Fiscal Cutoff Gradually Morphs Into a Horizon





Quick action by President Obama and Congress could still help the economy escape the full impact of hundreds of billions in tax increases and automatic spending cuts set to take effect shortly after the last minutes of 2012 tick away next week. But if the deadlock in Washington persists much longer than a few weeks, the consequences will quickly mount, economists warn.




Until late last week, most observers had expected the president and Congressional Republicans to come up with at least a short-term compromise before the year-end deadline. But the failure of Speaker John A. Boehner to win support for tax increases on the wealthiest Americans from fellow House Republicans has forced many economic observers to reconsider what might happen if political leaders remain deadlocked into 2013.


Wall Street is still betting on a quick deal, but that confidence is misplaced, said Julia Coronado, chief North American economist at BNP Paribas. “Markets have been incredibly complacent about this,” she said. If a compromise cannot be found by Jan. 1, she said, “the markets will take that hard.”


Some hits — like a two percentage point increase in payroll taxes and the end of unemployment benefits for more than two million jobless Americans — would be felt right away. But other effects, like tens of billions in automatic spending cuts, to include both military and other programs, would be spread out between now and the end of the 2013 fiscal year in September. These could quickly be reversed if a compromise is found.


Similarly, the expiration of Bush-era tax cuts on Jan. 1 would not have a major impact on consumers if Congress quickly agreed to extend them for all but the wealthiest Americans in early 2013, as is widely expected.


Other probable changes, like a jump in taxes on capital gains and dividends, would most likely be felt over a broader period rather than as an immediate blow to the economy.


In the meantime, more observers are contemplating what the impact will be if Washington ignores the year-end deadline and waits until January or February to act.


“It’s still possible they will work something out by the end of the year, but the probability seems reasonably high that we may go into January with no agreement,” said Dean Maki, chief United States economist at Barclays Capital. “But the longer this goes on, the more nervous I get about first-quarter growth. If negotiations were to linger into March, then the first quarter could be much weaker.”


If the impasse lasted even longer and the full force of more than $500 billion in tax increases and spending cuts hit the economy, the Congressional Budget Office predicts the country would slip into recession in the first half of 2013, with unemployment rising to 9.1 percent by the fourth quarter of 2013. But for all the pessimism recently, most observers still think a compromise will be reached, even if it takes a few more weeks.


Negotiations are set to resume in the coming days, following a break for Christmas, although hopes for a so-called grand bargain have faded. Instead, President Obama is pushing for a scaled-back plan that would extend the Bush-era tax cuts on incomes below $250,000, while suspending the automatic spending cuts and extending unemployment benefits.


Michelle Meyer, senior United States economist at Bank of America Merrill Lynch, said there is a 40 percent chance of what she calls a “bungee-jump over the fiscal cliff,” with Congress failing to act until after Jan. 1 but eventually averting the full package of tax increases and spending cuts by mid-January. If that were to happen, she predicts a steep sell-off on Wall Street, which would quickly force political leaders to compromise.


Over all, Ms. Meyer estimates that the economy will grow by just 1 percent in the first quarter of 2013, well below the 3.1 percent pace recorded in the third quarter of 2012.


What’s worrisome, she added, is that consumer anxiety about the fiscal impasse has begun to mount, catching up with business leaders who have been warning of economic danger since summer. “What’s been missing in this recovery has been confidence,” she said. “We’d see a healthy recovery if it weren’t for this uncertainty and the potential shock from Washington.”


Indeed, the economy has been showing signs of life recently. Unemployment in November sank to 7.7 percent, a four-year low. Consumer spending has been picking up, and the housing market has continued to recover in many parts of the country. Overseas worries like slowing growth in China and recession in Europe have also faded.


Those trends have encouraged some observers, like Steve Blitz, chief economist at ITG Investment Research. He estimates that the economy will grow by nearly 2.5 percent in the first quarter if Washington comes up with even a modest compromise. In the absence of a deal, the pace of growth would be more like 1 percent, he said.


