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The efforts to protect thepeople of the United Stateshave sometimes clashed withthe Constitution.
ByBEN FINLEY 
STAFF WRITER
After Sept. 11, 2001, Americanswanted to feel protected again. But justhow much we are willing to give up forthat comfort has been a topic of debateever since.An attempted terror attack aboard aDetroit-bound Northwest Airlinesflight from Amsterdam on ChristmasDay is pushing that debate again toweigh the options of privacy and securi-ty.We have sent our sons and daugh-ters, wives and husbands to fight in twowars — in Iraq and Afghanistan. Wehave passed laws that allow law enforce-ment agencies such as the FBI to searchtelephone, e-mail and financial recordswithout court orders. We have held“enemy combatants’’ imprisoned indef-initely without charging them with acrime. And we have beefed up securityat railways, seaports and airports.Officials believe full-body scannerscould have detected the explosivematerials Umar Farouk Abdulmutallabof Nigeria is accused of trying to igniteaboard a Northwest Airlines flight onChristmas. Although the Dutch airporthad those scanners, they were not usedto scan him. In Europe, as well ashere in the U.S., privacy concernsover the scanners’ ability to seethrough clothing have kept themfrom widespread use.For many Americans, the legacy of Sept. 11 has been the argument overwhether U.S. efforts to ensure nationalsecurity are justified and whether theycompromise people’s civil liberties andcivil rights.
 See
DECADE,
 Page
A4
JANUARY 3, 2010
The best moviesand music of 2009
LIFE D1 
Top-ranked Kansasrolls over Temple
SPORTS C1 
Eagles, Cowboys meetfor NFC East title
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BUCKS COUNTY
Vol. 101, No. 2
©
2010 Courier Times, Inc.
The Courier Times is printed in parton recycled paper and is recyclable.
INDEX:
Automotive
G1
|
Crossword
G4 |
Dear Abby
D2 |
Job Search
G7 |
Money
 A10 |
Movies
D3 |
Obituaries
B7-9 |
Opinion
 A12 |
Bucks Homes
G10 |
Television
inside |
Travel
H1
Mexico capturesalleged drug lord
Mexican police have capturedalleged drug lord Carlos BeltranLeyva, just two week after his evenmore powerful brother was killed in ashootout with troops — back-to-backvictories in President FelipeCalderon’s drug war.The Public Safety office said in astatement Saturday night that CarlosBeltran Leyva was arrested inCuliacan, the capital of the Pacificcoast state of Sinaloa, where he andseveral of his brothers were born andallegedly started their gang. Two weeksago, his brother Arturo, reputed chief of the Beltran Leyva Cartel, was killedin a shootout with Mexican marines inthe central city of Cuernavaca.Mexican officials in the past havedescribed Carlos Beltran as a keymember of the gang, but it wasunclear if he took over as chief of thecartel after his brother died. A thirdbrother, Alfredo Beltran Levya, wasarrested in January 2008.
Pa. Turnpike usersnow paying more
The cost of traveling thePennsylvania Turnpike has gone up.A 3 percent toll increaseannounced a year ago went into effectat 12:01 a.m. today. It marks the sev-enth increase in nearly 70 years.Turnpike officials say the extrarevenue will go toward improvementsto off-turnpike roads and bridges.The most common cash rate forpassenger vehicles will increase from95 cents to $1.Meanwhile, the most-commoncash rate for class-five commercialvehicles will increase from $7.85 to$8.10.
Identical twins bornin separate decades
Identical twin boys in Florida willget to celebrate their birthdays indi-vidually after they were born in sepa-rate decades.Margarita Velasco delivered thetwins by cesarean section at TampaGeneral Hospital.Marcello was delivered just beforemidnight. His twin, Stephano, wasdelivered just as the new year began.Their father Juan says it’ll be goodfor each boy to have his own birthdayparty.The twins are in intensive carebecause they were born about 10weeks early. Doctors say they’ll get togo home in about eight weeks.
