AP PHOTOS: Simple surgery heals blind Indonesians

PADANG SIDEMPUAN, Indonesia (AP) — They came from the remotest parts of Indonesia, taking crowded overnight ferries and riding for hours in cars or buses — all in the hope that a simple, and free, surgical procedure would restore their eyesight.

Many patients were elderly and needed help to reach two hospitals in Sumatra where mass eye camps were held earlier this month by Nepalese surgeon Dr. Sanduk Ruit. During eight days, more than 1,400 cataracts were removed.

The patients camped out, sleeping side-by-side on military cots, eating donated food while fire trucks supplied water for showers and toilets. Many who had given up hope of seeing again left smiling after their bandages were removed.

"I've been blind for three years, and it's really bad," said Arlita Tobing, 65, whose sight was restored after the surgery. "I worked on someone's farm, but I couldn't work anymore."

Indonesia has one of the highest rates of blindness in the world, making it a target country for Ruit who travels throughout the developing world holding free mass eye camps while training doctors to perform the simple, stitch-free procedure he pioneered. He often visits hard-to-reach remote areas where health care is scarce and patients are poor. He believes that by teaching doctors how to perform his method of cataract removal, the rate of blindness can be reduced worldwide.

Cataracts are the leading cause of blindness globally, affecting about 20 million people who mostly live in poor countries, according to the World Health Organization.

"We get only one life, and that life is very short. I am blessed by God to have this opportunity," said Ruit, who runs the Tilganga Eye Center in Katmandu, Nepal. "The most important of that is training, taking the idea to other people."

During the recent camps, Ruit trained six doctors from Indonesia, Thailand and Singapore.

Here, in images, are scenes from the mobile eye camps:

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Massachusetts natural gas explosion damaged 42 buildings

SPRINGFIELD, Mass. (AP) — Preliminary investigations show more than 40 buildings were damaged in a natural gas explosion in Massachusetts that injured 18 people, building inspectors said Saturday.

A strip club was flattened and a day care center was heavily damaged in the massive explosion Friday night in Springfield, one of New England's biggest cities.

No one was killed in the explosion.

Investigators were trying Saturday to figure out what caused the blast that could be heard for miles, left a large hole in the ground where the multistory brick building housing Scores Gentleman's Club once stood and scattered debris over several blocks.

Officials already had evacuated part of the entertainment district after responding to a gas leak and odor reported about an hour before the explosion. Gas workers venting a gas leak got indications that the building was about to explode and they ducked for cover behind a utility truck — along with firefighters and police officers — just before the blast, said Mark McDonald, president of the New England Gas Workers Association.

Most of the injured were in that group, and the truck that saved their lives was essentially demolished, he said.

"It really is a miracle and it's an example of our public safety officials, each and every day, putting themselves in harm's way, taking what could have been considered a very routine call of an odor of gas, but they took the proper precautions," State Fire Marshal Stephen Coan said. "And thanks to God that they did."

Officials also marveled how the 5:30 p.m. blast occurred when a day care center next door was closed. The center's building was heavily damaged.

Lt. Gov. Tim Murray and Springfield Mayor Domenic Sarno were attending a tree-lighting ceremony when the explosion occurred. Sarno said some people mistakenly thought the boom was part of the holiday event.

The explosion blew out windows in a three-block radius, leaving at least three buildings irreparably damaged and causing emergency workers to evacuate a six-story apartment building that was buckling, police said. Pieces of broken glass littered streets and sidewalks. It was unclear how many residents had been evacuated. A shelter was set up at a school, but city officials said no one stayed there overnight.

Omar Fermin, manager of the Punta Cana Restaurant two blocks from the explosion site, found the floor-to-ceiling windows blasted out when he came to check on the property Saturday morning.

"It looks like an earthquake hit," said Fermin, a native of the Dominican Republic. "I've never seen anything like it."

He said he was waiting for someone to come and assess the damage. He worried the restaurant would remain closed for weeks while the owner seeks to replace the massive custom-made windows.

Authorities cordoned off the center of the explosion Saturday as building inspectors worked to identify unsafe structures. Anxious residents gathered at the perimeter, waiting for permission to visit their buildings.

Preliminary reports show the blast damaged 42 buildings housing 115 residential units, said Thomas Walsh, spokesman for Springfield Mayor Domenic Sarno.

Three buildings were immediately condemned, and 24 others require additional inspections by structural engineers to determine whether they are safe, Walsh said.