“I don’t think that not having a deal going into the new year is all that critical,” Mr. Blitz said. “It doesn’t mean you will immediately go into a recession.”


Read More..

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.”


Read More..

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.”


Read More..

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..

Israel to Review Curbs on Women’s Prayer at Western Wall


Rina Castelnuovo for The New York Times


Members of a group called Women of the Wall read from the Torah near the Western Wall in Jerusalem in December.







JERUSALEM — Amid outrage across the Jewish diaspora over a flurry of recent arrests of women seeking to pray at the Western Wall with ritual garments in defiance of Israeli law, Prime Minister Benjamin Netanyahu has asked Natan Sharansky, the chairman of the Jewish Agency, to study the issue and suggest ways to make the site more accommodating to all Jews.




The move comes after more than two decades of civil disobedience by a group called Women of the Wall against regulations, legislation and a 2003 Israeli Supreme Court ruling that allow for gender division at the wall, one of Judaism’s holiest sites, and prohibit women from carrying a Torah or wearing prayer shawls there.


Although the movement has struggled to gain traction in Israel, where the ultra-Orthodox retain great sway over public life, the issue has deepened a divide between the Jewish state and Jews around the world at a time when Israel is battling international isolation over its settlement policy. Critics, particularly leaders of the Reform and Conservative movements in the United States, complain that the government’s recent aggressive enforcement of restrictions at the wall has turned a national monument into an ultra-Orthodox synagogue.


“The prime minister thinks the Western Wall has to be a site that expresses the unity of the Jewish people, both inside Israel and outside the state of Israel,” Ron Dermer, Mr. Netanyahu’s senior adviser, said in an interview on Tuesday. “He wants to preserve the unity of world Jewry. This is an important component of Israel’s strength.”


Mr. Sharansky, whose quasi-governmental nonprofit organization handles immigration for the state and is a bridge between Israel and Jews around the world, said that Mr. Netanyahu asked him on Monday to take up the matter, and that he expected to have recommendations within a few months. He and Mr. Dermer said the agenda would include improvements for Robinson’s Arch, a discreet area of the wall designated for coed prayer under the court ruling, and the easing of restrictions in the larger area known as the Western Wall plaza, along with the more sensitive questions regarding prayer at the main site.


Mr. Sharansky said the Jewish Agency itself stopped having ceremonies for new immigrants in the plaza about two years ago after the Western Wall Heritage Foundation, which controls the site, said that men and women could not sit together. Under pressure from the international groups that provide its financing, the agency passed a resolution on Oct. 30 calling for a “satisfactory approach to the issue of prayer at the Western Wall.”


Asked whether he could imagine a day when women could wear prayer shawls and read a Torah at the wall itself, Mr. Sharansky said, “I imagine very easily a situation where everybody will have their opportunity to express their solidarity with Judaism and the Jewish people and the state of Israel in a way he or she wants, without undermining the other.”


“That’s as much as I want to say at this moment,” he added. “Now I have to share this vision with the appropriate bodies.”


Mr. Sharansky, a former Soviet dissident and widely respected figure, has been called upon before to broker peace with the diaspora over questions of religious pluralism, most recently during a harsh fight over conversion. Anat Hoffman, the chairwoman of Women of the Wall, reacted with cautious optimism to Mr. Netanyahu’s initiative, but said it would not stop the Israel Religious Action Center, of which she is executive director, from filing a Supreme Court petition as soon as next week challenging the makeup of the heritage foundation’s board.


“It’s a good thing that after 24 years the highest echelons in Israel are actually paying attention to this rift that is breaking diaspora Jews from Israel,” she said. “The table that should run the Western Wall should have everyone who has an interest in the wall sitting around it.”


Rabbi Shmuel Rabinowitz, the head of the heritage foundation, said in an e-mailed statement that he was unaware of the Sharansky initiative and therefore “does not have an opinion about it.”


