Senate conducts opinion marathon on healthcare

John Whitesides and Donna Smith WASHINGTON Wed Mar 24, 2010 6:40pm EDT Factbox Factbox: Proposed Republican amendments to health billWed, Mar twenty-four 2010 Related News U.N. health classification praises U.S. health reformsWed, Mar twenty-four 2010

President Obama gives a ""high five"" to eleven year-old Marcelas Owens, of Seattle, after holding a convene celebrating the thoroughfare and signing in to law of the Patient Protection and Affordable Care Act health word remodel check whilst at the Interior Department in Washington, Mar 23, 2010.

Credit: Reuters/Larry Downing

WASHINGTON (Reuters) - The U.S. Senate launched a last marathon event on healthcare remodel on Wednesday, with Republicans forcing Democrats in to a array of politically formidable votes prior to senators can pass the last changes to the turning point law.

U.S.&&&&Barack Obama&&&&Health&&&&Healthcare Reform

The day after President Barack Obama sealed a unconditional renovate of the $2.5 trillion healthcare system, the Senate raced to finish a messenger package of changes sought by Obama and Democrats in the House of Representatives.

Republicans offering at slightest dual dozen amendments written to derail the package or force Democrats to take a formidable domestic position prior to November"s congressional elections.

Democrats killed the initial legislative addition -- grouping Medicare assets be put without delay behind in to the sovereign health plan for the aged -- on a 56-42 opinion and betrothed to reject them all in an around-the-clock "vote-a-rama" scheduled to last in to early Thursday.

The Senate"s capitulation of even one legislative addition would send the total package behind to the House for an additional vote, only days after the House upheld the unconditional $940 billion renovate in a close opinion that capped a yearlong domestic struggle.

"Make no mistake, the vigilant of each singular one of the amendments on the alternative side of the aisle is to kill healthcare reform," pronounced Max Baucus, Democratic authority of the Senate Finance Committee.

The Republican amendments embody proposals to repudiate erectile dysfunction drug to sex offenders, to safeguard that word premiums do not enlarge underneath the check and to forestall taxation hikes for family groups earning less than $250,000.

The opinion on last thoroughfare could be hold in the post-midnight hours on Thursday, or hold over to the illumination on Thursday.

Senate Democratic personality Harry Reid ridiculed the Republican try to force Democrats in to politically annoying stances.

"How vicious can they be?" Reid pronounced of Republicans. "Offering an legislative addition traffic with Viagra for rapists?"

Republicans betrothed to keep fighting the renovate and pronounced the amendments were written to urge a check that even Democrats determine needs fixing.

"SEE WHAT"S BEING DONE"

"This is called a fix-it bill. We"re suggesting you repair it," pronounced Judd Gregg, the ranking Republican on the Senate Budget Committee, rejecting Democratic claims that promulgation the check behind to the House would be a genocide sentence.

"That is absurd," he said. "We have referred to a array of amendments that will significantly urge this bill."

The package of changes to the healthcare overhaul, authorized in the House on Sunday, embody an enlargement of subsidies to have word some-more affordable and some-more state assist for the Medicaid module for the poor.

It additionally would discharge a argumentative Senate understanding exempting Nebraska from profitable for Medicaid enlargement costs, close a "doughnut hole" in medication drug coverage and cgange a Jan understanding on a taxation on high-cost word plans.

The last package would magnify taxes for Medicare, the sovereign health word module for the aged and disabled, to unmerited income. It additionally includes an renovate of the tyro loan program.

The renovate sealed by Obama represents the greatest changes to the healthcare complement in 4 decades. It expands word coverage to 32 million Americans and imposes new word regulations similar to exclusive companies from refusing to cover patients with pre-existing healing conditions.

The health word industry has been vicious of the plan, but the Morgan Stanley Healthcare Payor index of health insurers has risen about 1 percent given thoroughfare as investors were speedy that distinctness on health remodel was nearby and the check avoided worst-case scenarios.