Cops: Driver cookedmeth in back seat
Police say a driver passed out inhis car at a Tennessee gas stationwhile a batch of methamphetaminewas cooking in the back seat.An employee at the gas station inMurfreesboro, about 30 miles south-east of Nashville, called policebecause the car was sitting at thepump for about an hour on NewYear’s Day.Police say a chemical process tomake the drug was in progress. Somemeth-making ingredients can beexplosive.Thirty-one-year-old Nathan E.Beasley is being held on a $15,000bond on charges of driving under theinfluence, driving on a suspendedlicense, reckless endangerment andmanufacturing meth.
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Driver in fatal crash charged
Philadelphia police say JesseMaiden, 35, of Middletown,was under the influencewhen his Jeep hit another caron I-95 shortly after 3 a.m.New Year’s Day.
ByMATT COUGHLIN
STAFF WRITER
A Middletown-area man is in prisonafter he allegedly killed two peoplewhen he smashed his Jeep Cherokeeinto another car on I-95 in Philadelphiashortly after 3 a.m. New Year’s Day.Police said Jesse Maiden, 35, of Durham Road in Middletown, wasunder the influence at the time.According to state police, JosephIsaac Price, 59, of Philadelphia, was inthe northbound lanes of I-95 near theBridge Street exit in Philadelphia whenhis Dodge minivan was disabled by aflat tire in the left lane. NormanWilkerson, 45, slowed but struck Price’sminivan in the rear, police said. AsPrice, Wilkerson and Wilkerson’s pas-senger, 47-year-old Maria Cox, waitedfor police, Maiden’s Jeep Cherokeeslammed into Wilkerson’s FordContour, according to state police.The wreckage of the crash wasstrewn across the roadway. Wilkersonand Cox were killed. Police said thatPrice’s neck was broken.Inside Maiden’s Jeep, police foundcocaine and marijuana, according topublished reports.Maiden has been charged with twocounts of homicide by vehicle whileDUI, two counts of homicide by vehi-cle, aggravated assault by vehicle whileDUI, recklessly endangering anotherperson, drug offenses and DUI, accord-ing to court records. He was sent toprison on a total of $650,000 bail.Maiden has prior arrests for theft,burglary and drug possession and wassentenced to two to 12 months in prisonin 2005, court records indicate. He wascited for a turning violation last year.Maiden’s passenger, Kristen MarieParis, 21, also was arrested. Paris waswanted on prostitution charges, policesaid. She has prior prostitution convic-tions and was found guilty of obstruct-ing a highway in October, a summaryoffense for standing in the road.
Matt Coughlin can be reached at 215-949-4172or mcoughlin@phillyBurbs.com.
A Middletownman is charged
with two countsof homicide byvehicle after policesaid he causedthis accident onI-95 early NewYear’s Day inPhiladelphia
DAVID GARRETT
STAFFPHOTOGRAPHER
Obama: Al-Qaidaplannedattack
The president said it wasnot the first time theU.S. was targeted by theYemen-based terror group.
ByPHILIP ELLIOTT
ASSOCIATED PRESS
HONOLULU — An al-Qaida affili-ate in Yemen apparently ordered theChristmas Day plot against a U.S. air-liner, training and arming the 23-year-old Nigerian man accused in the failedbombing, President Barack Obama saidSaturday.“This is not the first time this grouphas targeted us,” Obama said, reportingon some of the findings of an adminis-tration review into how intelligenceagencies failed to prevent Umar FaroukAbdulmutallab from boarding Detroit-bound Northwest Flight 253.In his most direct public language todate, Obama described the paththrough Yemen of Abdulmutallab. Healso emphasized that the United Stateswould continue its partnerships withfriendly countries — citing Yemen, inparticular — to fight terrorists and
 See
OBAMA,
 Page
A6
HEALTH
Subtle signslengthen women’s heartattack care
Fewer than 30 percent of U.S.women reported chest painor discomfort before a heartattack, and 43 percent report-ed having no chest pain dur-ing any phase of the attack,according to a NationalInstitutes of Health study.
