What heals traumatized kids? Answers are lacking

CHICAGO (AP) — Shootings and other traumatic events involving children are not rare events, but there's a startling lack of scientific evidence on the best ways to help young survivors and witnesses heal, a government-funded analysis found.

School-based counseling treatments showed the most promise, but there's no hard proof that anxiety drugs or other medication work and far more research is needed to provide solid answers, say the authors who reviewed 25 studies. Their report was sponsored by the federal Agency for Healthcare Research and Quality.

According to research cited in the report, about two-thirds of U.S. children and teens younger than 18 will experience at least one traumatic event, including shootings and other violence, car crashes and weather disasters. That includes survivors and witnesses of trauma. Most will not suffer any long-term psychological problems, but about 13 percent will develop symptoms of post-traumatic stress, including anxiety, behavior difficulties and other problems related to the event.

The report's conclusions don't mean that no treatment works. It's just that no one knows which treatments are best, or if certain ones work better for some children but not others.

"Our findings serve as a call to action," the researchers wrote in their analysis, published online Monday by the journal Pediatrics.

"This is a very important topic, just in light of recent events," said lead author Valerie Forman-Hoffman, a researcher at RTI International, a North Carolina-based nonprofit research group.

She has two young children and said the results suggest that it's likely one of them will experience some kind of trauma before reaching adulthood. "As a parent I want to know what works best," the researcher said.

Besides the December massacre at Sandy Hook Elementary School in Connecticut, other recent tragedies involving young survivors or witnesses include the fatal shooting last month of a 15-year-old Chicago girl gunned down in front of a group of friends; Superstorm Sandy in October; and the 2011 Joplin, Mo., tornado, whose survivors include students whose high school was destroyed.

Some may do fine with no treatment; others will need some sort of counseling to help them cope.

Studying which treatments are most effective is difficult because so many things affect how a child or teen will fare emotionally after a traumatic event, said Dr. Denise Dowd, an emergency physician and research director at Children's Mercy Hospitals and Clinics in Kansas City, Mo., who wrote a Pediatrics editorial.

One of the most important factors is how the child's parents handle the aftermath, Dowd said.

"If the parent is freaking out" and has difficulty controlling emotions, kids will have a tougher time dealing with trauma. Traumatized kids need to feel like they're in a safe and stable environment, and if their parents have trouble coping, "it's going to be very difficult for the kid," she said.

The researchers analyzed 25 studies of treatments that included anti-anxiety and depression drugs, school-based counseling, and various types of psychotherapy. The strongest evidence favored school-based treatments involving cognitive behavior therapy, which helps patients find ways to cope with disturbing thoughts and emotions, sometimes including talking repeatedly about their trauma.

This treatment worked better than nothing, but more research is needed comparing it with alternatives, the report says.

"We really don't have a gold standard treatment right now," said William Copeland, a psychologist and researcher at Duke University Medical Center who was not involved in the report. A lot of doctors and therapists may be "patching together a little bit of this and a little bit of that, and that might not add up to the most effective treatment for any given child," he said.

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Online:

Pediatrics: http://www.pediatrics.org

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Benedict XVI First Pope to Resign in 600 Years

Pope Benedict XVI's unexpected announcement today that he will step down for health reasons makes him the first pontiff to resign in nearly 600 years, even catching the Vatican by surprise and setting off a chain reaction that will end with a conclave to elect a new pope before the end of March.

"My first reaction was this is, it's very startling," Cardinal Donald Wuerl, Archbishop of Washington, said. "I was totally unprepared for it. The second reaction was we're going to have to now think a little differently. This will be the first time in modern history that we've had a pope resign. How do we work with all of that?"

Announcing his decision in Latin during a meeting of Vatican cardinals, Benedict, 85, said he will resign Feb. 28, explaining that his role requires "both strength of mind and body."

FULL COVERAGE: Pope Benedict XVI Resignation

"After having repeatedly examined my conscience before God, I have come to the certainty that my strengths due to an advanced age are no longer suited to an adequate exercise of the Petrine ministry," he said. "I am well aware that this ministry, due to its essential spiritual nature, must be carried out not only by words and deeds but no less with prayer and suffering."

