Personal Health: Too Many Pills in Pregnancy

The thalidomide disaster of the early 1960s left thousands of babies with deformed limbs because their mothers innocently took a sleeping pill thought to be safe during pregnancy,

In its well-publicized wake, countless pregnant women avoided all medications, fearing that any drug they took could jeopardize their babies’ development.

I was terrified in December 1968 when, during the first weeks of my pregnancy, I developed double pneumonia and was treated with antibiotics and codeine. Before swallowing a single dose, I called my obstetrician, who told me to take what was prescribed, “reassuring” me that if I died of pneumonia I wouldn’t have a baby at all.

In the decades that followed, pregnancy-related hazards were linked to many medicinal substances: prescription and over-the-counter drugs and herbal remedies, as well as abused drugs and even some vitamins.

Now, however, the latest findings about drug use during pregnancy have ignited new concerns among experts who monitor the effects of medications on the developing fetus and pregnancy itself.

During the last 30 years, use of prescription drugs during the first trimester of pregnancy, when fetal organs are forming, has grown by more than 60 percent.

About 90 percent of pregnant women take at least one medication, and 70 percent take at least one prescription drug, according to the Centers for Disease Control and Prevention.

Since the late 1970s, the proportion of pregnant women taking four or more medications has more than doubled.

Nearly one woman in 10 takes an herbal remedy during the first trimester.

A growing number of pregnant women, naïvely assuming safety, self-medicate with over-the-counter drugs that were once sold only by prescription.

While many commonly taken medications are considered safe for unborn babies, the Food and Drug Administration estimates that 10 percent or more of birth defects result from medications taken during pregnancy. “We seem to have forgotten as a society that drugs pose risks,” Dr. Allen A. Mitchell, professor of epidemiology and pediatrics at Boston University Schools of Public Health and Medicine, said in an interview. “Many over-the-counter drugs were grandfathered in with no studies of their possible effects during pregnancy.”

Medical progress has contributed to the rising use of medications during pregnancy, Dr. Mitchell said. Various conditions, like depression, are now recognized as diseases that warrant treatment; drugs have been developed to treat conditions for which no treatment was previously available, and some conditions, like Type 2 diabetes and hypertension, have become more prevalent.

Misled by the Web

Now a new concern has surfaced: Bypassing their doctors, more and more women are using the Internet to determine whether the medication they are taking or are about to take is safe for an unborn baby.

A study, published online last month in Pharmacoepidemiology and Drug Safety, of so-called “safe lists for medications in pregnancy” found at 25 Web sites revealed glaring inconsistencies and sometimes false reassurances or alarms based on “inadequate evidence.”

The report was prepared by Cheryl S. Broussard of the Centers for Disease Control and Prevention with co-authors from Emory, Georgia State University, the University of British Columbia and the Food and Drug Administration.

“Among medications approved for use in the U.S.A. from 2000 to 2010, over 79% had no published human data on which to assess teratogenic risk (potential to cause birth defects), and 98% had insufficient published data to characterize such risk,” the authors wrote.

But that did not stop the 25 Web sites from characterizing 245 medications as “safe” for use by pregnant women, which “might encourage use of medications during pregnancy even when they are not necessary,” the authors suggested.

Furthermore, the information found online was sometimes contradictory. “Twenty-two of the products listed as safe by one or more sites were stated not to be safe by one or more of the other sites,” the study found.

The question of timing was often ignored. A drug that could interfere with fetal organ development might be safe to take later in pregnancy. Or one (for example, ibuprofen) that is safe early in pregnancy could become a hazard later if it raises the risk of excessive bleeding or premature delivery.

Fewer than half the sites advised taking medication only when necessary, and only 13 sites encouraged pregnant women to consult their doctors before stopping or starting a medication.

Doctors, too, are often poorly informed about pregnancy-related hazards of various medications, the authors noted. One woman I know was advised to wean off an antidepressant before she became pregnant, but another was told to continue taking the same drug throughout her pregnancy.

“In many instances the best bet is for mom to stay on her medication,” said Dr. Siobhan M. Dolan, an obstetrician and geneticist at Albert Einstein College of Medicine. She said that if a woman is depressed during pregnancy, her risk of postpartum depression is greater and she may have difficulty bonding with her baby.

Dr. Dolan, who is author, with Alice Lesch Kelly, of the March of Dimes’ newest book, “Healthy Mom Healthy Baby,” emphasized the importance of weighing benefits and risks in deciding whether to take medication during pregnancy and which drugs to take.

