At Western Wall, a Divide Over Prayer Deepens

Rina Castelnuovo for The New York Times

Members of Women of the Wall prayed this month while wearing tallits, fringed prayer shawls, and tefillin, leather prayer boxes, both of which Jewish men are told to wear.

JERUSALEM — The face-off at the security gate outside the Western Wall one Friday this month was familiar: for more than two decades, women have been making a monthly pilgrimage to pray at one of Judaism’s holiest sites in a manner traditionally preserved for men, and the police have stopped them in the name of maintaining public order.

Rina Castelnuovo for The New York Times

Bonna Devora Haberman, 52, of Women of the Wall, was confronted by the police this month after trying to bring in her prayer shawl.

But after a flurry of arrests this fall that set off an international outcry, the women arrived for December’s service to find a new protocol ordered by the ultra-Orthodox rabbi who controls the site. To prevent the women from defying a Supreme Court ruling that bars them from wearing ritual garments at the wall, they were blocked by police officers from bringing them in.

“How can you say this to me?” demanded a tearful Bonna Devora Haberman, 52, a Canadian immigrant who helped found the group Women of the Wall in 1988. “I’m a Jew. This is my state.”

The officer was unmoved. “At the Western Wall, you can’t pray with a tallit,” he said, referring to the fringed prayer shawl in Ms. Haberman’s backpack. “You can’t go in with it.”

After years of legislative and legal fights, the movement for equal access for people to pray as they wish at the site has become a rallying cause for liberal Jews in the United States and around the world, though it has long struggled to gain traction here in Israel, where the ultra-Orthodox retain great sway over public life.

This has deepened a divide between the Jewish state and the Jewish diaspora, in which some leaders have become increasingly vocal in criticizing Israel’s policies on settlements in the Palestinian territories; laws and proposals that are seen as antidemocratic or discriminatory against Arab citizens; the treatment of women; and the ultra-Orthodox control over conversion and marriage.

“When my kids start expressing frustration with Israel as a society because what they hear and see from a distance is not welcoming to them in their religious practice — that’s not good for the Jewish people, let alone for the state of Israel,” said Rabbi Steven C. Wernick, the director of the United Synagogue of Conservative Judaism.

Rabbi Levi Weiman-Kelman, an American immigrant who runs Kol Haneshama, a leading Reform synagogue here, said Women of the Wall “is an issue that really brings out the gap between Israeli Jews and American Jews.”

While more than 60 percent of Jews in the United States identify with the Reform or Conservative movements, where women and men have equal standing in prayer and many feminists have adopted ritual garments, in Israel it is one in 10. Instead, about half call themselves secular, and experts say that most of those consider Orthodoxy as the true Judaism, feel alienated from holy sites like the Western Wall, and view a woman in a prayer shawl as an alien import from abroad.

(Jewish law requires only men to pray daily, though many women have taken on the obligation voluntarily. It also says women should not dress like men.)

“Secular Israelis do not see this as their problem; to them it’s a bunch of crazy American ladies,” said Shari Eshet, who represents the New York-based National Council of Jewish Women here. “It’s embarrassing for Israel, it’s embarrassing for Jews, and the American Jewish community is beginning to understand that it’s a slippery slope here.”

The increased agitation around the wall is part of a broader clash over Judaism and gender that has roiled Israel in recent months. Women have won lawsuits against segregation on buses and sidewalks imposed in religious neighborhoods. But a bus line recently stopped accepting advertisements with images of people after religious vandals routinely blacked out women’s faces in the name of modesty.

In January, speakers at a conference on health and Jewish law canceled their appearances because women were barred from the podium — a demand of the most Orthodox — while the chief rabbi of the air force quit after religious soldiers were not excused from events where women sang.

These controversies concern the imposition of Orthodox doctrine in secular spheres. More complicated are questions of how Judaism itself should be practiced. This spring, the Supreme Court ruled that the government must pay the salary of a Reform rabbi along with hundreds of Orthodox ones. A small group of Jerusalem restaurants has been seeking an alternative kosher certification system to the one run by the government’s rabbinical council.

“The next chapter of what it means to be a Jewish state is being defined right now,” said Elana Sztokman, the director of the Jewish Orthodox Feminist Alliance, who is writing a book that includes a chapter about Women of the Wall. “We have to figure out what does Israel want, what role do we really want religion to have in this state? And it’s happening on the backs of women.”

Irit Pazner Garshowitz and Myra Noveck contributed reporting.