The quarrelsome healthcare plead in the House still echoed in the Capitol on Wednesday. House Democratic leaders met with Capitol law coercion officials to plead security after genocide threats and acts of assault opposite lawmakers accompanied the week end vote.

Bricks were tossed by the windows of one member"s office, whilst an additional lawmaker was squabble at by a protester on Capitol Hill and an additional was the aim of a secular slur. Democrats called on Republicans to reject the attacks.

"It"s some-more unfortunate to me that Republican care has not cursed these attacks and instead appears to be fanning the abandon with coded rhetoric," pronounced House Rules Committee Chairwoman Louis Slaughter.

Obama sealed an senior manager sequence reaffirming a anathema on utilizing sovereign supports to compensate for abortions, piece of a understanding with about a half-dozen anti-abortion House Democrats that won their await on Sunday.

The Democratic termination rights opponents in the House had pronounced they were endangered the restrictions on sovereign termination appropriation were not clever sufficient in the healthcare bill.

(Additional stating by Thomas Ferraro, Lewis Krauskopf, David Morgan; Editing by David Alexander and Peter Cooney)

U.S. Barack Obama Health Healthcare Reform for acne crude associations between acne and high intake of chocolate and chips and low intake of vegetables

Argentina goes to UN as Falklands row escalates

Argentinas unfamiliar apportion is to encounter UN Secretary-General Ban Ki-moon currently as tensions rose over British oil scrutiny off the Falkland Islands.

Jorge Taiana will encounter Mr Ban at 3.30pm New York time (8.30pm British time), the bureau of the orator for the Secretary-General said.

The Argentinian unfamiliar apportion requested the meeting.

Meanwhile Argentinas boss spoke out at a informal summit, reiterating the countrys government explain to the islands and blaming the Foreign Office for adding to tensions.

Todays Times journal pronounced a fortitude was additionally set to be tabled in the UN General Assembly condemning Britain for permitting Desire Petroleums Ocean Guardian to proceed training 60 miles north of the islands after Argentina voiced new shipping controls.

Defence Minister Bill Rammell pronounced the Government will take whatever stairs are required to strengthen the islands, that had a bona fide right to rise an oil industry inside of their waters.

Ocean Guardian was towed 8,000 miles from Scotland to the south Atlantic isles for the exploration.

Argentina rigourously objected to the move and tightened shipping regulations in the region.

Latin American and Caribbean nations corroborated Argentinas explain of government to the islands as the brawl collected pace.

At the Rio Group limit of 32 countries hosted by Mexico, Argentina presented a matter quoting Mexican President Felipe Calderon as observant that the heads of state represented here reaffirm their await for the bona fide rights of the commonwealth of Argentina in the government brawl with Great Britain.

Argentinian boss Cristina Fernandez ruled out any plans to try to keep the British boats or rigs out. We do not hold in methods similar to blockades, she told reporters.

However in a matter to informal leaders in Cancun, Mexico she reiterated Argentinas explain to the islands and blamed the Foreign Office for fanning tensions.

An English interpretation of her discuss was posted on the central website of Argentinas presidency.

In the statement, Ms Fernandez criticised the Foreign Office.

She said: When in these last couple of days England motionless to implement an oil supply offshore and Argentinain practice of the done at home lawmade decisions as a Sovereign State, the Foreign Office floated the thought of a intensity fight hazard by Argentina. I would contend that is ridiculous, asocial since couple of countries have shown some-more signs of pacific intentions than Argentina after the appearance of democracy.

Our armed forces usually experience in corner UN assent missions in Haiti and Cyprus. We are not benefaction in Afghanistan or Iraq; we are against to any sort of occupation; to any sort of defilement of general law since we hold this is one of the reasons for a universe that is apropos some-more insecure, dangerous, fragmented and not since of ideological disputes that as already referred to characterised the 20th centurybut since of some-more critical counts such as religions or deeper interests as the doing by each of the countries of the right to own and have use of the renewable and nonrenewable healthy resources.