“In anticipation of pregnancy, a woman taking more than one drug to treat her condition should try to get down to a single agent,” Dr. Dolan said in an interview. “Of the various medications available to treat a condition, is there a best choice — one least likely to cause a problem for either the baby or the mother?”

She cautioned against sharing medications prescribed for someone else and assuming that a remedy labeled “natural” or “herbal” is safe. Virtually none have been tested for safety in pregnancy.

Among medications a woman should be certain to avoid, in some cases starting three months before becoming pregnant, are isotretinoin (Accutane and others) for acne; valproic acid for seizure disorders; lithium for bipolar disorder; tetracycline for infections, and angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor antagonists for hypertension, Dr. Dolan said.

“Many medications that are not recommended during pregnancy can be replaced with low-risk alternatives,” she wrote.

Dr. Broussard, who did the “safe lists” study, said in an interview, “We’ve heard about women seeing medications on these lists and deciding on their own that it’s O.K. to take them. “Women who are pregnant or even thinking about getting pregnant should talk directly to their doctors before taking anything. They should be sure they’re taking only what’s necessary for their health condition.”

A reliable online resource for both women and their doctors, Dr. Mitchell said, are fact sheets prepared by OTIS, the Organization of Teratology Information Specialists, which are continually updated as new facts become available: http://www.otispregnancy.org.

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Personal Health: Too Many Pills in Pregnancy

The thalidomide disaster of the early 1960s left thousands of babies with deformed limbs because their mothers innocently took a sleeping pill thought to be safe during pregnancy,

In its well-publicized wake, countless pregnant women avoided all medications, fearing that any drug they took could jeopardize their babies’ development.

I was terrified in December 1968 when, during the first weeks of my pregnancy, I developed double pneumonia and was treated with antibiotics and codeine. Before swallowing a single dose, I called my obstetrician, who told me to take what was prescribed, “reassuring” me that if I died of pneumonia I wouldn’t have a baby at all.

In the decades that followed, pregnancy-related hazards were linked to many medicinal substances: prescription and over-the-counter drugs and herbal remedies, as well as abused drugs and even some vitamins.

Now, however, the latest findings about drug use during pregnancy have ignited new concerns among experts who monitor the effects of medications on the developing fetus and pregnancy itself.

During the last 30 years, use of prescription drugs during the first trimester of pregnancy, when fetal organs are forming, has grown by more than 60 percent.

About 90 percent of pregnant women take at least one medication, and 70 percent take at least one prescription drug, according to the Centers for Disease Control and Prevention.

Since the late 1970s, the proportion of pregnant women taking four or more medications has more than doubled.

Nearly one woman in 10 takes an herbal remedy during the first trimester.

A growing number of pregnant women, naïvely assuming safety, self-medicate with over-the-counter drugs that were once sold only by prescription.

While many commonly taken medications are considered safe for unborn babies, the Food and Drug Administration estimates that 10 percent or more of birth defects result from medications taken during pregnancy. “We seem to have forgotten as a society that drugs pose risks,” Dr. Allen A. Mitchell, professor of epidemiology and pediatrics at Boston University Schools of Public Health and Medicine, said in an interview. “Many over-the-counter drugs were grandfathered in with no studies of their possible effects during pregnancy.”

Medical progress has contributed to the rising use of medications during pregnancy, Dr. Mitchell said. Various conditions, like depression, are now recognized as diseases that warrant treatment; drugs have been developed to treat conditions for which no treatment was previously available, and some conditions, like Type 2 diabetes and hypertension, have become more prevalent.

Misled by the Web

Now a new concern has surfaced: Bypassing their doctors, more and more women are using the Internet to determine whether the medication they are taking or are about to take is safe for an unborn baby.

A study, published online last month in Pharmacoepidemiology and Drug Safety, of so-called “safe lists for medications in pregnancy” found at 25 Web sites revealed glaring inconsistencies and sometimes false reassurances or alarms based on “inadequate evidence.”

The report was prepared by Cheryl S. Broussard of the Centers for Disease Control and Prevention with co-authors from Emory, Georgia State University, the University of British Columbia and the Food and Drug Administration.

“Among medications approved for use in the U.S.A. from 2000 to 2010, over 79% had no published human data on which to assess teratogenic risk (potential to cause birth defects), and 98% had insufficient published data to characterize such risk,” the authors wrote.