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Drew Barrymore: My Dogs Are So Protective of Baby Olive

People Pets
Only on People.com

By Julie Jordan and Amy Jamieson

12/22/2012 at 05:30 PM EST

Drew Barrymore, Will Kopelman and dog Douglas

NPG

She may have been a nervous wreck after baby Olive arrived this fall, but the Drew Barrymore could have rested easy because her dogs had everything under control.

"They're so protective of her. They're so sweet," she tells PEOPE of her pups, Douglas and shepherd mix Oliver. "And Douglas, the little blonde one, just comes and licks [Olive's] head, and it's just so goofy and silly and I always say, 'Douglas, is this your baby?' "

The first-time mom, 37, and her husband Will Kopelman were careful when it came to introducing their furbabies to the real baby.

"We brought her stuff home to them to sniff and play with," she tells PEOPLE. "I put her with them right away. I was holding her and protective but there are all these wonderful studies that kids that grow up with dogs have better immunities because of the dander and the pollen. And it's a proven fact that dogs just improve the quality of your life."

In just a few months, Douglas has assumed the role of bodyguard over 10-week-old Olive, whom Barrymore calls "Super Baby" because she sleeps and eats so well.

"He's literally sitting [and] looking out the window," she says, "in, like, a guard dog position."

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Predicting who's at risk for violence isn't easy

CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.

Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.

But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.

"They're yellow flags. They only become red flags once the blood is spilled," he said.

Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.

Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)

Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.

Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.

"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."

The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."

In a guidelines for families, the academy lists several risk factors for violence, including:

—Previous violent or aggressive behavior

—Being a victim of physical or sexual abuse

—Guns in the home

—Use of drugs or alcohol

—Brain damage from a head injury

Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.

Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.

Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.

According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.

Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.

Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.

And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.

All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.

Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.

Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.

Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.

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Online:

American Academy of Child & Adolescent Psychiatry: http://www.aacap.org

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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2 bombers target mobile phone firms in Nigeria

KANO, Nigeria (AP) — Authorities blame a radical Islamist sect for twin suicide car bombings targeting two major mobile phone companies, an official said Saturday, blacking out a top operator’s network in most of Nigeria‘s northern commercial hub.

A suicide bomber drove an explosive-laden car into the facilities of the Nigerian subsidiary of Bharti Airtel Ltd. of India at about 8 a.m. in the city of Kano, said Capt. Iweha Ikedichi, who speaks for a special taskforce deployed in Kano to reduce the threat of the Islamic rebels known as Boko Haram. The attack left an Airtel worker injured, authorities said. It also damaged a switch station, said James Eze, an Airtel spokesman. He said the company was still assessing how bad the damage was, but declined to comment further.

Switch stations control the regional mobile phone network and if they are seriously damaged, the entire network could go down. An Airtel staff who spoke on condition of anonymity because he is not authorized to speak to the press said the targeted switch station covered six northern states, including Kano. But while Airtel’s network appeared to be down across Kano Sunday, calls to lines in some of the other states went through.

At about the same time as the Airtel attack, another bomber targeted the facilities of the Nigerian subsidiary of South Africa-based MTN Group Ltd., about two miles (three kilometers) away. That attack was botched by security officers who shot the bomber, causing an explosion at the company’s gate, Ikedichi said.

The target of the foiled attack was MTN’s switch station, said Funmilayo Omogbenigun, spokeswoman for Nigeria’s largest cell phone network provider.

Authorities suspect the Boko Haram sect is behind the attacks. The group is held responsible for more than 770 deaths this year alone, according to figures compiled by The Associated Press. Boko Haram’s campaign of bombings and shootings has targeted mosques, churches, schools, universities and government buildings. But, four months ago, the group broadened its scope by attacking mobile phone towers for the first time.

In September, a series of attacks damaged more than 31 towers operated by all the major mobile phone providers in the country. Other attacks have occurred since then, further straining the one link Nigeria relies on for communication in a country with very few landlines. While no one claimed responsibility for the attacks, the Islamist sect had threatened mobile phone companies earlier in the year, warning that they would be targeted for cooperating with the government to flush out its members.

In Nigeria, Africa’s most populous country with more than 160 million people, mobile phones serve as a valuable lifeline in both cities and rural communities. Landlines remain almost nonexistent, as the state-run telephone company has collapsed and repeated efforts to privatize it have failed. More 87 million mobile phone lines were in use in 2009, according to estimates.