Pope Benedict XVI was the oldest pope to be elected at age 78 on April 19, 2005. He was the first German pope since the 11th century and his reign will rank as one of the shortest in history at seven years, 10 months and three days.

RELATED: Pope Benedict XVI Resigns: The Statement

The last pope to resign was Pope Gregory XII, who stepped down in 1415.

Vatican officials said they've noticed that he has been getting weaker, while Benedict said he is aware of the significance of his decision and made it freely.

Pope Benedict XVI Resignation: Who Will Be Next? Watch Video

Pope Benedict XVI Never Aspired to Be Pope: Historian

Vatican Communications Director Greg Burke told ABC News that he was surprised but not shocked by the announcement, and cited an interview in which Benedict said a pope not only could resign, but should resign, if necessary.

"[Pope Benedict] is slowing a bit, and there's nothing immediately serious or grave," Burke said. "He has an older brother. He just thought the demands of the job were too much for his physical well being."

INTERACTIVE: Key Dates in the Life of Pope Benedict XVI

Benedict's brother, Monsignor Georg Ratzinger, had shared his concerns about the pope's health in September 2011, telling Germany's Bunte magazine that he should resign if health issues made the work impossible. More recently, Ratzinger has apparently cited his brother's difficulty in walking and his age, saying that Benedict had been advised by his doctor to cease transatlantic trips and that he had been considering stepping down for months, according to the German DPA news agency.

Among other ailments, the pope reportedly suffers from arthritis and arthrosis -- a debilitating joint-degeneration condition -- and his declining health drew attention about a year ago when he used a cane at the airport on his way to a trip to Mexico and Cuba.

Benedict has been a less charismatic leader than his predecessor, John Paul II, but tending to the world's roughly 1 billion Catholics still requires stamina Benedict seems to believe he now lacks.

PHOTOS: Pope Benedict XVI Through the Years

"Obviously, it's a great surprise for the whole church, for everyone in the Vatican and I think for the whole Catholic world," the Rev. John Wauck, a U.S. priest of the Opus Dei, told "Good Morning America" today. "But, at the same time, it's not completely surprising given what the pope had already written about the possibility of resigning.

"It's clear in terms of his mental capacity he's in excellent shape, he's very sharp, and so when he says he's making this official with whole freedom, it's clear that that's the case, that makes one believe that this is an act taken out of a sense of responsibility and love for the church."

It is a road that leads back to the 1930s.

Ratzinger started seminary studies in 1939 at the age of 12. In his memoirs, he wrote of being enrolled in Hitler's Nazi youth movement against his will when he was 14 in 1941, when membership was compulsory. In 1943, he was drafted into a Nazi anti-aircraft unit in Munich. He says he was soon let out because he was a priest in training.

He returned home only to find an army draft notice waiting for him in the fall of 1944.

As World War II came to an end, the 18-year-old Ratzinger deserted the army. In May 1945, U.S. troops arrived in his town and he was sent to a prisoner-of-war camp.

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Netanyahu to discuss Iran, Syria, Palestinians with Obama

JERUSALEM (Reuters) - Iran's nuclear ambitions, the civil war in Syria and stalled Israeli-Palestinian peace efforts will top the agenda of U.S. President Barack Obama's visit to Israel, Prime Minister Benjamin Netanyahu said on Sunday.

"It is a very important visit that will emphasize the strong alliance between Israel and the United States," Netanyahu, who has had a testy relationship with Obama, told his cabinet.

The White House announced on Tuesday that Obama plans to visit Israel, the West Bank and Jordan this spring, raising prospects of a new U.S. push to restart Israeli-Palestinian peace efforts frozen for the past two years.

The White House gave no exact dates for the trip, Obama's first to Israel since taking office. Israel's Channel 10 television station cited unnamed sources in Washington last week saying the visit to Israel would start on March 20.

In public remarks at the cabinet session, Netanyahu put Iran at the top of his list of talking points with Obama and referred only in general terms to peace efforts with the Palestinians, stopping short of setting a revival of bilateral negotiations as a specific goal of the visit.

"The president and I spoke about this visit and agreed that we would discuss three main issues ... Iran's attempt to arm itself with nuclear weapons, the unstable situation in Syria ... and the efforts to advance the diplomatic process of peace between the Palestinians and us," Netanyahu said.