Dogs trapped in abandoned buildings barked loudly Saturday as building inspectors fanned out across the area. One inspector said he wished he could get a ladder and permission to retrieve a dog that was barking in the upper floor of one building sealed off from residents.

Authorities are opening an animal shelter for pets affected by the explosion, Walsh said.

Coan, the fire marshal, said his office is investigating the cause of the blast and its possible origin. The state's Department of Public Utilities was also investigating.

Sheila Doiron, a spokeswoman for Columbia Gas of Massachusetts, said the company will continue to monitor for any potential leaks within several blocks of the blast site. So far, she said, the company hadn't yet found any measurable readings.

The utility will keep at least 30 workers at the scene, along with a so-called sniffing car mounted with sophisticated gadgets capable of detecting low levels of gas leaks, Walsh said.

Doiron said the company also didn't find in its records any gas odor calls to the area where the strip club was located.

Authorities also deployed police officers throughout the area to prevent looting, Walsh said.

The victims were taken to two hospitals in the city. Those injured were nine firefighters, two police officers, four Columbia Gas workers, two civilians and another city employee.

Springfield, which is 90 miles west of Boston and has about 150,000 residents, is the largest city in western Massachusetts. It's known as the home of the Basketball Hall of Fame, which is not near the blast site.

The city has been rebuilding from damage caused by a tornado in June 2011.

Wayne Davis, who lives about a block from the destroyed building, said he felt his apartment shake.

"I was laying down in bed, and I started feeling the building shaking and creaking," he said.

The Navy veteran said the boom from the explosion was louder than anything he'd ever heard, including the sound of a jet landing on an aircraft carrier.

The blast was so loud it was heard in several neighboring communities. Video from WWLP-TV showed the moment of the explosion, with smoke billowing into the air above the neighborhood.

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Associated Press writers Rodrique Ngowi, Bridget Murphy and Bob Salsberg in Boston and Jessica Hill in Springfield contributed to this report.

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US troops in Afghanistan celebrate Thanksgiving

KABUL, Afghanistan (AP) — It was Army Sgt. Keith Wells' first Thanksgiving Day away from his family and despite a cornucopia of food provided for the troops, his taste buds were craving his wife's macaroni and cheese back home.

"My wife's a foodie — you know the Food Network, cooking shows. Everything she makes is golden," Wells of Charlotte, N.C., said Thursday at a large international military base in the Afghan capital, Kabul.

The dining hall served up mac-and-cheese along with traditional Thanksgiving Day fixings. Wells was thankful for the good food, but he still missed his wife's home-cooking.

Huge hunks of beef greeted the estimated 2,500 diners as soldiers lined up in the dining hall. Red-white-and-blue decorations filled the room. Brochures titled "Learn about combat stress" served as table centerpieces.

There was roast turkey, sliced turkey, ham and rib-eye steaks. The troops were served steaming side dishes of dressing, corn, collard greens, yams and mashed potatoes and gravy that some lapped up with spoons. For dessert, there was a massive cake with a turkey etched in icing, pumpkin spice cookies and scores of pies.

A short walk from the dining hall, service members were playing a modified version of American football.

Parts of the scene could have come from a snapshot of any U.S. city: American guys in sweats tossing the pigskin, a scoreboard, a coin toss to start the game.

But on this military base, concrete barriers surrounded the field. The referees wore camouflaged shirts and the spectators carried rifles. The artificial turf was frayed and so dusty that when one player spiked the football, a puff of dirt rose from the field.

The players used a regulation football, but the game was a mix of football, soccer and rugby to fit the short field.

Some soldiers commented about the 11-year-old war that has claimed the lives of 2,029 American service members.

Army Chief Warrant Officer 4 Chuck Minton of Monroe, Ga., who has traveled extensively across Afghanistan, was optimistic. "It's been progressing here, getting better. The Afghans have taken over more missions," Minton said.

President Barack Obama pulled 10,000 troops out of Afghanistan in 2011 and 23,000 more this year, leaving about 66,000 American service members still deployed in the country. Nearly all international combat troops are to withdraw by the end of 2014 when Afghan forces will be fully in charge of securing the nation.

Army Maj. Rodney Gehrett of Colorado Springs, Colo., said he was surprised that the war was barely mentioned during the last U.S. presidential election — evidence that some Americans had tuned out the news from the front line a half a world away.