“Never would we have expected that telecommunications could be targeted,” said Damien Udeh, a spokesman for the Association of Licensed Telecommunications Operators of Nigeria. “It portends a dangerous situation for everybody, especially government.”

___

Associated Press writer Yinka Ibukun contributed to this report from Lagos, Nigeria

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Wall Street Week Ahead: A lump of coal for "Fiscal Cliff-mas"

NEW YORK (Reuters) - Wall Street traders are going to have to pack their tablets and work computers in their holiday luggage after all.

A traditionally quiet week could become hellish for traders as politicians in Washington are likely to fall short of an agreement to deal with $600 billion in tax hikes and spending cuts due to kick in early next year. Many economists forecast that this "fiscal cliff" will push the economy into recession.

Thursday's debacle in the U.S. House of Representatives, where Speaker John Boehner failed to secure passage of his own bill that was meant to pressure President Obama and Senate Democrats, only added to worry that the protracted budget talks will stretch into 2013.

Still, the market remains resilient. Friday's decline on Wall Street, triggered by Boehner's fiasco, was not enough to prevent the S&P 500 from posting its best week in four.

"The markets have been sort of taking this in stride," said Sandy Lincoln, chief market strategist at BMO Asset Management U.S. in Chicago, which has about $38 billion in assets under management.

"The markets still basically believe that something will be done," he said.

If something happens next week, it will come in a short time frame. Markets will be open for a half-day on Christmas Eve, when Congress will not be in session, and will close on Tuesday for Christmas. Wall Street will resume regular stock trading on Wednesday, but volume is expected to be light throughout the rest of the week with scores of market participants away on a holiday break.

For the week, the three major U.S. stock indexes posted gains, with the Dow Jones industrial average <.dji> up 0.4 percent, the S&P 500 <.spx> up 1.2 percent and the Nasdaq Composite Index <.ixic> up 1.7 percent.

Stocks also have booked solid gains for the year so far, with just five trading sessions left in 2012: The Dow has advanced 8 percent, while the S&P 500 has climbed 13.7 percent and the Nasdaq has jumped 16 percent.

IT COULD GET A LITTLE CRAZY

Equity volumes are expected to fall sharply next week. Last year, daily volume on each of the last five trading days dropped on average by about 49 percent, compared with the rest of 2011 - to just over 4 billion shares a day exchanging hands on the New York Stock Exchange, the Nasdaq and NYSE MKT in the final five sessions of the year from a 2011 daily average of 7.9 billion.

If the trend repeats, low volumes could generate a spike in volatility as traders keep track of any advance in the cliff talks in Washington.

"I'm guessing it's going to be a low volume week. There's not a whole lot other than the fiscal cliff that is going to continue to take the headlines," said Joe Bell, senior equity analyst at Schaeffer's Investment Research, in Cincinnati.

"A lot of people already have a foot out the door, and with the possibility of some market-moving news, you get the possibility of increased volatility."

Economic data would have to be way off the mark to move markets next week. But if the recent trend of better-than-expected economic data holds, stocks will have strong fundamental support that could prevent selling from getting overextended even as the fiscal cliff negotiations grind along.

Small and mid-cap stocks have outperformed their larger peers in the last couple of months, indicating a shift in investor sentiment toward the U.S. economy. The S&P MidCap 400 Index <.mid> overcame a technical level by confirming its close above 1,000 for a second week.

"We view the outperformance of the mid-caps and the break of that level as a strong sign for the overall market," Schaeffer's Bell said.

"Whenever you have flight to risk, it shows investors are beginning to have more of a risk appetite."

Evidence of that shift could be a spike in shares in the defense sector, expected to take a hit as defense spending is a key component of the budget talks.

The PHLX defense sector index <.dfx> hit a historic high on Thursday, and far outperformed the market on Friday with a dip of just 0.26 percent, while the three major U.S. stock indexes finished the day down about 1 percent.

Following a half-day on Wall Street on Monday ahead of the Christmas holiday, Wednesday will bring the S&P/Case-Shiller Home Price Index. It is expected to show a ninth-straight month of gains.

U.S. jobless claims on Thursday are seen roughly in line with the previous week's level, with the forecast at 360,000 new filings for unemployment insurance, compared with the previous week's 361,000.