ByJO CIAVAGLIA
STAFF WRITER
When cardiologist Dr. StevenGuidera noticed that women experienc-ing a heart attack took an average 13minutes longer than men to undergo aroutine procedure to unblock the arter-ies, he wondered what was behind thedelay.Did the time of day make a differ-ence? Was there a holdup in transfer-ring women to the cardiac catheteriza-tion labs? Are women’s smaller bloodvessels a factor?
 See
HEART,
 Page
A2
From Y2K to H1N1: Security
ASSOCIATED PRESS FILE PHOTO
Former Homeland Security chief TomRidge
said measures to increase oursecurity do not have to come at theexpense of our civil rights.
Fact:
1,002 nonofiction bookshave been written about the Sept. 11,2001 terrorist attacks, according  to Amazon.com.
COURIER TIMES FILE PHOTO
SWAT team members
make their way down a corridor in Pennridge South Middle School during a training exercisein 2001.Security concerns have been a huge issue in the past decade.
S
EARCHINGFORSECURITY
Mummers usherin the new year.
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What Guidera found is thedifference wasn’t related to treat-ment, rather diagnosis. Womenwaited twice as long as men inthe ER before undergoing thetest that confirms a heart attack.As a result of the discovery,Doylestown Hospital and itsheart care center have initiatedboth an in-house and communi-ty awareness campaign empha-sizing the atypical heart attacksymptoms that many womenexperience.Most health care professionalsconsider chest pain the mostobvious heart attack symptom,but among women the mostcommonly reported signs wereunusual fatigue, sleep distur-bance and shortness of breath,according to a recent NationalInstitutes of Health study.Fewer than 30 percent of women reported chest pain ordiscomfort before a heart attack,and 43 percent reported havingno chest pain during any phaseof the attack, according to theNIH study.The study also found thatwomen have more unrecognizedheart attacks than men and theyare more likely to be “mistaken-ly diagnosed and dischargedfrom emergency departments.”Any cardiologist will tell you,time is muscle. The faster youopen a blocked artery, the lessmuscle damage. That means thefaster you can diagnosis a heartattack, the better the patient out-come.Like other hospitals,Doylestown routinely reviewshow long it takes before anartery is unblocked in a patientexperiencing a heart attack, atime frame called door-to-bal-loon. The goal is faster treat-ment.Other area hospitals reportvarious results for door-to-bal-loon times for men versuswomen.St. Mary Medical Center inMiddletown says it isn’t seeingtreatment time differences. AtHoly Redeemer Medical Centerand Hospital in Abington, theaverage response time for womenwas 5 minutes faster than menthis year — 70 minutes versus 75for men.Few national studies havelooked at gender differences indoor-to-balloon times and mostinvolved Medicare patients.Guidera analyzed data for 106patients of various ages whoexperienced heart attack symp-toms in 2008 through this year;he also examined the timing foreach part of the process.What he found is that averagetime for men was 66 minutesfrom the time they entered theemergency department until theartery was unblocked. Forwomen the average was 79 min-utes.Both times are below the 90-minute standard the AmericanCollege of Cardiology recom-mends, but the discrepancy dis-turbed Guidera. The main rea-son for the time difference isthat women waited an average of 8 minutes for an EKG, whilemen waited 4 minutes.“It was a sizable difference,statistically significant,” he said.Especially since, once thediagnosis was made, men andwomen had virtually identicalaverage times in all other phasesof treatment.
