking to reporters, Fitzpatrick hugged Johnson, and the two left with the receiver's arm over the quarterback's shoulder.
Reading from notes he jotted on a Bills pad, Gailey's eyes welled with tears when he credited Bills fans for their loyalty, and Buffalo for being a passionate football city.
"I think that the next staff will have a great opportunity for success, and make this another great football franchise," Gailey said. "This will probably be, and I say probably, but I think it will be the first place that's ever fired me that I'll pull for.
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Chiefs fire Crennel, restructure organization

the end of an NFL football game, Sunday, Dec. 30, 2012, in Denver. Denver won 38-3. …more
KANSAS CITY, Mo. (AP) — The Kansas City Chiefs are doing more than looking for a new coach after firing Romeo Crennel on Monday. They're changing the entire structure of the organization.
Chiefs chairman Clark Hunt said in an interview with The Associated Press that he will hire the next head coach and that person will report directly to him. That's a departure from the previous 53 years in Kansas City, where the head coach had always reported to the general manager.
"The reason for it is I think it gives us the best chance of hiring the most outstanding coach," said Hunt, who had already begun working the phones to find Crennel's replacement.
Hunt relieved the 65-year-old Crennel of his duties after a 38-3 loss to Denver on Sunday that finished off a 2-14 season, tied for the worst in franchise history. But he has not made a decision on the future of GM Scott Pioli, whose job has hung in the balance for weeks.
"I don't have a timeline laid out on that," Hunt said. "Obviously the beginning of February, there are a lot of important events related to the upcoming draft, the combine and so forth, and we want to be solidified in that regard before that."
The Chiefs will have the No. 1 pick for the first time since joining the NFL.
The Chiefs' only victories this season were against New Orleans and Carolina, the latter coming one day after linebacker Jovan Belcher shot his girlfriend to death and then drove to the team's practice facility and turned the gun on himself as Crennel and Pioli looked on.
Crennel seemed to know the end was coming Sunday night when he was asked to defend his job and said, "If your criteria is wins and losses, there's not much defense."
"The NFL is a performance-based league, and we weren't able to win," Crennel said in a statement Monday. "As for my future, I'm planning to take some time to reflect on this season, evaluate everything, and make a decision based on what's right for myself and my family."
The only other time the Chiefs finished 2-14 was 2008, the year before Pioli was hired. They were 2-12 in 1977, the only other time they've failed to win at least three games.
"It's a tough day, but I can't say I didn't see it coming," said right tackle Eric Winston, among several players cleaning out their lockers Monday.
With five players voted to the Pro Bowl last week, there are certainly pieces in place for the Chiefs to make rapid improvement. But four of them were inherited by Pioli's regime, and that haul of Pro Bowl players may have been Crennel's biggest indictment.
"You always want to be able to give a head coach as long as you can to build a program. I just felt we really were not headed in the right direction," Hunt said. "The Pro Bowl balloting tells us a little about what coaches and players around the league think about the roster, that there's some very talented players. But at the same time, we all know there are holes."
The biggest hole is at quarterback, where the Chiefs benched Matt Cassel and his $63 million contract in favor of Brady Quinn, who struggled all year and is now a free agent.
The Chiefs' inept offense managed 18 touchdowns in 16 games, finished minus-24 in turnover margin and lost nine times by two touchdowns or more. Along the way, they broke an 83-year-old NFL record by not holding a lead in regulation until their ninth game.
"It has been by far the hardest year I've ever had as a professional," Hunt said. "I was miserable throughout the season, just in terms of what I was seeing. It was so hard on me because I want the team to succeed, not only for everyone in this building but most importantly for our fans. It just killed me that we weren't competitive. I hated it."
Crennel, whose career record as a head coach is 28-55, was hired in 2010 as defensive coordinator. Respected by his players, he was appointed interim coach last December when Pioli fired Todd Haley with three games left in the season.
Crennel immediately brought a sense of stability to a floundering franchise, defeating the previously unbeaten Green Bay Packers and winning at Denver in the season finale.
With the support of the players, Pioli made Crennel the permanent coach a few weeks later, giving him another opportunity as a head coach after four failed seasons in Cleveland.
This season was a disappointment from the start, too. The Chiefs were blown out by the Falcons in their opener, trounced by the Bills and later lost eight consecutive games.
Empty seats began to multiply at Arrowhead Stadium, once one of the NFL's most intimidating venues. An organized fan rebellion paid for banners to be towed behind airplanes asking for Pioli to be fired, and the majority of fans dressed in black for a home game against Cincinnati.
Nothing Crennel did seemed to work, either.
He fired himself as the defensive coordinator and turned those duties over to linebackers coach Gary Gibbs. He shuffled his quarterbacks, changed inspirational posters outside the locker room and even tinkered with the way practice was run.