(Wall St Week Ahead runs every Friday. Questions or comments on this column can be emailed to: rodrigo.campos(at)thomsonreuters.com)

(Reporting by Rodrigo Campos; Additional reporting by Chuck Mikolajczak; Editing by Jan Paschal)

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Putin Further Distances Himself From Syria’s Leader

BRUSSELS — President Vladimir V. Putin of Russia on Friday added to recent signals that Moscow is slowly distancing itself from the regime of Syria’s president, Bashar al-Assad, its longstanding but now severely weakened ally.

Asserting that Russia’s main goal is to avoid chaos, Mr. Putin restated Russia’s position that Syria’s civil war could be resolved only through talks between the parties involved. But he insisted that “we aren’t a defender of the current Syrian leadership” and said Moscow wants “a democratic regime in Syria based on the expression of the people’s will.”

He made the remarks at a joint news conference in Brussels with European Union leaders at the end of mostly fruitless talks centered on quarrels over energy and trade at the headquarters of the 27-nation bloc.

European nations are themselves divided over what to do about Syria but have increasingly tilted toward providing at least diplomatic support for the opponents of Mr. Assad.

Russia has been the Syrian government’s main backer since an uprising against Mr. Assad began in 2011 and, along with China, has used its veto in the United Nations Security Council to block resolutions that would have imposed penalties on Syria.

But a senior Russian Foreign Ministry official said recently that Mr. Assad’s government could lose its struggle for survival and that Moscow was making contingency plans to evacuate citizens from the country.

At the same time, Russia’s foreign minister, Sergey V. Lavrov, said in an interview with Russia Today, a government news organization, that Moscow was still rejecting appeals from other countries to help persuade the Syrian leader to flee.

Mr. Putin described Russia’s policy, which has put it at odds with Washington and also Arab countries that support Mr. Assad’s opponents, as intended to avoid mayhem. “We will do what we can so that there will be order in Syria,” he said. “Whatever changes are occurring in Syria, we would not like to see the same chaos there which we are seeing in other countries in the region.”

Mr. Putin’s talks in Brussels focused mainly on energy, an issue of far more immediate importance to his own hold on power in Russia, where earnings from natural gas exports to Europe are a central pillar of an economic and political system built around state control of natural resources.

Mr. Putin pressed the European Union to exempt the natural gas behemoth Gazprom from rules aimed at promoting greater competition in the energy market. But he won no favors for the company, Russia’s biggest.

Russia is Europe’s main external energy supplier, and disputes over natural gas have dominated discussions between Moscow and the bloc for years. Friday’s talks yielded no significant progress, said a European Union official briefed on them. While the visit to Brussels produced no breakthroughs, it did avoid the angry polemics of some previous meetings.

“We’ve had worse summits,” the official said.

In Syria, meanwhile, activists reported fierce fighting in Hama Province, where rebel forces have spent days attacking checkpoints and other government positions. Opposition commanders described the moves as part of a broad offensive aimed at controlling a strategic link between the north, where the rebels control broad areas of territory, and the government strongholds in the center.

Abu Hadi, an activist in the village of Kafarzita,, north of Hama city, said the village and others had come under heavy government shelling on Friday. “The situation is very bad,” he said. “People are panicking in the streets.”

Mr. Putin, who started his third term as president in May after taking a four-year break to serve as prime minister, dropped the combative language that has characterized previous appearances in Brussels. At the end of the news conference, he threw his arm over the shoulder of the European Commission president, José Manuel Barroso. The two men had earlier sparred over European Union energy regulations that Mr. Putin described as “discriminatory” but that Mr. Barroso defended as applying to all countries, not just Russia.

The bloc has demanded that Gazprom open its export pipelines that run through member countries to other gas producers.

Mr. Putin complained that European energy regulation violated an earlier agreement on Russia-European Union economic relations, a claim the Europeans rejected. “It creates confusion and undermines confidence in our mutual work,” he said ahead of talks with Mr. Barroso and Herman Van Rompuy, the president of the European Council, which represents the governments of the member states.

Ellen Barry contributed reporting from Brussels, and Hania Mourtada and Hwaida Saad from Beirut, Lebanon.

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See If You Can Spot the One Color That Popped on the Carpet This Week

Stylewatch
Style News Now

12/21/2012 at 12:00 PM ET

Getty; Splash News Online; WireImage

Even though we didn’t see as many stars on the red carpet this week as last — it’s quiet in Hollywood this holiday season! — we still saw some strong trends emerge at various events. What were they? Let’s get to it!