But that did not stop the 25 Web sites from characterizing 245 medications as “safe” for use by pregnant women, which “might encourage use of medications during pregnancy even when they are not necessary,” the authors suggested.

Furthermore, the information found online was sometimes contradictory. “Twenty-two of the products listed as safe by one or more sites were stated not to be safe by one or more of the other sites,” the study found.

The question of timing was often ignored. A drug that could interfere with fetal organ development might be safe to take later in pregnancy. Or one (for example, ibuprofen) that is safe early in pregnancy could become a hazard later if it raises the risk of excessive bleeding or premature delivery.

Fewer than half the sites advised taking medication only when necessary, and only 13 sites encouraged pregnant women to consult their doctors before stopping or starting a medication.

Doctors, too, are often poorly informed about pregnancy-related hazards of various medications, the authors noted. One woman I know was advised to wean off an antidepressant before she became pregnant, but another was told to continue taking the same drug throughout her pregnancy.

“In many instances the best bet is for mom to stay on her medication,” said Dr. Siobhan M. Dolan, an obstetrician and geneticist at Albert Einstein College of Medicine. She said that if a woman is depressed during pregnancy, her risk of postpartum depression is greater and she may have difficulty bonding with her baby.

Dr. Dolan, who is author, with Alice Lesch Kelly, of the March of Dimes’ newest book, “Healthy Mom Healthy Baby,” emphasized the importance of weighing benefits and risks in deciding whether to take medication during pregnancy and which drugs to take.

“In anticipation of pregnancy, a woman taking more than one drug to treat her condition should try to get down to a single agent,” Dr. Dolan said in an interview. “Of the various medications available to treat a condition, is there a best choice — one least likely to cause a problem for either the baby or the mother?”

She cautioned against sharing medications prescribed for someone else and assuming that a remedy labeled “natural” or “herbal” is safe. Virtually none have been tested for safety in pregnancy.

Among medications a woman should be certain to avoid, in some cases starting three months before becoming pregnant, are isotretinoin (Accutane and others) for acne; valproic acid for seizure disorders; lithium for bipolar disorder; tetracycline for infections, and angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor antagonists for hypertension, Dr. Dolan said.

“Many medications that are not recommended during pregnancy can be replaced with low-risk alternatives,” she wrote.

Dr. Broussard, who did the “safe lists” study, said in an interview, “We’ve heard about women seeing medications on these lists and deciding on their own that it’s O.K. to take them. “Women who are pregnant or even thinking about getting pregnant should talk directly to their doctors before taking anything. They should be sure they’re taking only what’s necessary for their health condition.”

A reliable online resource for both women and their doctors, Dr. Mitchell said, are fact sheets prepared by OTIS, the Organization of Teratology Information Specialists, which are continually updated as new facts become available: http://www.otispregnancy.org.

Read More..

DealBook: Obama’s Nominee for S.E.C. Tries to Allay Skepticism

Mary Jo White’s path to the Securities and Exchange Commission has reached a crucial juncture: the Congressional charm campaign.

Lawmakers are scrutinizing Ms. White ahead of her Senate confirmation hearing, raising questions about the former prosecutor’s lack of regulatory experience and the challenge of policing Wall Street firms she recently defended in private practice. But Ms. White is seeking to quell concerns about potential conflicts of interest.

She recently scheduled meetings with Senate Banking Committee members, who must clear her nomination, and answered a 20-page boilerplate questionnaire detailing her qualifications, according to a copy provided to The New York Times. The document sheds new light on her list of Wall Street clients, including little-known work performed for HSBC’s former chief executive. It also describes her ties to New York Democratic causes and laurels she earned both as a defense lawyer and federal prosecutor.

The questionnaire, created by the banking committee, focused significant attention on her movement through the revolving door between government service and private practice, a concern that has loomed since President Obama nominated Ms. White in January.

“As a government official, I believe I have an established track record and the reputation of being tough, but fair,” she said in the document.

Ms. White also offered a previously undisclosed concession, vowing “as far as can be foreseen,” never to return to Debevoise & Plimpton, where she had built a lucrative legal practice. To avert potential conflicts stemming from her work on behalf of Wall Street giants, Ms. White had already agreed to recuse herself for one year from most matters that involve former clients.

While Ms. White’s nomination is expected to sail through the committee before receiving full Senate approval, four Congressional officials who spoke anonymously warned that some Democrats have lingering reservations.