But injuries were numerous, turnovers plentiful and penalties crippling as blown assignments became the hallmark of a team that was rarely competitive in games.
Then came the morning of Dec. 1, when tragedy struck.
Belcher, a part-time starter, shot the mother of his 3-month-old daughter, Kasandra Perkins, multiple times at a home not far from Arrowhead Stadium. The linebacker then sped to the team's practice facility and was confronted by Pioli, who tried to talk him out of more violence.
After thanking Pioli and Crennel for his chance in the NFL, Belcher shot himself in the head.
The Chiefs played the following day against Carolina, and Crennel was praised for the way he stoically led a team in turmoil. Kansas City put together its best performance in a 27-21 victory.
It wound up being their last win. The Chiefs were blown out by Cleveland, shut out by Oakland and beaten by the Colts before an embarrassing finale against the Broncos.
That was enough to finish Crennel, and enough to put Pioli's future in jeopardy.
"I kept looking for the team to improve, to show signs that we were turning the corner," Hunt said, "and we just never got there.
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Who might fill the NFL coaching openings

When NFL coaching jobs open, the names Jon Gruden, Bill Cowher and Tony Dungy immediately surface as potential candidates.
Much more likely than any of those Super Bowl winners returning to the sideline for 2013 would be the hirings of more obscure assistant coaches such as Mike Zimmer, Mike McCoy and Gus Bradley.
And Jon Gruden's younger brother, Jay.
Sure, some of the best-known coaches, including Andy Reid, Lovie Smith and Ken Whisenhunt, who lost their jobs Monday, will be in the mix. So might college coaches Chip Kelly of Oregon and Bill O'Brien of Penn State.
Maybe even Nick Saban, although leaving Alabama for the NFL is a long shot.
Bringing in highly accomplished coordinators has been the most common route for NFL teams lately. Cincinnati's Zimmer and Gruden and Denver's McCoy top most lists, along with Bruce Arians, who went 9-3 as Indianapolis' interim coach this season.
"Obviously, he's earned any phone call he gets, he's earned that right," Colts coach Chuck Pagano said of Arians, who replaced him for 12 games while Pagano underwent chemotherapy for leukemia. "And let me just say this, we do not want to lose Bruce Arians. We know who he is and what he's meant to this football team ..."
Zimmer was turned down twice last season after interviewing with Tampa Bay, which brought in Rutgers coach Greg Schiano, and Miami (Green Bay offensive coordinator Joe Philbin). The defensive mastermind still wants to be a head coach somewhere, but isn't getting his hopes up.
"Honestly, I don't listen to that stuff anymore," he said in early December. "Honest-to-God's truth. I've had for so many years, have people say, 'This is your year.' Then at the end of the year for about three days I'm totally depressed because I see this guy get a job, that guy get a job, that guy get a job.
"So it's in my best interest not to think about it, talk about it and just try to do the best job I can because I'm like (everybody else), I get disappointed too."
Gruden, who cut his coaching teeth in Arena Football and has revived Cincinnati's offense around Andy Dalton and A.J. Green, got some interest from other teams after last season. He quickly took himself out of the running, but might get more suitors with seven jobs open.
So might McCoy, whose adaptability is unquestioned after he adjusted Denver's offense for Tim Tebow's skill set last season, then made Peyton Manning's transition from the Colts to the Broncos so smooth.
Arians joined the Colts after he was released as Pittsburgh's offensive coordinator. When Pagano was diagnosed with leukemia, Arians stepped in and guided a team that went 2-14 a year ago into the playoffs.
Bradley has helped Pete Carroll build a physical, sometimes intimidating and always effective defense in Seattle. That style of defense will be attractive to teams such as the Bears, Browns and Eagles who have to deal with cold weather late in the schedule.
Kelly is one of the most intriguing candidates. The NFL is loath to admit it is enamored of anything college teams do, but Kelly's wide-open, speed-based offense has lots of pro franchises salivating.
He has been mentioned for most NFL openings, and that figures to continue.
Retreads also will get interviews, and not only the coaches who were canned on Monday. Denver defensive coordinator Jack Del Rio and Atlanta DC Mike Nolan might have earned another chance.
"When you're a young guy and you haven't been there, the urgency and desire to get that opportunity is such that you'd take just about any job given to you," said Del Rio, who was in charge in Jacksonville for nine seasons. "I don't feel that way now. If there's something that fits and the right situation comes along, so be it. But in the meantime, I'm all in, 100 percent as a lieutenant on this staff. I'm somebody that John Fox, John Elway ... and the players can count on. I'm 100 percent invested in helping them be their best.
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