U.S.-hosted negotiations between Israel and the Palestinians collapsed in September 2010 in a dispute over Israeli settlement-building in the occupied West Bank, land captured in a 1967 war and which Palestinians seek as part of a future state that includes Gaza and East Jerusalem.

Obama and Netanyahu discussed the coming trip in a January 28 telephone call.

COALITION TALKS

The visit will take place only after Netanyahu puts together a new governing coalition following his narrower-than-expected victory in Israel's January 22 election.

Netanyahu, who heads the right-wing Likud party, has begun talks with prospective political partners and still has up to five weeks to complete the process.

Citing the dangers Israel faces from the "earthquake that is happening around us", a reference to Arab upheaval in the region and the prospect of a nuclear-armed Iran, Netanyahu said Obama's visit now was particularly important.

Obama's tensions with Netanyahu have been aggravated by the Israeli leader's demands for U.S. "red lines" on Iran's nuclear program - something the president has resisted, though he has said military options are on the table if sanctions and diplomacy fail.

Iranian President Mahmoud Ahmadinejad said on Sunday that Tehran would not negotiate about its nuclear program under pressure, and would talk to its adversaries only if they stopped "pointing the gun".

Iran dismisses Western suspicions that its nuclear program is aimed at building weapons. Israel is widely believed to have the Middle East's only nuclear arsenal.

Netanyahu has insisted he will stick to the red line laid down in September, when he told the United Nations that Iran should not have enough enriched uranium to make even a single warhead.

He gave a rough deadline of summer 2013, and Israeli political commentators have speculated that Obama had opted to visit Israel before that date to caution Netanyahu against any go-it-alone attack against Iran's nuclear facilities.

Obama visited Israel as a presidential candidate in 2008 but drew Republican criticism for not travelling there in his first term. His Republican predecessor, former President George W. Bush, also waited until his second term to go to Israel.

(Editing by Matthew Tostevin)

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Three Korean doctors slain in north Nigeria: police

KANO, Nigeria: Men armed with knives slit the throats of three South Korean doctors in a pre-dawn attack Sunday in a volatile town in northeastern Nigeria in the latest in a spate of killings of foreigners in recent months, police said.

The attack in Potiskum also came just two days after gunmen killed at least 10 people in horrifying attacks on two Nigerian polio clinics in a new blow to the campaign to wipe out disease, but it was not clear if the incidents were related.

Yobe State police commissioner Sanusi Rufa'i would not say if the Islamist group Boko Haram, which has been active in Potiskum, was responsible for Sunday's killings, but that the attack was being investigated.

He said unknown attackers scaled the fence of an apartment housing the three doctors at around 1:00 am and slit their throats, initially describing the victims as Chinese.

"Further investigations have shown that the victims were Korean nationals and not Chinese as earlier stated. They were doctors from South Korea," Rufa'i told AFP, in comments confirmed by a senior military official in the state.

Residents said the Koreans, whose bodies were found by neighbours, were employees of the state ministry of health and had been living in the city for one year.

In Seoul, the foreign ministry said it was checking the reports, but noted that few Koreans live in the town.

"The chance that the slain would be Koreans is not high," a foreign ministry official told Yonhap news agency. "But we are checking further related situations via diverse channels."

A local resident said the bodies of the Koreans were found in their room by neighbours who alerted security agents,

"People became worried when the doctors did not open their door in the morning," one resident who did not want to be named told AFP.

He said the victims had their throats slit, but it was not immediately clear if the assailants also came with guns.

"It is still premature to point any accusing fingers but we have commenced an investigation to unravel the killings," said Rufa'i, adding: "No arrest has been made."

Sunday's attack was the latest in a spate of killings of foreigners, especially Chinese nationals, in the country's restive northeast.

In November, gunmen shot dead two Chinese construction workers in nearby Borno State, the stronghold of the Boko Haram extremists.

Three other Chinese nationals have also been killed in separate attacks in the region.

Although no group claimed responsibility for the attacks, they were similar to previous strikes against foreigners by Boko Haram.

