Recipes for Health: Penne With Mushroom Ragout and Spinach

Andrew Scrivani for The New York Times

Penne with mushroom ragout and spinach.

​​Mushrooms and spinach together is always a match made in heaven. I use a mix of wild and regular white or cremini mushrooms for this, but don’t hesitate to make it if regular mushrooms are all that is available.

 

1/2 ounce (about 1/2 cup) dried porcini mushrooms

2 tablespoons extra virgin olive oil

1/2 medium onion or 2 shallots, chopped

2 garlic cloves, minced

1 pound mixed regular and wild mushrooms or 1 pound regular white or cremini mushrooms, trimmed and cut in thick slices (or torn into smaller pieces, depending on the type of mushroom)

Salt and freshly ground pepper

1/4 cup fruity red wine, such as a Côtes du Rhone or Côtes du Luberon

2 teaspoons chopped fresh thyme or a combination of thyme and rosemary

6 ounces baby spinach or 12 ounces bunch spinach (1 bunch), stemmed and thoroughly cleaned

3/4 pound penne

Freshly grated Parmesan to taste

 

1. Place the dried mushrooms in a Pyrex measuring cup and pour on 2 cups boiling water. Let soak 30 minutes, while you prepare the other ingredients. Place a strainer over a bowl, line it with cheesecloth or paper towels, and drain the mushrooms. Squeeze the mushrooms over the strainer to extract all the flavorful juices. Then rinse the mushrooms, away from the bowl with the soaking liquid, until they are free of sand. Squeeze dry and set aside. If very large, chop coarsely. Measure out 1 cup of the soaking liquid and set aside.

2. Heat the olive oil in a large, heavy, nonstick skillet over medium heat and add the onion or shallots. Cook, stirring often, until tender, about 5 minutes. Turn up the heat to medium-high and add the fresh mushrooms. Cook, stirring often, until they begin to soften and sweat, about 5 minutes. Add the garlic and salt to taste, stir together for about 30 seconds, then add the reconstituted dried mushrooms and the wine and turn the heat to high. Cook, stirring, until the liquid boils down and glazes the mushrooms. Add the herbs and the mushroom soaking liquid. Bring to a simmer, add salt to taste, and cook over medium-high heat, stirring often, until the mushrooms are thoroughly tender and fragrant. Turn off the heat, stir in some freshly ground pepper, taste and adjust salt.

3. Bring a large pot of water to a boil and salt generously. Fill a bowl with ice water. Add the spinach to the boiling water and blanch for 20 seconds only. Remove with a skimmer and transfer to the ice water, then drain and squeeze out water. Chop coarsely and add to the mushrooms. Reheat gently over low heat.

4. Bring the water back to a boil and cook the pasta al dente following the timing suggestions on the package. If there is not much broth in the pan with the mushrooms and spinach, add a ladleful of pasta water. Drain the pasta, toss with the mushrooms and spinach, add Parmesan to taste, and serve at once.

Yield: Serves 4

Advance preparation: The mushroom ragout will keep for 3 or 4 days in the refrigerator and tastes even better the day after you make it.

Nutritional information per serving: 437 calories; 9 grams fat; 1 gram saturated fat; 2 grams polyunsaturated fat; 5 grams monounsaturated fat; 0 milligrams cholesterol; 73 grams carbohydrates; 5 grams dietary fiber; 48 milligrams sodium (does not include salt to taste or Parmesan); 17 grams protein

​

Up Next: Spinach Gnocchi

 

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

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The 30-Minute Interview: The 30-Minute Interview With Nick J. Romito

Mr. Romito, 30, is the founder and chief executive of View the Space, a new real estate technology business that creates online video tours, primarily of office space, and provides data-tracking services to commercial real estate companies, among them SL Green Realty, Vornado Realty Trust and Silverstein Properties.

Before starting the business last year, Mr. Romito worked as a commercial broker and tenant and landlord representative.

Q. How has business been so far?

A. Business is good. We launched the beta version of the Web site about a year ago, and this April was when we took the beta logo off and decided that we were at a point where we could start charging for the product. We’ve grown extraordinarily fast, but that’s a good thing.

Q. Are you profitable yet?

A. We had profitability in May, then like most start-up companies we scaled up. We hit profitability again in October.

I put in all my life savings, which was roughly $50,000 to $100,000, with my wife’s help. As we were going into the market and trying to get people to believe in our dream it gets rough. But we actually got really lucky and found some great partners — a syndicate of hedge fund professionals who knew commercial real estate and invest in start-ups — who liked our idea. We raised about $650,000.

Q. Let’s talk about the services you provide.

A. As you probably know, commercial real estate is an antiquated business, more or less reluctant to embrace technology. We thought we were a crazy enough bunch to change that. We decided we could improve the process by taking it online from start to finish. So for us that means video. We’ve created a style of shooting video for office space that’s really never existed. Ours is the closest thing to actually being there, where you fly through the space and you actually feel like you’re in it. You just can’t touch the walls.

On the landlord side, we allow you to track how a person is interacting with the tour. So you get to see 1) the prospect who’s looking at it; 2) how many times they’ve watched it; and 3) how engaged are they with it. You’ll actually be able to tell whether a specific firm has taken the tour 10 times — that’s a very, very high level of engagement — and they’re a serious prospect so I’m going to follow up with them.

Q. What kind of analytics software accomplishes this?

A. We had to build a pretty serious back end of data that’s taken us awhile. You’ve got I.P. addresses all over the place, so we had to build a library of those, which we can identify for the most part which companies are viewing your space.

