News Analysis: Getting Polio Campaigns Back on Track

How in the world did something as innocuous as the sugary pink polio vaccine turn into a flash point between Islamic militants and Western “crusaders,” flaring into a confrontation so ugly that teenage girls — whose only “offense” is that they are protecting children — are gunned down in the streets?

Nine vaccine workers were killed in Pakistan last week in a terrorist campaign that brought the work of 225,000 vaccinators to a standstill. Suspicion fell immediately on factions of the Pakistani Taliban that have threatened vaccinators in the past, accusing them of being American spies.

Polio eradication officials have promised to regroup and try again. But first they must persuade the killers to stop shooting workers and even guarantee safe passage.

That has been done before, notably in Afghanistan in 2007, when Mullah Muhammad Omar, spiritual head of the Afghan Taliban, signed a letter of protection for vaccination teams. But in Pakistan, the killers may be breakaway groups following no one’s rules.

Vaccination efforts are also under threat in other Muslim regions, although not this violently yet.

In Nigeria, another polio-endemic country, the new Islamic militant group Boko Haram has publicly opposed it, although the only killings that the news media have linked to polio were those of two police officers escorting vaccine workers. Boko Haram has killed police officers on other missions, unrelated to polio vaccinations.

In Mali, extremists took over half of the country in May, declaring an Islamic state. Vaccination is not an issue yet, but Mali had polio cases as recently as mid-2011, and the virus sometimes circulates undetected.

Resistance to polio vaccine springs from a combination of fear, often in marginalized ethnic groups, and brutal historical facts that make that fear seem justified. Unless it is countered, and quickly, the backlash threatens the effort to eradicate polio in the three countries where it remains endemic: Pakistan, Afghanistan and Nigeria.

In 1988, long before donors began delivering mosquito nets, measles shots, AIDS pills, condoms, deworming drugs and other Western medical goods to the world’s most remote villages, Rotary International dedicated itself to wiping out polio, and trained teams to deliver the vaccine.

But remote villages are often ruled by chiefs or warlords who are suspicious not only of Western modernity, but of their own governments.

The Nigerian government is currently dominated by Christian Yorubas. More than a decade ago, when word came from the capital that all children must swallow pink drops to protect them against paralysis, Muslim Hausas in the far-off north could be forgiven for reacting the way the fundamentalist Americans of the John Birch Society did in the 1960s when the government in far-off Washington decreed that, for the sake of children’s teeth, all drinking water should have fluoride.

The northerners already had grievances. In 1996, the drug company Pfizer tested its new antibiotic, Trovan, during a meningitis outbreak there. Eleven children died. Although Pfizer still says it was not to blame, the trial had irregularities, and last year the company began making payments to victims.

Other rumors also spring from real events.

In Pakistan, resistance to vaccination, low over all, is concentrated in Pashtun territory along the Afghan border and in Pashtun slums in large cities. Pashtuns are the dominant tribe in Afghanistan but a minority in Pakistan among Punjabis, Sindhis, Baluchis and other ethnic groups. Many are Afghan refugees and are often poor and dismissed as medieval and lawless.

Pakistan’s government is friendly with the United States while the Pashtuns’ territory in border areas has been heavily hit by American Taliban-hunting drones, which sometimes kill whole families.

So, when the Central Intelligence Agency admitted sponsoring a hepatitis vaccination campaign as a ruse to get into a compound in Pakistan to confirm that Osama bin Laden was there, and the White House said it had contemplated wiping out the residence with a drone missile, it was not far-fetched for Taliban leaders to assume that other vaccinators worked for the drone pilots.

Even in friendly areas, the vaccine teams have protocols that look plenty suspicious. If a stranger knocked on a door in Brooklyn, asked how many children under age 5 were at home, offered to medicate them, and then scribbled in chalk on the door how many had accepted and how many refused — well, a parent might worry.

In modern medical surveys — though not necessarily on polio campaigns — teams carry GPS devices so they can find houses again. Drones use GPS coordinates.

The warlords of Waziristan made the connection specific, barring all vaccination there until Predator drones disappeared from the skies.

Dr. Bruce Aylward, a Canadian who is chief of polio eradication for the World Health Organization, expressed his frustration at the time, saying, “They know we don’t have any control over drone strikes.”

The campaign went on elsewhere in Pakistan — until last week.

The fight against polio has been hampered by rumors that the vaccine contains pork or the virus that causes AIDS, or is a plot to sterilize Muslim girls. Even the craziest-sounding rumors have roots in reality.

The AIDS rumor is a direct descendant of Edward Hooper’s 1999 book, “The River,” which posited the theory — since discredited — that H.I.V. emerged when an early polio vaccine supposedly grown in chimpanzee kidney cells contaminated with the simian immunodeficiency virus was tested in the Belgian Congo.

The sterilization claim was allegedly first made on a Nigerian radio station by a Muslim doctor upset that he had been passed over for a government job. The “proof” was supposed to be lab tests showing it contained estrogen, a birth control hormone.

The vaccine virus is grown in a broth of live cells; fetal calf cells are typical. They may be treated with a minute amount of a digestive enzyme, trypsin — one source of which is pig pancreas, which could account for the pork rumor.

In theory, a polio eradicator explained, if a good enough lab tested the vaccine used at the time the rumor started, it might have detected estrogen from the calf’s mother, but it would have been far less estrogen than is in mother’s milk, which is not accused of sterilizing anyone. The trypsin is supposed to be washed out.

In any case, polio vaccine is now bought only from Muslim countries like Indonesia, and Muslim scholars have ruled it halal — the Islamic equivalent of kosher.