Violence linked to Boko Haram is believed to have left some 3,000 people dead since 2009, including killings by the security forces.

The killings in Potiskum, which lies about 100 kilometres (60 miles) from the state capital Damaturu, followed attacks on other health workers in the northern city of Kano on Friday.

Nine women and a man were shot dead in two separate attacks in Kano after a local cleric denounced polio vaccination campaigns and some local radio stations aired conspiracy theories about the vaccine being a Western plot to harm Muslims.

Nigerian President Goodluck Jonathan condemned Friday's killings, describing them as "dastardly terrorist attacks" and vowed to track down the perpetrators.

Boko Haram has claimed to be fighting for the creation of an Islamic state, but its demands have shifted repeatedly and it is believed to include various factions. Criminal gangs and imitators are also suspected of carrying out violence under the guise of the group.

Nigeria, Africa's most populous nation and largest oil producer, is divided between a mainly Muslim north and predominantly Christian south.

- AFP/ck

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Ten killed in Allahabad railway station stampede

ALLAHABAD: At least 10 persons were killed and scores of others injured on Sunday evening in a stampede at Allahabad railway station teeming with thousands of pilgrims returning after a holy dip at the Mahakumbh here.

According to divisional railway manager Harinder Rao, 10 people died and scores were injured in the mishap.

The stampede occurred at 7pm when Platforms No 5 and 6 were packed with thousands of passengers.

Eyewitnesses said the stamepede was triggered when the railing leading to the foot overbridge over platform number 6 collapsed when hundreds of passengers rushed to board a train. Three hours after the mishap bodies of 10 victims were lying on the platform.

They said there was a sudden surge of passengers ater an annoucement over the public address system about the arrival of a train. The platform number 6 was sealed by authorities.

There were reports of a lathicharge which compounded the tragedy.

Eyewitnesses claimed there was a lathicharge by police but Rao said the incident happened when passengers were being told to stand in a line to bring the movement of the crowd under control.

The injured have been rushed to various hospitals. Prime Minister Manmohan Singh condoled loss of lives in the tragey and instructed Railway ministry to provide all possible assistance.

Singh also directed central government departments to extend all possible help to Uttar Pradesh government in relief operations.

Earlier in the day, two pilgrims were killed in a stampede at the Mahakumbh here as over three crore people converged for a holy dip on the occasion of " Mauni Amavasya", a day considered the most auspicious day during the 12-yearly congregation.

The stampede broke out in Sector 12 of the mela area this evening killing a woman hailing from Varanasi and a middle-aged man, who had come from West Bengal, sector magistrate Abhay Raj told PTI.

A few other persons received minor injuries in the stampede which occurred due to rush of devotees who were returning from the river banks, he said.

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After early start, worst of flu season may be over

NEW YORK (AP) — The worst of the flu season appears to be over.

The number of states reporting intense or widespread illnesses dropped again last week, and in a few states there was very little flu going around, U.S. health officials said Friday.

The season started earlier than normal, first in the Southeast and then spreading. But now, by some measures, flu activity has been ebbing for at least four weeks in much of the country. Flu and pneumonia deaths also dropped the last two weeks, the Centers for Disease Control and Prevention reported.

"It's likely that the worst of the current flu season is over," CDC spokesman Tom Skinner said.

But flu is hard to predict, he and others stressed, and there have been spikes late in the season in the past.

For now, states like Georgia and New York — where doctor's offices were jammed a few weeks ago — are reporting low flu activity. The hot spots are now the West Coast and the Southwest.

Among the places that have seen a drop: Lehigh Valley Hospital-Cedar Crest in Allentown, Pa., which put up a tent outside its emergency room last month to help deal with the steady stream of patients. There were about 100 patients each day back then. Now it's down to 25 and the hospital may pack up its tent next week, said Terry Burger, director of infection control and prevention for the hospital.

"There's no question that we're seeing a decline," she said.

In early December, CDC officials announced flu season had arrived, a month earlier than usual. They were worried, saying it had been nine years since a winter flu season started like this one. That was 2003-04 — one of the deadliest seasons in the past 35 years, with more than 48,000 deaths.

