// a href = ./ //

ALMATY, Kazakhstan (AP) -- World powers began a new round of high-level talks with Iranian officials Tuesday, trying to find a way out of a yearslong tussle over Tehran's nuclear program and its feared ability to make atomic weapons in the future.

Few believe the latest attempt to forge a compromise will yield any major breakthroughs, but negotiators are optimistically casting it as a stepping stone toward reaching a workable solution.

Officials described the latest diplomatic discussions as a way to build confidence with Iran as the country steadfastly maintains its right to enrich uranium in the face of harsh international sanctions.

"The offer addresses the international concern on the exclusively peaceful nature of the Iranian nuclear program, but it is also responsive to Iranian ideas," said Michael Mann, spokesman for EU foreign policy chief Catherine Ashton, who is leading the negotiations. "We've put some proposals forward which will hopefully allow Iran to show some flexibility."

Mehdi Mohammadi, a member of the Iranian delegation, said Tehran was prepared to make an offer of its own to end the deadlock but will resist some of the West's core demands.

The Obama administration is pushing for diplomacy to solve the impasse but has not ruled out the possibility of military intervention in Iran to prevent it from acquiring a nuclear weapon. Israel has threatened it will use all means to stop Iran from being able to build a bomb, potentially as soon as this summer, raising the specter of a possible Mideast war.

A senior U.S. official at the talks said Monday that some sanctions relief would be part of the offer to Iran but refused to elaborate. The new relief is part of a package that the U.S. official said included "substantive changes."

The official acknowledged reports earlier this month that sanctions would be eased to allow Iran's gold trade to progress, but would neither confirm nor deny they are included in the new relief offer, and spoke only on condition of anonymity to discuss the sensitive diplomatic talks more candidly.

In a statement before the talks began Tuesday, the Interfax news agency cited Russia's envoy as saying the easing of sanctions was possible only if Iran can assure the world that its nuclear program is for exclusively peaceful purposes.

"There is no certainty that the Iranian nuclear program lacks a military dimension, although there is also no evidence that there is a military dimension," Russian Deputy Foreign Minister Sergei Ryabkov said.

China's Foreign Ministry said diplomacy offered the only route to resolve the dispute and called for all sides to show flexibility.

"We think the Iranian nuclear issue is very complicated and sensitive. All parties should have firm confidence in peacefully resolving the issue through dialogue and negotiation and take an objective and pragmatic attitude," Chinese Foreign Ministry spokeswoman Hua Chunying said at a daily briefing in Beijing.

Members of the Chinese and Iranian delegations met at a bilateral session before the main talks got under way.

Interfax cited an unidentified Iranian delegation member as saying Iran might also hold one-on-one talks with Russia, but ruled out direct negotiations with the United States in Almaty.

Officials from both sides have set low expectations for a breakthrough in Almaty - the first time the high-level negotiators have met since last June's meeting in Moscow that threatened to derail the delicate efforts.

While Mann acknowledged the Almaty talks would unlikely lead to a firm, he insisted that it remained an important stepping stone toward a definitive solution.

"We're not interested in talks just for talk's sake. We're not here to talk, we're here to make concrete progress," he said.

The first session talks are being held in private at a hotel in Almaty, Kazakhstan's largest city, and were deemed so sensitive that reporters were not allowed on the premises Tuesday save for a small handful of TV cameras and photographers allowed to watch Ashton greet Saeed Jalili, secretary of Iran's Supreme National Security Council.

The opening round Tuesday afternoon lasted 2 1/2 hours.

Tehran maintains it is enriching uranium only to make reactor fuel and medical isotopes, and insists it has a right to do so under international law. It has signaled it does not intend to stop, and U.N. nuclear inspectors last week confirmed Iran has begun a major upgrade of its program at the country's main uranium enrichment site.

Over the last eight months, the international community has imposed harsh economic sanctions on Iran that U.S. officials said have, among other things, cut the nation's daily oil output by 1 million barrels and slashed its employment rate. Western powers have hoped that the Iranian public would suffer under sanctions so the government would feel a moral obligation to slow its nuclear program.

The six world powers - United States, Russia, China, Britain, France and Germany -want Iran to suspend enrichment in its underground Fordo nuclear facility, and to ship its stockpile of high-grade uranium out of the country.