She pronounced tactful efforts to settle government would continue, saying: Argentina will demand on the approved goal of entirely with regard to general law in the explain and shall adopt, inside of the horizon of the done at home law, all reserve and resolutions that lend towards to reassert the government over the Southern Archipelagos. This is no humour of this President or of prior presidents but a order of the National Constitution.

In 1994 when the National Constitution was nice I had the honour of behaving as a Constitutional Reform Assembly member. On that occasion, the Constitution was done to bless the requisite of all governments to go on claiming and reaffirming the government over the Malvinas Islands.

Desire pronounced the well is being drilled to an estimated aim abyss of about 3,500 metres (11,500 feet), and training operations are approaching to take about thirty days.

The association pronounced the supply is sitting resolutely inside UK waters.

Argentina claims the Falklandsknown as Las Malvinas in Buenos Airesare assigned by Britain illegally.

Argentina invaded the Falklands in 1982, prior to a UK taskforce done up of a small 100 ships seized them behind in a fight that claimed the lives of 255 British servicemen and women and some-more than 600 Argentinians.

Brazilian President Luiz Inacio Lula da Silva criticised the United Nations for not pulling some-more forcefully to free the discuss on the Falkland Islands.

What is the geographic, the domestic or mercantile reason for the UK to be in Las Malvinas? Mr da Silva asked.

Could it be since the UK is a permanent part of the UNs Security Council where they can do all and the others nothing?

Jan Cheek, a part of the Falklands legislative assembly, pronounced she was not astounded by the Latin American countries" statement, as they had historically tended to behind Argentina in the dispute.

Ms Cheek told BBC Radio 4s Today programme: We dont feel isolated, since we dont rely as well heavily on Latin America for most of the reserve or most of the communication.

I would most cite it if we could provide all the Latin American neighbours as great accessible neighbours, but underneath the benefaction Argentine system of administration I dont think that will happen.

Argentina does continually take this issue to the UN but it has really small outcome on us, especially since what they are looking is to have us a cluster of Argentina whilst we have openly chosen, by self-determination, to be an abroad domain of the UK.

Ms Cheek pronounced there is no reason because Argentinas position should affect the poke for oil, adding: It positively creates no disproportion to the right to permit the healthy resources of the territory.

Home palliative sedation checklist might ease concerns

Their investigate appears in the biography Palliative Medicine, published by SAGE.

Physicians make make make use of of specific sedatives to soothe frightful pang as patients nearby genocide -- a make make use of well known as palliative sedation (PS). The rate of PS make make make use of of varies at large from 3-52% in terminally ill patients according to the novel -- a far-reaching range deliberation it is deliberate reliable and legally excusable for those with irrevocable and modernized disease. This raises questions over either the clarification of PS, or the environment could be at the back of these differences.

Despite a direction for PS in patients" homes augmenting in new years, academics know really small about what kinds of sedation are administered -- or who is reception it -- at home. Some fright that utilizing PS, quite at home, should not reinstate consummate comment and diagnosis of patients" earthy symptoms, or their mental or devout distress. A set of customary discipline offers one solution.

Alberto Alonso-Babarro from Hospital Universitario La Paz, Madrid led the investigate in to home PS, that was conducted in Madrid by a palliative home caring group (PHCT) stoical of dual physicians, dual nurses, a helper assistant, a part-time amicable worker, and an executive clerk. The PHCT continually follows up patients with progressive, incorrigible diseases with infancy symptoms who are referred by strident caring hospitals, healing oncologists or family physicians.

Alonso-Babarro and his group retrospectively reviewed healing annals from 370 patients, all of whom had been followed by a palliative home caring team. They grown a decision-making and diagnosis checklist, that they used to cruise how mostly PS was used for cancer patients failing at home, and how in effect it was. A sum of 245 patients (66%) died at home, and 125 patients (34%) died at a sanatorium or hospice.