"The war in Afghanistan wasn't even brought up as a topic of conversation" during the election, Gehrett said. "It was a little surprising to me. Hopefully, that will change and people will realize that we still have troops here and they are fighting every day."

Army Sgt. Adam Draughn of Denver, Colo., said some people back home have the impression that the Afghan people don't want American troops in their country.

"Honestly, I think the biggest misconception in my opinion is that, you know, we actually are loved here," Draughn said. "The nationals do care about us. They do want us here to help them. We're not here uninvited."

Most of the holiday chatter, however, was focused on family.

Taking a break from the game, Army Capt. Robert Mikyska of North Aurora, Ill., pulled out a photocopied photo that was taken of he and his wife just before he deployed to Afghanistan nine months ago.

"Hi, honey!" Mikyska said, looking at the picture. "In a couple weeks, I'll be home. I can't wait to be back."

"My family's here," Army Spc. Ricky Clay, also of Monroe, Ga., said as he smiled and embraced his teammates on the sidelines of the football field.

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Lawsuit against Madonna dismissed in Russia

ST. PETERSBURG, Russia (AP) — A Russian court on Thursday dismissed a lawsuit that sought millions of dollars in damages from Madonna for allegedly traumatizing minors by speaking up for gay rights during a concert in St. Petersburg.

The ruling came after a one-day hearing that bordered on the farcical. During it, plaintiffs claimed that Madonna's so-called "propaganda of perversion" would negatively affect Russia's birthrate and erode the nation's defense capability by depriving the country of future soldiers. At one point, the judge threatened to expel journalists from the courtroom if they laughed too much.

In the end, the Moskovsky district court in St. Petersburg threw out the Trade Union of Russian Citizens' lawsuit and the 333 million rubles ($10.7 million) it sought from the singer for allegedly exposing youths to "homosexual propaganda."

Madonna did not attend the trial, and her publicist Liz Rosenberg said Thursday the star wouldn't comment about it.

Anti-gay sentiment is strong in Russia, particularly in St. Petersburg, where local legislators passed a law in February that made it illegal to promote homosexuality to minors. Six months later, Madonna criticized the law on Facebook, then stood up for gay rights during a concert in St. Petersburg that drew fans as young as 12.

"Who will children grow up to be if they hear about the equal rights of the lesbian lobby and manly love with traditional sexual relations?" one of the plaintiffs, Darya Dedova, testified Thursday. "The death rate prevails over the birth rate in the West; young guys are becoming gender neutral."

The plaintiffs submitted evidence about gay culture drawn from Wikipedia pages, claiming that a real encyclopedia could not have articles about homosexuality.

"We aren't against homosexual people, but we are against the propaganda of perversion among minors," Dedova told the court. "We want to defend the values of a traditional family, which are currently in crisis in this country. Madonna violated our laws and she should be punished."

Madonna, who performed in Moscow and St. Petersburg in August as part of her world tour, also angered Russian officials by supporting jailed members of the Russian punk band Pussy Riot. The American said during her Moscow concert that she would "pray for them," then turned around so the audience could see the words "Pussy Riot" written on her back. The singer also donned a ski mask similar to those worn by Pussy Riot.

Despite international outrage, three of that band's members were sentenced to two years in jail on hooliganism charges for performing a "punk prayer" at Moscow's main cathedral, during which they pleaded with the Virgin Mary to deliver Russia from President Vladimir Putin. One of the Pussy Riot members was later released from jail on appeal, but the other two were sent to prison camps to serve their sentences.

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Seddon reported from Moscow.

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Study finds mammograms lead to unneeded treatment

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.

It's the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call "cancer" are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don't really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it's relatively new to the debate over breast cancer screening.

"We're coming to learn that some cancers — many cancers, depending on the organ — weren't destined to cause death," said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, "once a woman is diagnosed, it's hard to say treatment is not necessary."

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday's New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it's most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment.

Researchers used federal surveys on mammography and cancer registry statistics from 1976 through 2008 to track how many cancers were found early, while still confined to the breast, versus later, when they had spread to lymph nodes or more widely.

The scientists assumed that the actual amount of disease — how many true cases exist — did not change or grew only a little during those three decades. Yet they found a big difference in the number and stage of cases discovered over time, as mammograms came into wide use.

Mammograms more than doubled the number of early-stage cancers detected — from 112 to 234 cases per 100,000 women. But late-stage cancers dropped just 8 percent, from 102 to 94 cases per 100,000 women.