The Democrats note that her husband, John W. White, is co-chairman of the corporate governance practice at Cravath, Swaine & Moore, where he represents many of the companies that the S.E.C. regulates. They also question whether Ms. White’s recusals, even if well-intentioned, could cripple her ability to run the agency.

In a meeting on Tuesday with Senator Sherrod Brown, Democrat of Ohio, Ms. White did little to alleviate the fears.

“Senator Brown respects Ms. White’s credentials and experience, but is concerned with Washington’s long-held bias toward Wall Street,” his spokeswoman, Meghan Dubyak, said in a statement. “He pushed Ms. White,” to explain “whether her previous employment or her spouse’s current employment could cause her to recuse herself from key business facing the S.E.C.” The agency has already fallen behind in writing dozens of new rules for Wall Street.

Ms. White’s supporters counter that, before the White House announced the appointment, the Office of Government Ethics vetted her disclosures. The nonpartisan officials concluded that, even with her recusals, Ms. White could effectively run the agency.

Her supporters also trumpet her long tenure as a tenacious prosecutor. During stints as a federal prosecutor in Brooklyn and as the first woman United States attorney in Manhattan, she helped oversee the prosecution of the crime figure John Gotti and directed the case against those responsible for the 1993 World Trade Center bombing. The cases won her praise from several lawmakers.

Ms. White still has time to win over remaining skeptics. Her confirmation hearing is not expected until the week of March 11, Congressional officials briefed on the matter said.

Until then, Ms. White is blitzing through the halls of Congress, a routine practice for nominees. She began her charm offensive at the top of the banking committee’s roster, visiting this month with the Democratic chairman, Senator Tim Johnson, of South Dakota. A Congressional official briefed on the matter said Ms. White performed well at the gathering, and no major issues arose.

In the next round of meetings, she will face off with a more liberal arm of the committee known to scrutinize nominees. After meeting Mr. Brown, Ms. White is scheduled to see Senator Jeff Merkley, Democrat of Oregon. She also will meet Elizabeth Warren, the Massachusetts Democrat who is an outspoken critic of Wall Street, Ms. Warren’s office confirmed on Tuesday.

Even if Ms. White fails to satisfy lawmakers’ concerns, the meetings are an important step in clearing the way for her appointment.

“Senators will have a chance to size Mary Jo up, and I believe will come away with a great sense of comfort that she’s a candidate of true quality,” said Harvey Pitt, who passed through the confirmation process in 2001 to lead the S.E.C.

He noted that additional disclosures could bolster her candidacy. “I do think she will need to provide a level of comfort to the committee that she is aware of the issue, has a definitive plan for navigating through the potential conflict issues, and will be completely open about when she has a potential recusal issue, and how she has handled it,” he said.

Ms. White, a political independent, assured lawmakers in her questionnaire that she was “completely independent of political or personal influences.” She did disclose, however, $13,000 in campaign donations to Democratic candidates. She also served on the campaign committee of a Democrat who had run for New York attorney general.

Her ties to Debevoise — and its clients — are more significant; she represented JPMorgan Chase, UBS and Michael Geoghegan, the former head of HSBC.

Ms. White, 65, said this month said that she would retire from Debevoise after taking over the S.E.C. and would forgo the firm’s typical retirement perks: office space and a free BlackBerry. She also will sever financial ties to the firm during her term at the S.E.C., taking an upfront lump-sum retirement payment rather than collecting a monthly installment of $42,500.

Her husband has also offered concessions. He agreed to convert his partnership at Cravath, Swaine & Moore from equity to nonequity status and promised not to “communicate directly” with the S.E.C. about rule-making. Ms. White will not participate in a matter with a direct effect on his compensation.

In line with a standard move for federal appointees, Ms. White further agreed to recuse herself for one year from voting on enforcement cases involving Debevoise clients. There are limitations to the policy, though, in case it is “in the public interest” and a “reasonable” person would not object.

Some lawmakers dismiss questions about her potential conflicts, but still question her mastery of regulatory minutiae. While Ms. White is a skilled litigator, she lacks experience in financial rule-writing, unlike a predecessor, Mary Schapiro, a lifelong regulator who ran the S.E.C. for nearly four years.

In her questionnaire, Ms. White highlighted her role as a director of the Nasdaq exchange and other experiences that she said gave her “a firm grounding” in securities laws.

She also, inadvertently, drew a connection to Ms. Schapiro. Like Ms. Schapiro, Ms. White is an animal lover, currently serving as a board member of the American Society for the Prevention of Cruelty to Animals.