Twenty-nine of 245 patients (12%) who died at home perceived PS. Those who perceived it had a younger meant age (58) than those who did not (69), but there were no alternative differences rescued in in between these dual studious groups. The infancy usual reasons for utilizing PS were derangement (62%) and dyspnea (laboured breathing), in the box of 14% of patients. The immeasurable infancy of patients were since the opiate drug midazolam for PS, with less than a tenth reception levomepromazine, an anti-psychotic opiate used in Europe and Canada, but not now purebred in the US.

On average, patients died 2.6 days after PS, and in roughly half of cases the preference to make make make use of of PS was taken with both the studious and his or her family. In alternative cases the family done the decision. Importantly, the authors resolved that utilizing PS does not dive death.

Other engaging commentary were that at home, PS was used at a reduce rate than in sanatorium (where 20-50% of palliative patients have PS). Hospitalised patients mostly have a larger sign burden, or might be some-more vibrated and so disposed to derangement than in a home setting, the authors suggest.

There is additionally debate in the palliative caring novel around psycho-existential suffering, where informative context appears to fool around a role. In particular, a multi-centre investigate found that patients in Spain had a higher rate of PS for this reason than in alternative countries. Alonso-Babarro suggests that miss of agreement on diagnosis in in between the patients and their family groups in Spain could be a poignant cause in this distress. Incorporating the patientwishes per PS in modernized directives or deliberating these issues with patients before to the last days of their lives might assistance equivocate nonessential studious and caregiver highlight and burden, he suggests.

We resolved that palliative sedation might be used safely and efficaciously to yield failing cancer patients with adverse symptoms at home, pronounced Alonso-Babarro, who added: To the knowledge, this is one of initial studies addressing PS in the home environment to denote the reserve and efficiency of at-home PS administered by a PHCT.

The checklist his group grown recommends commencement PS with midazolam followed by levomepromazine if midazolam proves ineffective. If both midazolam and levomepromazine fail, phenobarbital is the subsequent choice to consider. The group additionally recommends these medications should be injected.

The group goal that their checklist will yield alternative researchers and clinicians with an easy-to-use preference assist and diagnosis apparatus to promote the PS process. Researchers will need to lift out serve multi-centre impending home-based studies to replicate their findings.

In a little cases, PS might be the usually approach to grasp a pacific genocide at home, to illustrate ensuring that the wishes of the patients and their caregivers are respected.

Declining Organ Donations Causes Widening Need Gap

The series of vital organ donors is on the decline,according to a new study. The outcome show that overall, vital kidney, liver,and lung donations has decreased over the last five years, going from about7,000 in 2004 to 6,219 in 2008.

In addition, viscera from defunct donors went down for thefirst time 2008. Until then, the series of defunct donors had regularly increasedcompared to the prior year.

"This decrease has resulted in a wideninggap in in in between the series of organsavailable for transplant, and the series of patients who are available a donororgan," pronounced investigate writer Andrew S. Klein, M.D., executive of Cedars-SinaiMedical Centers Comprehensive Transplant Center in Los Angeles.

The investigate looked at trends in organ concession in in in between 1999and 2008. In that time frame, usually the series of livingkidney donors increased, but this climb essentially occurred in in in between 1999 and2004 and the numbers have depressed each year since.

Among alternative concession groups, vital liver donors forsaken in2008 to less than 50 percent of their rise (524) in 2001. There were 58 livinglung donors in 1999, but no vital lung donors in 2008.

While the series of defunct donors increasing steadilybetween 2003 and 2006, it reached a mountainous country in the center of the decade, andslightly dipped in 2008, going from 28,405 in 2007 to 27,958.

The headlines comes only days after Apple CEO Steve Jobsannounced plans to assistance raise Californias organ concession program. On March19, Jobs suggested publically that he had perceived a liver medical operation in Memphisbecause there were not sufficient donors in California, according to the San JoseMercury News.