The imbalance suggests a lot of overdiagnosis from mammograms, which now account for 60 percent of cases that are found, Bleyer said. If screening were working, there should be one less patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage, he explained.

"Instead, we're diagnosing a lot of something else — not cancer" in that early stage, Bleyer said. "And the worst cancer is still going on, just like it always was."

Researchers also looked at death rates for breast cancer, which declined 28 percent during that time in women 40 and older — the group targeted for screening. Mortality dropped even more — 41 percent — in women under 40, who presumably were not getting mammograms.

"We are left to conclude, as others have, that the good news in breast cancer — decreasing mortality — must largely be the result of improved treatment, not screening," the authors write.

The study was paid for by the study authors' universities.

"This study is important because what it really highlights is that the biology of the cancer is what we need to understand" in order to know which ones to treat and how, said Dr. Julia A. Smith, director of breast cancer screening at NYU Langone Medical Center in New York. Doctors already are debating whether DCIS, a type of early tumor confined to a milk duct, should even be called cancer, she said.

Another expert, Dr. Linda Vahdat, director of the breast cancer research program at Weill Cornell Medical College in New York, said the study's leaders made many assumptions to reach a conclusion about overdiagnosis that "may or may not be correct."

"I don't think it will change how we view screening mammography," she said.

A government-appointed task force that gives screening advice calls for mammograms every other year starting at age 50 and stopping at 75. The American Cancer Society recommends them every year starting at age 40.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the study should not be taken as "a referendum on mammography," and noted that other high-quality studies have affirmed its value. Still, he said overdiagnosis is a problem, and it's not possible to tell an individual woman whether her cancer needs treated.

"Our technology has brought us to the place where we can find a lot of cancer. Our science has to bring us to the point where we can define what treatment people really need," he said.

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Online:

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

Screening advice: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Sandy victims cheered by NYC's Thanksgiving parade

NEW YORK (AP) — Victims of Superstorm Sandy in New York and elsewhere in the Northeast were comforted Thursday by kinder weather, free holiday meals and — for some — front row seats to the annual Macy's Thanksgiving Day Parade.

"It means a lot," said Karen Panetta, of the hard-hit Broad Channel section of Queens, as she sat in a special viewing section set aside for New Yorkers displaced by the storm.

"We're thankful to be here and actually be a family and to feel like life's a little normal today," she said.

The popular Macy's parade, attended by more than 3 million people and watched by 50 million on TV, included such giant balloons as Elf on a Shelf and Papa Smurf, a new version of Hello Kitty, Buzz Lightyear, Sailor Mickey Mouse and the Pillsbury Doughboy. Real-life stars included singer Carly Rae Jepsen and Rachel Crow of "The X Factor."

The young, and the young at heart, were delighted by the sight and sound of marching bands, performers and, of course, the giant balloons. The sunny weather quickly surpassed 50 degrees.

Alan Batt and his 11-year-old twins, Kyto and Elina, took in the parade at the end of the route, well away from the crowd and seemingly too far away for a good view. But they had an advantage: Two tall stepladders they hauled over from their apartment eight blocks away — one for each twin.

"We're New Yorkers," the 65-year-old Batt said. "We know what we're doing."

With the height advantage, "I get to see everything!" Kyto said.

At nearby Greeley Square, social worker Lowell Herschberger, 40, of Brooklyn, sought in vain to tear his sons, 8-year-old Logan and 6-year-old Liam, from a foosball table set up in the tiny park as the balloons crept by on the near horizon.

"Hey, guys — there's Charlie Brown," he said, pointing at the old standby balloon.

The boys didn't look up.

"I guess they're over it," the father said with a shrug.

Mayor Michael Bloomberg was reflective Thursday as he praised police, firefighters, armed services personnel, sanitation workers and volunteers involved in the storm response. His office was coordinating the distribution of 26,500 meals at 30 sites in neighborhoods affected by Sandy, and other organizations also were pitching in.

The disaster zones on Staten Island were flooded — this time with food and volunteers from Glen Rock, N.J. organized using social media.

"We had three carloads of food," said volunteer Beth Fernandez. "The whole town of Glen Rock pitched in. ... It's really cool. It's my best, my favorite Thanksgiving ever."

On Long Island, the Long Beach nonprofit Surf For All hosted a Thanksgiving event that fed 1,200 people. Carol Gross, 72, a Long Beach native, said she went to volunteer but was turned away because of a surplus of helpers.