She agreed to step down from the board once she is sworn in at the S.E.C.

A version of this article appeared in print on 02/27/2013, on page B1 of the NewYork edition with the headline: Nominee For S.E.C. Tries to Allay Skepticism.

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India Ink: Image of the Day: Feb. 26

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Gadgetwise Blog: Q&A: Staying Safe From Java Threats

I hear lots of scary stuff about hackers getting into computers thru Java. What do I need to do to make my Mac and PC safe? Any worries about tablets?

Java is a computing platform with its own programming language that is used in many games, business applications and other utilities. It runs on more than 850 million computers worldwide and is used often by Web browsers. Recent attacks on Apple and Facebook used a flaw in the Java Web browser plug-in to infect computers with malicious software when visiting certain sites, and the Department of Homeland Security even issued a warning about Java back in January.

Computers running Windows, Mac OS X and Linux are most at risk. Tablets running systems like Android and iOS are not generally affected; mobile browsers have a setting for the JavaScript programming language, but JavaScript is basically unrelated to Java and its not subject to the current malware issues.

Disabling Java in your Web browser should protect your computer from the recent types of security threats, although you may not be able to play certain games or use Java-dependent applications. Oracle, which develops Java, has instructions for disabling Java in several browsers on Windows, Mac and Linux systems. Independent security sites, like Krebs on Security and Sophos, have additional information.

Apple released its own Mac OS X update to deal with the Java problem on Feb. 19, and the Macworld site has an article on going beyond the browser plug-in and removing Java altogether. Oracle has instructions for uninstalling Java completely on a Windows system, as well as on a Mac.

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Recipes for Health: Roasted Carrots and Scallions — Recipes for Health

Andrew Scrivani for The New York Times

I bought incredibly sweet, thick red scallions and multicolored bunches of carrots from a farmer at my market and roasted them with fresh thyme. Then I sprinkled on some crushed toasted hazelnuts, which contributed a nice crunchy texture and nutty finish to the dish. If you have a bottle of hazelnut oil or walnut oil on hand, a small drizzle just before serving is a welcome touch.

1 ounce hazelnuts (about 1/4 cup)

1 pound carrots, preferably young small carrots, any color (but a mix is nice)

1 bunch white or purple spring onions or scallions

Salt and freshly ground pepper

2 teaspoons fresh thyme leaves

2 tablespoons extra virgin olive oil

Optional: a drizzle of hazelnut oil or walnut oil for serving

1. Preheat the oven to 325 degrees. Place the hazelnuts on a baking sheet and roast for 8 to 10 minutes, until they smell toasty and they are golden all the way through (cut one in half to check). Remove from the oven and turn up the heat to 425 degrees.

2. Immediately wrap the hazelnuts in a clean, dry dish towel. Rub them in the towel to remove the skins. Then place the skinned hazelnuts in a plastic bag or, if you have one, a disposable pastry bag and set on your work table in one layer. Use a rolling pin to crush the nuts by rolling over them with the pin. Set aside.

3. Line a sheet pan with parchment or oil a baking dish large enough to fit all of the vegetables in a single layer. If the carrots are small, just peel and trim the tops and bottoms. If they are medium-sized, peel, cut in half and cut into 4-inch lengths. Quarter large carrots and cut into 4-inch lengths. Trim the root ends and greens from the spring onions or scallions. If they are bulbous, cut them in half. Season with salt and pepper, add the thyme and olive oil and toss well, either directly on the pan or in the dish or in a bowl. Spread in an even layer in the baking dish or on the baking sheet.

4. Roast in the oven for 20 to 30 minutes, stirring every 10 minutes. The onions may be done after 10 minutes – they should be soft and lightly browned. Remove them from the pan if they are and hold on a plate. When the carrots and onions are tender and browned in places, remove from the oven. Add the onions back into the mix if you removed them and toss together. Sprinkle on the toasted ground hazelnuts, drizzle on the optional nut oil, and serve.

Yield: Serves 4

Advance preparation: The vegetables can hold for a few hours once roasted; cover and reheat in a medium oven.

Nutritional information per serving: 171 calories; 11 grams fat; 1 gram saturated fat; 1 gram polyunsaturated fat; 8 grams monounsaturated fat; 0 milligrams cholesterol; 16 grams carbohydrates; 6 grams dietary fiber; 89 milligrams sodium (does not include salt to taste); 2 grams protein

Martha Rose Shulman is the author of “The Very Best of Recipes for Health.”