Up: Pops of red. You can thank the holidays for this festive mini-trend, which we spotted on Hailee Steinfeld’s purse, Bella Heathcote’s dress and Rose Byrne’s jacket. Adding just a hint of the bold hue to your outfit is an easy way to look all holiday-y without going overboard.

Up: Head-to-toe black. What, are stars sick of sequined dresses already? This week we saw nearly one dozen leading ladies wear all black: Britney Spears, Demi Lovato, LeAnn Rimes, Alexa Chung, Jessica Chastain, Miley Cyrus, Krysten Ritter and Kerry Washington … to name a few. As New Yorkers, we’re always happy to see all-black ensembles en force, and it is a look that’s usually pretty failsafe — and slimming.

Down: Stick-straight hair. Rita Ora was the only woman we saw with pin-straight locks this week; everyone else went for bouncy curls and elegant updos (and cropped cuts, if you count Miley Cyrus!). With Christmas and New Year’s Even upon us, we predict we’ll be seeing a lot more exciting hairdos and less of the minimalist straight looks.

Tell us: Which color are you more likely to wear at the holidays: red or black?

Want more Trend Report? Click to hear our thoughts on mini dresses, cut-outs and collars.

FIND ALL THE LATEST RED CARPET NEWS AND PHOTOS HERE!

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AP IMPACT: Big Pharma cashes in on HGH abuse

A federal crackdown on illicit foreign supplies of human growth hormone has failed to stop rampant misuse, and instead has driven record sales of the drug by some of the world's biggest pharmaceutical companies, an Associated Press investigation shows.

The crackdown, which began in 2006, reduced the illegal flow of unregulated supplies from China, India and Mexico.

But since then, Big Pharma has been satisfying the steady desires of U.S. users and abusers, including many who take the drug in the false hope of delaying the effects of aging.

From 2005 to 2011, inflation-adjusted sales of HGH were up 69 percent, according to an AP analysis of pharmaceutical company data collected by the research firm IMS Health. Sales of the average prescription drug rose just 12 percent in that same period.

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EDITOR'S NOTE — Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

___

Unlike other prescription drugs, HGH may be prescribed only for specific uses. U.S. sales are limited by law to treat a rare growth defect in children and a handful of uncommon conditions like short bowel syndrome or Prader-Willi syndrome, a congenital disease that causes reduced muscle tone and a lack of hormones in sex glands.

The AP analysis, supplemented by interviews with experts, shows too many sales and too many prescriptions for the number of people known to be suffering from those ailments. At least half of last year's sales likely went to patients not legally allowed to get the drug. And U.S. pharmacies processed nearly double the expected number of prescriptions.

Peddled as an elixir of life capable of turning middle-aged bodies into lean machines, HGH — a synthesized form of the growth hormone made naturally by the human pituitary gland — winds up in the eager hands of affluent, aging users who hope to slow or even reverse the aging process.

Experts say these folks don't need the drug, and may be harmed by it. The supposed fountain-of-youth medicine can cause enlargement of breast tissue, carpal tunnel syndrome and swelling of hands and feet. Ironically, it also can contribute to aging ailments like heart disease and Type 2 diabetes.

Others in the medical establishment also are taking a fat piece of the profits — doctors who fudge prescriptions, as well as pharmacists and distributors who are content to look the other way. HGH also is sold directly without prescriptions, as new-age snake oil, to patients at anti-aging clinics that operate more like automated drug mills.

Years of raids, sports scandals and media attention haven't stopped major drugmakers from selling a whopping $1.4 billion worth of HGH in the U.S. last year. That's more than industry-wide annual gross sales for penicillin or prescription allergy medicine. Anti-aging HGH regimens vary greatly, with a yearly cost typically ranging from $6,000 to $12,000 for three to six self-injections per week.

Across the U.S., the medication is often dispensed through prescriptions based on improper diagnoses, carefully crafted to exploit wiggle room in the law restricting use of HGH, the AP found.

HGH is often promoted on the Internet with the same kind of before-and-after photos found in miracle diet ads, along with wildly hyped claims of rapid muscle growth, loss of fat, greater vigor, and other exaggerated benefits to adults far beyond their physical prime. Sales also are driven by the personal endorsement of celebrities such as actress Suzanne Somers.

Pharmacies that once risked prosecution for using unauthorized, foreign HGH — improperly labeled as raw pharmaceutical ingredients and smuggled across the border — now simply dispense name brands, often for the same banned uses. And usually with impunity.