Q. And how do the clients see this information?

A. They can see it in real time whenever they want — from their dashboard. And if they’re not online we’ll e-mail it to them.

Q. Has this service helped to sell property faster?

A. Yeah. We’re at about 1.5 million square feet leased on View the Space since December 2011.

Q. How many clients do you have right now?

A. Over 50. We’ve got most of the larger commercial real estate institutions both on the public and private side.

It’s funny, when we first started, our thesis was that we would get all of the smaller landlords on board first because we have more access to them. But because we worked so tightly with the brokerage community to build this, SL Green caught wind of what we were doing very quickly and they ended up being our first big client.

So it’s kind of like a domino effect where you get the SL Greens of the world soon enough the Silversteins and all the other players want to find out what you’re doing.

Q. Where do you hope to see your business in, say, the next five to 10 years?

A. We think that technology is here to stay in commercial real estate. And we see us growing, hopefully, in every major market. We’re actively in 10 markets right now.

New York right now is probably 60 percent of the activity that we have.

Q. You don’t have a technology background, do you?

A. I don’t. During the first year of development I was still a broker. I tried to outsource the first part of this to India, which was a very painful process. You’ve got to start your day at 4 a.m., because of the time difference, and the language barrier was very difficult. Not only was I trying to learn Hindi, but also the language of technology.

Q. So when you’re not learning new languages, what do you do for fun?

A. I surf. That was more or less my life growing up on the Jersey Shore. In Toms River.

Q. Were you or your family affected by Hurricane Sandy?

A. My mom lost her house. She got a couple of feet of water, and now they’ll have to demo the house.

But as long as everyone is O.K., it’s just stuff. I think everybody down there is so resilient, and this is like when everybody really comes together.

Read More..

Changing of the Guard: Corrupt Chinese Officials Draw Unusual Publicity

BEIJING — The Chinese have become largely inured to tales of voracious officials stockpiling luxury apartments, $30,000 Swiss watches or enough stolen cash to buy their mistress a Porsche.

But when images of a bulbous-faced Communist Party functionary in southwest China having sex with an 18-year-old girl spread on the Internet late last month, even the most jaded citizens took note — as did the local party watchdogs who ordered his dismissal.

These have been especially nerve-racking times for Chinese officials who cheat, steal and bribe. Since the local bureaucrat, Lei Zhengfu, became an unwilling celebrity here, a succession of others have been publicly exposed. And despite the usual cries of innocence, most have been removed from office while party investigators sort through their bedrooms and bank accounts.

In the weeks since the Communist Party elevated a new slate of top leaders, the state media, often fed by freelance vigilantes, have been serving up a head-spinning collection of scandals.

Highlights include a deputy district official in Shanxi Province who fathered 10 children with four wives; a prefecture chief from Yunnan with an opium habit who managed to accumulate 23 homes, including 6 in Australia; and a Hunan bureaucrat with $19 million in unexplained assets who once gave his young daughter $32,000 in cash for her birthday.

“The anticorruption storm has begun,” People’s Daily, the party mouthpiece, wrote on its Web site this month.

The flurry of revelations suggests that members of China’s new leadership may be more serious than their predecessors about trying to tame the cronyism, bribery and debauchery that afflict state-run companies and local governments, right down to the outwardly dowdy neighborhood committees that oversee sanitation. Efforts began just days after Xi Jinping, the newly appointed Communist Party chief and China’s incoming president, warned that failing to curb corruption could put the party’s grip on power at risk.

“Something has shifted,” said Zhu Ruifeng, a Beijing journalist who has exposed more than a hundred cases of alleged corruption on his Web site, including the lurid exertions of Mr. Lei. “In the past, it might take 10 days for an official involved in a sex scandal to lose his job. This time he was gone in 66 hours.”

The licentiousness of Qi Fang, the public security chief of a small city in the far west, probably deserves a prize for originality. This month, an Internet sleuth revealed that Mr. Qi was maintaining two young sisters as mistresses. The sisters, as luck would have it, had also landed police department jobs and shared an apartment bankrolled by the city.

Mr. Qi lost his post, but not before denying any mischief and correcting one detail of the story: the sisters, contrary to earlier reports, are not twins.

Still, for all the salaciousness associated with the latest scandals, analysts say it is too soon to know whether Mr. Xi and other senior leaders have the stomach to wage a no-holds-barred war on the party’s pervasive corruption.

They point out that most of the recent scandals were uncovered by journalists, anonymous citizens or disgruntled colleagues who posted photographs and other damning allegations on the Internet, forcing the authorities to respond. Also significant is that most of those ousted were relatively minor officials.

The manager of a major Chinese Internet company said the party was effectively abetting the anticorruption free-for-all by declining to pull the plug on the online denunciations. But he said there was an implicit understanding that high-ranking officials were off limits.

“For now it’s spontaneous,” said the manager, who asked that the name of his company be withheld because of the political sensitivities involved. “But we also understand the parameters.”

This month, Luo Changping, deputy managing editor at the enterprising newsmagazine Caijing, published accusations on his microblog about improper business dealings by Liu Tienan, the director of China’s National Energy Administration. The postings, which also included charges that Mr. Liu had fabricated his academic qualifications and had threatened to kill his mistress, have caused something of an earthquake, given that they targeted such a high-level official. Just as astonishing, many say, is that Mr. Luo’s claims remain undeleted by censors despite Mr. Liu’s denials of wrongdoing.

Patrick Zuo contributed research.

Read More..

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.”

Read More..

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.”

Read More..

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.”

Read More..

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.

Read More..

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.

Read More..

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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