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Recipes for Health: Roasted Carrots and Scallions — Recipes for Health

Andrew Scrivani for The New York Times

I bought incredibly sweet, thick red scallions and multicolored bunches of carrots from a farmer at my market and roasted them with fresh thyme. Then I sprinkled on some crushed toasted hazelnuts, which contributed a nice crunchy texture and nutty finish to the dish. If you have a bottle of hazelnut oil or walnut oil on hand, a small drizzle just before serving is a welcome touch.

1 ounce hazelnuts (about 1/4 cup)

1 pound carrots, preferably young small carrots, any color (but a mix is nice)

1 bunch white or purple spring onions or scallions

Salt and freshly ground pepper

2 teaspoons fresh thyme leaves

2 tablespoons extra virgin olive oil

Optional: a drizzle of hazelnut oil or walnut oil for serving

1. Preheat the oven to 325 degrees. Place the hazelnuts on a baking sheet and roast for 8 to 10 minutes, until they smell toasty and they are golden all the way through (cut one in half to check). Remove from the oven and turn up the heat to 425 degrees.

2. Immediately wrap the hazelnuts in a clean, dry dish towel. Rub them in the towel to remove the skins. Then place the skinned hazelnuts in a plastic bag or, if you have one, a disposable pastry bag and set on your work table in one layer. Use a rolling pin to crush the nuts by rolling over them with the pin. Set aside.

3. Line a sheet pan with parchment or oil a baking dish large enough to fit all of the vegetables in a single layer. If the carrots are small, just peel and trim the tops and bottoms. If they are medium-sized, peel, cut in half and cut into 4-inch lengths. Quarter large carrots and cut into 4-inch lengths. Trim the root ends and greens from the spring onions or scallions. If they are bulbous, cut them in half. Season with salt and pepper, add the thyme and olive oil and toss well, either directly on the pan or in the dish or in a bowl. Spread in an even layer in the baking dish or on the baking sheet.

4. Roast in the oven for 20 to 30 minutes, stirring every 10 minutes. The onions may be done after 10 minutes – they should be soft and lightly browned. Remove them from the pan if they are and hold on a plate. When the carrots and onions are tender and browned in places, remove from the oven. Add the onions back into the mix if you removed them and toss together. Sprinkle on the toasted ground hazelnuts, drizzle on the optional nut oil, and serve.

Yield: Serves 4

Advance preparation: The vegetables can hold for a few hours once roasted; cover and reheat in a medium oven.

Nutritional information per serving: 171 calories; 11 grams fat; 1 gram saturated fat; 1 gram polyunsaturated fat; 8 grams monounsaturated fat; 0 milligrams cholesterol; 16 grams carbohydrates; 6 grams dietary fiber; 89 milligrams sodium (does not include salt to taste); 2 grams protein

Martha Rose Shulman is the author of “The Very Best of Recipes for Health.”

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Wall Street Sheds Morning Gains

After beginning the day with a partial rebound from Monday’s steep drop, stocks on Wall Street gave up some of their gains Tuesday in the course of Congressional testimony by Ben S. Bernanke, the Federal Reserve chairman.

In afternoon trading, the Standard & Poor’s 500-stock index was up 0.1 percent, while the Dow Jones industrial average rose 0.6 percent. The Nasdaq composite index was down 0.2 percent.

In his prepared testimony before the Senate Banking Committee, Mr. Bernanke defended the Fed’s bond-buying program and said the economy was growing at a “moderate if somewhat uneven pace.” Senators were questioning him on the prospects for a global currency war and the potential economic effects of the latest budget impasse in Congress.

The major indexes fell more than 1 percent on Monday, with the S.&P. 500 recording its biggest daily drop since November. The falloff came as investors fretted that if Italy does not undertake reforms, the euro zone could once again be destabilized. The Euro Stoxx 50 index was off more than 3 percent in late trading Tuesday.

Groups in Italy opposed to economic reforms posted a strong showing in the recent election, resulting in a political deadlock with a comedian’s protest party leading the poll and no group securing a clear majority in Parliament.

“We’ve gone to an environment of political stability to instability, and until we get some type of clarity over who is in charge, which could take days, the market will have renewed concerns,” said Art Hogan, managing director of Lazard Capital Markets in New York.

Still, market participants speculated that a coalition government would eventually emerge in Italy and ease worries about a new euro zone crisis.