Reviving the campaign will mean quelling many rumors. It may also require adding other medical “inducements,” like deworming medicine, mosquito nets or vitamin A, whose immediate benefits are usually more obvious.

But changing mind-sets will be a crucial step, said Dr. Aylward, who likened the shootings of the girls to those of the schoolchildren in Newtown, Conn.

More police involvement — what he called a “bunkerized approach” — would not solve either America’s problem or Pakistan’s, he argued. Instead, average citizens in both countries needed to rise up, reject the twisted thinking of the killers and “generate an understanding in the community that this kind of behavior is not acceptable.”

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Gun Makers Based in Connecticut Form a Potent Lobby

Gun owners packed a hearing room in the Connecticut capital, vowing to oppose a bill that would require new markers on guns so that they are easier to trace.

One after another, they testified that the technology, called microstamping, was flawed and would increase the cost of guns.

But the witness who commanded the most attention in Hartford that day in 2009 was a representative of one of Connecticut’s major employers: the Colt Manufacturing Company, the gun maker.

The Colt executive, Carlton S. Chen, said the company would seriously consider leaving the state if the bill became law. “You would think that the Connecticut government would be in support of our industry,” Mr. Chen said.

Soon, Connecticut lawmakers shelved the bill; they have declined to take it up since. Now, in the aftermath of the school massacre in Newtown, the lawmakers are formulating new gun-control measures, saying the state must serve as a national model.

But the failed effort to enact the microstamping measure shows how difficult the climate has been for gun control in state capitals. The firearm companies have played an important role in defeating these measures by repeatedly warning that they will close factories and move jobs if new state regulations are approved.

The companies have issued such threats in several states, especially in the Northeast, where gun control is more popular. But their views have particular resonance in Connecticut, a cradle of the American gun industry.

Like manufacturing in Connecticut over all, the state’s gun industry is not as robust as it once was. Still, Connecticut remains the seventh-largest producer of firearms in the country, according to federal data.

Colt, based in Connecticut since the 1800s, employs roughly 900 people in the state. Two other major gun companies, Sturm, Ruger & Company and Mossberg & Sons, are also based in the state. In all, the industry employs about 2,000 people in Connecticut, company officials said.

Gun-control advocates have long viewed Hartford, the capital, as hospitable terrain, because Connecticut is a relatively liberal state and already has more gun restrictions than most. Democrats control both houses of the legislature.

Yet lawmakers in Hartford did more than shelve the microstamping bill in 2009. They also declined to push a bill last year that would have banned high-capacity ammunition magazines — the very accessory used by Adam Lanza to kill 26 people, including 20 children, at Sandy Hook Elementary School in Newtown.

In several states, the gun companies have enlisted unions that represent gun workers, mindful that Democratic lawmakers who might otherwise back gun control also have close ties to labor.

In Connecticut, the United Automobile Workers, which represents Colt workers, has testified against restrictions. The union’s arguments were bolstered last year when Marlin Firearms, a leading manufacturer of rifles, closed a factory in Connecticut that employed more than 200 people. Marlin cited economic pressures, not gun regulation, for the decision, but representatives of the gun industry have said the combination of the two factors could spur others to move.

State law significantly restricts the ability of corporations to make political donations in Connecticut. Employees of Connecticut gun companies have contributed several thousand dollars in total in recent years to state candidates, mostly Republicans, according to an analysis of state records.

Financially, the gun companies and their employees in Connecticut have exerted influence by donating to national groups, especially the National Rifle Association, which have in turn helped Connecticut gun rights groups, according to interviews and financial records.

But it appears that in Hartford, the companies are relying largely on economic arguments.

Their strategy has been led by the industry’s trade group, the National Shooting Sports Foundation, which happens to have its national headquarters in Newtown, a few miles from the site of the shootings.

When Connecticut lawmakers held a hearing in 2011 on the measure to ban high-capacity ammunition magazines, the director of government regulations for the foundation, Jake McGuigan, opened his testimony with some statistics.

Mr. McGuigan told lawmakers that the state’s gun companies contributed $1.3 billion to the Connecticut economy, through their own operations and those of their suppliers.

“Each year, they get courted by other firearm-friendly states, like Idaho, Virginia, North Carolina,” Mr. McGuigan said. He later added, “It’s not an idle threat.”

The federation and Colt have declined to comment on gun-control legislation since the school killings.

“Our hearts go out to our fellow Connecticut residents who have suffered such unimaginable loss,” Colt said in a statement. “We do not believe it is appropriate to make further public statements at this very emotional time.”

Gun-control advocates in Hartford said the gun companies’ strategy was shrewd because it allowed Democratic lawmakers to oppose new regulations while proclaiming that they had not bowed to the National Rifle Association.

Michael Moss and Griff Palmer contributed reporting.

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N.Y.U. and Others Offer Shorter Courses Through Medical School

Training to become a doctor takes so long that just the time invested has become, to many, emblematic of the gravity and prestige of the profession.

But now one of the nation’s premier medical schools, New York University, and a few others around the United States are challenging that equation by offering a small percentage of students the chance to finish early, in three years instead of the traditional four.

Administrators at N.Y.U. say they can make the change without compromising quality, by eliminating redundancies in their science curriculum, getting students into clinical training more quickly and adding some extra class time in the summer.

Not only, they say, will those doctors be able to hang out their shingles to practice earlier, but they will save a quarter of the cost of medical school — $49,560 a year in tuition and fees at N.Y.U., and even more when room, board, books, supplies and other expenses are added in.

