Proposed changes in the definition of autism would sharply reduce the skyrocketing rate at which the disorder is diagnosed and might make it harder for many people who would no longer meet the criteria to get health, educational and social services, a new analysis suggests.
The definition is now being reassessed by an expert panel appointed by the American Psychiatric Association, which is completing work on the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, the first major revision in 17 years. The D.S.M., as the manual is known, is the standard reference for mental disorders, driving research, treatment and insurance decisions. Most experts expect that the new manual will narrow the criteria for autism; the question is how sharply.
The results of the new analysis are preliminary, but they offer the most drastic estimate of how tightening the criteria for autism could affect the rate of diagnosis. For years, many experts have privately contended that the vagueness of the current criteria for autism and related disorders like Asperger syndrome was contributing to the increase in the rate of diagnoses — which has ballooned to one child in 100, according to some estimates.
The psychiatrists’ association is wrestling with one of the most agonizing questions in mental health — where to draw the line between unusual and abnormal — and its decisions are sure to be wrenching for some families. At a time when school budgets for special education are stretched, the new diagnosis could herald more pitched battles. Tens of thousands of people receive state-backed services to help offset the disorders’ disabling effects, which include sometimes severe learning and social problems, and the diagnosis is in many ways central to their lives. Close networks of parents have bonded over common experiences with children; and the children, too, may grow to find a sense of their own identity in their struggle with the disorder.
The proposed changes would probably exclude people with a diagnosis who were higher functioning. “I’m very concerned about the change in diagnosis, because I wonder if my daughter would even qualify,” said Mary Meyer of Ramsey, N.J. A diagnosis of Asperger syndrome was crucial to helping her daughter, who is 37, gain access to services that have helped tremendously. “She’s on disability, which is partly based on the Asperger’s; and I’m hoping to get her into supportive housing, which also depends on her diagnosis.”
The new analysis, presented Thursday at a meeting of the Icelandic Medical Association, opens a debate about just how many people the proposed diagnosis would affect.
The changes would narrow the diagnosis so much that it could effectively end the autism surge, said Dr. Fred R. Volkmar, director of the Child Study Center at the Yale School of Medicine and an author of the new analysis of the proposal. “We would nip it in the bud.”
Experts working for the Psychiatric Association on the manual’s new definition — a group from which Dr. Volkmar resigned early on — strongly disagree about the proposed changes’ impact. “I don’t know how they’re getting those numbers,” Catherine Lord, a member of the task force working on the diagnosis, said about Dr. Volkmar’s report.
Previous projections have concluded that far fewer people would be excluded under the change, said Dr. Lord, director of the Institute for Brain Development, a joint project of NewYork-Presbyterian Hospital, Weill Medical College of Cornell University, Columbia University Medical Center and the New York Center for Autism.
Disagreement about the effect of the new definition will almost certainly increase scrutiny of the finer points of the psychiatric association’s changes to the manual. The revisions are about 90 percent complete and will be final by December, according to Dr. David J. Kupfer, a professor of psychiatry at the University of Pittsburgh and chairman of the task force making the revisions.
At least a million children and adults have a diagnosis of autism or a related disorder, like Asperger syndrome or “pervasive developmental disorder, not otherwise specified,” also known as P.D.D.-N.O.S. People with Asperger’s or P.D.D.-N.O.S. endure some of the same social struggles as those with autism but do not meet the definition for the full-blown version. The proposed change would consolidate all three diagnoses under one category, autism spectrum disorder, eliminating Asperger syndrome and P.D.D.-N.O.S. from the manual. Under the current criteria, a person can qualify for the diagnosis by exhibiting 6 or more of 12 behaviors; under the proposed definition, the person would have to exhibit 3 deficits in social interaction and communication and at least 2 repetitive behaviors, a much narrower menu.
Dr. Kupfer said the changes were an attempt to clarify these variations and put them under one name. Some advocates have been concerned about the proposed changes.
“Our fear is that we are going to take a big step backward,” said Lori Shery, president of the Asperger Syndrome Education Network. “If clinicians say, ‘These kids don’t fit the criteria for an autism spectrum diagnosis,’ they are not going to get the supports and services they need, and they’re going to experience failure.”
Saturday, January 21, 2012
Haywire (2012) review
Someone Done Her Wrong. Horrible Mistake.
When you think about it, the phrase “action movie” is a bit redundant. Really, what else are motion pictures for? In the earliest days of cinema our ancestors were thrilled to behold images of galloping horses, hurtling trains and capering dancers. Though our entertainments are now more elaborate, our appetites are not so different. A large part of what we crave is action: running, jumping, fighting, driving, flying. Sometimes everything else — plot, character, emotion — can seem superfluous.
This appears to be the working hypothesis behind “Haywire,” a cold and kinetic experiment in high-impact, low-concept genre filmmaking directed by Steven Soderbergh. Starting with a brawl in a rural roadside diner, the film, written by Lem Dobbs, proceeds through a series of expertly choreographed, meticulously edited scuffles and chases, set pieces threaded around a plot that seems almost defiantly preposterous and uninteresting.
The main character is Mallory Kane, played by the mixed martial arts fighter and “American Gladiators” cast member Gina Carano, making her acting debut. Mallory is a professional black-ops superwarrior (at least I think that’s what her business card says) whose troubles are a reminder of just how dangerous it can be to mix work and romance. To say too much about the guys she deals with would be to risk inflaming the spoiler-sensitive, but her dealings with them frequently end, and sometimes begin, with punches and kicks, though there are also occasional kisses and job interviews.
Mallory is the victim of an elaborate double-cross, which she explains to one of the few men not implicated in it, a young fellow named Scott (Michael Angarano), whose chivalrous intervention in that diner melee plunges him into a welter of mayhem and high-speed exposition. As Mallory drives Scott’s car toward the next showdown, a flurry of flashbacks explains the significance of certain proper nouns, notably Aaron, Paul, Kenneth and Barcelona.
Kenneth (Ewan McGregor) is Mallory’s ex-boyfriend and also her erstwhile employer at a firm that does nasty contract work for the government, here represented by Michael Douglas. Aaron (Channing Tatum) did a job with Mallory in Barcelona, where things got a little complicated. So that takes care of that. Further complications turn out to involve Antonio Banderas and Michael Fassbender (who is Paul, but that’s enough for now). Apart from Scott, the only man Mallory trusts (there are no other women in the world of “Haywire”) is her father (Bill Paxton), a former Marine (as is his daughter) with a wonderfully cinematic and conveniently isolated house in New Mexico.
Another important stop on Mallory’s itinerary of flight and payback is Dublin, scene of an intricate and suspenseful foot chase that serves as Mr. Soderbergh’s critique of current trends in action filmmaking, in particular those associated with the British director Paul Greengrass. Instead of the splintered, speeded-up cutting favored by Mr. Greengrass and his followers — most memorably deployed in the second and third “Bourne” movies, which turned the cities of the world into Google Earth kaleidoscopes of controlled chaos — Mr. Soderbergh builds momentum and uncertainty through extended tracking shots and tight, restricted perspectives. Like Mallory the audience can’t see everything that’s happening and isn’t sure what will happen next.