TOUGHING IT OUT
Guidera believes the door-to-EKG time discrepancy betweenmen and women reflects a long-standing gender bias in the med-ical community.Simply put, health careproviders don’t take women’ssymptoms as seriously. One rea-son is that often women experi-ence more subtle heart attacksigns.“It’s not due to less concernabout health concerns inwomen,” Guidera said. “It’s dueto a long standing lack of recog-nition of the importance of heartdisease in women.”Women’s symptoms, whichcaninclude nausea, shortness of breath or dizziness, often don’tcause alarm in the triage processto rush the patient to an EKG, hesaid. Sometimes even the patientdoesn’t know she is having a heartattack, so she doesn’t complain.“Women are tougher thanguys,” said John Mitchell, execu-tive director for cardiovascularservices for the Heart Institute of Doylestown Hospital. “They’llcome and sit down in the emer-gency room and not say any-thing.”A few years ago, a woman satin the Doylestown Hospital’s ERfor longer than 10 minutes — therecommended door-to-EKG time— before a nurse asked her if shewas OK. The woman replied thatshe just didn’t feel right.Tests revealed she was havinga heart attack; the woman sur-vived, Mitchell added.As a result of the findings,Doylestown Hospital and its heartcare center are implementing anin-house and community aware-ness campaign designed to ensurethat women experiencing heartattack symptoms get a rapid EKG.Frontline triage nursing staff is undergoing more training andeducation to heighten awarenessof the subtle heart attack symp-toms women can experience,Guidera and Mitchell said. Thehospital launches a communityawareness campaign called“Hear her Heart” in February.The study findings alsoimpressed the American HeartAssociation, which invitedGuidera and his 16- year-olddaughter, Jennifer, who did thestatistical analysis of the data, topresent the study at its annualnational convention inNovember.“Dr. Guidera is really righton the money here,” said Dr.Howard Eisen, chief cardiologistat Drexel University School of Medicine and an AmericanHeart Association board mem-ber.The medical community firstrecognized the symptom differ-ences in women about 20 yearsago, but until recently womenhad consistently worse heartattack outcomes, in part, becauseof the difference in medicalresponse time, Eisen said.About half of women experi-encing heart attacks do not haveclassic chest-pain related symp-toms and, as a result, health careprofessionals do not always treatwomen as aggressively as men,he said. Women not only need tobe more aware of heart attacksymptoms but also need to bemore vocal about them, includ-ing insisting on an EKG.“Everyone needs to be theirown advocate,” Eisen added.“The medical profession needsto be more aware.”
Jo Ciavaglia can be reached at 215-949-4181 or jciavaglia@phillyBurbs.com.
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Heart
Continued from Page A1
WOMEN’S MAJOR SYMPTOMSPRIOR TO A HEART ATTACK INCLUDE:
■
Unusual fatigue
■
Disturbed sleep
■
Shortness of breath
■
Indigestion
■
Anxiety
WOMEN’S MAJOR SYMPTOMSDURING A HEART ATTACK INCLUDE:
■
Shortness of breath
■
Weakness
■
Unusual fatigue
■
Cold sweat
■
Dizziness
ATYPICAL SYMPTOMS WOMENMAY EXPERIENCE DURING AHEART ATTACK:
■
Lower chest discomfort
■
Upper abdominal pressure ordiscomfort that may feel likeindigestion
■
Back pain
CLASSIC CHEST-RELATEDHEART ATTACK SIGNS:
■
Pressure, fullness or asqueezing pain in the center of thechest, which may spread to theneck, shoulder or jaw
■
Chest discomfort withlightheadedness, fainting, sweating,nausea or shortness of breath
Source:National Institutes of Health
RICK KINTZEL / 
STAFF PHOTOGRAPHER
Doylestown Hospital cardiologist
Dr.Steven Guidera, withstatistical help from daughter Jennifer, 16, presented a study thatshowed women wait longer for care after a heart attack because thesigns of an attack are different than those in men.