“We’re confident that our three-year students are going to get the same depth and core knowledge, that we’re not going to turn it into a trade school,” said Dr. Steven Abramson, vice dean for education, faculty and academic affairs at N.Y.U. School of Medicine.

At this point, the effort involves a small number of students at three medical schools: about 16 incoming students at N.Y.U., or about 10 percent of next year’s entering class; 9 at Texas Tech Health Science Center School of Medicine; and even fewer, for now, at Mercer University School of Medicine’s campus in Savannah, Ga. A similar trial at Louisiana State University has been delayed because of budget constraints.

But Dr. Steven Berk, the dean at Texas Tech, said that 10 or 15 other schools across the country had expressed interest in what his university was doing, and the deans of all three schools say that if the approach works, they will extend the option to larger numbers of students.

“You’re going to see this kind of three-year pathway become very prominent across the country,” Dr. Abramson predicted.

The deans say that getting students out the door more quickly will accomplish several goals. By speeding up production of physicians, they say, it could eventually dampen a looming doctor shortage, although the number of doctors would not increase unless the schools enrolled more students in the future.

The three-year program would also curtail student debt, which now averages $150,000 by graduation, and by doing so, persuade more students to go into shortage areas like pediatrics and internal medicine, rather than more lucrative specialties like dermatology.

The idea was supported by Dr. Ezekiel J. Emanuel, a former health adviser to President Obama, and a colleague, Victor R. Fuchs. In an editorial in the Journal of the American Medical Association in March, they said there was “substantial waste” in the nation’s medical education. “Years of training have been added without evidence that they enhance clinical skills or the quality of care,” they wrote. They suggested that the 14 years of college, medical school, residency and fellowship that it now takes to train a subspecialty physician could be reduced by 30 percent, to 10 years.

That opinion, however, is not universally held. Other experts say that a three-year medical program would deprive students of the time they need to delve deeply into their subjects, to consolidate their learning and to reach the level of maturity they need to begin practicing, while adding even more pressure to a stressful academic environment.

“The downside is that you are really tired,” said Dr. Dan Hunt, co-secretary of the Liaison Committee on Medical Education, the accrediting agency for medical schools in the United States and Canada. But because accreditation standards do not dictate the fine points of curriculum, the committee has approved N.Y.U.’s proposal, which exceeds by five weeks its requirement that schools provide at least 130 weeks of medical education.

The medical school is going ahead with its three-year program despite the damage from Hurricane Sandy, which forced NYU Langone Medical Center to evacuate more than 300 patients at the height of the storm and temporarily shut down three of its four main teaching hospitals.

Dr. Abramson of N.Y.U. said that postgraduate training, which typically includes three years in a hospital residency, and often fellowships after that, made it unnecessary to try to cram everything into the medical school years. Students in the three-year program will have to take eight weeks of class before entering medical school, and stay in the top half of their class academically. Those who do not meet the standards will revert to the four-year program.

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N.Y.U. and Others Offer Shorter Courses Through Medical School

Training to become a doctor takes so long that just the time invested has become, to many, emblematic of the gravity and prestige of the profession.

But now one of the nation’s premier medical schools, New York University, and a few others around the United States are challenging that equation by offering a small percentage of students the chance to finish early, in three years instead of the traditional four.

Administrators at N.Y.U. say they can make the change without compromising quality, by eliminating redundancies in their science curriculum, getting students into clinical training more quickly and adding some extra class time in the summer.

Not only, they say, will those doctors be able to hang out their shingles to practice earlier, but they will save a quarter of the cost of medical school — $49,560 a year in tuition and fees at N.Y.U., and even more when room, board, books, supplies and other expenses are added in.

“We’re confident that our three-year students are going to get the same depth and core knowledge, that we’re not going to turn it into a trade school,” said Dr. Steven Abramson, vice dean for education, faculty and academic affairs at N.Y.U. School of Medicine.

At this point, the effort involves a small number of students at three medical schools: about 16 incoming students at N.Y.U., or about 10 percent of next year’s entering class; 9 at Texas Tech Health Science Center School of Medicine; and even fewer, for now, at Mercer University School of Medicine’s campus in Savannah, Ga. A similar trial at Louisiana State University has been delayed because of budget constraints.

But Dr. Steven Berk, the dean at Texas Tech, said that 10 or 15 other schools across the country had expressed interest in what his university was doing, and the deans of all three schools say that if the approach works, they will extend the option to larger numbers of students.

“You’re going to see this kind of three-year pathway become very prominent across the country,” Dr. Abramson predicted.

The deans say that getting students out the door more quickly will accomplish several goals. By speeding up production of physicians, they say, it could eventually dampen a looming doctor shortage, although the number of doctors would not increase unless the schools enrolled more students in the future.

The three-year program would also curtail student debt, which now averages $150,000 by graduation, and by doing so, persuade more students to go into shortage areas like pediatrics and internal medicine, rather than more lucrative specialties like dermatology.

The idea was supported by Dr. Ezekiel J. Emanuel, a former health adviser to President Obama, and a colleague, Victor R. Fuchs. In an editorial in the Journal of the American Medical Association in March, they said there was “substantial waste” in the nation’s medical education. “Years of training have been added without evidence that they enhance clinical skills or the quality of care,” they wrote. They suggested that the 14 years of college, medical school, residency and fellowship that it now takes to train a subspecialty physician could be reduced by 30 percent, to 10 years.

That opinion, however, is not universally held. Other experts say that a three-year medical program would deprive students of the time they need to delve deeply into their subjects, to consolidate their learning and to reach the level of maturity they need to begin practicing, while adding even more pressure to a stressful academic environment.