While Ms. Hoffman said the women’s group would be satisfied if it were allowed to pray at the wall once a month with full regalia, her religious action center wants hours each day, between scheduled prayer times, when the gender partition is removed and people can freely enjoy the site as a cultural monument.


“If in the end what happens is that the Robinson’s Arch area will be run by the Jewish Agency instead of the antiquities department, then we’re talking about who’s going to take care of the air-conditioning in the back of the bus,” she said. “I don’t care about that. I don’t want to sit in the back of the bus. I want to dismantle the Western Wall Heritage Foundation.”


Abraham H. Foxman, the director of the Anti-Defamation League, said he discussed the wall and other questions of religious pluralism with Mr. Netanyahu in Jerusalem on Monday.


“This is a wise initiative, but it’s only a beginning,” Mr. Foxman said.


Irit Pazner Garshowitz contributed reporting.



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.”


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India Ink: Adding Indian Spice to Christmas

For those who celebrate Christmas, the meal eaten to mark the holiday can be as important as the ritual of exchanging gifts or decorating a green tree.

South Asians, of course, make food center stage at any occasion, and many have come to embrace the tradition of Christmas dinner, whether they’re Hindu, Muslim or Christian. But just as Indians adjust Western dishes to their tastes – like adding cilantro to pasta or green chili to grilled cheese – so do they “Indianize” Christmas food classics.

NYCDesi

The Indian Scene, as Seen From New York

Saira Malhotra, a recipe developer based in New York and founder of the food site Passport Pantry, recalled how many Indians in her hometown of London would use tandoori masala and ginger to marinate the traditional British meal of turkey, fearing the traditional holiday recipes might not stand up to a palate accustomed to spice.

A plate of meat with mint jelly and roasted potatoes might sound like a nice enough meal, but for many South Asians it can be a bit bland. An Indian chef might add roasted cumin to the potatoes, chilies in the chutney and a crust of mango powder on the meat.

It’s easy to get creative with Indian-fusion renditions of Christmas dishes, and Ms. Malhotra has a few recipes she recommends to bring the two cultures together on one plate.

Habanero Savory Cheesecake
This cheesecake, served as an appetizer or side dish, combines Christmas elements, like the rosemary crust, with plenty of heat.

Ingredients

1 packet of rosemary crackers (1½ cups crushed)
1 stick softened butter
3 tablespoons cornstarch
1 teaspoon salt
5 ounces sour cream
16 ounces cream cheese (2 regular-sized packs)
5 ounces blue cheese
2 eggs
4 tablespoons habanero jelly (or any other chili jelly)
Fresh cracked pepper

Method

For the crust:
As the oven heats to 350 degrees Fahrenheit, crush the crackers with the butter and pack tightly against the base of a nine-inch springform pan. Bake for 10 minutes, remove from the oven and set aside to cool. Reduce the oven temperature to 250 degrees Fahrenheit.

For the cheese filling:

1. Beat the salt, sour cream, cream cheese and cornstarch. Add the blue cheese and combine well. Add the eggs one at a time, combining thoroughly each time. Swirl in half the habanero jelly and black pepper.

2. Pour mixture over the cooled crust and bake for one hour. Do not overcook the cheesecake or it will lose its creaminess. Once the cheesecake is set on the sides and wobbly in the middle, it is done.

3. Remove and cool completely. It will continue to stiffen as it cools. Wrap well and refrigerate for at least four hours. Spread remaining habanero jelly on top before serving.

Mango and Ginger Chutney
The sweetness of the mango works well with savory dishes, and the sharpness of the ginger and spices balances the richness of a roasted ham or a charcuterie and cheese plate.