In another sense, though, nothing is really in doubt, and very little is at stake. Unlike the “Bourne” films, whose baroque webbing of plot and counterplot suggested an allegory of global paranoia, “Haywire” goes to great lengths to avoid being about anything beyond its immediate situations and effects. It is self-consciously and aggressively trivial, a feast for formalists who sentimentalize the gloriously cheap B-movies of the past.
Nowadays everyone must love (or at least pretend to love) pleasures that were supposedly once disdained or taken for granted: dive bars, street food, trashy films. But knowing, sophisticated attempts to replicate those things often traffic in their own kind of snobbery, confusing condescension with authenticity. Movies like “The American,” “Drive” and now “Haywire” offer strained pulp, neither as dumb as we want them to be nor as smart as they think they are, and not, in the end, all that much fun.
There is no doubting Mr. Soderbergh’s skill or the sincerity of his interest in some of the technical problems of postmodern cinema. And “Haywire” explores interesting questions about the nature of acting. Ms. Carano does, strictly speaking, very little of it. Her expressions run the gamut from glower to pout, and her features give little indication of her character’s inner state.
This is partly consistent with Mallory’s guardedness, but her blankness also contrasts with the nimble, slick pretending of Ms. Carano’s male co-stars. Their professionalism manifests itself in different ways — Mr. McGregor and Mr. Douglas are practiced hams, while Mr. Fassbender prefers to keep kosher — but in each case there is a fascinating awkwardness to their encounters with Ms. Carano, who is a more purely physical screen presence. (She and Mr. Tatum, on the other hand, have the chemistry of shared clumsiness.)
The fighting that Ms. Carano and her co-stars pretend to do in “Haywire” is something she has done more or less for real, which makes her performance, like the porn star Sasha Grey’s in Mr. Soderbergh’s “Girlfriend Experience,” an intriguing curiosity and something of a conceptual puzzle. Once the talking stops and the action begins, her professionalism is very much in evidence and exciting to watch. And yet, somehow, it cannot quite relieve the tedium of a movie that is too cool even to pretend that there is anything worth fighting about.
“Haywire” is rated R (Under 17 requires accompanying parent or adult guardian). Strong action and rough talk.
HAYWIRE
Opens on Friday nationwide.
Directed by Steven Soderbergh; written by Lem Dobbs; production design by Howard Cummings; music by David Holmes; costumes by Shoshana Rubin; produced by Gregory Jacobs and Ryan Kavanaugh; released by Relativity Media. Running time: 1 hour 33 minutes.
WITH: Gina Carano (Mallory Kane), Ewan McGregor (Kenneth), Michael Fassbender (Paul), Michael Douglas (Coblenz), Channing Tatum (Aaron), Antonio Banderas (Rodrigo), Bill Paxton (Mr. Kane), Michael Angarano (Scott) and Mathieu Kassovitz (Studer).
This article has been revised to reflect the following correction:
Correction: January 21, 2012
A film review on Friday about “Haywire,” starring Gina Carano, misidentified her role on the television show “American Gladiators.” She was a member of the gladiator cast, not a contestant.
When you think about it, the phrase “action movie” is a bit redundant. Really, what else are motion pictures for? In the earliest days of cinema our ancestors were thrilled to behold images of galloping horses, hurtling trains and capering dancers. Though our entertainments are now more elaborate, our appetites are not so different. A large part of what we crave is action: running, jumping, fighting, driving, flying. Sometimes everything else — plot, character, emotion — can seem superfluous.
This appears to be the working hypothesis behind “Haywire,” a cold and kinetic experiment in high-impact, low-concept genre filmmaking directed by Steven Soderbergh. Starting with a brawl in a rural roadside diner, the film, written by Lem Dobbs, proceeds through a series of expertly choreographed, meticulously edited scuffles and chases, set pieces threaded around a plot that seems almost defiantly preposterous and uninteresting.
The main character is Mallory Kane, played by the mixed martial arts fighter and “American Gladiators” cast member Gina Carano, making her acting debut. Mallory is a professional black-ops superwarrior (at least I think that’s what her business card says) whose troubles are a reminder of just how dangerous it can be to mix work and romance. To say too much about the guys she deals with would be to risk inflaming the spoiler-sensitive, but her dealings with them frequently end, and sometimes begin, with punches and kicks, though there are also occasional kisses and job interviews.
Mallory is the victim of an elaborate double-cross, which she explains to one of the few men not implicated in it, a young fellow named Scott (Michael Angarano), whose chivalrous intervention in that diner melee plunges him into a welter of mayhem and high-speed exposition. As Mallory drives Scott’s car toward the next showdown, a flurry of flashbacks explains the significance of certain proper nouns, notably Aaron, Paul, Kenneth and Barcelona.
Kenneth (Ewan McGregor) is Mallory’s ex-boyfriend and also her erstwhile employer at a firm that does nasty contract work for the government, here represented by Michael Douglas. Aaron (Channing Tatum) did a job with Mallory in Barcelona, where things got a little complicated. So that takes care of that. Further complications turn out to involve Antonio Banderas and Michael Fassbender (who is Paul, but that’s enough for now). Apart from Scott, the only man Mallory trusts (there are no other women in the world of “Haywire”) is her father (Bill Paxton), a former Marine (as is his daughter) with a wonderfully cinematic and conveniently isolated house in New Mexico.
Another important stop on Mallory’s itinerary of flight and payback is Dublin, scene of an intricate and suspenseful foot chase that serves as Mr. Soderbergh’s critique of current trends in action filmmaking, in particular those associated with the British director Paul Greengrass. Instead of the splintered, speeded-up cutting favored by Mr. Greengrass and his followers — most memorably deployed in the second and third “Bourne” movies, which turned the cities of the world into Google Earth kaleidoscopes of controlled chaos — Mr. Soderbergh builds momentum and uncertainty through extended tracking shots and tight, restricted perspectives. Like Mallory the audience can’t see everything that’s happening and isn’t sure what will happen next.
In another sense, though, nothing is really in doubt, and very little is at stake. Unlike the “Bourne” films, whose baroque webbing of plot and counterplot suggested an allegory of global paranoia, “Haywire” goes to great lengths to avoid being about anything beyond its immediate situations and effects. It is self-consciously and aggressively trivial, a feast for formalists who sentimentalize the gloriously cheap B-movies of the past.
Nowadays everyone must love (or at least pretend to love) pleasures that were supposedly once disdained or taken for granted: dive bars, street food, trashy films. But knowing, sophisticated attempts to replicate those things often traffic in their own kind of snobbery, confusing condescension with authenticity. Movies like “The American,” “Drive” and now “Haywire” offer strained pulp, neither as dumb as we want them to be nor as smart as they think they are, and not, in the end, all that much fun.
There is no doubting Mr. Soderbergh’s skill or the sincerity of his interest in some of the technical problems of postmodern cinema. And “Haywire” explores interesting questions about the nature of acting. Ms. Carano does, strictly speaking, very little of it. Her expressions run the gamut from glower to pout, and her features give little indication of her character’s inner state.