“The downside is that you are really tired,” said Dr. Dan Hunt, co-secretary of the Liaison Committee on Medical Education, the accrediting agency for medical schools in the United States and Canada. But because accreditation standards do not dictate the fine points of curriculum, the committee has approved N.Y.U.’s proposal, which exceeds by five weeks its requirement that schools provide at least 130 weeks of medical education.

The medical school is going ahead with its three-year program despite the damage from Hurricane Sandy, which forced NYU Langone Medical Center to evacuate more than 300 patients at the height of the storm and temporarily shut down three of its four main teaching hospitals.

Dr. Abramson of N.Y.U. said that postgraduate training, which typically includes three years in a hospital residency, and often fellowships after that, made it unnecessary to try to cram everything into the medical school years. Students in the three-year program will have to take eight weeks of class before entering medical school, and stay in the top half of their class academically. Those who do not meet the standards will revert to the four-year program.

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Raw Data: Deciphering the Decline in Spanish Mobile Accounts

BERLIN — It would take the unimaginable — a major power outage, a natural disaster or a sudden, permanent loss of income — for many people to abandon their mobile phones.

That is what appears to be happening in Spain in the midst of its economic crisis. But in the country’s telecom sector, as in a Salvador Dalí painting, there may be more than meets the eye.

The Spanish regulator, Comisión del Mercado de las Telecomunicaciones, said last week that 486,183 mobile phone accounts were deactivated by Spanish operators in October alone, the ninth straight month of contraction that has seen two million prepaid accounts, or 9.4 percent of the current total, taken off networks since February.

The biggest reason for the industry’s difficulties is the most obvious: Spain’s economic slowdown, highlighted by its 26.2 percent unemployment rate in October, including a jobless rate of nearly 50 percent among cellphone-conscious young consumers.

Rosalind Craven, who analyzes West European mobile operators at International Data Corp. in London, said the nine months of contracting figures reported by Telefónica’s Movistar and Vodafone Spain, the two largest mobile operators, reflected the economic challenges facing consumers.

“Because it has been going on for so long, this indicates that the reason is indeed the country’s economic distress,” she said. “People in Spain have less money and are looking to save where they can.”

From January through October, Movistar, the market leader, has deactivated 2.3 million mobile accounts. Vodafone Spain, the No.2, shut off 1.3 million accounts, according to the telecommunications commission. Conversely, Orange Spain, the No.3, has gained 124,420 customers and Yoigo, owned by TeliaSonera of Sweden, has added 412,580. Virtual operators, which are low-cost resellers, have added 1.1 million customers.

But three other developments unrelated to Spain’s slowing economy may be exaggerating signs of a telecom sector meltdown.

The first was the decision by Movistar and Vodafone this year to stop subsidizing new handsets. The cost-cutting move caused many customers to switch to Orange, Yoigo and virtual operators like Simyo, which continued to provide subsidies. Both Movistar and Vodafone have since partially reinstated subsidies.

The other influence was a decision by Telefónica and Vodafone to focus on their most lucrative clients — contract customers who pay on average about €25, or $33, each month, more than double what prepaid customers pay. Telefónica, for example, has signed up one million customers since October to a new plan called Movistar Fusión, a package of mobile, fixed and Internet flat-rate service starting at €49.99 a month.

A third, less obvious reason, may be the counting methods used by the operators, which during economic downturns have been known to purge inactive accounts more aggressively from subscriber lists. Such cullings bolster the average monthly revenue per user, the main bellwether used by investors to value operators.

Representatives for Telefónica and Vodafone declined to say if they were aggressively purging their lists. Ms. Craven, the I.D.C. analyst, said operators in Greece conducted a mass purge in 2009 as that country’s economic crisis began to worsen.

Operators generally declare accounts to be inactive when they are unused for three or six months. In good economic times, bigger customer rolls help operators claim greater market share. In bad times, the bigger lists dilute scarce earnings.

Spaniards do not appear to be abandoning their “móviles.” Cellphone penetration in Spain was 116 percent in October, and many people carry more than one SIM card. The inactive accounts being shut down, said Agustín Diaz-Pinés, an analyst at the Organization for Economic Cooperation and Development in Paris, are likely to be extra SIM accounts.

“Undoubtedly the economic downturn plays a role here, but I don’t think many people are dropping their mobile subscriptions,” he said. “They may rather be canceling duplications, for example, the prepaid line you never use.”

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IHT Rendezvous: What Will You Do With All That Gift Wrap?

Paris — With the season of exuberant gift giving, joyful excess and artificial Christmas trees at hand, activists, academics and filmmakers are warning of growing landfills and environmental pollution fed by our unsustainable consumption cycle.

“Waste is very much an unseen problem. Though the waste itself is very visible, people don’t regard waste as a pollution problem,” said Andy Cundy, a professor who researches applied geology and environmental management at the University of Brighton in Britain.

As economies slowly rebound and we rejoice in being able to buy our loved ones (or ourselves) gifts, our garbage dumps continue to grow. And whether our household waste ultimately ends up in landfills or is incinerated (in some cases allowing for energy recapture), it puts a stress on the environment. When trash is exported to developing countries — where rules governing disposal tend to be lax or nonexistent —  the environmental impact is especially troubling, as two new documentary films show.

“Trashed” follows host Jeremy Irons on a discovery of the global problem of household waste. Our colleagues at the Green Blog asked Mr. Irons a couple of questions about the film earlier this month. Mr. Irons told Joanna Foster:

“I didn’t realize that all this non-degradable rubbish and consumerism is in large part thanks to World War II and the massive war production apparatus that needed to be developed for peaceful purposes after the days of making weapons had ended. I was born in 1948, so it’s really only in my lifetime that this throwaway society has emerged.”