Like this year, the major flu strain was one that tends to make people sicker, especially the elderly, who are most vulnerable to flu and its complications

But back then, that year's flu vaccine wasn't made to protect against that bug, and fewer people got flu shots. The vaccine is reformulated almost every year, and the CDC has said this year's vaccine is a good match to the types that are circulating. A preliminary CDC study showed it is about 60 percent effective, which is close to the average.

So far, the season has been labeled moderately severe.

Like others, Lehigh Valley's Burger was cautious about making predictions. "I'm not certain we're completely out of the woods," with more wintry weather ahead and people likely to be packed indoors where flu can spread around, she said.

The government does not keep a running tally of flu-related deaths in adults, but has received reports of 59 deaths in children. The most — nine — were in Texas, where flu activity was still high last week. Roughly 100 children die in an average flu season, the CDC says

On average, about 24,000 Americans die each flu season, according to the CDC.

According to the CDC report, the number of states with intense activity is down to 19, from 24 the previous week, and flu is widespread in 38 states, down from 42.

Flu is now minimal in Florida, Kentucky, Maine, Montana, New Hampshire and South Carolina.

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Online:

CDC: http://www.cdc.gov/flu/

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Paterno Family Fights 'Rush to Injustice'

The Paterno family is fighting to restore the legacy of former Penn State football coach Joe Paterno, flatly denying the allegations in the report by former FBI Director Louis Freeh that the legendary coach was complicit in a coverup of child sexual abuse by a former assistant coach.

"The Critique of the Freeh Report: The Rush to Injustice Regarding Joe Paterno," the report prepared by King & Spalding and released on paterno.com this morning, is described as an attempt to set the record straight with independent expert analysis examining the "most glaring errors on which the Freeh report is based."

"The Freeh report reflects an improper 'rush to injustice,'" the 238-page critique says. "There is no evidence that Joe Paterno deliberately covered up known incidents of child molestation by Jerry Sandusky to protect Penn State football or for any other reason; the contrary statements in the Freeh report are unsupported and unworthy of belief."

In their critique of the Freeh report, former U.S. Attorney General Dick Thornburgh and experts Jim Clemente and Fred Berlin examined the Freeh report and found that the report is "deeply flawed and that key conclusions regarding Joe Paterno are unsubstantiated and unfair."

According to the critique, the Freeh report "uncovers little new factual information as to Joe Paterno and does very little to advance the truth regarding his knowledge, or more accurately lack of knowledge, of Jerry Sandusky's molestation of children."

Freeh called the critique a "self-serving report" that "does not change the facts."

Patrick Smith/Getty Images|Gene J. Puskar/AP Photo

Jerry Sandusky Sentenced: 30 to 60 Years in Prison Watch Video

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Jerry Sandusky Sentencing: Why Did He Release Statement? Watch Video

READ: Louis Freeh's Statement in Response to Critique

Penn State, which commissioned Freeh to conduct the investigation, stood by the report and said it is moving forward with the 119 recommendations Freeh made.

"To date, the University has implemented a majority of those recommendations, which are helping to make the University stronger and more accountable," the school said in a statement today. "The University intends to implement substantially all of the Freeh recommendations by the end of 2013."

Former assistant coach Jerry Sandusky was sentenced last year to 30 to 60 years in prison after he was convicted of 45 criminal counts of sexually abusing young boys.

Some of the abuse occurred at the Penn State campus, and at least one incident was observed by a graduate assistant who said he reported it to Paterno. However, school officials did not report the allegations to law enforcement.

PHOTOS: Jerry Sandusky Gets 30 Years in Prison for Sex Abuse

In the wake of the Sandusky scandal, Joe Paterno, who coached the Nittany Lions for 46 years and became the winningest coach in Division 1 football history in 2011, was dismissed.

The allegations of Paterno's involvement in a coverup came as a shock that reverberated beyond the Penn State campus, because of his reputation as a coach who valued character and academic achievement as much as winning.

Following his dismissal, Paterno was diagnosed with lung cancer and broke his hip. He died on Jan. 22, 2012, at the age of 85.

Former Penn State University President Graham Spanier, along with Penn State athletic director Tim Curley, and school vice president Gary Schultz are awaiting a hearing after they were accused of lying and concealing the sex abuse allegations against Sandusky.