This is partly consistent with Mallory’s guardedness, but her blankness also contrasts with the nimble, slick pretending of Ms. Carano’s male co-stars. Their professionalism manifests itself in different ways — Mr. McGregor and Mr. Douglas are practiced hams, while Mr. Fassbender prefers to keep kosher — but in each case there is a fascinating awkwardness to their encounters with Ms. Carano, who is a more purely physical screen presence. (She and Mr. Tatum, on the other hand, have the chemistry of shared clumsiness.)
The fighting that Ms. Carano and her co-stars pretend to do in “Haywire” is something she has done more or less for real, which makes her performance, like the porn star Sasha Grey’s in Mr. Soderbergh’s “Girlfriend Experience,” an intriguing curiosity and something of a conceptual puzzle. Once the talking stops and the action begins, her professionalism is very much in evidence and exciting to watch. And yet, somehow, it cannot quite relieve the tedium of a movie that is too cool even to pretend that there is anything worth fighting about.
“Haywire” is rated R (Under 17 requires accompanying parent or adult guardian). Strong action and rough talk.
HAYWIRE
Opens on Friday nationwide.
Directed by Steven Soderbergh; written by Lem Dobbs; production design by Howard Cummings; music by David Holmes; costumes by Shoshana Rubin; produced by Gregory Jacobs and Ryan Kavanaugh; released by Relativity Media. Running time: 1 hour 33 minutes.
WITH: Gina Carano (Mallory Kane), Ewan McGregor (Kenneth), Michael Fassbender (Paul), Michael Douglas (Coblenz), Channing Tatum (Aaron), Antonio Banderas (Rodrigo), Bill Paxton (Mr. Kane), Michael Angarano (Scott) and Mathieu Kassovitz (Studer).
This article has been revised to reflect the following correction:
Correction: January 21, 2012
A film review on Friday about “Haywire,” starring Gina Carano, misidentified her role on the television show “American Gladiators.” She was a member of the gladiator cast, not a contestant.
Scientists to Pause Research on Deadly Strain of Bird Flu
The scientists who altered a deadly flu virus to make it more contagious have agreed to suspend their research for 60 days to give other international experts time to discuss the work and determine how it can proceed without putting the world at risk of a potentially catastrophic pandemic.
Suspensions of biomedical research are almost unheard of; the only other one in the United States was a moratorium from 1974 to 1976 on some types of recombinant DNA research, because of safety concerns.
A letter explaining the flu decision is being published in two scientific journals, Science and Nature, which also plan to publish reports on the research, but in a redacted form, omitting details that would let other researchers copy the experiments. The letter is signed by the scientists who produced the new, more contagious form of the flu virus, as well as by more than 30 other leading flu researchers.
“We recognize that we and the rest of the scientific community need to clearly explain the benefits of this important research and the measures taken to minimize its possible risks,” the letter states. At an international meeting next month in Geneva, participants selected by the World Health Organization will consider what to do next. Dr. Anthony Fauci, head of the National Institutes of Health, said the gathering would “address some of these difficult issues on an international scale instead of something restricted to the United States government.”
The scientists say their work has important public health benefits, but they acknowledge that it has sparked intense public fears that the deadly virus could accidentally leak out of a laboratory, or be stolen by terrorists, and result in a devastating pandemic. A national biosecurity panel in the United States has already taken the unusual step of asking the scientists to keep part of their data secret to prevent others from reproducing their work.
Scientists are split regarding the research, with some praising it as important and urging that it be published, and others saying the experiments are so dangerous that they should never have been done.
The experiments involve a type of bird flu virus known as H5N1, which rarely infects people but is highly deadly when it does. The work, paid for by the National Institutes of Health, was done by two separate research teams, at Erasmus Medical Center in Rotterdam, the Netherlands, and at the University of Wisconsin, Madison.
Ron Fouchier, a virologist who conducted the research at Erasmus Medical Center, explained why he and his colleagues decided to pause the research. “It is unfortunate that we need to take this step to help stop the controversy in the United States,” he said. “I think if this were communicated better in the United States it might not have been needed to do this. In the Netherlands we have been very proactive in communicating to the press, politicians and public, and here we do not have such a heated debate.”
Dr. Fauci said that he had never seen the scientific world so polarized, and that led him to urge the researchers to show good faith and flexibility by declaring the moratorium themselves. A concern “looming in the background,” he said, was that biosecurity experts might overreact and impose excessive restrictions on the research.
“I think it’s important research that needs to go forward,” Dr. Fauci said. “I think we need to get greater input on the conditions in which it goes forward.”
Dr. Fauci and others who support the research say it may help explain how flu viruses that start out in animals adapt to humans and become transmissible, and therefore able to cause pandemics. That information, the researchers say, could help them recognize viruses on the way to developing pandemic potential.
Richard H. Ebright, a molecular biologist at Rutgers, is among those who oppose the research because of its risks, and doubts that it could be used to predict pandemics. He said that a moratorium was a good idea, but that this one did not go far enough. He said that the letter did not acknowledge the need for improved “biosafety, biosecurity and oversight,” and that in any case, 60 days would not be enough time to put the needed safeguards in place. The letter noted a “perceived fear” among the public, Dr. Ebright said, and seemed to suggest that the debate would cool down if people would just let the researchers explain that they had done the experiments safely.
Dr. Ebright said experiments with this virus should be done only in laboratories with the highest biosafety rating, BSL4, not in the “enhanced BSL3” in which the work was actually done.
Dr. Fouchier disagreed. He also said that his center did not have BSL4 labs.
Dr. Fauci said various expert groups, including the Centers for Disease Control and Prevention, had determined that enhanced BSL3 was good enough for bird flu research.
Since 1997, when the H5N1 virus was first identified, about 600 people have been infected, and more than half died — an extraordinarily high death rate. The saving grace of H5N1 is that when people do become infected — nearly always from contact with birds — they almost never transmit the disease to other people. But the virus has persisted in the environment, infecting millions of birds, and scientists have warned that if it mutates to become more contagious in people, disaster could ensue.
But what mutations would make the virus more easily transmissible? And how hard, or easy, would it be for those mutations to occur? Hoping to answer those questions, some researchers began experimenting with bird flu, working with ferrets, which are considered the best model for studying flu, because they contract it and get sick in much the same way that people do. Recently, the teams in Rotterdam and Madison announced that they had produced a form of H5N1 with mutations that allowed it to “go airborne,” meaning that it spread through the air from one ferret to another. Presumably, though not certainly, the virus could spread in the same way among people.
Dr. Fouchier said he was surprised by how easy it was to change the virus into the very form that the world has been dreading. Now, scientists around the world will have to grapple with what to do with Dr. Fouchier’s creation.
Suspensions of biomedical research are almost unheard of; the only other one in the United States was a moratorium from 1974 to 1976 on some types of recombinant DNA research, because of safety concerns.
A letter explaining the flu decision is being published in two scientific journals, Science and Nature, which also plan to publish reports on the research, but in a redacted form, omitting details that would let other researchers copy the experiments. The letter is signed by the scientists who produced the new, more contagious form of the flu virus, as well as by more than 30 other leading flu researchers.
“We recognize that we and the rest of the scientific community need to clearly explain the benefits of this important research and the measures taken to minimize its possible risks,” the letter states. At an international meeting next month in Geneva, participants selected by the World Health Organization will consider what to do next. Dr. Anthony Fauci, head of the National Institutes of Health, said the gathering would “address some of these difficult issues on an international scale instead of something restricted to the United States government.”