The trailer for “Trashed”:

The film “Landfill Harmonic” follows a youth orchestra in a Paraguayan slum that plays on instruments built from other people’s trash (to see some photos of the recycled orchestra’s instruments, check out this NBC report).

“Our film shows how trash and recycled materials can be transformed into beautiful-sounding musical instruments; but more importantly, it brings witness to the transformation of human beings,” the filmmakers write on their website.

The teaser for “Landfill Harmonic” has become a minor Internet sensation, with nearly 1.5 million views since its launch in November:

Here, in the European Union, more than 3 billion tons of waste is thrown out yearly, which comes out to 6 tons per citizen, according to Eurostat. And while there are some signs of progress in waste reduction, recycling and treatment, the Union’s 27 countries are still a long way from meeting their 2020 targets under the waste reduction plan.

The so-called Waste Framework Directive calls for at least half of all paper, metal, plastic and glass waste from households to be recycled by 2020. In the United Kingdom, which is among the Union’s more ambitious recyclers, the total household rate for recycling did not even reach 40 percent in 2010, according to a government-commissioned study.

The most meaningful way of reducing the stream of waste is by reducing consumption, explained Dr. Cundy, who also served as an expert in the film “Trashed.”

Mr. Irons suggests unwrapping products and leaving the packaging in the store. As he put it in his interview with the Green Blog:

“I consider myself quite capable of getting my tomatoes home safely without sitting on them, so why must they come packaged in plastic armor? And I think I can even get a pair of scissors home without chopping off my hand so I really don’t need that damned impenetrable plastic shell.”

Dr. Cundy says composting at home can do much to cut the amount of general waste households produce.

Municipal governments can help the process by reducing services for general garbage (smaller bins, fewer weekly pick-ups) and by enhancing services for recycling and composting.

“It forces people to change their habits about their own lifestyle choices,” Dr. Cundy said in a recent interview. “It’s very simple: reuse, recycle rather than throw it away.”

Do you try to limit the amount of trash you throw out? How? What do you wish you did more religiously, or what do you wish was easier or different when it comes to reusing and recycling?

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Midge Turk Richardson, Ex-Nun Who Edited Seventeen Magazine, Dies at 82

Midge Turk Richardson, who spent 18 years as a nun before spending 18 years as the editor of Seventeen magazine, a redoubt of worldly concerns like clothes, makeup and dating, died last weekend at her home in Manhattan. She was 82.

Mrs. Richardson, whose body was found by family members on Monday, apparently died in her sleep sometime during the weekend, her stepson Kevin Richardson said.

A former Roman Catholic nun, Mrs. Richardson left her order in 1966, a journey she recounted in a memoir, “The Buried Life,” published in 1971. In secular life, she became a member of New York’s social set, and was married for three decades to Ham Richardson, a tennis star who later ran his own investment concern, with homes on Park Avenue and in Bridgehampton, on Long Island.

At Seventeen, which she edited from 1975 until her retirement in 1993, Mrs. Richardson was known for introducing frank discussions of delicate subjects — including sex, anorexia and suicide — from which the magazine, aimed at teenage girls and long considered a bastion of wholesomeness, had traditionally shied away.

Under Mrs. Richardson’s stewardship, certain aspects of the magazine remained comfortably familiar. “Secrets of Staying Thin,” promised one cover, from 1980; “Those Dreamy Summer Romances,” proclaimed another that year.

But other cover lines betrayed her resolve to address modern readers’ concerns: “Teen Suicide: The Danger Signals,” “What You Must Know About Herpes.”

In 1982, Mrs. Richardson instituted a regular column, “Sex and Your Body,” which explored subjects like gynecological health, sexual relations and birth control.

“We’ve been talking about it for years and trying to figure out how to go at it in a tasteful manner,” she told The Chicago Tribune in 1983. “We don’t want to be frightening to a young girl, or permissive. But the demands of the time finally brought us around to it.”

All this was a far cry from her life as Sister Agnes Marie, and from the quiet routine of her days in the convent, where she had lived from the ages of 18 to 36.

Agnes Theresa Turk, known as Midge because of her petite stature, was born in Los Angeles on March 26, 1930, the youngest daughter of a Roman Catholic family. As a girl, she worked as an extra in more than a hundred Hollywood films, sometimes appearing opposite Shirley Temple.

At 18, wanting a life of service, she forsook her lively home, her active social life and her boyfriend to enter the Sisters of the Immaculate Heart of Mary, a teaching order with a motherhouse in the Hollywood hills.

Sister Agnes Marie, as she was known in religion, earned bachelor’s and master’s degrees from Immaculate Heart College, run by her order. She embarked on a career as an educator, teaching English, French and drama in local parochial schools and later becoming the principal of a Catholic high school in a blighted, largely Latino section of Los Angeles.

She loved the life, but by the mid-1960s she had become depressed and exhausted — frustrated, she wrote, by what she saw as the failure of diocesan hierarchy to meet the needs of the impoverished community she served. She suffered two bouts of temporary blindness, brought on, her doctors told her, by strain.

In 1966, after much soul-searching, Sister Agnes Marie asked to be released from her vows. (In 1970, Anita Caspary, the mother superior of the Sisters of the Immaculate Heart, led an exodus of 300 nuns from the order in response to what they described as the failure of the diocese to lift outmoded restrictions on nuns’ lives.)

At 36, Agnes Turk found herself on her own for the first time. Carrying a single suitcase, she made for New York: it was one place, she reasoned, that offered career opportunities for women. She found a job as an assistant to a dean at New York University, sleeping on the floor of her tiny Greenwich Village apartment because she could not afford furniture.