Ingredients

3 pounds ripe Mexican mangoes, peeled and cut into small pieces
1 medium-sized onion, diced
2 fresh red or green chilies, chopped into ¼-inch pieces
14 ounces rice wine vinegar
14 ounces jaggery, broken into small pieces (if you can’t find jaggery at your ethnic specialty store, substitute brown sugar)
2 tablespoons cooking oil
1 teaspoon each of cumin seeds, coriander powder (or crushed coriander seeds), fenugreek seeds, nigella seeds
4-6 cloves
6 whole peppercorns

Method

1. Sterilize the pickling jars in boiling water.

2. Heat the cooking oil in a pan. Add the cumin, fenugreek and nigella seeds, coriander, cloves and whole peppercorns. Allow the spices to turn a couple of shades darker.

3. Sauté the onions and fresh chilies in the same pan until the onions are translucent. Add the jaggery/sugar and vinegar and allow the sweetening agent to fully dissolve.

4. Add the mangoes, bring to a boil and turn down the heat to a simmer. Cook for approximately 1 hour or until the chutney has thickened. The mango will have become translucent at this point and will have a sheen to it.

5. Fill the sterilized jars while the chutney is still hot and seal them.

Roasted Yams with Spice Crust
The spices provide complexity to this typically one-toned side dish, thanks to the contrasting components of flavor.

Ingredients

3 pounds yams
1 teaspoon coriander seeds
1 teaspoon cumin seeds
2 whole dried red chilies or ½ teaspoon chili flakes
1 teaspoon salt
1 teaspoon pepper
¼ cup of olive oil

Method

1. Heat oven to 400 degrees Fahrenheit. In the meantime, boil water in a large pot and add the whole yams with the skin. Boil yams until halfway tender (approximately 10 minutes). (Be careful not to overcook the yams as they will swell with water and not hold their shape.) Cut into wedges with the skin on and cool.

2. To toast the spices, heat a pan and add the coriander, cumin seeds and red chilies. Toast until the essential oils release and an aroma emerges. Break down the spices and chilies with a mortar and pestle.

3. Coat yam wedges with the oil and spices. Fully cook the yams in the oven, approximately 15 minutes, until golden brown with a nice crust.

Warm Potato and Bacon Salad
This spin on classic potato salad benefits from the zing from smoked paprika. It works well as a side dish but also is a nice accompaniment to cold cuts.

Ingredients

1½ pounds new potatoes
½-pound slab of bacon, cut into ¼-inch pieces
2 shallots, finely diced
1 teaspoon smoked paprika
4 tablespoon red wine vinegar
Zest and juice of 1 lemon
¼ cup olive oil
½ teaspoon mustard
Salt and pepper
1 tablespoon crème fraîche or sour cream
1 tablespoon chopped chives

Method

1. Bring the potatoes to a boil, starting them off in cold water. Sauté the bacon, then remove with slotted spoon. In the bacon fat, sauté shallots until translucent.

2. For the dressing: Shake the vinegar, lemon zest and juice, olive oil, mustard, salt and pepper and paprika in a bottle. (The bacon can be quite salty so use a light hand with the salt.)

3. Once potatoes are tender (10-15 minutes), cut them in half and toss the potatoes with the dressing while they are still warm. Combine the crème fraîche, shallots, bacon and 1 tablespoon of the bacon fat with the warm potatoes. Sprinkle chives before serving.

Sticky Toffee and Cardamom Pudding
Cardamom adds a floral note to a British classic.

Ingredients

For sticky toffee and pecan sauce:
1 ounce chopped pecans
6 ounces soft brown sugar
6 tablespoons double cream
4 ounces margarine

For date and cardamom cake:
3 ounces margarine, room temperature
5 ounces sugar
6 ounces self-raising flour
2 eggs
2 ounces finely sliced dates
½ teaspoon vanilla essence
½ teaspoon cardamom powder
2 teaspoons coffee essence, like Camp Coffee
¼ teaspoon bicarbonate of soda
9 cupcake cups

Method

For the sauce:
Combine sugar, margarine, double cream and pecans in a saucepan over medium-low heat until the margarine has completely melted.