Freeh Report Critique

Released in July, the 267-page report by Freeh concluded that Joe Paterno and his superiors valued the football program and the image of Penn State more than they valued the safety of Sandusky's victims.

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Tunisian Islamists rally to show "power of street"

TUNIS (Reuters) - Thousands of Islamists marched in Tunis on Saturday in a show of strength, a day after the funeral of an assassinated secular politician drew the biggest crowds seen on the streets since Tunisia's uprising two years ago.

About 6,000 supporters of the ruling Ennahda movement rallied to back their leader Rachid al-Ghannouchi, who was the target of angry slogans raised by mourners at Friday's mass funeral of Chokri Belaid, a rights lawyer and opposition leader.

"The people want Ennahda again," the Islamists chanted, waving Tunisian and party flags as they marched towards the Interior Ministry on Habib Bourguiba Avenue in the city centre.

The demonstration was dwarfed by the tens of thousands who had turned out in Tunis and other cities to honor Belaid and to protest against the Islamist-led government the day before, shouting slogans that included "We want a new revolution".

Belaid's killing by an unidentified gunman on Wednesday, Tunisia's first such political assassination in decades, has shaken a nation still seeking stability after the overthrow of veteran strongman Zine al-Abidine Ben Ali in January 2011.

The family of the slain politician has accused Ennahda of responsibility for his killing. The party denies any hand in it.

"We are here to support legitimacy, but if you prefer the power of the street, look at the streets today, we have this power," Lotfi Zitoun, an Ennahda leader, said in a speech to the Islamist demonstrators in Tunis.

Tunisia's political transition has been more peaceful than those in other Arab nations such as Egypt, Libya and Syria, but tensions are running high between Islamists elected to power and liberals who fear the loss of hard-won liberties.

FREEDOMS THREATENED

"We have gained things - the freedom of expression, the freedom to meet, to form organizations, parties, to work in the open," said Radhi Nasraoui, a veteran human rights campaigner.

"The problem is that these freedoms are still threatened, and there are attempts (by Islamists) to touch the gains of women," she told Reuters.

After Belaid's death, Prime Minister Hamadi Jebali promised to form a non-partisan, technocratic cabinet to run the country until an election could take place, despite complaints from within his own Ennahda party and its two junior non-Islamist coalition partners that he had failed to consult them.

Jebali told France 24 television on Saturday that he would resign if political parties refused to support his proposal, which he said was intended to "save the country from chaos".

The state news agency TAP said the prime minister would unveil his new government next week.

Secular groups have accused the Islamist-led government of a lax response to attacks by ultra-orthodox Salafi Islamists on cinemas, theatres, bars and individuals in recent months.

Prolonged political uncertainty and street unrest could damage an economy that relies on tourism. Unemployment and other economic grievances fuelled the revolt against Ben Ali in 2011.

Tunisia's stock exchange has fallen 3.32 percent since Belaid's assassination.

France, the former colonial power, ordered its schools in Tunis to stay closed on Friday and Saturday, warning its nationals to stay clear of potential flashpoints in the capital.

Some of the Islamist demonstrators shouted "France, out", in response to remarks by French Interior Minister Manuel Valls which were rejected by Jebali, the prime minister, on Friday.

"We must support all those who fight to maintain values and remain aware of the dangers of despotism, of Islamism that threatened those values today through obscurantism," Valls had said on Europe 1 radio on Thursday in comments on Tunisia.

"There is an Islamic fascism which is on the rise in many places."

Tunisian Foreign Minister Rafik Abdessalem described Valls's remarks as "worrying and unfriendly".

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Tennis: Czechs lead Australia 2-0 in Fed Cup

PRAGUE: Petra Kvitova and Lucie Safarova handed holders Czech Republic a 2-0 lead over Australia after the first day of their Fed Cup World Group tie in the eastern Czech city of Ostrava on Saturday.

In the first rubber, Kvitova, the Czech number one and world number eight, beat Australia's 168-ranked Jarmila Gajdosova 7-6 (7/2), 6-3 in an hour and 35 minutes.

Safarova, the world number 18, then snatched two tie-breaks for a 7-6 (8/6), 7-6 (7/4) win over ninth-ranked Samantha Stosur in two hours and 28 minutes.