She learned to navigate an alien social world. Once, preparing for a date, she washed her hair only to realize she did not own a hair dryer. She stuck her head pragmatically in the oven, emerging with singed hair.

After working as the college editor of Glamour magazine and at Scholastic Publications, she joined Seventeen as executive editor, becoming editor in chief in 1985.

Mrs. Richardson’s husband, whom she married in 1974, died in 2006. The No. 1-ranked tennis player in the United States in 1956 and 1958, he won 17 national titles and played on seven Davis Cup teams.

Besides her stepson Kevin, survivors include another stepson, Ken Richardson; a stepdaughter, Kit Sawers; two sisters, Gwendolyn Tighe and Marie Smith; and five step-grandchildren.

Mrs. Richardson was also the author of a children’s biography of a friend, the photographer Gordon Parks.

In an interview with The New York Times in 1970, she described the forces that led her first to take the veil and later to relinquish it:

“I entered the convent not so much because I believed in the church as that I believed in helping people,” she said. “I’d never had any great thing about dressing up in those clothes and jangling my rosary beads.”

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Genetic Gamble : Drugs Aim to Make Several Types of Cancer Self-Destruct

C.J. Gunther for The New York Times

Dr. Donald Bergstrom is a cancer specialist at Sanofi, one of three companies working on a drug to restore a tendency of damaged cells to self-destruct.

For the first time ever, three pharmaceutical companies are poised to test whether new drugs can work against a wide range of cancers independently of where they originated — breast, prostate, liver, lung. The drugs go after an aberration involving a cancer gene fundamental to tumor growth. Many scientists see this as the beginning of a new genetic age in cancer research.

Great uncertainties remain, but such drugs could mean new treatments for rare, neglected cancers, as well as common ones. Merck, Roche and Sanofi are racing to develop their own versions of a drug they hope will restore a mechanism that normally makes badly damaged cells self-destruct and could potentially be used against half of all cancers.

No pharmaceutical company has ever conducted a major clinical trial of a drug in patients who have many different kinds of cancer, researchers and federal regulators say. “This is a taste of the future in cancer drug development,” said Dr. Otis Webb Brawley, the chief medical and scientific officer of the American Cancer Society. “I expect the organ from which the cancer came from will be less important in the future and the molecular target more important,” he added.

And this has major implications for cancer philanthropy, experts say. Advocacy groups should shift from fund-raising for particular cancers to pushing for research aimed at many kinds of cancer at once, Dr. Brawley said. John Walter, the chief executive officer of the Leukemia and Lymphoma Society, concurred, saying that by pooling forces “our strength can be leveraged.”

At the heart of this search for new cancer drugs are patients like Joe Bellino, who was a post office clerk until his cancer made him too sick to work. Seven years ago, he went into the hospital for hernia surgery, only to learn he had liposarcoma, a rare cancer of fat cells. A large tumor was wrapped around a cord that connects the testicle to the abdomen. “I was shocked,” he said in an interview this summer.

Companies have long ignored liposarcoma, seeing no market for drugs to treat a cancer that strikes so few. But it is ideal for testing Sanofi’s drug because the tumors nearly always have the exact genetic problem the drug was meant to attack — a fusion of two large proteins. If the drug works, it should bring these raging cancers to a halt. Then Sanofi would test the drug on a broad range of cancers with a similar genetic alteration. But if the drug fails against liposarcoma, Sanofi will reluctantly admit defeat.

“For us, this is a go/no-go situation,” said Laurent Debussche, a Sanofi scientist who leads the company’s research on the drug.

The genetic alteration the drug targets has tantalized researchers for decades. Normal healthy cells have a mechanism that tells them to die if their DNA is too badly damaged to repair. Cancer cells have grotesquely damaged DNA, so ordinarily they would self-destruct. A protein known as p53 that Dr. Gary Gilliland of Merck calls the cell’s angel of death normally sets things in motion. But cancer cells disable p53, either directly, with a mutation, or indirectly, by attaching the p53 protein to another cellular protein that blocks it. The dream of cancer researchers has long been to reanimate p53 in cancer cells so they will die on their own.

The p53 story began in earnest about 20 years ago. Excitement ran so high that, in 1993, Science magazine anointed it Molecule of the Year and put it on the cover. An editorial held out the possibility of “a cure of a terrible killer in the not too distant future.”

Companies began chasing a drug to restore p53 in cells where it was disabled by mutations. But while scientists know how to block genes, they have not figured out how to add or restore them. Researchers tried gene therapy, adding good copies of the p53 gene to cancer cells. That did not work.

Then, instead of going after mutated p53 genes, they went after half of cancers that used the alternative route to disable p53, blocking it by attaching it to a protein known as MDM2. When the two proteins stick together, the p53 protein no longer functions. Maybe, researchers thought, they could find a molecule to wedge itself between the two proteins and pry them apart.

The problem was that both proteins are huge and cling tightly to each other. Drug molecules are typically tiny. How could they find one that could separate these two bruisers, like a referee at a boxing match?

In 1996, researchers at Roche noticed a small pocket between the behemoths where a tiny molecule might slip in and pry them apart. It took six years, but Roche found such a molecule and named it Nutlin because the lab was in Nutley, N.J.

But Nutlins did not work as drugs because they were not absorbed into the body.

Roche, Merck and Sanofi persevered, testing thousands of molecules.