The scientists say their work has important public health benefits, but they acknowledge that it has sparked intense public fears that the deadly virus could accidentally leak out of a laboratory, or be stolen by terrorists, and result in a devastating pandemic. A national biosecurity panel in the United States has already taken the unusual step of asking the scientists to keep part of their data secret to prevent others from reproducing their work.
Scientists are split regarding the research, with some praising it as important and urging that it be published, and others saying the experiments are so dangerous that they should never have been done.
The experiments involve a type of bird flu virus known as H5N1, which rarely infects people but is highly deadly when it does. The work, paid for by the National Institutes of Health, was done by two separate research teams, at Erasmus Medical Center in Rotterdam, the Netherlands, and at the University of Wisconsin, Madison.
Ron Fouchier, a virologist who conducted the research at Erasmus Medical Center, explained why he and his colleagues decided to pause the research. “It is unfortunate that we need to take this step to help stop the controversy in the United States,” he said. “I think if this were communicated better in the United States it might not have been needed to do this. In the Netherlands we have been very proactive in communicating to the press, politicians and public, and here we do not have such a heated debate.”
Dr. Fauci said that he had never seen the scientific world so polarized, and that led him to urge the researchers to show good faith and flexibility by declaring the moratorium themselves. A concern “looming in the background,” he said, was that biosecurity experts might overreact and impose excessive restrictions on the research.
“I think it’s important research that needs to go forward,” Dr. Fauci said. “I think we need to get greater input on the conditions in which it goes forward.”
Dr. Fauci and others who support the research say it may help explain how flu viruses that start out in animals adapt to humans and become transmissible, and therefore able to cause pandemics. That information, the researchers say, could help them recognize viruses on the way to developing pandemic potential.
Richard H. Ebright, a molecular biologist at Rutgers, is among those who oppose the research because of its risks, and doubts that it could be used to predict pandemics. He said that a moratorium was a good idea, but that this one did not go far enough. He said that the letter did not acknowledge the need for improved “biosafety, biosecurity and oversight,” and that in any case, 60 days would not be enough time to put the needed safeguards in place. The letter noted a “perceived fear” among the public, Dr. Ebright said, and seemed to suggest that the debate would cool down if people would just let the researchers explain that they had done the experiments safely.
Dr. Ebright said experiments with this virus should be done only in laboratories with the highest biosafety rating, BSL4, not in the “enhanced BSL3” in which the work was actually done.
Dr. Fouchier disagreed. He also said that his center did not have BSL4 labs.
Dr. Fauci said various expert groups, including the Centers for Disease Control and Prevention, had determined that enhanced BSL3 was good enough for bird flu research.
Since 1997, when the H5N1 virus was first identified, about 600 people have been infected, and more than half died — an extraordinarily high death rate. The saving grace of H5N1 is that when people do become infected — nearly always from contact with birds — they almost never transmit the disease to other people. But the virus has persisted in the environment, infecting millions of birds, and scientists have warned that if it mutates to become more contagious in people, disaster could ensue.
But what mutations would make the virus more easily transmissible? And how hard, or easy, would it be for those mutations to occur? Hoping to answer those questions, some researchers began experimenting with bird flu, working with ferrets, which are considered the best model for studying flu, because they contract it and get sick in much the same way that people do. Recently, the teams in Rotterdam and Madison announced that they had produced a form of H5N1 with mutations that allowed it to “go airborne,” meaning that it spread through the air from one ferret to another. Presumably, though not certainly, the virus could spread in the same way among people.
Dr. Fouchier said he was surprised by how easy it was to change the virus into the very form that the world has been dreading. Now, scientists around the world will have to grapple with what to do with Dr. Fouchier’s creation.
Friday, January 20, 2012
Afghanistan’s Soldiers Step Up Killings of Allied Forces
Afghanistan’s Soldiers Step Up Killings of Allied Forces
KABUL, Afghanistan — American and other coalition forces here are being killed in increasing numbers by the very Afghan soldiers they fight alongside and train, in attacks motivated by deep-seated animosity between the supposedly allied forces, according to American and Afghan officers and a classified coalition report.
A decade into the war in Afghanistan, the report makes clear that these killings have become the most visible symptom of a far deeper ailment plaguing the war effort: the contempt each side holds for the other, never mind the Taliban. The ill will and mistrust run deep among civilians and militaries on both sides, raising questions about what future role the United States and its allies can expect to play in Afghanistan.
Underscoring the danger, a gunman in an Afghan Army uniform killed four French service members and wounded several others on Friday, according to an Afghan police official in Kapisa Province in eastern Afghanistan, prompting the French president to suspend his country’s operations here.
The violence, and the failure by coalition commanders to address it, casts a harsh spotlight on the shortcomings of American efforts to build a functional Afghan Army, a pillar of the Obama administration’s strategy for extricating the United States from the war in Afghanistan, said the officers and experts who helped shape the strategy.
The problems risk leaving the United States and its allies dependent on an Afghan force that is permeated by anti-Western sentiment and incapable of combating the Taliban and other militants when NATO’s combat mission ends in 2014, they said.
One instance of the general level of antipathy in the war exploded into uncomfortable view last week when video emerged of American Marines urinating on dead Taliban fighters. Although American commanders quickly took action and condemned the act, chat-room and Facebook posts by Marines and their supporters were full of praise for the desecration.
But the most troubling fallout has been the mounting number of Westerners killed by their Afghan allies, events that have been routinely dismissed by American and NATO officials as isolated episodes that are the work of disturbed individual soldiers or Taliban infiltrators, and not indicative of a larger pattern. The unusually blunt report, which was prepared for a subordinate American command in eastern Afghanistan, takes a decidedly different view. The Wall Street Journal reported on details of the investigation last year. A copy was obtained by The New York Times.
“Lethal altercations are clearly not rare or isolated; they reflect a rapidly growing systemic homicide threat (a magnitude of which may be unprecedented between ‘allies’ in modern military history),” it said. Official NATO pronouncements to the contrary “seem disingenuous, if not profoundly intellectually dishonest,” said the report, and it played down the role of Taliban infiltrators in the killings.
The coalition refused to comment on the classified report. But “incidents in the recent past where Afghan soldiers have wounded or killed I.S.A.F. members are isolated cases and are not occurring on a routine basis,” said Lt. Col. Jimmie E. Cummings Jr. of the Army, a spokesman for the American-led International Security Assistance Force. “We train and are partnered with Afghan personnel every day and we are not seeing any issues or concerns with our relationships.”
The numbers appear to tell a different story. Although NATO does not release a complete tally of its forces’ deaths at the hands of Afghan soldiers and the police, the classified report and coalition news releases indicate that Afghan forces have attacked American and allied service members nearly three dozen times since 2007.
Two members of the French Foreign Legion and one American soldier were killed in separate episodes in the past month, according to statements by NATO. The classified report found that between May 2007 and May 2011, when it was completed, at least 58 Western service members were killed in 26 separate attacks by Afghan soldiers and the police nationwide. Most of those attacks have occurred since October 2009. This toll represented 6 percent of all hostile coalition deaths during that period, the report said.