Kvitova, the 2011 Wimbledon champion who led the Czechs to Fed Cup victories in 2011 and 2012, struggled for composure in the first set before dominating the second.

"It wasn't an easy match and she had moments when she played very well, but she also helped me a few times," the 22-year-old Kvitova said.

"I was terribly nervous in the first set."

Gajdosova, who has sunk from a career-high ranking of 25 in the past two seasons, said she had played a "pretty decent match."

"I had a lot of chances in the first and second set. Unfortunately I didn't take them," said the 25-year-old Gajdosova, who was born in Slovakia which formed a single country with the Czech Republic until 1993.

On the hard surface in Ostrava, about 320 kilometres (200 miles) east of Prague, Safarova then battled Stosur in a tight game, with each giving up five breaks.

"It was very hard, the games with her are always tight. But I handled it very well," said the 26-year-old Safarova.

Stosur, 28, failed to convert five set points in the first set and then gave up a break as she served for the second set.

"Unfortunately for me, I guess she got all those important points to get it back even and then kick on and get each set," said the 2011 US Open champion.

On Sunday, Kvitova will first face Stosur. If she gives the Czechs a winning 3-0 lead, the tie will go straight to doubles, while if she loses, Safarova will take on Gajdosova.

In the doubles, Czechs Andrea Hlavackova and Lucie Hradecka, the world numbers three and four in the format, will face Australian Open finalists Casey Dellacqua (21 in doubles) and 16-year-old Ashleigh Barty (46).

The Czech Republic and former Czechoslovakia have won seven Fed Cup trophies together, just like Australia whose last success was back in 1974.

This puts both teams second in the historic Fed Cup rankings behind the US with 17 trophies.

- AFP/jc

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Doctors to pay Rs 38.4 lakh for brain damage after fertility test

NEW DELHI: A compensation of Rs 38.4 lakh has been awarded to the family of a woman chartered accountant, who suffered brain damage and is in vegetative state since 1999 after undergoing a fertility test at a Hyderabad-based maternity clinic, by the apex consumer commission.

The clinic and its two doctors were directed by the National Consumer Disputes Redressal Commission (NCDRC) to pay the compensation on a plea by the husband and the minor daughter of the patient Rupa Mutha.

They had alleged she suffered brain damage after undergoing fallopian tube test at the Desai Maternity Clinic and Nursing Home run by Dr Jayashree Desai, who along with Dr Sampath Kumar, the anaesthetist, performed the test.

The NCDRC relied on the medical records of the patient's treatment at the clinic and the affidavit of Hyderabad-based Care Hospital which had said she was brought to it in comatose condition and had suffered brain damage due to hypoxia (inadequate supply of oxygen to the brain).

"In the background of the detailed consideration of the evidence on record, the findings reached by us and in the light of the applicable law, we have no hesitation in holding that the opposite parties (the two doctors and the clinic) have committed serious deficiency of service in the treatment of Rupa Mutha (patient).

"Therefore, the complaint must succeed. The opposite parties need to compensate her for her medical condition resulting directly from her treatment by them," the bench presided by Justice JM Malik said.

Rupa's husband, Sanjay Mutha, had sought compensation of Rs 6.8 crore towards the incurred and projected expenses of her treatment and loss of her professional earnings as she was a chartered accountant.

The NCDRC, however, awarded Rs 20.4 lakh towards expenses incurred on her treatment and maintenance along with Rs 18 lakh as compensation for physical and mental suffering undergone by her and her family.

The doctors in their defence had refuted the allegations of medical negligence against them.

Dr Desai and Dr Kumar had contended that all proper and reasonable care was taken while performing the test, but she had suddenly developed breathing difficulties and suffered cardiac arrest after the procedure was completed.

They had also contended that they immediately provided her with oxygen and performed cardio-pulmonary resuscitation (CPR) to revive her and hypoxia had not occurred during or after the test.

This contention was rejected by the commission which said the doctors' assertion was in conflict with the certificate of Care Hospital which said the patient was brought to it in comatose condition and had suffered brain damage due to hypoxia which occurred after the test was conducted.

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