At Sanofi, the stubborn scientist leading the way, Dr. Debussche, maintained an obsession with p53 for two decades. Finally, in 2009, his team, together with Shaomeng Wang at the University of Michigan and a biotech company, Ascenta Therapeutics, found a promising compound.

The company tested the drug by pumping it each day into the stomachs of mice with sarcoma.

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Genetic Gamble : Drugs Aim to Make Several Types of Cancer Self-Destruct

C.J. Gunther for The New York Times

Dr. Donald Bergstrom is a cancer specialist at Sanofi, one of three companies working on a drug to restore a tendency of damaged cells to self-destruct.

For the first time ever, three pharmaceutical companies are poised to test whether new drugs can work against a wide range of cancers independently of where they originated — breast, prostate, liver, lung. The drugs go after an aberration involving a cancer gene fundamental to tumor growth. Many scientists see this as the beginning of a new genetic age in cancer research.

Great uncertainties remain, but such drugs could mean new treatments for rare, neglected cancers, as well as common ones. Merck, Roche and Sanofi are racing to develop their own versions of a drug they hope will restore a mechanism that normally makes badly damaged cells self-destruct and could potentially be used against half of all cancers.

No pharmaceutical company has ever conducted a major clinical trial of a drug in patients who have many different kinds of cancer, researchers and federal regulators say. “This is a taste of the future in cancer drug development,” said Dr. Otis Webb Brawley, the chief medical and scientific officer of the American Cancer Society. “I expect the organ from which the cancer came from will be less important in the future and the molecular target more important,” he added.

And this has major implications for cancer philanthropy, experts say. Advocacy groups should shift from fund-raising for particular cancers to pushing for research aimed at many kinds of cancer at once, Dr. Brawley said. John Walter, the chief executive officer of the Leukemia and Lymphoma Society, concurred, saying that by pooling forces “our strength can be leveraged.”

At the heart of this search for new cancer drugs are patients like Joe Bellino, who was a post office clerk until his cancer made him too sick to work. Seven years ago, he went into the hospital for hernia surgery, only to learn he had liposarcoma, a rare cancer of fat cells. A large tumor was wrapped around a cord that connects the testicle to the abdomen. “I was shocked,” he said in an interview this summer.

Companies have long ignored liposarcoma, seeing no market for drugs to treat a cancer that strikes so few. But it is ideal for testing Sanofi’s drug because the tumors nearly always have the exact genetic problem the drug was meant to attack — a fusion of two large proteins. If the drug works, it should bring these raging cancers to a halt. Then Sanofi would test the drug on a broad range of cancers with a similar genetic alteration. But if the drug fails against liposarcoma, Sanofi will reluctantly admit defeat.

“For us, this is a go/no-go situation,” said Laurent Debussche, a Sanofi scientist who leads the company’s research on the drug.

The genetic alteration the drug targets has tantalized researchers for decades. Normal healthy cells have a mechanism that tells them to die if their DNA is too badly damaged to repair. Cancer cells have grotesquely damaged DNA, so ordinarily they would self-destruct. A protein known as p53 that Dr. Gary Gilliland of Merck calls the cell’s angel of death normally sets things in motion. But cancer cells disable p53, either directly, with a mutation, or indirectly, by attaching the p53 protein to another cellular protein that blocks it. The dream of cancer researchers has long been to reanimate p53 in cancer cells so they will die on their own.

The p53 story began in earnest about 20 years ago. Excitement ran so high that, in 1993, Science magazine anointed it Molecule of the Year and put it on the cover. An editorial held out the possibility of “a cure of a terrible killer in the not too distant future.”

Companies began chasing a drug to restore p53 in cells where it was disabled by mutations. But while scientists know how to block genes, they have not figured out how to add or restore them. Researchers tried gene therapy, adding good copies of the p53 gene to cancer cells. That did not work.

Then, instead of going after mutated p53 genes, they went after half of cancers that used the alternative route to disable p53, blocking it by attaching it to a protein known as MDM2. When the two proteins stick together, the p53 protein no longer functions. Maybe, researchers thought, they could find a molecule to wedge itself between the two proteins and pry them apart.

The problem was that both proteins are huge and cling tightly to each other. Drug molecules are typically tiny. How could they find one that could separate these two bruisers, like a referee at a boxing match?

In 1996, researchers at Roche noticed a small pocket between the behemoths where a tiny molecule might slip in and pry them apart. It took six years, but Roche found such a molecule and named it Nutlin because the lab was in Nutley, N.J.

But Nutlins did not work as drugs because they were not absorbed into the body.

Roche, Merck and Sanofi persevered, testing thousands of molecules.

At Sanofi, the stubborn scientist leading the way, Dr. Debussche, maintained an obsession with p53 for two decades. Finally, in 2009, his team, together with Shaomeng Wang at the University of Michigan and a biotech company, Ascenta Therapeutics, found a promising compound.

The company tested the drug by pumping it each day into the stomachs of mice with sarcoma.

Read More..

Amazon Book Reviews Deleted in a Purge Aimed at Manipulation

Giving raves to family members is no longer acceptable. Neither is writers’ reviewing other writers. But showering five stars on a book you admittedly have not read is fine.

After several well-publicized cases involving writers buying or manipulating their reviews, Amazon is cracking down. Writers say thousands of reviews have been deleted from the shopping site in recent months.

Amazon has not said how many reviews it has killed, nor has it offered any public explanation. So its sweeping but hazy purge has generated an uproar about what it means to review in an era when everyone is an author and everyone is a reviewer.

Is a review merely a gesture of enthusiasm or should it be held to a higher standard? Should writers be allowed to pass judgment on peers the way they have always done offline or are they competitors whose reviews should be banned? Does a groundswell of raves for a new book mean anything if the author is soliciting the comments?