Eight companies have been granted permission to market HGH by the U.S. Food and Drug Administration, which reviews the benefits and risks of new drug products. By contrast, three companies are approved for the diabetes drug insulin.

The No. 1 maker, Roche subsidiary Genentech, had nearly $400 million in HGH sales in the U.S. last year, up an inflation-adjusted two-thirds from 2005. Pfizer and Eli Lilly were second and third with $300 million and $220 million in sales, respectively, according to IMS Health. Pfizer now gets more revenue from its HGH brand, Genotropin, than from Zoloft, its well-known depression medicine that lost patent protection.

On their face, the numbers make no sense to the recognized hormone doctors known as endocrinologists who provide legitimate HGH treatment to a small number of patients.

Endocrinologists estimate there are fewer than 45,000 U.S. patients who might legitimately take HGH. They would be expected to use roughly 180,000 prescriptions or refills each year, given that typical patients get three months' worth of HGH at a time, according to doctors and distributors.

Yet U.S. pharmacies last year supplied almost twice that much HGH — 340,000 orders — according to AP's analysis of IMS Health data.

While doctors say more than 90 percent of legitimate patients are children with stunted growth, 40 percent of 442 U.S. side-effect cases tied to HGH over the last year involved people age 18 or older, according to an AP analysis of FDA data. The average adult's age in those cases was 53, far beyond the prime age for sports. The oldest patients were in their 80s.

Some of these medical records even give explicit hints of use to combat aging, justifying treatment with reasons like fatigue, bone thinning and "off-label," which means treatment of an unapproved condition

Even Medicare, the government health program for older Americans, allowed 22,169 HGH prescriptions in 2010, a five-year increase of 78 percent, according to data released by the Centers for Medicare and Medicaid Services in response to an AP public records request.

"There's no question: a lot gets out," said hormone specialist Dr. Mark Molitch of Northwestern University, who helped write medical standards meant to limit HGH treatment to legitimate patients.

And those figures don't include HGH sold directly by doctors without prescriptions at scores of anti-aging medical practices and clinics around the country. Those numbers could only be tallied by drug makers, who have declined to say how many patients they supply and for what conditions.

First marketed in 1985 for children with stunted growth, HGH was soon misappropriated by adults intent on exploiting its modest muscle- and bone-building qualities. Congress limited HGH distribution to the handful of rare conditions in an extraordinary 1990 law, overriding the generally unrestricted right of doctors to prescribe medicines as they see fit.

Despite the law, illicit HGH spread around the sports world in the 1990s, making deep inroads into bodybuilding, college athletics, and professional leagues from baseball to cycling. The even larger banned market among older adults has flourished more recently.

FDA regulations ban the sale of HGH as an anti-aging drug. In fact, since 1990, prescribing it for things like weight loss and strength conditioning has been punishable by 5 to 10 years in prison.

Steve Kleppe, of Scottsdale, Ariz., a restaurant entrepreneur who has taken HGH for almost 15 years to keep feeling young, said he noticed a price jump of about 25 percent after the block on imports. He now buys HGH directly from a doctor at an annual cost of about $8,000 for himself and the same amount for his wife.

Many older patients go for HGH treatment to scores of anti-aging practices and clinics heavily concentrated in retirement states like Florida, Nevada, Arizona and California.

These sites are affiliated with hundreds of doctors who are rarely endocrinologists. Instead, many tout certification by the American Board of Anti-Aging and Regenerative Medicine, though the medical establishment does not recognize the group's bona fides.

The clinics offer personalized programs of "age management" to business executives, affluent retirees, and other patients of means, sometimes coupled with the amenities of a vacation resort. The operations insist there are few, if any, side effects from HGH. Mainstream medical authorities say otherwise.

A 2007 review of 31 medical studies showed swelling in half of HGH patients, with joint pain or diabetes in more than a fifth. A French study of about 7,000 people who took HGH as children found a 30 percent higher risk of death from causes like bone tumors and stroke, stirring a health advisory from U.S. authorities.

For proof that the drug works, marketers turn to images like the memorable one of pot-bellied septuagenarian Dr. Jeffry Life, supposedly transformed into a ripped hulk of himself by his own program available at the upscale Las Vegas-based Cenegenics Elite Health. (He declined to be interviewed.)

These promoters of HGH say there is a connection between the drop-off in growth hormone levels through adulthood and the physical decline that begins in late middle age. Replace the hormone, they say, and the aging process slows.