For date and cardamom cake:

1. As the oven warms to 350 Fahrenheit, beat margarine and sugar in a bowl, until fluffy.

2. In a separate bowl, add eggs and slowly whisk in the creamed margarine and sugar. Then fold in the flour (to incorporate air).

3. In a separate bowl, mix 6 fluid ounces of boiling water with vanilla essence, cardamom powder, bicarbonate of soda and coffee essence. Don’t be alarmed if the liquid becomes fizzy.

4. Stir the liquid into the butter, sugar, egg and flour mixture so that it forms a batter. Pour the batter into cupcake cups to about three-fourths full.

5. Sprinkle 4 slivers of dates on each pudding, then bake for approximately 15 minutes. Insert a skewer in the center, and if it comes out clean, your pudding is ready. Pour the toffee and pecan sauce over the pudding just before serving.

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Advertising: Selling Made in U.S.A., but Very Carefully





BRANDS reviving the “Made in the U.S.A.” slogan to attract buyers for American-produced goods are relying less on patriotism and more on data that shows consumers are willing to pay a premium for better quality, quicker availability and product safety.




But many companies are stepping gingerly, avoiding sweeping claims and spelling out what “Made in the U.S.A.” means for their products. Consumers are more shrewd about how few consumer goods actually are made in the United States, leaving companies less wiggle room about the origin of products.


The Whirlpool Corporation, for example, specified in full-page print advertisements this year that 80 percent of its appliances “sold in the U.S. come from our U.S. factories.” Despite its deep American roots, the 101-year-old company — which makes Maytag, Amana, KitchenAid and Jenn-Air products — has, like other corporate giants, moved some manufacturing abroad.


As a result of its centennial celebrations last year, some consumers have urged the company to talk more about its American origins, said William Beck, a senior marketing director at Whirlpool, which spent $57.4 million in 2011 on advertising, according to Kantar Media, a WPP unit.


In recent months, the appliance giant has been underlining its American factories, and noting in its overall brand advertising that it employs about 22,000 workers (15,000 of them at its manufacturing plants), and spends $7.4 million annually on operating and maintaining its factories in Iowa, Ohio, Oklahoma and Tennessee.


But Whirlpool, whose ad drew a full-page rebuttal from the International Association of Machinists and Aerospace Workers accusing it of shutting factories in the United States, said nostalgia and similar sentiments do not drive its sales. “Whirlpool’s key differentiating points are quality and innovation,” said Mr. Beck, and “the icing is that, hey, we’re made in the United States.”


Whirlpool does not share its market research, but other market studies show that customers increasingly take note of where a product is made. Perception Research Services International, in a September study, found that four out of five shoppers notice a “Made in the U.S.A.” label on packaging, and 76 percent of them said they would be more likely to buy a product because of the label.


While shoppers, especially those over 35, say they want to help the economy by buying United States-made goods, “the motivating factors actually may be quality and safety,” said Jonathan Asher, executive vice president of Perception Research Services. The company, which is based in Teaneck, N.J., surveyed 1,400 consumers last summer. “People are paying attention in categories that are ingested like food, medicine and personal care products, but less so in electronics, office supplies and appliances,” he said.


In a separate study, the Boston Consulting Group found that 80 percent of consumers surveyed said they would be willing to pay more for “Made in the U.S.A.” products than for those carrying a “Made in China” label.


They would pay the biggest differential for items like baby food and wooden toys, and a smaller percentage for electronics, apparel and appliances, said Kate Manfred, director of the group’s Center for Consumer and Customer Insight in the Americas, which released the study in mid-November.


“Safety and quality, and keeping jobs in America, are the important factors,” she said.


Bixbi, a Boulder, Colo., pet treat provider, has relied on safety to increase sales. The company, which started in 2008 amid revelations of tainted dog food ingredients imported from overseas, sells dog treats made from locally raised chickens and other animals.


“Our sales have grown 600 percent each year,” said James Crouch, who founded the small company with his brother, Michael. “Locally sourced is a key advantage.”


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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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