Mohammadi said that the shuttering of Fordo was "out of the question."

Negotiators hope that easing some of the sanctions will make Tehran more agreeable to halting production of 20 percent enriched uranium - the highest grade of enrichment that Iran has acknowledged and one that experts say could be turned into warhead grade in a matter of months.

Mohammadi said Iran would only agree to that stipulation on the condition of UN Security Council sanctions being suspended.

But an analysis released Monday by the International Crisis Group concluded that the web of international sanctions have become so entrenched in Iran's political and economic systems that they cannot be easily lifted piece by piece. It found that Tehran's clerical regime has begun adapting its policy to the sanctions, despite their crippling effect on the Iranian public. Doing so, the analysis concluded, has divided the public's anger "between a regime viewed as incompetent and an outside world seen as uncaring."

Iran has been unimpressed with earlier offers by the powers to provide it with medical isotopes and lift sanctions on spare parts for civilian airliners, and new bargaining chips that Tehran sees as minor are likely to be snubbed as well. Iran insists, as a starting point, that world powers must recognize the republic's right to enrich uranium.

© 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.

NEW YORK (AP) -- Dr. C. Everett Koop has long been regarded as the nation's doctor- even though it has been nearly a quarter-century since he was surgeon general.

Koop, who died Monday at his home in Hanover, N.H., at age 96, was by far the best known and most influential person to carry that title. Koop, a 6-foot-1 evangelical Presbyterian with a biblical prophet's beard, donned a public health uniform in the early 1980s and became an enduring, science-based national spokesman on health issues.

He served for eight years during the Reagan administration and was a breed apart from his political bosses. He thundered about the evils of tobacco companies during a multiyear campaign to drive down smoking rates, and he became the government's spokesman on AIDS when it was still considered a "gay disease" by much of the public.

"He really changed the national conversation, and he showed real courage in pursuing the duties of his job," said Chris Collins, a vice president of amfAR, the Foundation for AIDS Research.

Even before that, he had been a leading figure in medicine. He was one of the first U.S. doctors to specialize in pediatric surgery at a time when children with complicated conditions were often simply written off as untreatable. In the 1950s, he drew national headlines for innovative surgeries such as separating conjoined twins.

His medical heroics are well noted, but he may be better remembered for transforming from a pariah in the eyes of the public health community into a remarkable servant who elevated the influence of the surgeon general - if only temporarily.

"He set the bar high for all who followed in his footsteps," said Dr. Richard Carmona, who served as surgeon general a decade later under President George W. Bush.

Koop's religious beliefs grew after the 1968 death of his son David in a mountain-climbing accident, and he became an outspoken opponent of abortion. His activism is what brought him to the attention of the administration of President Ronald Reagan, who decided to nominate him for surgeon general in 1981. Though once a position with real power, surgeon generals had been stripped of most of their responsibilities in the 1960s.

By the time Koop got the job, the position was kind of a glorified health educator.

But Koop ran with it. One of his early steps involved the admiral's uniform that is bestowed to the surgeon general but that Koop's predecessors had worn only on ceremonial occasions. In his first year in the post, Koop stopped wearing his trademark bowties and suit jackets and instead began wearing the uniform, seeing it as a way to raise the visual prestige of the office.

In those military suits, he surprised the officials who had appointed him by setting aside his religious beliefs and feelings about abortion and instead waging a series of science-based public health crusades.

He was arguably most effective on smoking. He issued a series of reports that detailed the dangers of tobacco smoke, and in speeches began calling for a smoke-free society by the year 2000. He didn't get his wish, but smoking rates did drop from 38 percent to 27 percent while he was in office - a huge decline.

Koop led other groundbreaking initiatives, but perhaps none is better remembered than his work on AIDS.

The disease was first identified in 1981, before Koop was officially in office, and it changed U.S. society. It destroyed the body's immune system and led to ghastly death, but initially was identified in gay men, and many people thought of it as something most heterosexuals didn't have to worry about.

U.S. scientists worked hard to identify the virus and work on ways to fight it, but the government's health education and policy efforts moved far more slowly. Reagan for years was silent on the issue. Following mounting criticism, Reagan in 1986 asked Koop to prepare a report on AIDS for the American public.