Jobs discussed ideas with the states administrator ArnoldSchwarzenegger, and the governors bureau is operative on a check to need allthose requesting for California drivers licenses to answer either or not they wouldbe an organ donor in the eventuality of their death. Currently, the statesDepartment of Motor Vehicles does not need field to answer thatquestion prior to reception a license.

"Ironically, the singular largest cause in todays donororgan shortfall is that plain organ transplants have turn sosuccessful," Klein said. �

"Improved presence rates and the expectancy that organreplacement will raise peculiarity of hold up have speedy some-more doctors and theirpatients with organ disaster to opt for transplantation," he added.

The investigate additionally identified a series of alternative factors thatcould be contributing to the organ shortage. These include:

���������Financial obstacles that essentially outcome in aloss of income for the donor, well known as "disincentives"for vital organ concession (including loss of income whilst off work afterthe procedure, intensity destiny insurability issues, and losses that might notbe lonesome by insurance.)

���������Failure to rivet the open in developingtransplant policies, such as miss of submit from donors and recipients thatcould outcome in improved studious education, quite about short- and long-termconsequences of organ donation.

���������Low agree rates for defunct organ donation,driven partly by improper perceptions about the concession process.

"This investigate showed that most people have questions andconcerns about organ donation," Klein noted. "Educating the publicand mending clarity of the organ concession and transplantation processand opening are vicious to squeezing the donor organ gap."

The formula were published online in the American Journal of Transplantation.

Great Debate: Should Organ Donors Be Paid? Donating a Kidney Doesnt Shorten Donors Life Body Part Theft: Truth Vs. Myth

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Yemen offers talks with separatists

Cynthia Johnston DUBAI Tue Mar 9, 2010 4:37pm EST Related News Yemen offers talks with separatists as unrest flaresTue, Mar 9 2010

DUBAI (Reuters) - Yemen, under international pressure to quiet domestic unrest and focus its sights on al Qaeda, has offered to hold talks with southern separatists and hear their grievances, state media said on Tuesday.

World

The move by President Ali Abdullah Saleh follows an escalation in violence on both sides in south Yemen that has left a trail of dead and wounded in recent weeks even as insurgent violence elsewhere in the country fades.

North and South Yemen united in 1990, but many in the south -- home to most of Yemen"s oil facilities -- complain northerners have seized resources and discriminate against them.

"We say to them: Come talk with your brothers in the authority, and we will talk with you. We extend the hand of dialogue without (you) having to resort to violence or blocking roads or raising the flag of separation," Saleh said in an address at a military academy.

"I am certain the flags of separation will burn in the days and weeks ahead. We have one flag we voted on with our free will. We welcome any political demands. Come to dialogue," he said, according to the Defense Ministry"s online newspaper.

Pressure mounted on Yemen to concentrate its efforts on containing al Qaeda after the Yemen-based regional arm of the militant group claimed responsibility for a failed attempt to bomb a U.S.-bound passenger plane in December.

Western allies and neighboring Saudi Arabia fear al Qaeda is exploiting instability in Yemen, where 42 percent of the people live in poverty, and using the country as a base from which to prepare attacks in the region and beyond.

The offer for talks with separatists was not Saleh"s first.

Diplomats say previous offers have not been followed by concrete action to address southern complaints that Sanaa neglects the southern region and treats southerners unfairly, including in property disputes, jobs and pension rights.

Some southerners say Saleh"s ties to Saudi Arabia, Yemen"s biggest donor, have led the president to tolerate inroads by the kingdom"s puritanical Wahhabi sect of Sunni Islam.

SHOW OF STRENGTH

Yemen agreed last month to a truce with northern Shi"ite rebels to end a separate conflict there that had drawn in top oil exporter Saudi Arabia. Since that truce began, violence in the north has faded while clashes in the south have escalated.