"A lot of people like me, old-timers, we've never seen anything like this horror," she said, recalling the destruction.

Gross' brother, Jerry, who moved to Arizona in the 1960s, was stunned by what he saw when he returned for Thanksgiving.

"To come back and see the boardwalk all devastated like it is, it's like going to Manhattan and finding Times Square gone," he said.

George Alvarez, whose Toms River, N.J., home suffered moderate damage when Sandy hit the coast, said his family usually does "the traditional big dinner" on Thanksgiving. But this year, they chose to attend a community dinner held at an area church.

"This storm not only impacted us, it impacted a lot of our friends, our community, our psyche," Alvarez said shortly before his family headed out for their meal. "We could have had our usual dinner here at home, but this year it felt like we should be with others who are experiencing the same concerns we are. We made it through this devastating storm, and that's something to celebrate."

Across the country, other cities offered a mix of holiday cheer and acts of charity.

Thousands of people made the most of the mild, sunny fall weather to watch Detroit's Thanksgiving parade, hours ahead of the Lions' annual home game.

Floats and marching bands poured down Woodward Avenue on Thursday morning, with many spectators forgoing the cold-weather gear of past parades. Detroit's temperature hit 52 degrees at 11 a.m., with a warm wind blowing from the South.

Parade participants also included NASCAR driver Brad Keselowski, a 28-year-old Rochester Hills native and the first Michigan-born driver to win the Sprint Cup Series.

In San Francisco, lines of the homeless and less fortunate began forming late Wednesday outside a church in the city's tough Tenderloin district that expected to serve more than 5,000 meals, said the Rev. Cecil Williams.

"We must make sure people can overcome all adversities," Williams said. "You can, you will and you must."

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AP radio correspondent Julie Walker, AP video journalist Ted Shaffrey and Associated Press writers Kiley Armstrong and Karen Matthews in New York, Alison Barnwell on Long Island, Bruce Shipkowski in New Jersey and Terry Collins in San Francisco contributed to this report.

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Afghan revolving door: 5 US generals, 5 years

KABUL, Afghanistan (AP) — For former CIA director David Petraeus, it was a one-year stint as top U.S. commander in Afghanistan. His replacement is scheduled to leave next year after 18 months in the job.

And now the sex scandal that draws them together — Petraeus' career toppled and Marine Gen. John Allen's possibly on hold — also has placed greater attention to the quick turnover of American battlefield chiefs in the 11-year war.

Nearly two dozen generals have commanded troops from the United States and the NATO-led International Security Assistance Force, or ISAF, since the American invasion in late 2001 — with five U.S. generals running both commands in the past five years alone.

There is no firm evidence the Pentagon's revolving door in Afghanistan has posed any significant obstacles for U.S. troops, but some military analysts suggest the frequent changes at the top create potential breaks in continuity in the critical cooperation with the Afghan political leadership and security officials.

"The learning curve is pretty steep," said retired Lt. Gen. David Barno, who commanded U.S. forces in Afghanistan in 2003 and 2004. "One of the critical coins of the realm in being effective in this kind of environment is relationships among your allies, relationships with the host nation, and with the Afghans."

Iraq also had regular command changes, including Petraeus in charge during the U.S. troop "surge" in 2007 that helped dislodge insurgent control from key areas. But the war strategy in Afghanistan has, at many times, been even more complex as fronts shift and Taliban fighters regain strength.

"Rotating top commanders on an annual basis makes no management sense," Thomas E. Ricks, a senior fellow at the Center for a New American Security, wrote in an opinion piece published recently in The New York Times.

"Imagine trying to run a corporation by swapping the senior executives every year," he continued. "Or imagine if, at the beginning of 1944, six months before D-Day, Gen. George C. Marshall, the Army chief of staff, told Gen. Dwight D. Eisenhower, the supreme allied commander, that it was time to give someone else a chance to lead."

Petraeus, a four-star general, took over the Afghan command in July 2010 to fill a void after Gen. Stanley A. McChrystal was fired because of scathing remarks about America's civilian leadership. McChrystal's predecessor, Gen. David McKiernan, was ousted on May 11, 2009, a year before his term as commander was set to end because newly elected President Barack Obama wanted a new war policy. He had succeeded Gen. Dan McNeill, who served in 2007-08.

Petraeus completed a one-year term and retired to become CIA director in September 2011.