His report, released later that year, stressed that AIDS was a threat to all Americans and called for wider use of condoms and more comprehensive sex education, as early as the third grade. He went on to speak frankly about AIDS in an HBO special and engineered the mailing of an educational pamphlet on AIDS to more than 100 million U.S. households in 1988.

Koop personally opposed homosexuality and believed sex should be saved for marriage. But he insisted that Americans, especially young people, must not die because they were deprived of explicit information about how HIV was transmitted.

Koop's speeches and empathetic approach made him a hero to a wide swath of America, including public health workers, gay activists and journalists. Some called him a "scientific Bruce Springsteen." AIDS activists chanted "Koop, Koop" at his appearances and booed other officials.

"I was walking down the street with him one time" about five years ago, recalled Dr. George Wohlreich, director of the College of Physicians of Philadelphia, a medical society with which Koop had longstanding ties. "People were yelling out, `There goes Dr. Koop!' You'd have thought he was a rock star."

Koop angered conservatives by refusing to issue a report requested by the Reagan White House, saying he could not find enough scientific evidence to determine whether abortion has harmful psychological effects on women.

He got static from some staff at the White House for his actions, but Reagan himself never tried to silence Koop. At a congressional hearing in 2007, Koop spoke about political pressure on the surgeon general post. He said Reagan was pressed to fire him every day.

After his death was reported Monday, the tributes poured forth, including a statement from New York Mayor Michael Bloomberg, who has made smoking restrictions a hallmark of his tenure.

"The nation has lost a visionary public health leader today with the passing of former Surgeon General C. Everett Koop, who was born and raised in Brooklyn," Bloomberg said. "Outspoken on the dangers of smoking, his leadership led to stronger warning labels on cigarettes and increased awareness about second-hand smoke, creating an environment that helped millions of Americans to stop smoking - and setting the stage for the dramatic changes in smoking laws that have occurred over the past decade."

Dr. Anthony Fauci of the National Institutes of Health taught Koop what was known about AIDS during quiet after-hours talks in the early 1980s and became a close friend.

"A less strong person would have bent under the pressure," Fauci said. "He was driven by what's the right thing to do."

Carmona, a surgeon general years later, said Koop was a mentor who preached the importance of staying true to the science in speeches and reports - even when it made certain politicians uncomfortable.

"We remember him for the example he set for all of us," Carmona said.

Koop's nomination originally was met with staunch opposition. Women's groups and liberal politicians complained Reagan had selected him only because of his conservative views, especially his staunch opposition to abortion.

Foes noted that Koop traveled the country in 1979 and 1980 giving speeches that predicted a progression "from liberalized abortion to infanticide to passive euthanasia to active euthanasia, indeed to the very beginnings of the political climate that led to Auschwitz, Dachau and Belsen."

But Koop, a devout Presbyterian, was confirmed as surgeon general after he told a Senate panel he would not use the post to promote his religious ideology. He kept his word and eventually won wide respect with his blend of old-fashioned values, pragmatism and empathy.

Koop was modest about his accomplishments, saying before leaving office in 1989, "My only influence was through moral suasion."

The office declined after that. Few of his successors had his speaking ability or stage presence. Fewer still were able to secure the support of key political bosses and overcome the meddling of everyone else. The office gradually lost prestige and visibility, and now has come to a point where most people can't name the current surgeon general. (It's Dr. Regina Benjamin.)

Even after leaving office, Koop continued to promote public health causes, from preventing childhood accidents to better training for doctors.

"I will use the written word, the spoken word and whatever I can in the electronic media to deliver health messages to this country as long as people will listen," he promised.

In 1996, he rapped Republican presidential hopeful Bob Dole for suggesting that tobacco was not invariably addictive, saying Dole's comments "either exposed his abysmal lack of knowledge of nicotine addiction or his blind support of the tobacco industry."

He maintained his personal opposition to abortion. After he left office, he told medical students it violated their Hippocratic oath. In 2009, he wrote to Senate Majority Leader Harry Reid, urging that health care legislation include a provision to ensure doctors and medical students would not be forced to perform abortions. The letter briefly set off a security scare because it was hand delivered.

Koop served as chairman of the National Safe Kids Campaign and as an adviser to President Bill Clinton's health care reform plan.