The early market gains suggested the recent trend of investors buying on dips would continue. Last week, concerns that the Federal Reserve might roll back its stimulus efforts earlier than expected prompted a sharp two-day decline, though equities recovered most of the lost ground by the end of the week.

“Investors are taking advantage of the drop, and once some kind of coalition government is formed, most of our concerns will be put to rest,” Mr. Hogan said.

Home Depot reported adjusted earnings and sales that beat expectations, sending shares up more than 5 percent.

Macy’s rose 3.1 percent after stating it expected full-year earnings to be above analysts’ forecasts because of strong sales in the holiday period.

For the benchmark S.&P. 500, 1,500 points will be watched as a key benchmark after the index closed below it on Monday for the first time since Feb. 4, with selling accelerating after falling below it. An inability to break back above it could portend further losses.

Financial shares may be among the most volatile, as that sector is closely tied to the pace of global economic growth. Morgan Stanley was one of the top percentage losers on the S.&P. on Monday, dropping more than 6 percent on concerns about the company’s exposure to European debt. It was up 0.4 percent.

This article has been revised to reflect the following correction:

Correction: February 26, 2013

Because of an editing error, an earlier version of this article misidentified the Senate panel before which Ben S. Bernanke, the Federal Reserve chairman, was testifying Tuesday. It was the Banking Committee, not the Finance Committee.

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South Korea’s Park Geun-hye Warns North Against Nuclear Pursuits

Park Jin-Hee/Getty Images

Park Geun-Hye, South Korea's president, salutes during her inauguration ceremony in front of the National Assembly building on Monday in Seoul.

SEOUL, South Korea — The country’s new president, Park Geun-hye, was sworn into office on Monday, facing far more complicated fissures both within South Korea and with North Korea than her father did during his Cold War dictatorship, which ended with his assassination 33 years ago.

Ms. Park, 61, is the first child of a former president to take power here, as well as the first woman, a remarkable turn for a country where Parliament, the cabinet and corporate board rooms are predominantly male and the gender income gap is the widest among member countries of the Organization for Economic Cooperation and Development.

In her address, Ms. Park called for the revival of an economic boom her father, Park Chung-hee, had once overseen and urged North Korea to abandon its nuclear weapons program.

After the ceremony, in front of the National Assembly, her motorcade moved through a downtown Seoul packed with well-wishers. Her return to the presidential Blue House, her childhood home, was a triumphant moment for her and old South Koreans loyal to her father. His quashing of dissent and censorship of the press in his 18-years of iron-fisted rulewere much maligned among South Koreans during the country’s struggle for democracy.

She was elected Dec. 19, thanks largely to the support of South Koreans in their 50s and older who grew disenchanted with fractured politics and recalled how, South Korea under the dictatorship had begun its evolution from a country where per-capita income was just $100 a year into what is now a global economic powerhouse whose smartphones, cars and ships are exported around the world.

But while her father, Ms. Park begins a single, five-year term facing sharp criticism from younger and liberal South Koreans who have no fear of speaking out. When she named Queen Elizabeth I of Britain as her role model, they filled blogswith derision for her sense of entitlement. They openly called her election a return to the past, arguing that the seeds of some of the country’s biggest problems, such as the unruly influence of family controlled conglomerates, were sown under her father and accused her of glorifying his rule.

South Korea’s political rivalries are freewheeling, evidenced most recently by the arrest of a 76-year-old Christian pastor last week who claimed that Ms. Park had sex with the North Korean leader Kim Jong-il during her visit to Pyongyang in 2002. His videotaped allegations were circulated widely through the Internet.

Meanwhile, two weeks before Ms. Park’s inauguration, North Korea detonated an underground nuclear device, testing her campaign promise to reach out to the North to help end five years of diplomatic silence and high tension on the divided Korean Peninsula under her predecessor, Lee Myung-bak, a fellow conservative.

In her inaugural address, “North Korea’s recent nuclear test is a challenge to the survival and future of the Korean people, and there should be no mistake that the biggest victim will be none other than North Korea itself.”

Speaking before a large crowd that was entertained by the rapper Psy of “Gangnam Style” fame on the lawn in front of the National Assembly, she urged North Korea to abandon its nuclear ambitions without delay, “instead of wasting its resources on nuclear and missile development and continuing to turn its back to the world in self-imposed isolation.”