He resigned Nov. 9 after he had an extramarital affair with his biographer. Allen, who also has four stars, is under investigation following revelations that he exchanged thousands of emails with a Florida socialite also involved in the Petraeus case, including a few which were found to be of a questionable nature.

Some analysts and former military officers say that rotating generals so quickly creates a disconnect between the commanders and their Afghan allies, including the mercurial President Hamid Karzai. Commanders also have to deal with billions of dollars in funds and the complexities of handing over security to the Afghans by the end of 2014, including building an army and police of 352,000 almost from scratch.

Gen. Mohammad Zahir Azimi, a spokesman for the Afghan Ministry of Defense, said the longer a NATO commander stays in the job, the more chance he has to really understand Afghanistan.

"For us, an Afghan army corps commander should stay in his position for at least three years," he said.

Jawed Kohistani, military analyst in Kabul, said he thinks a constant changeover of senior NATO commanders or Afghan military leaders hampers coordination of the two forces. Staying longer, he believes, allows a commander to know insurgents and their weaknesses.

"It gives an opportunity for the enemy to use this gap — the time between the leaving of one commander and the arrival of another — to their advantage," Kohistani said. "There should be enough time for a NATO commander to get to know the Afghan president, vice presidents, security ministers and assess the situation. If he doesn't have enough time to do all these things, it has a negative effect on the security situation."

Obama sped up the confirmation hearing last week for Gen. Joseph Dunford to become the 15th ISAF commander and replace Allen, who was to leave in the spring after 18 months at the helm for a new job as U.S. European Command chief and NATO supreme allied commander. But Allen's confirmation has been postponed until an investigation into his role is concluded.

There have also been about a half-dozen U.S. generals who only commanded American combat troops in the first years of the conflict.

By comparison, the command tours of generals in Iraq "averaged almost twice as long as ISAF's," said Stephen Biddle, a professor of political science and international affairs at George Washington University.

Given the huge funds involved in the war effort, running the Afghan campaign has been as complicated as managing a multibillion dollar corporation.

Anthony Cordesman, a national security expert at the Center for Strategic and International Studies, said the lack of continuity includes both the military and civilian presence in Afghanistan, including the State Department and other agencies.

"What the Afghans see is constant change at every level," he said. "They constantly see people come and go. They have no reason to establish lasting relationships. People leave at the point where they're becoming most effective."

He added that "this constant rotation is a problem everybody recognizes, but no one has really been willing to address."

The Pentagon also has a number of senior leaders — ranging from the chairman of the joint chiefs of staff and defense secretary to the commander of U.S. Central Command — who also play key roles in the war strategy and provide some continuity.

"There is no doubt that the frequent changeover is tough. There is a learning curve each time a new man takes the helm,"

"The good aspect to this is that it brings a fresh set of eyes," said Michael O'Hanlon, a fellow at the Brookings Institution in Washington. "It's not realistic to have commanders serve a whole lot longer than, say, Gen. Allen ... as these folks get tired."

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Baldor reported from Washington. Associated Press writers Rahim Faiez and Deb Riechmann in Kabul contributed to this report.

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News Summary: India outrage over Facebook arrests

WHAT HAPPENED: As India‘s financial capital shut down for the weekend funeral of a powerful politician linked to waves of mob violence, a woman posted on Facebook that the closures in Mumbai were “due to fear, not due to respect.” A friend of hers hit the “like” button. For that, both women were arrested.

THE RATIONALE: The arrests were seen as a move by police to prevent any outbreak of violence by supporters of Bal Thackeray, a powerful Hindu fundamentalist politician who died Saturday.

THE REACTION: But analysts and the media are slamming the Maharashtra state government for what they said was a flagrant misuse of the law and an attempt to curb freedom of expression.

Social Media News Headlines – Yahoo! News

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Ex-'Price is Right' model wins suit against show

LOS ANGELES (AP) — A Los Angeles jury says a former model on "The Price is Right" was discriminated against by producers because of her pregnancy.

The Superior Court jury awarded $776,944 to Brandi Cochran on Tuesday after deliberations that began last week.

City News Service reports that a second phase of the trial will determine whether Cochran should be awarded punitive damages.

The 41-year-old Cochran is a former Miss USA. She claimed she was rejected by producers when she tried to rejoin "The Price is Right" in 2010 after taking maternity leave.

FremantleMedia North America, one of the producers named in the suit, blamed the verdict on a "flawed process." It says that key evidence was excluded by the court.