KABUL, Afghanistan — American and other coalition forces here are being killed in increasing numbers by the very Afghan soldiers they fight alongside and train, in attacks motivated by deep-seated animosity between the supposedly allied forces, according to American and Afghan officers and a classified coalition report.
A decade into the war in Afghanistan, the report makes clear that these killings have become the most visible symptom of a far deeper ailment plaguing the war effort: the contempt each side holds for the other, never mind the Taliban. The ill will and mistrust run deep among civilians and militaries on both sides, raising questions about what future role the United States and its allies can expect to play in Afghanistan.
Underscoring the danger, a gunman in an Afghan Army uniform killed four French service members and wounded several others on Friday, according to an Afghan police official in Kapisa Province in eastern Afghanistan, prompting the French president to suspend his country’s operations here.
The violence, and the failure by coalition commanders to address it, casts a harsh spotlight on the shortcomings of American efforts to build a functional Afghan Army, a pillar of the Obama administration’s strategy for extricating the United States from the war in Afghanistan, said the officers and experts who helped shape the strategy.
The problems risk leaving the United States and its allies dependent on an Afghan force that is permeated by anti-Western sentiment and incapable of combating the Taliban and other militants when NATO’s combat mission ends in 2014, they said.
One instance of the general level of antipathy in the war exploded into uncomfortable view last week when video emerged of American Marines urinating on dead Taliban fighters. Although American commanders quickly took action and condemned the act, chat-room and Facebook posts by Marines and their supporters were full of praise for the desecration.
But the most troubling fallout has been the mounting number of Westerners killed by their Afghan allies, events that have been routinely dismissed by American and NATO officials as isolated episodes that are the work of disturbed individual soldiers or Taliban infiltrators, and not indicative of a larger pattern. The unusually blunt report, which was prepared for a subordinate American command in eastern Afghanistan, takes a decidedly different view. The Wall Street Journal reported on details of the investigation last year. A copy was obtained by The New York Times.
“Lethal altercations are clearly not rare or isolated; they reflect a rapidly growing systemic homicide threat (a magnitude of which may be unprecedented between ‘allies’ in modern military history),” it said. Official NATO pronouncements to the contrary “seem disingenuous, if not profoundly intellectually dishonest,” said the report, and it played down the role of Taliban infiltrators in the killings.
The coalition refused to comment on the classified report. But “incidents in the recent past where Afghan soldiers have wounded or killed I.S.A.F. members are isolated cases and are not occurring on a routine basis,” said Lt. Col. Jimmie E. Cummings Jr. of the Army, a spokesman for the American-led International Security Assistance Force. “We train and are partnered with Afghan personnel every day and we are not seeing any issues or concerns with our relationships.”
The numbers appear to tell a different story. Although NATO does not release a complete tally of its forces’ deaths at the hands of Afghan soldiers and the police, the classified report and coalition news releases indicate that Afghan forces have attacked American and allied service members nearly three dozen times since 2007.
Two members of the French Foreign Legion and one American soldier were killed in separate episodes in the past month, according to statements by NATO. The classified report found that between May 2007 and May 2011, when it was completed, at least 58 Western service members were killed in 26 separate attacks by Afghan soldiers and the police nationwide. Most of those attacks have occurred since October 2009. This toll represented 6 percent of all hostile coalition deaths during that period, the report said.
Wednesday, January 18, 2012
Osteoporosis Patients Advised to Delay Bone Density Retests
Osteoporosis Patients Advised to Delay Bone Density Retests
Bone loss and osteoporosis develop so slowly in most women whose bones test normal at age 65 that many can safely wait as long as 15 years before having a second bone density test, researchers report in a new study.
The study, published in Thursday’s issue of The New England Journal of Medicine, is part of a broad rethinking of how to diagnose and treat the potentially debilitating bone disease that can lead to broken hips and collapsing spines.
A class of drugs, bisphosphonates, which includes Fosamax, have been found to prevent fractures in people with osteoporosis. But medical experts no longer recommend the medicines to prevent osteoporosis itself. They no longer want women to take them indefinitely, and no longer consider bone density measurements the sole defining factor in deciding if a woman needs to be treated.
Now, with the new study, researchers are asking whether frequent bone density measurements even make sense for the majority of older women whose bone density is not near a danger zone on initial tests, recommended at age 65.
“Bone density testing has been oversold,” said Steven Cummings, the study’s principal investigator and an emeritus professor of medical epidemiology and biostatistics at the University of California, San Francisco.
The study followed nearly 5,000 women ages 67 and older for more than a decade. The women had a bone density test when they entered the study and did not have osteoporosis. (In a separate national study by the Centers for Disease Control and Prevention, about 70 percent of women over age 65 did not have osteoporosis.)
The researchers report that fewer than 1 percent of women with normal bone density when they entered the study, and fewer than 5 percent with mildly low bone density, developed osteoporosis in the ensuing 15 years. But of those with substantially low bone density at the study’s start, close to the cutoff point for osteoporosis of fewer than 2.5 standard deviations from the reference level, 10 percent progressed to osteoporosis in about a year.
Dr. Margaret Gourlay, the study’s lead author and a family practice specialist and osteoporosis researcher at the University of North Carolina, said she and her colleagues were surprised by how slowly osteoporosis progressed in women.
Medicare pays for a bone density test every two years and many doctors have assumed that is the ideal interval, although national guidelines recommend them only at “regular intervals.”
“I think this will change the way doctors think about screening,” Dr. Gourlay said.
The results, said Joan A. McGowan, director of the division of musculoskeletal diseases at the National Institute of Arthritis and Musculoskeletal and Skin Diseases, “provide telling evidence that you are not going to fall off a cliff if you have normal bone density in your 60s or early 70s, that you are not going to have osteoporosis in the next five years unless something else happens.”
For example, said Dr. McGowan, who was not involved in the study, a woman who had to take high doses of corticosteroids for another medical condition would lose bone rapidly. But the findings “cover most normal women,” she said.
Bone density screening took off after Fosamax, the first bisphosphonate, was approved at the end of 1995. For the first time, doctors had a specific treatment that had been shown to prevent fractures in people with osteoporosis.
For years doctors were overly enthusiastic, prescribing it for women whose bone density was lower than normal but not in a danger zone, keeping women on the drug indefinitely. They even gave a name, osteopenia, to lower than normal bone density, although it was not clear it had real clinical significance.
Now, osteoporosis experts consider osteopenia to be a risk factor, not a disease, and its importance varies depending on a patient’s age, said Dr. Ethel S. Siris, an osteoporosis researcher at Columbia University who was not involved in the study.
Doctors are more likely to prescribe bisphosphonates for older patients and recommend against them for most younger postmenopausal women with osteopenia.
The experts also generally recommend that most people on bisphosphonates take them for just five years at a time, followed by a drug holiday of undetermined length. The idea is to reduce the risk of rare but serious side effects, including unusual thighbone fractures and loss of bone in the jaw.
A risk calculator, FRAX, can help determine whether treatment is recommended. It assesses a combination of risk factors: whether a parent has had a hip fracture, the age of the patient, steroid use, bone density at the hip, and whether the person has broken a bone after age 50, an especially important indicator. Nearly half who break a hip already had already broken another bone, Dr. Siris said.