Ms. Park invoked her father’s era, calling for a “second miracle on the Han River.” The first was the transformation under him of Seoul, the capital city, which straddles the river, from the rubble of the 1950-53 Korean War into an industrialized metropolis. He nurtured a handful of family controlled companies, such as Samsung and Hyundai, as engines of an export-driven economy. These companies have grown into globally recognized conglomerates.

Now, decades later, his daughter vowed to bring South Korea’s slowing economy “rejuvenation” and “revival,” terms favored under her father. But she nodded to the biggest complaints of ordinary South Koreans — widening economic inequality and the conglomerates’ overpowering expansion at the cost of smaller businesses — grievances, saying the second Han River miracle should be based on “economic democratization.”

Ms. Park promised to end unfair practices by big businesses and strengthen small and medium-sized enterprises so that “such businesses can prosper alongside large companies.”

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Disruptions: Disruptions: Google Flu Trends Shows Problems of Big Data Without Context

Several years ago, Google, aware of how many of us were sneezing and coughing, created a fancy equation on its Web site to figure out just how many people had influenza. The math works like this: people’s location + flu-related search queries on Google + some really smart algorithms = the number of people with the flu in the United States.

So how did the algorithms fare this wretched winter? According to Google Flu Trends, at the flu season’s peak in mid-January, nearly 11 percent of the United States population had influenza.

Yikes! Take vitamins. Don’t leave the house. Wash your hands. Wash them again!

But wait. According to an article in the science journal Nature, Google’s disease-hunting algorithms were wrong: their results were double the actual estimates by the Centers for Disease Control and Prevention, which put the coughing and sniffling peak at 6 percent of the population.

Kelly Mason, a public affairs spokeswoman for Google, said the company’s Flu Trends site was meant to be only one source in addition to the C.D.C. and other flu surveillance methods. “We review and potentially update our model each season,” she said.

Scientists have a theory about what went wrong, as well.

“Several researchers suggest that the problems may be due to widespread media coverage of this year’s severe U.S. flu season,” Declan Butler wrote in Nature. Then add social media, which helped news of the flu spread quicker than the virus itself.

In other words, Google’s algorithm was looking only at the numbers, not at the context of the search results.

In today’s digitally connected world, data is everywhere: in our phones, search queries, friendships, dating profiles, cars, food, reading habits. Almost everything we touch is part of a larger data set. But the people and companies that interpret the data may fail to apply background and outside conditions to the numbers they capture.

“Data inherently has all of the foibles of being human,” said Mark Hansen, director of the David and Helen Gurley Brown Institute for Media Innovation at Columbia University. “Data is not a magic force in society; it’s an extension of us.”

Society has encountered similar situations for centuries. In the 1600s, Dr. Hansen said, an early census was recorded in England as the Great Plague of London killed tens of thousands of Britons. To calculate the spread of the disease, officials started recording every christening and death in the city. And although this helped quantify the mortality rate, it also created other problems. There was now an astounding collection of statistical information for scientists to review and understand, but it took time to develop systems that could accurately assess the information.

Now, as we enter a world of big data, we have to learn how to apply context to these numbers.

Dr. Hansen said the problem of data without context could be summed up in a quote from the playwright Eugène Ionesco: “Of course, not everything is unsayable in words, only the living truth.”

I experienced this firsthand in the spring of 2010, when I was an adjunct professor at New York University teaching graduate students in the Interactive Telecommunications Program.

I created a class called “Telling Stories With Data, Sensors and Humans,” with the goal of determining whether sensors and data could become reporters and collect information. Students built little electronic contraptions with $30 computers called Arduinos, and attached several sensors, including ones that could detect light, noise and movement.

We wondered if we could use these sensors to determine whether students used the elevators more than the stairs, and whether that changed throughout the day. (Esoteric, sure, but a perfect example of a computer sitting there taking notes, rather than a human.)

We set up the sensors in some elevators and stairwells at N.Y.U. and waited. To our delighted surprise, the data we collected told a story, and it seemed that our experiment had worked.

As I left campus that evening, one of the N.Y.U. security guards who had seen students setting up the computers in the elevators asked how our experiment had gone. I explained that we had found that students seemed to use the elevators in the morning, perhaps because they were tired from staying up late, and switch to the stairs at night, when they became energized.

“Oh, no, they don’t,” the security guard told me, laughing as he assured me that lazy college students used the elevators whenever possible. “One of the elevators broke down a few evenings last week, so they had no choice but to use the stairs.”

E-mail: bilton@nytimes.com

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