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OB/GYNs back over-the-counter birth control pills

WASHINGTON (AP) — No prescription or doctor's exam needed: The nation's largest group of obstetricians and gynecologists says birth control pills should be sold over the counter, like condoms.

Tuesday's surprise opinion from these gatekeepers of contraception could boost longtime efforts by women's advocates to make the pill more accessible.

But no one expects the pill to be sold without a prescription any time soon: A company would have to seek government permission first, and it's not clear if any are considering it. Plus there are big questions about what such a move would mean for many women's wallets if it were no longer covered by insurance.

Still, momentum may be building.

Already, anyone 17 or older doesn't need to see a doctor before buying the morning-after pill — a higher-dose version of regular birth control that can prevent pregnancy if taken shortly after unprotected sex. Earlier this year, the Food and Drug Administration held a meeting to gather ideas about how to sell regular oral contraceptives without a prescription, too.

Now the influential American College of Obstetricians and Gynecologists is declaring it's safe to sell the pill that way.

Wait, why would doctors who make money from women's yearly visits for a birth-control prescription advocate giving that up?

Half of the nation's pregnancies every year are unintended, a rate that hasn't changed in 20 years — and easier access to birth control pills could help, said Dr. Kavita Nanda, an OB/GYN who co-authored the opinion for the doctors group.

"It's unfortunate that in this country where we have all these contraceptive methods available, unintended pregnancy is still a major public health problem," said Nanda, a scientist with the North Carolina nonprofit FHI 360, formerly known as Family Health International.

Many women have trouble affording a doctor's visit, or getting an appointment in time when their pills are running low — which can lead to skipped doses, Nanda added.

If the pill didn't require a prescription, women could "pick it up in the middle of the night if they run out," she said. "It removes those types of barriers."

Tuesday, the FDA said it was willing to meet with any company interested in making the pill nonprescription, to discuss what if any studies would be needed.

Then there's the price question. The Obama administration's new health care law requires FDA-approved contraceptives to be available without copays for women enrolled in most workplace health plans.

If the pill were sold without a prescription, it wouldn't be covered under that provision, just as condoms aren't, said Health and Human Services spokesman Tait Sye.

ACOG's opinion, published in the journal Obstetrics & Gynecology, says any move toward making the pill nonprescription should address that cost issue. Not all women are eligible for the free birth control provision, it noted, citing a recent survey that found young women and the uninsured pay an average of $16 per month's supply.

The doctors group made clear that:

—Birth control pills are very safe. Blood clots, the main serious side effect, happen very rarely, and are a bigger threat during pregnancy and right after giving birth.

—Women can easily tell if they have risk factors, such as smoking or having a previous clot, and should avoid the pill.

—Other over-the-counter drugs are sold despite rare but serious side effects, such as stomach bleeding from aspirin and liver damage from acetaminophen.

—And there's no need for a Pap smear or pelvic exam before using birth control pills. But women should be told to continue getting check-ups as needed, or if they'd like to discuss other forms of birth control such as implantable contraceptives that do require a physician's involvement.

The group didn't address teen use of contraception. Despite protests from reproductive health specialists, current U.S. policy requires girls younger than 17 to produce a prescription for the morning-after pill, meaning pharmacists must check customers' ages. Presumably regular birth control pills would be treated the same way.

Prescription-only oral contraceptives have long been the rule in the U.S., Canada, Western Europe, Australia and a few other places, but many countries don't require a prescription.

Switching isn't a new idea. In Washington state a few years ago, a pilot project concluded that pharmacists successfully supplied women with a variety of hormonal contraceptives, including birth control pills, without a doctor's involvement. The question was how to pay for it.

Some pharmacies in parts of London have a similar project under way, and a recent report from that country's health officials concluded the program is working well enough that it should be expanded.

And in El Paso, Texas, researchers studied 500 women who regularly crossed the border into Mexico to buy birth control pills, where some U.S. brands sell over the counter for a few dollars a pack. Over nine months, the women who bought in Mexico stuck with their contraception better than another 500 women who received the pill from public clinics in El Paso, possibly because the clinic users had to wait for appointments, said Dr. Dan Grossman of the University of California, San Francisco, and the nonprofit research group Ibis Reproductive Health.

"Being able to easily get the pill when you need it makes a difference," he said.

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Online:

OB/GYN group: http://www.acog.org

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