“If you are an older individual, a man or a woman, who already broke a major bone — spine, hip, shoulder, or pelvis or wrist — take it very seriously and get treated,” she said. “If you have relatively good bone density then you are not at risk now.”
Bone loss and osteoporosis develop so slowly in most women whose bones test normal at age 65 that many can safely wait as long as 15 years before having a second bone density test, researchers report in a new study.
The study, published in Thursday’s issue of The New England Journal of Medicine, is part of a broad rethinking of how to diagnose and treat the potentially debilitating bone disease that can lead to broken hips and collapsing spines.
A class of drugs, bisphosphonates, which includes Fosamax, have been found to prevent fractures in people with osteoporosis. But medical experts no longer recommend the medicines to prevent osteoporosis itself. They no longer want women to take them indefinitely, and no longer consider bone density measurements the sole defining factor in deciding if a woman needs to be treated.
Now, with the new study, researchers are asking whether frequent bone density measurements even make sense for the majority of older women whose bone density is not near a danger zone on initial tests, recommended at age 65.
“Bone density testing has been oversold,” said Steven Cummings, the study’s principal investigator and an emeritus professor of medical epidemiology and biostatistics at the University of California, San Francisco.
The study followed nearly 5,000 women ages 67 and older for more than a decade. The women had a bone density test when they entered the study and did not have osteoporosis. (In a separate national study by the Centers for Disease Control and Prevention, about 70 percent of women over age 65 did not have osteoporosis.)
The researchers report that fewer than 1 percent of women with normal bone density when they entered the study, and fewer than 5 percent with mildly low bone density, developed osteoporosis in the ensuing 15 years. But of those with substantially low bone density at the study’s start, close to the cutoff point for osteoporosis of fewer than 2.5 standard deviations from the reference level, 10 percent progressed to osteoporosis in about a year.
Dr. Margaret Gourlay, the study’s lead author and a family practice specialist and osteoporosis researcher at the University of North Carolina, said she and her colleagues were surprised by how slowly osteoporosis progressed in women.
Medicare pays for a bone density test every two years and many doctors have assumed that is the ideal interval, although national guidelines recommend them only at “regular intervals.”
“I think this will change the way doctors think about screening,” Dr. Gourlay said.
The results, said Joan A. McGowan, director of the division of musculoskeletal diseases at the National Institute of Arthritis and Musculoskeletal and Skin Diseases, “provide telling evidence that you are not going to fall off a cliff if you have normal bone density in your 60s or early 70s, that you are not going to have osteoporosis in the next five years unless something else happens.”
For example, said Dr. McGowan, who was not involved in the study, a woman who had to take high doses of corticosteroids for another medical condition would lose bone rapidly. But the findings “cover most normal women,” she said.
Bone density screening took off after Fosamax, the first bisphosphonate, was approved at the end of 1995. For the first time, doctors had a specific treatment that had been shown to prevent fractures in people with osteoporosis.
For years doctors were overly enthusiastic, prescribing it for women whose bone density was lower than normal but not in a danger zone, keeping women on the drug indefinitely. They even gave a name, osteopenia, to lower than normal bone density, although it was not clear it had real clinical significance.
Now, osteoporosis experts consider osteopenia to be a risk factor, not a disease, and its importance varies depending on a patient’s age, said Dr. Ethel S. Siris, an osteoporosis researcher at Columbia University who was not involved in the study.
Doctors are more likely to prescribe bisphosphonates for older patients and recommend against them for most younger postmenopausal women with osteopenia.
The experts also generally recommend that most people on bisphosphonates take them for just five years at a time, followed by a drug holiday of undetermined length. The idea is to reduce the risk of rare but serious side effects, including unusual thighbone fractures and loss of bone in the jaw.
A risk calculator, FRAX, can help determine whether treatment is recommended. It assesses a combination of risk factors: whether a parent has had a hip fracture, the age of the patient, steroid use, bone density at the hip, and whether the person has broken a bone after age 50, an especially important indicator. Nearly half who break a hip already had already broken another bone, Dr. Siris said.
“If you are an older individual, a man or a woman, who already broke a major bone — spine, hip, shoulder, or pelvis or wrist — take it very seriously and get treated,” she said. “If you have relatively good bone density then you are not at risk now.”
Russian Says Western Support for Arab Revolts Could Cause a ‘Big War’
Russian Says Western Support for Arab Revolts Could Cause a ‘Big War’
MOSCOW — Russia’s foreign minister, Sergey V. Lavrov, warned Wednesday that outside encouragement of antigovernment uprisings in the Middle East and North Africa could lead to “a very big war that will cause suffering not only to countries in the region, but also to states far beyond its boundaries.”
Mr. Lavrov’s annual news conference was largely devoted to a critique of Western policies in Iran and Syria, which he said could lead to a spiral of violence.
His remarks came on the heels of a report on state-controlled television that accused the American ambassador to Russia, Michael McFaul, who has been in Moscow for less than a week, of working to provoke a revolution here. Prime Minister Vladimir V. Putin, at an impromptu meeting with prominent editors, also unleashed an attack on the liberal radio station Ekho Moskvy, which he said was serving American interests.
Mr. Lavrov said Russia would use its position on the United Nations Security Council to veto any United Nations authorization of military strikes against the government of President Bashar al-Assad of Syria. The United Nations has repeatedly called for Syria end a crackdown on opposition demonstrators, which Arab League monitors say resulted in hundreds of deaths over the past month.
“If someone conceives the idea of using force at any cost — and I’ve already heard calls for sending some Arab troops to Syria — we are unlikely to be able to prevent this,” Mr. Lavrov said. “But this should be done on their own initiative and should remain on their conscience. They won’t get any authorization from the Security Council.”
Mr. Lavrov said foreign governments were arming “militants and extremists” in Syria, and he gave a bristling response to Susan E. Rice, the American ambassador to the United Nations, who on Tuesday expressed concern about possible Russian arms shipments to Syria.
“We don’t find it necessary to explain or justify anything,” Mr. Lavrov said. “We are only trading goods with Syria that are not prohibited by international law.”
Mr. Lavrov offered a similarly grave message about the possibility of a military strike against Iran, which he said would be a “catastrophe.” He said sanctions now being proposed against Tehran were “intended to have a smothering effect on the Iranian economy and the Iranian population, probably in the hopes of provoking discontent.”
Relations between Moscow and Washington have worsened over the past year, as the cordial tone of the “reset” between President Obama and President Dmitri A. Medvedev has been replaced by a drumbeat of criticism. Mr. Lavrov said that Russia and the United States were not adversaries, and that “the cold war ended a long time ago.” By contrast, however, he was glowing about Russia’s cooperation with China, which he said was “the highest in the history of our bilateral relationship.”
Late on Tuesday night, Russia’s Channel 1 broadcast a segment about Mr. McFaul, who is one of Mr. Obama’s top advisers on Russia and a primary architect of the relationship’s reset. The commentary emphasized Mr. McFaul’s relationship with opposition leaders and suggested that his intent was to lay the groundwork for revolution.