In a debate percolating on blogs and on Amazon itself, quite a few writers take a permissive view on these issues.

The mystery novelist J. A. Konrath, for example, does not see anything wrong with an author indulging in chicanery. “Customer buys book because of fake review = zero harm,” he wrote on his blog.

Some readers differ. An ad hoc group of purists has formed on Amazon to track its most prominent reviewer, Harriet Klausner, who has over 25,000 reviews. They do not see how she can read so much so fast or why her reviews are overwhelmingly — and, they say, misleadingly — exaltations.

“Everyone in this group will tell you that we’ve all been duped into buying books based on her reviews,” said Margie Brown, a retired city clerk from Arizona.

Once a populist gimmick, the reviews are vital to making sure a new product is not lost in the digital wilderness. Amazon has refined the reviewing process over the years, giving customers the opportunity to rate reviews and comment on them. It is layer after layer of possible criticism.

“A not-insubstantial chunk of their infrastructure is based on their reviews — and all of that depends on having reviews customers can trust,” said Edward W. Robertson, a science fiction novelist who has watched the debate closely.

Nowhere are reviews more crucial than with books, an industry in which Amazon captures nearly a third of every dollar spent. It values reviews more than other online booksellers like Apple or Barnes & Noble, featuring them prominently and using them to help decide which books to acquire for its own imprints by its relatively new publishing arm.

So writers have naturally been vying to get more, and better, notices. Several mystery writers, including R. J. Ellory, Stephen Leather and John Locke, have recently confessed to various forms of manipulation under the general category of “sock puppets,” or online identities used to deceive. That resulted in a widely circulated petition by a loose coalition of writers under the banner, “No Sock Puppets Here Please,” asking people to “vote for book reviews you can trust.”

In explaining its purge of reviews, Amazon has told some writers that “we do not allow reviews on behalf of a person or company with a financial interest in the product or a directly competing product. This includes authors.” But writers say that rule is not applied consistently.

In some cases, the ax fell on those with a direct relationship with the author.

“My sister’s and best friend’s reviews were removed from my books,” the author M. E. Franco said in a blog comment. “They happen to be two of my biggest fans.” Another writer, Valerie X. Armstrong, said her son’s five-star review of her book, “The Survival of the Fattest,” was removed. He immediately tried to put it back “and it wouldn’t take,” she wrote.

In other cases, though, the relationship was more tenuous. Michelle Gagnon lost three reviews on her young adult novel “Don’t Turn Around.” She said she did not know two of the reviewers, while the third was a longtime fan of her work. “How does Amazon know we know each other?” she said. “That’s where I started to get creeped out.”

Mr. Robertson suggested that Amazon applied a broad brush. “I believe they caught a lot of shady reviews, but a lot of innocent ones were erased, too,” he said. He figures the deleted reviews number in the thousands, or perhaps even 10,000.

The explosion of reviews for “The 4-Hour Chef” by Timothy Ferriss shows how the system has evolved from something spontaneous to a means of marketing and promotion. On Nov. 20, publication day, dozens of highly favorable reviews immediately sprouted. Other reviewers quickly criticized Mr. Ferriss, accusing him of buying supporters.

He laughed off those suggestions. “Not only would I never do that — it’s unethical — I simply don’t have to,” he wrote in an e-mail, saying he had sent several hundred review copies to fans and potential fans. “Does that stack the deck? Perhaps, but why send the book to someone who would hate it? That doesn’t help anyone: not the reader, nor the writer.”

As a demonstration of social media’s grip on reviewing, Mr. Ferriss used Twitter and Facebook to ask for a review. “Rallying my readers,” he called it. Within an hour, 61 had complied.

A few of his early reviews were written by people who admitted they had not read the book but were giving it five stars anyway because, well, they knew it would be terrific. “I am looking forward to reading this,” wrote a user posting under the name mhpics.

A spokesman for Amazon, which published “The 4-Hour Chef,” offered this sole comment for this article: “We do not require people to have experienced the product in order to review.”

The dispute over reviews is playing out in the discontent over Mrs. Klausner, an Amazon Hall of Fame reviewer for the last 11 years and undoubtedly one of the most prolific reviewers in literary history.

Mrs. Klausner published review No. 28,366, for “A Red Sun Also Rises” by Mark Hodder. Almost immediately, it had nine critical comments. The first accused it of being “riddled with errors in grammar, spelling and punctuation.” The rest were no more kind. The Harriet Klausner Appreciation Society had struck again.

Mrs. Klausner, a 60-year-old retired librarian who lives in Atlanta, has published an average of seven reviews a day for more than a decade. “To watch her in action is unbelievable,” said her husband, Stanley. “You see the pages turning.”

Mrs. Klausner, who says ailments keep her home and insomnia keeps her up, scoffs at her critics. “You ever read a Harlequin romance?” she said. “You can finish it in one hour. I’ve always been a speed reader.” She has a message for her naysayers: “Get a life. Read a book.”

More than 99.9 percent of Mrs. Klausner’s reviews are four or five stars. “If I can make it past the first 50 pages, that means I like it, and so I review it,” she said. But even Stanley said, “She’s soft, I won’t deny that.”

The campaign against Mrs. Klausner has pushed down her reviewer ratings, which in theory makes her less influential. But when everything is subject to review, the battle is never-ending.

Ragan Buckley, an aspiring novelist active in the campaign against Mrs. Klausner under the name “Sneaky Burrito,” is a little weary. “There are so many fake reviews that I’m often better off just walking into a physical store and picking an item off the shelf at random,” she said.

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