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BY GARY D. ROBERTSON
ASSOCIATED PRESS
DURHAM, N.C. — Indozens of states, Gary Richardswouldn’t have been able to lightup a Marlboro before tuckinginto his meat-lover’s pizza, as hedid at Satisfaction Restaurant &Bar this week. But in NorthCarolina, the nation’s leadingtobacco producer, limits onindoor smoking have laggedbehind those in much of thecountry.That changed Saturday, whensmoking in restaurants and barswas banned in the state that ishome to two major tobacco com-panies and where the golden leaf helped build Duke and WakeForest universities.“There’s smokers and there’snonsmokers. We’ve gotten alongin the past,” Richards, 52, saidthis week during a pre-mealsmoke at the restaurant inside aformer tobacco warehouse.“Why can’t I come in here andhave my beer and a couple of slices of pizza and a cigarette?”The dangers of secondhandsmoke to employee health andcomplaints from patrons aboutthe smell finally won out whenthe Legislature approved the banin 2009 after years of failures.“This law doesn’t tell any-body they shouldn’t smoke,”said state Rep. Hugh Holliman,a lung cancer survivor whose sis-ter died of lung cancer. He ledthe charge for the legislation.“It’s saying nonsmokers shouldhave the same right to breatheclean air.”North Carolina is a relativelatecomer to tobacco prohibi-tions in public places. NorthCarolina is at least the 29th stateto ban smoking in restaurantsand 24th for bars, according tothe American Lung Association.The new prohibitions repre-sent a dramatic turn for a statethat produces nearly half of thenation’s tobacco.The headquarters for R.J.Reynolds Tobacco Co. andLorillard Inc. remain in NorthCarolina, where colonists begangrowing tobacco in the 1600s.The leaf became the top cashcrop by far for eastern NorthCarolina farmers.But the golden leaf’s role haschanged dramatically as the stateshifted from a predominantlyagricultural economy to one ledby manufacturing, and mostrecently by services and technol-ogy.In 1978, tobacco accountedfor 34 percent of all farm incomein North Carolina, or $1.1 bil-lion. Thirty years later tobaccoproduction fell to $687 million,or only 7 percent of farmincome, according to federalagricultural data. The amount of tobacco grown also fell duringthe same period from about 850million pounds to 390 millionpounds.Still, about 21 percent of thestate’s adult population smokedin 2008, compared to 18 percentnationwide, according to theCenters for Disease Control andPrevention.Other traditional tobacco-growing states have few, if any,statewide restrictions on smok-ing in public places and worksites. Virginia passed a statewideban that took effect Dec. 1 butrestaurants and bars can getaround it if they have separateventilation systems for smokingand nonsmoking sections.“Nationally, it’s a huge step,”said Thomas Carr, the lung asso-ciation’s national policy manag-er. “It just proves that if NorthCarolina can do it, then any statecan prohibit smoking in barsand restaurants.”The state mailed packets to24,000 restaurants and bars,including “no smoking” signsthey must post. The changesbegan Saturday so they didn’tinterfere with New Year’s cele-brations. Nonprofit private clubsand most cigar bars are exempt.Smokers who refuse to snuff out and scofflaw owners andmanagers face fines.Restaurant owners are gener-ally pleased with the ban, partic-ularly because it includes bars,according to Paul Stone with theNorth Carolina Restaurant andLodging Association. Many barswould have been exempt underprevious legislation that failed.
A3
BUCKS COUNTY COURIER TIMES
Sunday, January 3, 2010
WWW.COURIERTIMESNOW.COM
NATION
Tobacco-rich NC bans smoking in bars, restaurants
GOP: US willovercome war,recession
WASHINGTON (AP) —Senate Republican leader MitchMcConnell says the United Stateswill overcome war, recession anddouble-digit unemployment.Challenges will be met, betterdays are ahead and the nation’sleaders will unite for the com-mon good despite sometimessharp political disagreements,which are the hallmark of avibrant democracy, McConnellsaid in the GOP’s weekly radioand Internet address Saturday.“The new year always bringswith it renewed hope and a spiritof optimism — qualities thathave exemplified our nation andits people from the very start,”said McConnell, R-Ky.He drew a historical parallel,citing the colonial army of 230years ago winning a great mili-tary victory amid the exhaustionof a war in which the colonistswere facing impossible oddsagainst the British.“Powerful forces may bealigned against us ... but whenthe challenges are greatest,Americans always join ranks,”the senator said.Democrats and Republicanshave been sharply at odds overnumerous issues in the last year,from economic stimulus to ener-gy legislation to overhauling thehealth care system.
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