Security forces have come down hard on separatist protests in recent weeks, and at least two demonstrators have been shot dead. Ensuing unrest sparked security sweeps that have netted 150-200 arrests and sparked sometimes deadly clashes.

In the latest sweeps, 22 people were arrested in two southern provinces for offences ranging from armed attacks to chanting separatist slogans, the Defense Ministry website said.

Separately, a security court in the southern city of Aden issued suspended jail sentences of one year each on Tuesday against two leaders of the Southern Movement, which has led the protest movement, on charges of threatening Yemen"s unity, independent news website Marebpress reported.

"They have to escalate before they start to negotiate," Yemeni analyst Ali Seif Hassan said of the government. "This is their style of doing things. Show them you are strong. You can do things. Then you start to negotiate."

But he added the sides were unlikely to achieve more than a brief "cooling down" from the conflict in the medium term.

"I think it will continue for a long time," he said.

Saleh said Yemen would form committees to talk with the separatists. Analysts say the fractured nature of the movement, without a unified leadership, makes serious talks difficult.

Analysts said they believed the government was close to reaching a truce with one southern tribal leader, but said that did not mean tensions would subside throughout the south.

Recent attacks blamed on separatists, in which at least five people have died, have raised concerns that the mainly peaceful movement could become an armed campaign.

In the latest violence, five gunmen in a car fired at a state building, killing a soldier, state media said on Tuesday, blaming separatists for the attack late on Sunday.

Separately, Human Rights Watch urged Sanaa to use caution when targeting militants to avoid civilian casualties, citing a December air strike against al Qaeda in south Yemen that the government later acknowledged had also killed more than 42 civilians.

Yemen"s operations against al Qaeda have been focused in parts of the south where separatist sentiment is also prevalent.

"Civilian deaths in counterterrorism operations can have a strikingly counterproductive impact," said Joanne Mariner, terrorism and counterterrorism director at Human Rights Watch.

"The U.S. has learned the hard way that such deaths can anger and alienate people who normally would not support groups such as al Qaeda," she said.

(Additional reporting by Mohamed Sudam in Sanaa and Mohammed Mukhashaf in Aden; Editing by Mark Trevelyan)

World

Kremlin difficult on gas understanding forward of Yanukovich revisit

Dmitry Zhdannikov MOSCOW Thu Mar 4, 2010 1:33pm EST Related News Factbox: Key political risks to watch in UkraineWed, Mar 3 2010FACTBOX-Key political risks to watch in UkraineWed, Mar 3 2010WRAPUP 1-Ukraine leader vows reform, reliability in energyMon, Mar 1 2010Ukrainian president to discuss gas transit with EUSun, Feb 28 2010UPDATE 4-Yanukovich pledges to fight Ukraine"s woesThu, Feb 25 2010

MOSCOW (Reuters) - The Kremlin on Thursday said Ukraine should stick to existing gas deals with Russia, drawing a line on a divisive issue expected to be in focus during Viktor Yanukovich"s first visit to Moscow as Ukraine"s president.

World&&&&Russia

While it marks a fresh start in political ties that soured under Yanukovich"s pro-Western predecessor, the visit may be dominated by economic issues such as cash-strapped Ukraine"s bills for Russian natural gas.

Yanukovich, inaugurated last week, comes to Russia days after his first foreign trip as head of state, to Brussels, where he pledged to keep Ukraine on the reform path and ensure it remains a reliable gas transit route.

Europe, which gets a fifth of its gas needs from Russia via Ukraine, is hoping Yanukovich"s more pro-Russian stance can guarantee he will avoid repeating the price disputes which led to supply cuts to Europe in recent years.

But many analysts believe Kiev"s desperate public finances mean Yanukovich must change a long-term gas deal signed in 2009 by his election rival, former Prime Minister Yulia Tymoshenko, which made Russian gas more expensive for Ukraine than for most European countries.