Worried that medicine had lost old-fashioned caring and personal relationships between doctors and patients, Koop opened an institute at Dartmouth College in New Hampshire to teach medical students basic values and ethics. He also was a part-owner of a short-lived venture, drkoop.com, to provide consumer health care information via the Internet.

Koop was the only son of a Manhattan banker and the nephew of a doctor. He said by age 5 he knew he wanted to be a surgeon and at age 13 he practiced his skills on neighborhood cats. He attended Dartmouth, where he received the nickname Chick, short for "chicken Koop." It stuck for life.

He received his medical degree at Cornell Medical College, choosing pediatric surgery because so few surgeons practiced it. In 1938, he married Elizabeth Flanagan, the daughter of a Connecticut doctor. They had four children. Koop's wife died in 2007, and he married Cora Hogue in 2010.

He was appointed surgeon-in-chief at Children's Hospital in Philadelphia and served as a professor at the University of Pennsylvania School of Medicine. He pioneered surgery on newborns and successfully separated three sets of conjoined twins. He won national acclaim by reconstructing the chest of a baby born with the heart outside the body.

Although raised as a Baptist, he was drawn to a Presbyterian church near the hospital, where he developed an abiding faith. He began praying at the bedside of his young patients - ignoring the snickers of some of his colleagues.

---

Contributing to this report were Associated Press writers Wilson Ring in Montpelier, Vt.; Jeff McMillan in Philadelphia; and AP Medical Writer Lauran Neergaard in Washington.

© 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.

WASHINGTON (AP) -- Popping calcium and vitamin D pills in hopes of strong bones? Healthy older women shouldn't bother with relatively low-dose dietary supplements, say new recommendations from a government advisory group.

Both nutrients are crucial for healthy bones and specialists advise getting as much as possible from a good diet. The body also makes vitamin D from sunshine. If an older person has a vitamin deficiency or bone-thinning osteoporosis, doctors often prescribe higher-than-normal doses.

But for otherwise healthy postmenopausal women, adding modest supplements to their diet - about 400 international units of D and 1,000 milligrams of calcium - don't prevent broken bones but can increase the risk of kidney stones, the U.S. Preventive Services Task Force said Monday.

It isn't clear if those doses offer bone protection if taken before menopause, or if they help men's bones, the guidelines said.

What about higher-dose supplements that have become more common recently? There's not enough evidence to tell if they would prevent fractures, either, in an otherwise healthy person, the panel concluded. It urged more research to settle the issue.

It's a confusing message considering that for years, calcium and vitamin D supplements have been widely considered an insurance policy against osteoporosis, with little down side to taking them.

"Regrettably, we don't have as much information as we would like to have about a substance that has been around a long time and we used to think we understood," said Dr. Virginia Moyer of the Baylor College of Medicine, who heads the task force. "Turns out, there's a lot more to learn."

The main caution: These recommendations aren't for people at high risk of weak bones, including older adults who have previously broken a bone and are at risk for doing so again, said Dr. Sundeep Khosla of the American Society for Bone and Mineral Research. Those people should consult a doctor, said Khosla, a bone specialist at the Mayo Clinic who wasn't part of the panel's deliberations.

Calcium and vitamin D work together, and you need a lifetime of both to build and maintain strong bones. Vitamin D also is being studied for possibly preventing cancer and certain other diseases, something that Monday's guidelines don't address and that other health groups have cautioned isn't yet proven.

For now, national standards advise the average adult to get about 1,000 mg of calcium, 1,300 for postmenopausal women, every day. For vitamin D, the goal is 600 IUs of vitamin D every day, moving to 800 after age 70, according to the Institute of Medicine, which set those levels in 2010. The nutrients can come from various foods, including orange juice fortified with calcium and D; dairy foods such as milk, yogurt and cheese; certain fish including salmon; and fortified breakfast cereals. Harder to measure is how much vitamin D the body also produces from sunshine.

Most people should get enough calcium from food, said Mayo's Khosla. But while he cautions against too high doses, he frequently tells his patients to take a multivitamin because it's harder to get vitamin D from food and during the winter.

While supplement science gets sorted out, the task force's Moyer advises healthy seniors to exercise - proven to shore up bones and good for the rest of the body, too.

--- Online: HTTP://WWW.USPREVENTIVESERVICESTASKFORCE.ORG/RECOMMENDATIONS.HTM © 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.