“McFaul is not a specialist on Russia,” said Mikhail V. Leontyev, a Channel 1 commentator. “He is a specialist solely in the promotion of democracy.” Singling out a book by Mr. McFaul, titled “Russia’s Unfinished Revolution,” Mr. Leontyev added: “Is it possible Mr. McFaul came to Russia to work in his specialty? That is, to finish the revolution?”
The segment delved into Mr. McFaul’s previous work in Russia, including a stint in the 1990s with the National Democratic Institute, an organization that Mr. Leontyev said was “known for its proximity to the American intelligence services and its work preparing the political leaders of the third world.” Mr. McFaul should have “no problems” forging relationships with the opposition, Mr. Leontyev said. “Cooperating with the government is another story.”
The commentary followed news coverage on Channel 1 showing opposition leaders who visited the American Embassy to meet with Mr. McFaul. In the video, which was uploaded to YouTube with the title “Receiving Instructions at the United States Embassy,” people accost the opposition leaders on the sidewalk and ask: “Why did you come to the embassy today? What are your reasons for coming?”
Mr. McFaul dismissed the criticism of his meeting with the opposition figures, noting that he had already met with several high-ranking Russian officials.
“U.S. officials visiting Russia make a point of meeting with both government officials and civil society leaders,” he wrote on his blog in Russian and English.
The theme of American interference emerged again during a rapidly convened meeting between top journalists and Mr. Putin, which ended in a confrontation between the prime minister and Aleksei A. Venediktov, the editor of the radio station Ekho Moskvy. The station is an important platform for the opposition, and Mr. Putin said he had been horrified when he happened to hear a broadcast that contended that a planned United States missile defense system posed no great threat to Russia.
“Listen, it was such bull, I just don’t know — where do they get this stuff?” Mr. Putin said. “I thought, This is not information — what they’re broadcasting, it’s serving the foreign policy interests of one country with respect to another, to Russia.”
“I do not take offense when you pour diarrhea on me day in and day out, and yet you have taken offense,” Mr. Putin told Mr. Venediktov as the meeting came to a close, according to an official transcript. “I just said two words, and you took offense.”
MOSCOW — Russia’s foreign minister, Sergey V. Lavrov, warned Wednesday that outside encouragement of antigovernment uprisings in the Middle East and North Africa could lead to “a very big war that will cause suffering not only to countries in the region, but also to states far beyond its boundaries.”
Mr. Lavrov’s annual news conference was largely devoted to a critique of Western policies in Iran and Syria, which he said could lead to a spiral of violence.
His remarks came on the heels of a report on state-controlled television that accused the American ambassador to Russia, Michael McFaul, who has been in Moscow for less than a week, of working to provoke a revolution here. Prime Minister Vladimir V. Putin, at an impromptu meeting with prominent editors, also unleashed an attack on the liberal radio station Ekho Moskvy, which he said was serving American interests.
Mr. Lavrov said Russia would use its position on the United Nations Security Council to veto any United Nations authorization of military strikes against the government of President Bashar al-Assad of Syria. The United Nations has repeatedly called for Syria end a crackdown on opposition demonstrators, which Arab League monitors say resulted in hundreds of deaths over the past month.
“If someone conceives the idea of using force at any cost — and I’ve already heard calls for sending some Arab troops to Syria — we are unlikely to be able to prevent this,” Mr. Lavrov said. “But this should be done on their own initiative and should remain on their conscience. They won’t get any authorization from the Security Council.”
Mr. Lavrov said foreign governments were arming “militants and extremists” in Syria, and he gave a bristling response to Susan E. Rice, the American ambassador to the United Nations, who on Tuesday expressed concern about possible Russian arms shipments to Syria.
“We don’t find it necessary to explain or justify anything,” Mr. Lavrov said. “We are only trading goods with Syria that are not prohibited by international law.”
Mr. Lavrov offered a similarly grave message about the possibility of a military strike against Iran, which he said would be a “catastrophe.” He said sanctions now being proposed against Tehran were “intended to have a smothering effect on the Iranian economy and the Iranian population, probably in the hopes of provoking discontent.”
Relations between Moscow and Washington have worsened over the past year, as the cordial tone of the “reset” between President Obama and President Dmitri A. Medvedev has been replaced by a drumbeat of criticism. Mr. Lavrov said that Russia and the United States were not adversaries, and that “the cold war ended a long time ago.” By contrast, however, he was glowing about Russia’s cooperation with China, which he said was “the highest in the history of our bilateral relationship.”
Late on Tuesday night, Russia’s Channel 1 broadcast a segment about Mr. McFaul, who is one of Mr. Obama’s top advisers on Russia and a primary architect of the relationship’s reset. The commentary emphasized Mr. McFaul’s relationship with opposition leaders and suggested that his intent was to lay the groundwork for revolution.
“McFaul is not a specialist on Russia,” said Mikhail V. Leontyev, a Channel 1 commentator. “He is a specialist solely in the promotion of democracy.” Singling out a book by Mr. McFaul, titled “Russia’s Unfinished Revolution,” Mr. Leontyev added: “Is it possible Mr. McFaul came to Russia to work in his specialty? That is, to finish the revolution?”
The segment delved into Mr. McFaul’s previous work in Russia, including a stint in the 1990s with the National Democratic Institute, an organization that Mr. Leontyev said was “known for its proximity to the American intelligence services and its work preparing the political leaders of the third world.” Mr. McFaul should have “no problems” forging relationships with the opposition, Mr. Leontyev said. “Cooperating with the government is another story.”
The commentary followed news coverage on Channel 1 showing opposition leaders who visited the American Embassy to meet with Mr. McFaul. In the video, which was uploaded to YouTube with the title “Receiving Instructions at the United States Embassy,” people accost the opposition leaders on the sidewalk and ask: “Why did you come to the embassy today? What are your reasons for coming?”
Mr. McFaul dismissed the criticism of his meeting with the opposition figures, noting that he had already met with several high-ranking Russian officials.
“U.S. officials visiting Russia make a point of meeting with both government officials and civil society leaders,” he wrote on his blog in Russian and English.
The theme of American interference emerged again during a rapidly convened meeting between top journalists and Mr. Putin, which ended in a confrontation between the prime minister and Aleksei A. Venediktov, the editor of the radio station Ekho Moskvy. The station is an important platform for the opposition, and Mr. Putin said he had been horrified when he happened to hear a broadcast that contended that a planned United States missile defense system posed no great threat to Russia.
“Listen, it was such bull, I just don’t know — where do they get this stuff?” Mr. Putin said. “I thought, This is not information — what they’re broadcasting, it’s serving the foreign policy interests of one country with respect to another, to Russia.”
“I do not take offense when you pour diarrhea on me day in and day out, and yet you have taken offense,” Mr. Putin told Mr. Venediktov as the meeting came to a close, according to an official transcript. “I just said two words, and you took offense.”
Mexico’s Drug War Bloodies Areas Thought Safe
Mexico’s Drug War Bloodies Areas Thought Safe
MEXICO CITY — The Mexican drug war that has largely been defined by violence along the border is intensifying in interior and southern areas once thought clear of the carnage, broadening a conflict that has already overwhelmed the authorities and dispirited the public, according to analysts and new government data.
Last week, two headless bodies were found in a smoldering minivan near the entrance to one of the largest and most expensive malls in Mexico City, generally considered a refuge from the grisly atrocities that have gripped other cities throughout the drug war.