"It's an easy ruse. People equate hormones with youth," said Dr. Tom Perls, a leading industry critic who does aging research at Boston University. "It's a marketing dream come true."

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Associated Press Writer David B. Caruso reported from New York and AP National Writer Jeff Donn reported from Plymouth, Mass. AP Writer Troy Thibodeaux provided data analysis assistance from New Orleans.

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AP's interactive on the HGH investigation: http://hosted.ap.org/interactives/2012/hgh

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The AP National Investigative Team can be reached at investigate(at)ap.org

EDITOR'S NOTE _ Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

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Wall Street ends lower after "fiscal cliff" setback

NEW YORK (Reuters) - U.S. stocks finished lower on Friday after a Republican plan to avoid the "fiscal cliff" failed to gain sufficient support on Thursday night, draining hopes that a deal would be reached before 2013.

Still, stocks managed to rebound from the day's lows near the end of the session, and for the week, the three major U.S. stock indexes still ended higher, with the S&P 500 gaining 1.2 percent.

Trading was volatile because of waning confidence in the prospect of a deal out of Washington, and in part, as the result of the quarterly expiration of options and futures contracts. The CBOE Volatility Index <.vix> or VIX, the market's favorite barometer of investor anxiety, finished below its session high.

Republican House Speaker John Boehner failed to garner enough votes from even his own party to pass his "Plan B" tax bill late on Thursday. It was the latest setback in negotiations to avoid $600 billion in tax hikes and spending cuts that some say could tip the U.S. economy into recession.

"The failure with Plan B was disappointing, if not terribly surprising, but now there's a real lack of clarity about what will happen, and markets hate that," said Mike Hennessy, managing director of investments for Morgan Creek in Chapel Hill, North Carolina.

The Dow Jones industrial average <.dji> dropped 120.88 points, or 0.91 percent, to 13,190.84 at the close. The Standard & Poor's 500 Index <.spx> fell 13.54 points, or 0.94 percent, to 1,430.15. The Nasdaq Composite Index <.ixic> lost 29.38 points, or 0.96 percent, to 3,021.01.

"Amazingly, this sharp decline today may not actually change the technical picture much - unless the decline gets worse," said Larry McMillan, president of options research firm McMillan Analysis Corp, in a research note.

For the week, the Dow gained 0.4 percent and the Nasdaq climbed 1.7 percent.

On Friday, Herbalife dropped for an eighth straight session. Investor Bill Ackman recently ramped up his campaign against the company. The stock skidded 19.2 percent to $27.27 and has lost more than 35 percent this week.

Plan B, which called for tax increases on those who earn $1 million or more a year, was not going to pass the Democratic-led Senate or win acceptance from the White House anyway. But it exposed the reality that it will be difficult to get Republican support for the more expansive tax increases that President Barack Obama has urged.

Still, the declines of about 1 percent in the three major U.S. stock indexes suggest that investors do not believe the economy will be unduly damaged by the absence of a deal, said Mark Lehmann, president of JMP Securities, in San Francisco.

"You could have easily woken up today and seen the market down 300 or 400 points, and everyone would have said, 'That's telling you this is really dire,'" Lehmann said.

"I think if you get into mid-January and (the talks) keep going like this, you get worried, but I don't think we're going to get there."

Banking shares, which outperform during economic expansion and have led the market on signs of progress on resolving the fiscal impasse, led Friday's declines. Citigroup Inc fell 1.7 percent to $39.49, while Bank of America slid 2 percent to $11.29. The KBW Banks index <.bkx> lost 1.19 percent.

Volatility on Friday was exacerbated in part by "quadruple witching," the quarterly expiration of stock index futures and options, stock options and single stock futures contracts.

About 8.59 billion shares changed hands on major U.S. exchanges, more than the daily average of 6.47 billion daily in 2012, in part because of the "quadruple witching" expiration.

The day's round of data indicated the economy was surprisingly resilient in November; consumer spending rose by the most in three years and a gauge of business investment jumped.

But separate data showed consumer sentiment slumped in December. The S&P Retail Index <.spxrt> fell 1.2 percent.

U.S.-listed shares of Research in Motion sank 22.7 percent to $10.91 after the Canadian company, known as the BlackBerry maker, reported its first-ever decline in its subscriber numbers on Thursday alongside a new fee structure for its high-margin services segment.