"The Russian side proceeds from the need to rigorously implement all existing agreements and contracts in this (gas) sphere, taking into account the task of ensuring uninterrupted Russian gas supplies to European customers," the Kremlin said in a statement on Thursday.

Yanukovich has pleased Russia by making clear he opposes Ukraine joining NATO, as his predecessor Viktor Yushchenko hoped it would, saying Kiev would continue only partnership programs with the Western military alliance.

"The question of our joining NATO is not on the agenda. The depth of our cooperation is enough to ensure partner-like relations with NATO," Yanukovich said in an interview aired on Thursday on state-run Rossiya-24 television.

But analysts have said Yanukovich would have to offer Moscow bigger incentives -- such as a deal for the Russian Black Sea Fleet to stay in Ukraine"s port of Sevastopol beyond the official withdrawal deadline of 2017 -- to win a lower gas price deal.

Yanukovich has said he could allow the fleet to stay, a move Moscow sees as a certain guarantee that Kiev will not join NATO.

He also said he would revive the idea of a gas consortium that would allow Moscow and the European Union to co-manage Ukrainian pipelines.

Moscow had said it could increase supplies via Ukraine if it was allowed to co-own and manage gas pipelines, but Ukraine adopted a law forbidding their privatization.

Russia has decided to build North Stream and South Stream -- pipelines that would bypass Ukraine, delivering gas to Europe via the Baltic and Black Seas, and drastically cutting Kiev"s transit revenues.

Asked on Friday what he expects from his visit to Moscow, Yanukovich told Interfax-Ukraine: "That will be a major turning point in changing relations between our countries for the better. In all senses. You"ll see."

In the interview televised on Thursday, however, he stressed that Ukraine must also pursue productive ties with the European Union to the west.

"Ukraine"s interests in Europe are huge. This is a huge market," he said after he was asked why he travelled to Brussels first. "We are big trade partners. Our trade turnover with Europe is slightly bigger than with Russia given the fall in trade with Russia."

(Editing by Janet Lawrence)

World Russia

Beyonce and Jay Z hug up with a singular show of love as they watch the basketball

The fans may have been there to watch the game, but all eyes were on the celebrity couple in the front row.

Basketball fans Beyonc� and Jay-Z put on a rare public show of affection as they enjoyed the match in Dallas yesterday.

Sitting closely side by side the usually reserved couple laughed and joked together at the NBA game between the Los Angeles Lakers and the Dallas Mavericks.

Put A Hoop On It: Jay-Z and Beyonce Knowles attend a game between the Los Angeles Lakers and Dallas Mavericks in Dallas, Texas

The discreet couple have been married for two yearsand together since 2002, but to say they keep a low-profile issomething of an understatement.

Their demanding lives drag them all over the world - last week Jay-Z was at the Brits while Beyonce was performing in Trinidad - but they love a trip to the Lakers.

Although they frequently collaborate on music projects, Beyonc� hassaid that not publicly discussing their relationship has helped them.

Crazy In Love: The couple look up to the ceiling as they enjoy the game

But while Beyonc�, 28, may remain tight-lipped about her relationship, her feelings about her husband seem crystal clear.

Jay-Z, 40, recently broke his silence about his wife in an interview with Jonathan Ross.

Eye off the ball: Beyonce looks straight at the camera during the game while Jay-Z stares intently ahead

When asked if he watches the Single Ladies star"s performances, he said: "She"s a magnificent performer. I stealroutines from her. She steals from me."

More...Lady Gaga thrills in yet another revealing outfit as she prepares to work with Giorgio ArmaniLily Allen rests weary head on boyfriend after presenting and accepting NME awards, hitting the afterparty... and what looks like several hours in make-up

And when asked if shehad performed the now famous Single Ladies dance for him he joked: "Iactually created that dance too - that was me again. I wouldn"t reallytell anyone but you asked. I wouldn"t want to make myself seem moreimportant."

Standing to attention: The fans prepare for the game