Two other cities considered safe just six months ago — Guadalajara and Veracruz — have experienced their own episodes of brutality: 26 bodies were left in the heart of Guadalajara late last year, on the eve of Latin America’s most prestigious book fair, and last month the entire police force in Veracruz was dismissed after state officials determined that it was too corrupt to patrol a city where 35 bodies were dumped on a road in September.
The spreading violence, believed to largely reflect a widening turf war between two of the biggest criminal organizations in the country, has implications on both sides of the border, putting added pressure on political and law enforcement leaders who are already struggling to show that their strategies are working.
“It is a situation ever more complicated and complex,” said Ricardo Ravelo, a Mexican journalist who has written several books on criminal organizations. “Resources are and will be stretched to deal with this.”
American officials here acknowledge that the mayhem is unpredictable but contend that they have a way to help tackle it, spreading word that the $1.6 billion Merida Initiative, Washington’s signature antidrug program, will step up training and advising for the Mexican state and local police and judicial institutions this year, rather than emphasizing the delivery of helicopters and other equipment.
In a year in which President Felipe Calderón’s party, in power since 2000, may struggle to hang on to the presidency in July elections, the expanding violence is giving political rivals, all promising a more peaceful country, much to run on.
Discerning patterns of violence in the drug war can be perilous; it is often like a tornado skipping across terrain, devastating one area while leaving another untouched.
But government statistics released last week showed a surge in deaths presumed to be related to drug or organized crime in Mexico State, which surrounds the capital and is the nation’s most populous state, in the first nine months of last year. The government data also show that violence has now afflicted 831 communities nationwide, an increase of 7 percent.
Although questions have emerged about the government’s tally, many analysts agree that the violence is widening.
“There has been a definite shift of violence away from the border and back to the interior states,” said David A. Shirk, director of the Trans-Border Institute at the University of San Diego, who closely tracks drug crime.
In a way, he said, the shift is a stark reversal of the trend of six years ago, when violence exploded in more southerly states and migrated north along drug-trafficking routes, accelerating a drug war that has now left more than 47,000 people dead, according to the government.
In response, the Mexican government deployed its military and the federal police, arresting and killing more than two dozen cartel leaders and splintering or dismantling several groups. Their push has been backed by American aid in the form of helicopters, remotely piloted drones and the deepening involvement of American drug agents in investigations and raids.
The violence slackened in many areas along the border, including Ciudad Juárez, the bloodiest city, where homicides have been declining. Mexican officials say the decrease is proof that they are making headway, but analysts say it may have more to do with one rival group’s defeat of another, reducing competition and the bloodshed that comes with it.
As for the violence in other areas — Acapulco, in the south, is now the second most violent city — that, too, may reflect the shifting contours of the fights between criminal organizations.
The drug war, Mr. Shirk and other analysts say, is increasingly coming down to a fight to the death between the Sinaloa cartel, a more traditional drug-trafficking organization widely considered the most powerful, and Los Zetas, founded by former soldiers and considered the most violent as it expands into extortion, kidnapping and other rackets in regions far off the drug route map. A third, the Gulf Cartel, remains well armed and rises to attack from time to time.
Many of the clashes have been in central or more southern areas where the two main rivals have not previously fought each other so violently, analysts say. George W. Grayson, a longtime researcher of Mexican violence and co-author of a coming book on Los Zetas, said the group had spread to 17 states from 14 a year ago.
MEXICO CITY — The Mexican drug war that has largely been defined by violence along the border is intensifying in interior and southern areas once thought clear of the carnage, broadening a conflict that has already overwhelmed the authorities and dispirited the public, according to analysts and new government data.
Last week, two headless bodies were found in a smoldering minivan near the entrance to one of the largest and most expensive malls in Mexico City, generally considered a refuge from the grisly atrocities that have gripped other cities throughout the drug war.
Two other cities considered safe just six months ago — Guadalajara and Veracruz — have experienced their own episodes of brutality: 26 bodies were left in the heart of Guadalajara late last year, on the eve of Latin America’s most prestigious book fair, and last month the entire police force in Veracruz was dismissed after state officials determined that it was too corrupt to patrol a city where 35 bodies were dumped on a road in September.
The spreading violence, believed to largely reflect a widening turf war between two of the biggest criminal organizations in the country, has implications on both sides of the border, putting added pressure on political and law enforcement leaders who are already struggling to show that their strategies are working.
“It is a situation ever more complicated and complex,” said Ricardo Ravelo, a Mexican journalist who has written several books on criminal organizations. “Resources are and will be stretched to deal with this.”
American officials here acknowledge that the mayhem is unpredictable but contend that they have a way to help tackle it, spreading word that the $1.6 billion Merida Initiative, Washington’s signature antidrug program, will step up training and advising for the Mexican state and local police and judicial institutions this year, rather than emphasizing the delivery of helicopters and other equipment.
In a year in which President Felipe Calderón’s party, in power since 2000, may struggle to hang on to the presidency in July elections, the expanding violence is giving political rivals, all promising a more peaceful country, much to run on.
Discerning patterns of violence in the drug war can be perilous; it is often like a tornado skipping across terrain, devastating one area while leaving another untouched.
But government statistics released last week showed a surge in deaths presumed to be related to drug or organized crime in Mexico State, which surrounds the capital and is the nation’s most populous state, in the first nine months of last year. The government data also show that violence has now afflicted 831 communities nationwide, an increase of 7 percent.
Although questions have emerged about the government’s tally, many analysts agree that the violence is widening.
“There has been a definite shift of violence away from the border and back to the interior states,” said David A. Shirk, director of the Trans-Border Institute at the University of San Diego, who closely tracks drug crime.
In a way, he said, the shift is a stark reversal of the trend of six years ago, when violence exploded in more southerly states and migrated north along drug-trafficking routes, accelerating a drug war that has now left more than 47,000 people dead, according to the government.
In response, the Mexican government deployed its military and the federal police, arresting and killing more than two dozen cartel leaders and splintering or dismantling several groups. Their push has been backed by American aid in the form of helicopters, remotely piloted drones and the deepening involvement of American drug agents in investigations and raids.
The violence slackened in many areas along the border, including Ciudad Juárez, the bloodiest city, where homicides have been declining. Mexican officials say the decrease is proof that they are making headway, but analysts say it may have more to do with one rival group’s defeat of another, reducing competition and the bloodshed that comes with it.
As for the violence in other areas — Acapulco, in the south, is now the second most violent city — that, too, may reflect the shifting contours of the fights between criminal organizations.
The drug war, Mr. Shirk and other analysts say, is increasingly coming down to a fight to the death between the Sinaloa cartel, a more traditional drug-trafficking organization widely considered the most powerful, and Los Zetas, founded by former soldiers and considered the most violent as it expands into extortion, kidnapping and other rackets in regions far off the drug route map. A third, the Gulf Cartel, remains well armed and rises to attack from time to time.
Many of the clashes have been in central or more southern areas where the two main rivals have not previously fought each other so violently, analysts say. George W. Grayson, a longtime researcher of Mexican violence and co-author of a coming book on Los Zetas, said the group had spread to 17 states from 14 a year ago.
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