(Additional reporting by Ryan Vlastelica and Leah Schnurr; Editing by Bernadette Baum, Nick Zieminski and Jan Paschal)

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Narendra Modi, Polarizing Indian Politician, Gains Power

Reuters

Supporters of the Bharatiya Janata Party waved party flags and lighted firecrackers on Thursday as they celebrated outside a vote-counting center. More Photos »

NEW DELHI — The polarizing leader of the western state of Gujarat, Narendra Modi, inched closer on Thursday to becoming the leading political challenger to India’s dominant Gandhi family by winning a resounding re-election as chief minister.

“My biggest dream is to serve my masses, my people,” Mr. Modi said in a speech before a cheering throng that eventually began to shout “Delhi, Delhi, Delhi,” and then amended that to “P.M., P.M., P.M.,” signaling a hope that he wins the post of prime minister in national elections scheduled for 2014.

Mr. Modi had campaigned in the Gujarati language, but he gave his widely televised victory speech in Hindi — a clear sign that his intended audience extended well beyond his 60 million constituents. His message in the speech, as it has been throughout his campaign, was that he has brought wealth to Gujarat, which lies on the coast of the Arabian Sea, by encouraging economic development. His party won 115 seats in the state legislature. Although a decline of two seats, it is nonetheless a comfortable majority in a house of 182 seats.

Mr. Modi is a prominent politician in the Bharatiya Janata Party, which for years tried to win elections by uniting the country’s Hindu majority — in part by demonizing its Muslim minority. Indeed, shortly after Mr. Modi came to power a decade ago, riots convulsed Gujarat and cost the lives of about 1,000 people, mostly Muslims. Mr. Modi has been accused of not doing enough to stop the riots and of possibly of encouraging them, making him one of the most divisive figures in Indian politics.

He has since sought to broaden his national appeal by softening his overt Hindu nationalism and instead claiming the mantle of good governance and economic growth. In a country where new corruption scandals seem to emerge every month and economic growth has slowed, that message may have broad resonance.

But whether minorities and moderate Hindus in the rest of India will forgive or forget the government failures during the 2002 riots is very much of an open question.

Indeed, some leading members of the Bharatiya Janata Party have resisted Mr. Modi’s rising prominence because they fear that he will cost the party votes among religious minorities.

Nitish Kumar, the powerful chief minister of Bihar in the northeast, has promised to withdraw his support for the Bharatiya Janata Party if it selects Mr. Modi as its prime ministerial candidate for 2014. That would reduce the party’s chances of gaining a majority in the national Parliament, but whether Mr. Kumar would follow through on his threat is uncertain.

Mr. Modi’s role in the 2002 riots has long been a concern for governments in the West. The United States refuses to provide Mr. Modi with a visa.

But as he grows into a national political figure, more Western countries may rethink their refusal to talk with him in an official capacity. In October, Britain ended a 10-year diplomatic boycott of Mr. Modi when its high commissioner met with him for 50 minutes.

India’s religious, caste and regional differences have increasingly splintered the country’s politics. Since Hindus represent 80 percent of the electorate, they could dominate national politics if they managed to overcome the caste differences that divide them. But caste has long been the dominant nexus of Indian politics. The Bharatiya Janata Party has led the national government for only one period, from 1998 to 2004.

Leaders of the party said that Mr. Modi had solidified his place as one of India’s most important politicians, although top party officials refused to speculate on whether he would be its candidate for prime minister in 2014.

“This shows the people’s confidence and trust in the B.J.P. and Narendra Modi’s leadership,” said Dhansukh Bhanderi, a top party official.

Mr. Modi’s opponents played down the importance of his victory. Palaniappan Chidambaram, India’s finance minister and a leader of the governing Indian National Congress Party, said in a televised interview that he thought it had done well on Thursday because Mr. Modi had not managed to expand his political dominance in Gujarat.

In a related political development, it was announced Thursday that the Congress Party had defeated the Bharatiya Janata Party in state assembly elections in Himachal Pradesh, a hilly state in the Himalayas. The victory was an important balm to the Congress Party, which has been buffeted in recent years by corruption allegations and the rise of regional parties.

The election in Himachal Pradesh was between two political leaders who have traded control over the state between them for decades. Virbhadra Singh, 78, of the Congress Party, is now expected to become the state’s chief minister, a post he has already held four times. Prem Kumar Dhumal, 68, will resign after having served two nonconsecutive terms as chief minister.

Hari Kumar contributed reporting from New Delhi, and Haresh Pandya from Rajkot, India.

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